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Zhou A, Nanegrungsunk O, Bressler SB, Liu TYA, Sachdeva MM, Scott AW, Wenick AS, Bressler NM. Retinal characteristics in eyes with pathologic myopia among individuals self-identifying as Black. Can J Ophthalmol 2024; 59:119-127. [PMID: 36796442 DOI: 10.1016/j.jcjo.2023.01.011] [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] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 01/03/2023] [Accepted: 01/22/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Investigate retinal characteristics of pathologic myopia (PM) among patients self-identifying as Black. DESIGN Retrospective cohort single-institution retrospective medical record review. METHODS Adult patients between January 2005 and December 2014 with International Classification of Diseases (ICD) codes consistent with PM and given 5-year follow-up were evaluated. The Study Group consisted of patients self-identifying as Black, and the Comparison Group consisted of those not self-identifying as Black. Ocular features at study baseline and 5-year follow-up visit were evaluated. RESULTS Among 428 patients with PM, 60 (14%) self-identified as Black and 18 (30%) had baseline and 5-year follow-up visits. Of the remaining 368 patients, 63 were in the Comparison Group. For the study (n = 18) and Comparison Group (n = 29), median (25th percentile, 75th percentile) baseline visual acuity was 20/40 (20/25, 20/50) and 20/32 (20/25, 20/50) in the better-seeing eye and 20/70 (20/50, 20/1400) and 20/100 (20/50, 20/200), respectively, in the worse-seeing eye. In the eyes that did not have choroidal neovascularization (CNV) in the study and Comparison Group, median study baseline optical coherence tomography central subfield thickness was 196 μm (169, 306 μm) and 225 μm (191, 280 μm), respectively, in the better-seeing eye and 208 μm (181, 260 μm) and 194 μm (171, 248 μm), respectively, in the worse-seeing eye. Baseline prevalence of CNV was 1 Study Group eye (3%) and 20 Comparison Group eyes (34%). By the 5-year visit, zero (0%) and 4 (15%) additional eyes had CNV in the study and Comparison Group, respectively. CONCLUSION These findings suggest that the prevalence and incidence of CNV may be lower in patients with PM self-identifying as Black when compared with individuals of other races.
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Affiliation(s)
- Ashley Zhou
- From the Johns Hopkins University School of Medicine, Baltimore, MD
| | - Onnisa Nanegrungsunk
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD; Retina Division, Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand
| | - Susan B Bressler
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - T Y Alvin Liu
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mira M Sachdeva
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Adrienne W Scott
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Adam S Wenick
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Neil M Bressler
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD.
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Hsu WH, LaBella KA, Lin Y, Xu P, Lee R, Hsieh CE, Yang L, Zhou A, Blecher JM, Wu CJ, Lin K, Shang X, Jiang S, Spring DJ, Xia Y, Chen P, Shen JP, Kopetz S, DePinho RA. Oncogenic KRAS Drives Lipofibrogenesis to Promote Angiogenesis and Colon Cancer Progression. Cancer Discov 2023; 13:2652-2673. [PMID: 37768068 PMCID: PMC10807546 DOI: 10.1158/2159-8290.cd-22-1467] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 01/03/2023] [Revised: 08/01/2023] [Accepted: 09/26/2023] [Indexed: 09/29/2023]
Abstract
Oncogenic KRAS (KRAS*) contributes to many cancer hallmarks. In colorectal cancer, KRAS* suppresses antitumor immunity to promote tumor invasion and metastasis. Here, we uncovered that KRAS* transforms the phenotype of carcinoma-associated fibroblasts (CAF) into lipid-laden CAFs, promoting angiogenesis and tumor progression. Mechanistically, KRAS* activates the transcription factor CP2 (TFCP2) that upregulates the expression of the proadipogenic factors BMP4 and WNT5B, triggering the transformation of CAFs into lipid-rich CAFs. These lipid-rich CAFs, in turn, produce VEGFA to spur angiogenesis. In KRAS*-driven colorectal cancer mouse models, genetic or pharmacologic neutralization of TFCP2 reduced lipid-rich CAFs, lessened tumor angiogenesis, and improved overall survival. Correspondingly, in human colorectal cancer, lipid-rich CAF and TFCP2 signatures correlate with worse prognosis. This work unveils a new role for KRAS* in transforming CAFs, driving tumor angiogenesis and disease progression, providing an actionable therapeutic intervention for KRAS*-driven colorectal cancer. SIGNIFICANCE This study identified a molecular mechanism contributing to KRAS*-driven colorectal cancer progression via fibroblast transformation in the tumor microenvironment to produce VEGFA driving tumor angiogenesis. In preclinical models, targeting the KRAS*-TFCP2-VEGFA axis impaired tumor progression, revealing a potential novel therapeutic option for patients with KRAS*-driven colorectal cancer. This article is featured in Selected Articles from This Issue, p. 2489.
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Affiliation(s)
- Wen-Hao Hsu
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Kyle A. LaBella
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yiyun Lin
- Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ping Xu
- Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Rumi Lee
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Cheng-En Hsieh
- Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Lei Yang
- Department of Genetics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ashley Zhou
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jonathan M. Blecher
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Chang-Jiun Wu
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Kangyu Lin
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xiaoying Shang
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Shan Jiang
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Denise J. Spring
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Yan Xia
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Peiwen Chen
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - John Paul Shen
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Scott Kopetz
- Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ronald A. DePinho
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Ranasinghe PD, Zhou A. Women physicians and the COVID-19 pandemic: gender-based impacts and potential interventions. Ann Med 2023; 55:319-324. [PMID: 36594806 PMCID: PMC9815224 DOI: 10.1080/07853890.2022.2164046] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Aim: These are extraordinary times caused by the first global pandemic in our modern era. Physicians and other frontline healthcare providers face unique challenges, for which they have had little formal preparation. This combination of challenge and deficit leads to significant negative impacts, not only on what medical practices and health care systems can deliver to the public, but also on the individual healthcare providers themselves.Methods: In this essay, we specifically address women physicians, and explore the considerable impact they bear from the COVID-19 pandemic, particularly in the contexts of response to stress, social isolation, work-life integration, and autonomy. Because the language we use is important, we think it necessary to clarify that when we refer to 'women physicians,' we are referring to physicians that self-identify as women, and we acknowledge that not all the references we cite may use the same definition.Results: We offer several potential interventions that turn the challenges women physicians are facing into opportunities to address longstanding inequity. These interventions include tackling barriers to work-life balance, addressing gender and maternal bias, and promoting women physician representation in leadership.Conclusion: The COVID-19 pandemic is likely to become a chronic part of our lives; protecting vulnerable populations, such as women physicians, through thoughtful intervention is paramount.KEY MESSAGESWomen physicians experience considerable adversity during the COVID-19 pandemic, particularly in the contexts of response to stress, social isolation, work-life integration, and autonomy.These challenges create opportunities for interventions to improve equity in medicine during the COVID-19 pandemic and in the long-term, including tackling barriers to work-life balance, addressing gender and maternal bias, and promoting women physician representation in leadership.
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Affiliation(s)
| | - Ashley Zhou
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Zhou A, Leon C, O’Conor C, Johannesen C, Ranasinghe P. The physician gender pay gap in Maryland: current state and future directions. Ann Med 2023; 55:2258923. [PMID: 37782955 PMCID: PMC10547443 DOI: 10.1080/07853890.2023.2258923] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/10/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Over the last few decades, more attention has been paid to the physician gender pay gap and more interventions have been attempted. This paper discusses the physician gender pay gap between 2017 and 2021 in Maryland. METHODS An online cross-sectional survey was distributed to over 10,000 physicians in the Maryland Medical Society, featuring questions regarding employment characteristics, compensation, impact of the COVID-19 pandemic, and educational debt. Using descriptive and regression analyses, we explored cross-sectional associations between gender and employment characteristics. RESULTS Male physicians reported a significantly higher average 2020 pre-tax income ($333,732 per year) than female physicians ($225,473 per year, p < 0.001), amounting to a nearly 50% difference in raw income, consistent with a previously reported pay gap in 2016. Women physicians earned 31.5% less than their male colleagues in 2020 and were projected to earn 28.7% less in 2021. Female physicians were also more likely to have educational debt (33.6% vs.12.9%, p < 0.001) and also more likely to have a high burden of debt, with 36% owing over $200,000 in education loans, compared to 14.7% of men (p < 0.01). CONCLUSION The physician gender pay gap in Maryland has remained relatively stable over four years, including the period of the COVID-19 pandemic.
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Affiliation(s)
- Ashley Zhou
- The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Carlued Leon
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Carolyn O’Conor
- Georgetown University School of Medicine, Washington, DC, USA
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Zhang S, Zhao Y, Zhou A, Liu H, Zheng M. [Feasibility and safety of one-stage bilateral video-assisted thoracic surgery for resection of bilateral multiple pulmonary nodules]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:1254-1258. [PMID: 37488809 PMCID: PMC10366508 DOI: 10.12122/j.issn.1673-4254.2023.07.23] [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] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE To evaluate the feasibility and safety of one- stage bilateral video-assisted thoracic surgery (VATS) for resection of bilateral multiple pulmonary nodules (BMPNs). METHODS We analyzed the clinical characteristics, pathological features, perioperative outcomes and follow-up data of 41 patients with BMPNs undergoing one-stage bilateral VATS from July, 2011 to August, 2021. RESULTS One-stage bilateral VATS was performed uneventfully in 40 of the patients, and conversion to open surgery occurred in 1 case. The surgical approaches included bilateral lobectomy (4.9%), lobar-sublobar resection (36.6%) and sublobar-sublobar resection (58.5%) with a mean operative time of 196.3±54.5 min, a mean blood loss of 224.6±139.5 mL, a mean thoracic drainage duration of 4.7±1.1 days and a mean hospital stay of 14±3.8 days. Pathological examination revealed bilateral primary lung cancer in 15 cases, unilateral primary lung cancer in 21 cases and bilateral benign lesions in 5 cases. A total of 112 pulmonary nodules were resected, including 67 malignant and 45 benign lesions. Postoperative complications included pulmonary infection (5 cases), respiratory failure (2 cases), asthma attack (2 cases), atrial fibrillation (2 cases), and drug-induced liver injury (1 case). No perioperative death occurred in these patients, who had a 1-year survival rate of 97.6%. CONCLUSION With appropriate preoperative screening and perioperative management, one-stage bilateral VATS is feasible and safe for resection of BMPNs.
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Affiliation(s)
- S Zhang
- Department of Thoracic Surgery, Senior Department of Respiratory and Critical Care Medicine, Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - Y Zhao
- Department of Thoracic Surgery, Senior Department of Respiratory and Critical Care Medicine, Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - A Zhou
- Department of Thoracic Surgery, Senior Department of Respiratory and Critical Care Medicine, Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - H Liu
- Department of Thoracic Surgery, Senior Department of Respiratory and Critical Care Medicine, Eighth Medical Center of PLA General Hospital, Beijing 100091, China
| | - M Zheng
- Department of Thoracic Surgery, Senior Department of Respiratory and Critical Care Medicine, Eighth Medical Center of PLA General Hospital, Beijing 100091, China
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Larson E, Ruck J, Zhou A, Shou B, Kilic A. Outcomes of Heart Transplant for Valve Disease. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.106] [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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7
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Larson E, Jiang K, Ruck J, Shou B, Zhou A, Kilic A. Outcomes of Heart-Lung Transplant Compared to Lung Transplant in Patients with Secondary Pulmonary Hypertension. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1030] [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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Casillan A, Larson E, Ruck J, Zhou A, Ha J, Shah P, Merlo C, Bush E. Combined Lung-Kidney Transplantation Yields Better Survival Than Isolated Lung Transplantation in Recipients with Underlying Renal Failure. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1037] [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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9
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Ong SS, Ahmed I, Gonzales A, Aguwa UT, Beatson B, Dai X, Pham AT, Shah YS, Zhou A, Arsiwala LT, Wang J, Handa JT. Management of uncomplicated rhegmatogenous retinal detachments: a comparison of practice patterns and clinical outcomes in a real-world setting. Eye (Lond) 2023; 37:684-691. [PMID: 35338355 PMCID: PMC9998441 DOI: 10.1038/s41433-022-02028-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 10/29/2021] [Revised: 02/22/2022] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To investigate practice patterns and clinical outcomes in the repair of uncomplicated rhegmatogenous retinal detachments (RRD) in a real-world setting over a 10-year period. METHODS We compared preferences for scleral buckling (SB), pars plana vitrectomy (PPV), PPV/SB, or pneumatic retinopexy (PR) over time, and examined the 1-year single surgery anatomic success (SSAS) and best-corrected visual acuity (BCVA) at a tertiary academic institution from 2008-2018. RESULTS Eight hundred eight eyes had RRD repair between 2008-2011 (n = 240), 2012-2014 (n = 271), and 2015-2017 (n = 297). Compared to 2008-2011, PPV was preferred over SB in 2012-2014 (OR: 2.93; 95% CI: 1.86-4.63) and 2015-2017 (OR: 5.94; 95% CI: 3.76-9.38), and over PPV/SB in 2012-2014 (OR: 2.74; 95% CI: 1.65-4.56) and 2015-2017 (OR: 3.16; 95% CI: 31.96-5.12). PR was uncommonly utilized (<10%). Younger surgeons (graduating 2010-2017) favored PPV over SB when compared to older surgeons [graduating 1984-2000 (OR: 1.77; 95% CI: 1.18-2.65) and 2001-2009 (OR 1.73; 95% CI: 1.14-2.65)], but similarly selected PPV vs. PPV/SB as their older counterparts (p > 0.05). Compared to PPV, SSAS was higher with SB (OR: 1.53; 95% CI: 1.03-2.26) and PPV/SB (OR: 2.55; 95% CI: 1.56-4.17). One-year BCVA was markedly improved compared to baseline only for eyes that achieved SSAS (p < 0.001). CONCLUSIONS Over the past 10 years, PPV has become the favored approach to repair uncomplicated RRD and this appears to be driven by younger surgeons' preferences. Given the superior long-term SSAS in SB and PPV/SB as compared to PPV, SB and PPV/SB should be more frequently considered when determining the appropriate repair strategy for uncomplicated RRD.
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Affiliation(s)
- Sally S Ong
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Ishrat Ahmed
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Anthony Gonzales
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ugochi T Aguwa
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Bradley Beatson
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Xi Dai
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Alex T Pham
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Yesha S Shah
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ashley Zhou
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Lubaina T Arsiwala
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jiangxia Wang
- Johns Hopkins Biostatistics Center, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - James T Handa
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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Wu X, Zhou A, Heller M, Kohlbrenner R. Abstract No. 286 Prostate Artery Embolization and Minimally Invasive Urologic Procedures for Benign Prostatic Hyperplasia: A Cost-Effectiveness Analysis. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.353] [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: 02/26/2023] Open
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11
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Chen Z, Su Y, Peng D, Wang W, Zhong J, Zhou A, Tan L. Circ_0124055 promotes the progression of thyroid cancer cells through the miR-486-3p/MTA1 axis. J Endocrinol Invest 2023:10.1007/s40618-022-01998-x. [PMID: 36604405 DOI: 10.1007/s40618-022-01998-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/08/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Thyroid cancer is one of the malignancy cancers. CircRNA, a non-coding RNA, plays an important role in the development of cancer. The relationship and roles of circ_0124055, miR-486-3p and MTA1 in thyroid cancer have not been reported. METHODS Real-time quantitative polymerase chain reaction (RT-qPCR) was performed to analyze the RNA levels of circ_0124055, miR-486-3p and MTA1. Western blot was conducted to analyze the protein levels of MTA1, Epithelial cadherin (E-cadherin) and Neuro cadherin (N-cadherin). Subcellular localization assay was used to analyze circ_0124055 location in thyroid cancer cells. Colony formation assay and 5-Ethynyl-2'-deoxyuridine (EdU) assay were carried out to analyze cell proliferation. Cell migration and invasion were analyzed by wound-healing assay and transwell assay. Flow cytometry assay was performed to investigate cell apoptosis. Dual-luciferase reporter assay and RIP assay were employed to analyze the interactions among circ_0124055, miR-486-3p and MTA1. Immunohistochemical (IHC) assay was performed to assess the expression of Ki67, MTA1 and E-cadherin in tumor tissues. Thyroid cancer tumor growth in vivo was evaluated by tumor xenograft mouse model assay. RESULTS The expression of circ_0124055 was up-regulated in tumor tissues and cells. Knockdown of circ_0124055 could inhibit thyroid cancer cell proliferation, migration and invasion and promote cell apoptosis, accompanied by the dysregulation of E-cadherin and N-cadherin expression. Circ_0124055 could target miR-486-3p, and miR-486-3p could target MTA1. MiR-486-3p inhibitor could restore the effect of circ_0124055 knockdown in the progression of thyroid cancer. Moreover, MTA1 overexpression weakened the inhibitory effects of miR-486-3p mimics on the progression of thyroid cancer. Further, circ_0124055 could influence tumor growth in vivo. CONCLUSION Circ_0124055 promoted the progression of thyroid cancer cells through the miR-486-3p /MTA1 axis.
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Affiliation(s)
- Z Chen
- Department of Nuclear Medicine, Jiangxi Tumor Hospital, Nanchang, Jiangxi, China
| | - Y Su
- Department of Nuclear Medicine, Jiangxi Tumor Hospital, Nanchang, Jiangxi, China
| | - D Peng
- Department of Nuclear Medicine, Jiangxi Tumor Hospital, Nanchang, Jiangxi, China
| | - W Wang
- Department of Nuclear Medicine, Jiangxi Tumor Hospital, Nanchang, Jiangxi, China
| | - J Zhong
- Department of Nuclear Medicine, Jiangxi Tumor Hospital, Nanchang, Jiangxi, China
| | - A Zhou
- Department of Nuclear Medicine, Jiangxi Tumor Hospital, Nanchang, Jiangxi, China
| | - L Tan
- Department of Nuclear Medicine, The Second Affiliated Hospital of Nanchang University, No.1 Minde Road, Nanchang, 330006, Jiangxi, China.
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Summers SJ, Laing SN, Davidson RA, Jaffrey MA, Zhou A, Coltman CE. Do thoracoabdominal organ boundaries differ between males and females? Implications for body armour coverage and design. Appl Ergon 2023; 106:103891. [PMID: 36113184 DOI: 10.1016/j.apergo.2022.103891] [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] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/21/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
To optimise fit and protection of body armour systems, knowledge of the location of thoracoabdominal organ boundaries is required. The aims of this study were (i) determine the effect of sex on essential and desirable thoracoabdominal organ boundaries, and (ii) compare essential thoracoabdominal organ boundaries with small and large hard ballistic plate sizes from the National Institute of Justice (NIJ) and determine if coverage requirements differ between sexes. 33 males and 33 females underwent supine magnetic resonance imaging of their thoracoabdominal organs. Male participants on average displayed more laterally and inferiorly positioned essential and desirable organ boundaries than females. Based on NIJ plate sizes, insufficient coverage of essential organs was identified for male and female participants. A greater range of body armour sizes and designs that better cater to the diverse anatomy of soldier populations is warranted, but must be considered in the context of ergonomic and performance implications.
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Affiliation(s)
- S J Summers
- Discipline of Sport and Exercise Science, Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, Australia; School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - S N Laing
- Department of Defence, Defence Science and Technology Group, Fishermans Bend, Melbourne, Victoria, Australia
| | - R A Davidson
- Discipline of Medical Radiation Science, Faculty of Health, University of Canberra, Canberra, Australia
| | - M A Jaffrey
- Department of Defence, Defence Science and Technology Group, Fishermans Bend, Melbourne, Victoria, Australia
| | - A Zhou
- Discipline of Medical Radiation Science, Faculty of Health, University of Canberra, Canberra, Australia
| | - C E Coltman
- Discipline of Sport and Exercise Science, Research Institute for Sport and Exercise, Faculty of Health, University of Canberra, Canberra, Australia.
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Kampaktsis P, Doulamis I, Tzani A, Ruck J, Zhou A, Shah M, Kilic A, Kourek C, Briasoulis A. Outcomes of patients after repeat heart transplantation – insights from the UNOS database. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1021] [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: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac graft failure may require repeat heart transplantation (HTx). Outcomes of patients that undergo repeat HTx have not been well described.
Methods
We compared patients that received repeat HTx with patients that received initial HTx by inquiring the United Network for Organ Sharing database between 2015–2021. The primary endpoint was all-cause mortality.
Results
A total of 19,805 HTx patients were included in the study. Patients that underwent repeat HTx (n=578, 3%) were younger (43.8±15.3 vs. 53.7±12.7 years, p<0.001) with lower body mass index (26.8±5.3 vs. 27.6±4.9 kg/m2, p<0.001) and worse renal function (Cr 1.8±1.4 vs. 1.4±0.9 mg/dl). Patients with repeat HTx had increased risk for 1-year mortality (hazard ratio 1.49 [1.16–1.90], p=0.002) compared to patients with initial HTx after adjusting for age, ethnicity, use of left ventricular assist device, UNOS recipient status, diabetes, ischemic time, donor age and predicted heart mass mismatch (Figure 1). Results did not change with the new allocation system (10/2018).
Conclusion
Repeat HTx occurred in 3% of a contemporary UNOS cohort and carried an increased and independent risk for mortality.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- P Kampaktsis
- Columbia University Medical Center , New York , United States of America
| | - I Doulamis
- Johns Hopkins University School of Medicine , Baltimore , United States of America
| | - A Tzani
- Brigham and Women'S Hospital, Harvard Medical School , Boston , United States of America
| | - J Ruck
- Johns Hopkins University School of Medicine , Baltimore , United States of America
| | - A Zhou
- Johns Hopkins University School of Medicine , Baltimore , United States of America
| | - M Shah
- Johns Hopkins University School of Medicine , Baltimore , United States of America
| | - A Kilic
- Johns Hopkins University School of Medicine , Baltimore , United States of America
| | - C Kourek
- National & Kapodistrian University of Athens Medical School , Athens , Greece
| | - A Briasoulis
- University of Iowa Hospitals and Clinics , Iowa , United States of America
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14
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Ling J, Jenny LA, Zhou A, Tsang SH. Therapeutic Gene Editing in Inherited Retinal Disorders. Cold Spring Harb Perspect Med 2022; 13:cshperspect.a041292. [PMID: 36096547 PMCID: PMC10071418 DOI: 10.1101/cshperspect.a041292] [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: 11/25/2022]
Abstract
Since the development of CRISPR/Cas9 gene editing in 2012, therapeutic editing research has produced several phase 1-2a trials. Here we provide an overview of the mechanisms and applications of various gene-editing technologies including adeno-associated virus vectors, lentiviruses, CRISPR/Cas9 systems, base and prime editing, antisense oligonucleotides, short-hairpin RNAs, Cas13, and adenosine deaminase acting on RNA for the treatment of various inherited retinal diseases (IRDs). We outline the various stages of clinical trials using these technologies and the impacts they have made in advancing the practice of medicine.
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Affiliation(s)
- Jinjie Ling
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York 10032, USA
| | - Laura A Jenny
- Jonas Children's Vision Care, and Bernard and Shirley Brown Glaucoma Laboratory, Edward Harkness Eye Institute, Department of Ophthalmology, New York-Presbyterian Hospital, New York, New York 10032, USA
| | - Ashley Zhou
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York 10032, USA
| | - Stephen H Tsang
- Jonas Children's Vision Care, and Bernard and Shirley Brown Glaucoma Laboratory, Edward Harkness Eye Institute, Department of Ophthalmology, New York-Presbyterian Hospital, New York, New York 10032, USA.,Department of Biomedical Engineering, Columbia University, New York, New York 10032, USA.,Columbia Stem Cell Initiative, and Institute of Human Nutrition, Columbia University, New York, New York 10032, USA.,Department of Pathology and Cell Biology, Columbia University, New York, New York 10032, USA
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15
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Sun Y, Qu W, Sun M, Zhou J, Bi X, Zhou A. 1743P ALTN-AK105-II-02 cohort 4: A phase II study of penpulimab plus anlotinib in patients (pts) with previously treated locally advanced or metastatic urothelial carcinoma (UC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1821] [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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16
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Zhang J, Zhou A, Jawaid A, Adebayo O, Hashmi Y, Krkovic M, Ahmed Z. 876 Veriset Haemostatic Patch, Indications, Benefits and Complications: A Systematic Review. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.537] [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: 11/06/2022]
Abstract
Abstract
Aim
Achieving haemostasis intraoperatively is important for minimising blood loss, complications, and operation time. Suturing, cauterisation, fibrin glues and patches are used for this purpose. We explore Veriset, a patch consisting of polyethylene glycol and oxidised cellulose, to determine and compare its safety and effectiveness.
Method
Medline, Embase, Web of Science, Scopus, Cinahl and Cochrane databases were searched. Data points collected were Study/subject characteristics/demographics, surgery/specialty, time to haemostasis, proportion of haemostasis achieved, intraoperative adverse events, post operative complications, follow up time, and biochemical/histological analysis. Risk of Bias was assessed by Newcastle-Ottawa Scale
Results
Six studies were included; four human trials (3 RCTs, 1 case series) and two animal trials.
The human trials combined had 250 patients, with 147 using Veriset. In two RCTs, Veriset showed faster time to haemostasis and higher proportion of haemostasis achieved vs suturing and Tachosil haemostatic patch. In all three RCTs, no significant differences in adverse events and complications were seen between Veriset and suturing/Tachosil. Vascular, nephrectomy and hepatic surgery were investigated.
In the animal studies, the pig trial showed similar effectiveness and safety as the human trials. The rat study compared novel experimental patches to Veriset, and showed similar effectiveness to Veriset, at reduced costs.
Conclusions
Although current literature is scarce, Veriset is more effective than alternatives for haemostasis, with similar safety, although there are now other experimental patches that could have better health economic implications. Further clinical trials would be necessary to determine the breadth of applicable surgical fields for Veriset.
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Affiliation(s)
- J Zhang
- Clinical School of Medicine, University of Cambridge , Cambridge , United Kingdom
| | - A Zhou
- Clinical School of Medicine, University of Cambridge , Cambridge , United Kingdom
| | - A Jawaid
- University of Birmingham , Birmingham , United Kingdom
| | - O Adebayo
- University of Birmingham , Birmingham , United Kingdom
| | - Y Hashmi
- University of Birmingham , Birmingham , United Kingdom
| | - M Krkovic
- Addenbrookes Hospital , Cambridge , United Kingdom
| | - Z Ahmed
- University of Birmingham , Birmingham , United Kingdom
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17
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Lu V, Tennyson M, Zhou A, Fortune M, Thahir A, Krkovic M. 180 Retrograde Hindfoot Nailing for the Treatment of Acute Ankle Fractures in the Elderly - a Systematic Review and Meta-Analysis. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.422] [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: 11/05/2022]
Abstract
Abstract
Aim
Fragility ankle fractures are traditionally managed conservatively or with open reduction internal fixation (ORIF). Tibiotalocalcaneal (TTC) nailing is an alternative option for the geriatric patient. This meta-analysis provides the most detailed analysis of hindfoot nailing for fragility ankle fractures.
Method
A systematic search was performed on MEDLINE, EMBASE, Cochrane Library, Scopus, Web of Science, identifying fourteen studies for inclusion. Studies including patients over 60 with a fragility ankle fracture, treated with TTC nail were included. Patients with a previous fracture of the ipsilateral limb, fibular nails, and pathological fractures were excluded.
Meta-regression analyses were performed to explore sources of heterogeneity, and publication bias was assessed using Egger's test.
Results
312 ankle fractures were included. The mean age was 77.3 (32–101) years. 26.9% were male, and 41.9% were diabetics. The pooled proportion of superficial infection, deep infection, implant failure, malunion, and all-cause mortality was 0.10 (95%CI:0.06–0.16; I2=44%), 0.08 (95%CI:0.06–0.11, I2=0%), 0.11 (95%CI:0.07–0.15,I2=0%), 0.11 (95%CI:0.06–0.18; I2=51%), and 0.27 (95%CI:0.20–0.34; I2=11%), respectively. The pooled mean post-operative OMAS score was 54.07 (95%CI:48.98–59.16; I2=85%). The best-fitting meta-regression model included age and percentage of male patients as covariates (p=0.0263), and were inversely correlated with higher OMAS scores. Egger's test (p=0.56) showed no significant publication bias.
Conclusions
TTC nailing is an adequate alternative option for fragility ankle fracture management. However, current evidence includes mainly case series with inconsistent outcome measures reported and post-operative rehabilitation protocols. Prospective RCTs with long follow-up times and large cohort sizes are needed to clearly guide the use of TTC nailing for ankle fractures.
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Affiliation(s)
- V Lu
- University of Cambridge , Cambridge , United Kingdom
| | - M Tennyson
- Addenbrooke's Hospital , Cambridge , United Kingdom
| | - A Zhou
- University of Cambridge , Cambridge , United Kingdom
| | - M Fortune
- Department of Public Health and Primary Care, University of Cambridge , Cambridge , United Kingdom
| | - A Thahir
- Addenbrooke's Hospital , Cambridge , United Kingdom
| | - M Krkovic
- Addenbrooke's Hospital , Cambridge , United Kingdom
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18
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Zhang J, Lu V, Zhou A, Thahir A, Krkovic M. 893 Predictors for Infection Severity in Open Tibial Fractures. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.480] [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: 11/06/2022]
Abstract
Abstract
Aim
Open tibial fractures can be difficult to manage - many factors could affect treatment and outcome, including being complicated by infection. We present a cohort of 244 patients and analyse which factors are significantly associated with infection outcome.
Method
Open tibia fractures treated at a major trauma centre between 2015–2021 were included.
Infection status was categorized into no infection, superficial infection, osteomyelitis. Data collected were Age, mode of injury, polytrauma, fibula status, Gustilo-Anderson (GA) classification, wound contamination, time to first procedure. time to definitive plastics procedure, time to definitive fixation, type of definitive fixation, smoking/diabetic status, and BMI.
Multicollinearity was calculated, with highly correlated factors removed. Multinomial logistic regression was performed. Chi-Squared test, with Post-Hoc Bonferroni correction was performed for complex categorical factors.
Results
244 patients were included. Polytrauma and fibula status, and type of definitive fixation were excluded from the multivariate model due to strong multicollinearity. Compared to non-infected outcome, patients with superficial infection had higher BMI (p<0.01), higher GA grade (p<0.01), and osteomyelitis patients had longer time to definitive fixation (p=0.049) and longer time to definitive plastics procedure (p=0.013), higher GA grade, and wound contamination.
Post-hoc analysis showed “no infection” was positively associated with GA-I (p=0.029) and GA-II (p<0.01), and negatively associated with GA-IIIC (p<0.01). Osteomyelitis was positively associated with GA-IIIc (p<0.01)
Conclusions
This study investigated associations between injury and presentation factors that may have been associated with infection. We suggest clinicians should give extra consideration to the factors highlighted during management and take preventative measures to mitigate the infection risk.
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Affiliation(s)
- J Zhang
- Clinical School, University of Cambridge , Cambridge , United Kingdom
| | - V Lu
- Clinical School, University of Cambridge , Cambridge , United Kingdom
| | - A Zhou
- Clinical School, University of Cambridge , Cambridge , United Kingdom
| | - A Thahir
- Addenbrookes Hospital , Cambridge , United Kingdom
| | - M Krkovic
- Addenbrookes Hospital , Cambridge , United Kingdom
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19
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Lu V, Tennyson M, Zhang J, Thahir A, Zhou A, Krkovic M. 245 Ankle Fusion with Tibiotalocalcaneal Retrograde Nail for Fragility Ankle Fractures: Outcomes at a Major Trauma Centre. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.460] [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: 11/05/2022]
Abstract
Abstract
Aim
Fragility ankles fractures in the geriatric population are challenging to manage, due to fracture instability, soft tissue compromise, and patient co-morbidities. Traditional management options include open reduction internal fixation, or conservative treatment, both of which are fraught with high complication rates. We aimed to present functional outcomes of elderly patients with fragility ankle fractures treated with retrograde ankle fusion nails.
Method
171 patients received a tibiotalocalcaneal nail over a six-year period, but only twenty met the inclusion criteria of being over sixty and having poor bone stock. Primary outcome was mortality risk from co-morbidities according to Charlson co-morbidity index (CCI), and patients’ post-operative mobility status compared to pre-operative mobility. Secondary outcomes include intra-operative and post-operative complications, six-month mortality rate, time to mobilisation and union.
Results
Mean age was 77.82 years old. The average CCI was 5.05. Thirteen patients returned to their pre-operative mobility state. Patients with low CCI are more likely to return to pre-operative mobility status (p=0.16;OR=4.00).
Average time to bone union and mobilisation were 92.5 days and 7.63 days, respectively. Mean post-operative AOFAS ankle-hindfoot and Olerud-Molander scores were 53.0 and 50.9, respectively. There were four cases of superficial infection. Patients with high CCI were more likely to acquire superficial infections (p=0.264,OR=3.857). There were no deep infections, periprosthetic fractures, nail breakages, non-unions. Average follow-up time was 499.3 days.
Conclusions
Tibiotalocalcaneal nailing is an effective and safe option for managing fragility ankle fractures in the elderly. This technique leads to lower complication rates and earlier mobilisation than traditional fixation methods.
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Affiliation(s)
- V Lu
- University of Cambridge , Cambridge , United Kingdom
| | - M Tennyson
- Addenbrooke's Hospital , Cambridge , United Kingdom
| | - J Zhang
- University of Cambridge , Cambridge , United Kingdom
| | - A Thahir
- Addenbrooke's Hospital , Cambridge , United Kingdom
| | - A Zhou
- University of Cambridge , Cambridge , United Kingdom
| | - M Krkovic
- Addenbrooke's Hospital , Cambridge , United Kingdom
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20
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Zhou A, Ong SS, Ahmed I, Arevalo JF, Cai CX, Handa JT. Socioeconomic disadvantage and impact on visual outcomes in patients with viral retinitis and retinal detachment. J Ophthalmic Inflamm Infect 2022; 12:26. [PMID: 35916989 PMCID: PMC9346012 DOI: 10.1186/s12348-022-00303-4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/23/2022] [Indexed: 11/23/2022] Open
Abstract
While socioeconomic disparities impact clinical care and patient outcomes, their impact on the anatomic and visual outcomes of retinal detachment in patients with viral retinitis is unstudied. This case series included 18 eyes in 18 patients from a single academic institution between January 1, 2008 and December 31, 2018. Patient characteristics including age, sex, race, ethnicity, insurance, immunosuppression, viral retinitis, retinal detachment, retinal detachment repair, visual and anatomic outcomes, missed appointments, and Area Deprivation Index [ADI] were collected. The low-ADI group, indicating less socioeconomic disadvantage, was comprised of twelve patients with national ADIs less than 38, and the high-ADI group of six patients with national ADIs greater than 38. High-ADI patients tended to be younger (average age 38.0 versus 51.3; P = 0.06), of female sex (P = 0.03), and had more missed appointments (median 11.0 vs 0; P = 0.002). A similar number of patients in both the high-ADI and low-ADI groups underwent pars plana vitrectomy alone or pars plana vitrectomy with scleral buckle. Visual acuity was similar in the high-ADI group than in the low-ADI group at baseline, but worse at the final follow-up visit (P = 0.004). Post-operative and final visit ocular hypotony were more common in the high-ADI group (P = 0.02). In our series, socioeconomic disadvantage negatively affects the visual outcomes in patients with viral retinitis associated-retinal detachments. These factors should be considered by ophthalmologists when treating these patients.
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Affiliation(s)
- Ashley Zhou
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Sally S Ong
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ishrat Ahmed
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Cindy X Cai
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - James T Handa
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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21
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Zimar Z, Robert D, Zhou A, Giustozzi F, Setunge S, Kodikara J. Application of coal fly ash in pavement subgrade stabilisation: A review. J Environ Manage 2022; 312:114926. [PMID: 35364515 DOI: 10.1016/j.jenvman.2022.114926] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 06/14/2023]
Abstract
Expansive clays are found in many countries worldwide, and they exhibit inherent volume change during the seasonal moisture variation causing cracks, heaves, and damages to the overlying pavements. Chemical stabilisation is one of the most used approaches to treat the expansive clay subgrades. Cement, Lime and Fly ash are the most commonly used stabilisers, in which fly is cheaper and a by-product obtained from the coal power plant. This paper reviews fly ash stabilisation on various clay types, including low plasticity clays, high plasticity clays, silty clays, organic clays, and peats. The review begins with the properties of fly ash, followed by the characteristics of fly ash stabilised subgrades. The micro-level mechanism, physical, mechanical, and hydraulic characteristics of stabilised pavements are presented graphically for the Class C, and F fly ashes. The micro-level studies reveal that the pozzolanic reaction is stronger than the cation exchange during the fly ash stabilisation. The unconfined compressive strength (UCS), California bearing ratio (CBR) and resilient modulus (Mr) increased with the fly ash addition and curing time for most soft soils except peat clays. Based on the mechanical and hydraulic characteristics, using 15% class C fly ash with 7 days of curing is recommended for optimum performance. Although few research studies confirm that the leachate limit of stabilised soil is within the acceptable limit, further studies are required to investigate the uptake of heavy metals and other certain carcinogenic contaminants. This study will provide key information for researchers and Engineers on the selection of fly ash stabilisation measures for expansive subgrades.
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Affiliation(s)
- Z Zimar
- Civil Engineering Department, School of Engineering, RMIT University, VIC, 3001, Australia
| | - D Robert
- Civil Engineering Department, School of Engineering, RMIT University, VIC, 3001, Australia.
| | - A Zhou
- Civil Engineering Department, School of Engineering, RMIT University, VIC, 3001, Australia
| | - F Giustozzi
- Civil Engineering Department, School of Engineering, RMIT University, VIC, 3001, Australia
| | - S Setunge
- Civil Engineering Department, School of Engineering, RMIT University, VIC, 3001, Australia
| | - J Kodikara
- Civil Engineering Department, Monash University, VIC, Australia
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22
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Zhou A, Herzke C, Hong K. Abstract No. 256 Implementation and early performance of a joint internal medicine–interventional radiology bedside procedure service. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.337] [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] Open
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23
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Qu W, Jiang Z, Liu Z, Zhu L, Chen X, Liu B, Zhao Y, Li S, Yan H, Qu X, Zang A, Sun Y, Zhou A. P-246 Real-world outcomes in metastatic colorectal patients receiving regorafenib treatment in China. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.336] [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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Zhou A, Wu X, Youm J, Heller M, Lam A. Abstract No. 203 Drug-coated balloon angioplasty versus conventional balloon angioplasty for arteriovenous fistula stenosis: a cost effectiveness study. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.284] [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: 10/18/2022] Open
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25
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Cao C, Shou J, Sun Z, Zhou A, Lan X, Shang B, Jiang W, Guo L, Zheng S, Bi X. Phenotypical screening on metastatic PRCC-TFE3 fusion translocation renal cell carcinoma organoids reveals potential therapeutic agents. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01205-2] [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: 11/04/2022]
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26
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Zale AD, Song CI, Zhou A, Lai J, Jang M, Lipsett PA, Desai SV, Hanyok LA, Bienstock JL. A Qualitative Study of the Barriers and Benefits to Resident Education in Ambulatory Surgical Centers. J Surg Educ 2021; 78:1825-1837. [PMID: 34092534 DOI: 10.1016/j.jsurg.2021.04.002] [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] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/03/2021] [Accepted: 04/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE As Ambulatory Surgical Centers (ASCs) become more common in academic medical centers, large hospital systems must determine how to shift resident education from inpatient to outpatient surgical centers. This study aims to define stakeholders' views regarding the integration of surgical residents into ASCs. DESIGN Long-form interviews lasting 30 to 60 minutes were conducted. Interviews were hand-transcribed and analyzed by qualitative analysis to determine benefits of learning in ASCs for residents, challenges that arise from integrating residents, and recommendations to improve resident incorporation. SETTING Interviews were conducted using a video conferencing platform. PARTICIPANTS Residency program directors, attending surgeons, graduate medical learners, and a nursing manager were interviewed. Twenty-one total interviews were conducted, representing ten different departments. RESULTS Stakeholders agreed that residents benefit from being placed in ASCs because the fast, surgical pace allows the residents to engage in more cases. However, different stakeholders highlighted different challenges, all centered around the notion of inter-stakeholder conflict due to conflicting priorities among residents, attending physicians, and administration. Likewise, recommendations differed by stakeholder group-faculty members sought more defined learning objectives and enhanced communication, whereas residents desired that ambulatory surgical time be more structured. CONCLUSIONS Despite the pressures of rapid case turnover, stakeholders agreed that there are many benefits to resident education in ASCs. Findings related to challenges and recommendations support the need to strengthen communication between stakeholder groups and better plan for resident integration into ASCs.
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Affiliation(s)
- Andrew D Zale
- Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | | | - Ashley Zhou
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonathan Lai
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Minyoung Jang
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Pamela A Lipsett
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sanjay V Desai
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Laura A Hanyok
- Johns Hopkins University School of Medicine, Baltimore, Maryland
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27
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Zhang Y, Yao J, Quan Y, Wang J, Xing Y, Zhou A. [Treatment response to Conbercept of different types of diabetic macular edema classified based on optical coherence tomography]. Nan Fang Yi Ke Da Xue Xue Bao 2021; 41:1501-1508. [PMID: 34755665 DOI: 10.12122/j.issn.1673-4254.2021.10.08] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To compare different types of diabetic macular edema (DME) classified based on optical coherence tomography (OCT) for their responses to Conbercept injection and analyze the factors that affect the treatment responses. METHODS We retrospectively analyzed the clinical data of 65 patients (76 eyes) with DME diagnosed and treated with intravitreal injection of Conbercept (1+PRN) in our hospital from February, 2019 to February, 2021. According to OCT findings, DME in these patients was classified into cystic macular edema (CME; 28 eyes), serous retinal detachment (SRD; 33 eyes), and diffuse retinal thickening (DRT; 15 eyes). The best corrected visual acuity (BCVA) and central retinal thickness (CRT) were measured before and at 3 months after the first treatment. The baseline OCT characteristics of different types of DME were compared, and the correlation of these OCT characteristics with the treatment response to Conbercept was analyzed. RESULTS All the patients showed significant improvement of the BCVA 3 months after the treatment (P < 0.05). For all the 3 types of DME, the CRT at 3 months after the first treatment was significantly reduced as compared to the baseline (P < 0.05). The number of hyperreflective foci (HF) in the outer retina and the proportion of ellipsoid zone (EZ) interruption were the greatest in SRD group (P < 0.05). The baseline outer retinal HF was significantly correlated with the baseline CRT, CRT changes and CRT after treatment (all P < 0.05). The patients with baseline outer limiting membrane (ELM)/ EZ disruption had poorer baseline BCVA, greater baseline CRT, greater variation of CRT and poorer BCVA at 3 months after treatment (all P < 0.05). CONCLUSION For all the 3 types of DME, treatment with intravitreal injection of Conbercept can significantly improve the BCVA and CRT of the patients. DME of the SRD type has the best morphological response to Conbercept, while the DRT type has a relatively poor response. A greater number of HF at baseline may indicate a better morphological response to Conbercept treatment, and baseline ELM/EZ disruption may suggest a poor visual prognosis at 3 months after treatment.
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Affiliation(s)
- Y Zhang
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - J Yao
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Y Quan
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - J Wang
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Y Xing
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - A Zhou
- Department of Ophthalmology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
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28
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Zhou A, Girish M, Lim JA, Thahir A, Krkovic M. 33 Impact of Disruption of Tibio-Fibular Joints During Distraction Osteogenesis on Knee and Ankle Joint Function. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.964] [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: 11/14/2022]
Abstract
Abstract
Aim
The aim of this study is to investigate whether a disruption of proximal and/or distal tibio-fibular joint correlates to patient’s function and osteoarthritis.
Method
Retrospective analysis of 44 patients with lower limb bone defects treated by tibial corticotomy and distraction osteogenesis was conducted. Analysis of lower limb x-rays before surgery, immediately post-surgery and after frame removal permitted calculations of changes in tibial length and changes in fibula position relative to the tibia at the proximal and distal tibio-fibular joints. X-rays before and after treatment were also graded for osteoarthritis severity using Alhbäck's classification. Functional ability was scored using the American Orthopaedic Foot & Ankle Society (AOFAS) score and the Knee society score (KSS).
Results
15 patients showed a decrease in the distance between fibular tip and distal tibia, 5 showed no change and 12 showed an increase at the end of the treatment. No statistical significant association was noted with KSS or AOFAS score (p > 0.05), however one patient with a large distance increase exhibited severe radiological exacerbation of knee osteoarthritis. The distal corticotomy group achieved significantly higher length of new bone (p < 0.001) and were more likely to have exacerbation of knee osteoarthritis (p < 0.05). Conversely, proximal corticotomy group were significantly more likely to show an exacerbation of ankle osteoarthritis (p < 0.05).
Conclusions
Attempts should be made not to disrupt the tibio-fibular joints during bone transport, but disruption does not necessarily correlate to poorer outcomes. Our results show that lengthening index reduces with larger bone defects, suggesting that radical debridement/resection may not negatively affect the healing index.
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Affiliation(s)
- A Zhou
- University of Cambridge, Cambridge, United Kingdom
| | - M Girish
- University of Cambridge, Cambridge, United Kingdom
| | - J A Lim
- University of Cambridge, Cambridge, United Kingdom
| | - A Thahir
- Cambridge University Hospitals, Cambridge, United Kingdom
| | - M Krkovic
- Cambridge University Hospitals, Cambridge, United Kingdom
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Petrillo LA, Zhou A, Gui H, Sommer R, Lin JJ, Nipp RD, Traeger L, Greer JA, Temel JS. Types of information that patients with lung cancer with targetable driver mutations and their caregivers learn from online forums: Results of a qualitative study. J Clin Oncol 2021. [DOI: 10.1200/jco.2020.39.28_suppl.161] [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
161 Background: Patients and caregivers seek information about cancer from a variety of sources in addition to their medical team. In recent years, patients with specific lung cancer subtypes have created advocacy groups with active online forums for networking, support, and information exchange. We sought to describe the types of information that patients and caregivers learned from their peers online about lung cancer with targetable driver mutations. Methods: In this qualitative study, we enrolled patients with lung cancer with targetable driver alterations in EGFR, ALK, or ROS1 genes and their caregivers. We conducted individual, semi-structured interviews with participants from a single academic center, asking about their experiences learning about and living with lung cancer. Three reviewers used a framework analysis to code transcripts, and we synthesized the codes into themes. In this analysis, we focused on one theme that emerged from the data related to the information that participants learned from online forums. Results: Of 59 patients approached, 39 patients (mean age = 59, 56% female, median time from diagnosis 16 months) and 16 caregivers (69% male, all spouses or long-term partners) agreed to participate and completed interviews. Participants used online forums to compare their experiences with others to gain a preview of what might lie ahead. Specifically, they read about patients with long survival that were a source of hope, as well as patients’ experiences of progression and dying from cancer that made clinical estimates of prognosis more personal and vivid. Online forums provided a venue to learn about the latest research, available clinical trials, how to manage side effects, and where to find expert clinicians. Participants learned about the treatments received by patients at other centers. They were also exposed to emotionally intense stories of patients from around the world who lacked access to targeted therapy and sought advice from other forum members about how to find specialized care. Caregivers pointed out the distressing effect on patients of learning bad news about online peers as a downside of online forums, but overall found them beneficial and supported patients’ engagement with them. Conclusions: Online forums, particularly those that narrowly focus on specific diseases or treatments, provide patients and caregivers with anecdotal evidence that helps them with practical matters, such as how to manage side effects, as well as more existential issues, such as how long they can expect to live. These results suggest that clinicians should be open to and curious about the information that patients and caregivers learn from online forums in order to better understand the perspectives that patients and caregivers bring to discussions and decisions about their cancer.
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Affiliation(s)
- Laura A Petrillo
- Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | - Haiwen Gui
- Stanford University School of Medicine, Stanford, CA
| | | | | | | | | | - Joseph A. Greer
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Ma J, Zhou A, Ge Z. Topic: AS01-Diagnosis/AS01a-Cytomorphology. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106681.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Petrillo LA, Zhou A, Sullivan RJ, Volandes AE, Greer JA, Temel JS, El-Jawahri A. Knowledge about risks, benefits, and curative potential of immunotherapy among patients with advanced lung cancer or melanoma. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.6579] [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
6579 Background: Immunotherapy is a novel treatment paradigm that has improved survival for patients with advanced melanoma and lung cancer and poses new risks of immune-related adverse events, which are important for patients to recognize promptly. We aimed to describe patients’ knowledge about the risks and benefits of immunotherapy, and their understanding of the goal of treatment with immunotherapy. Methods: We conducted a cross-sectional study of patients at a single institution who had initiated therapy with an immune checkpoint inhibitor for advanced melanoma, small cell lung cancer, or non-small cell lung cancer in the past 12 weeks. We assessed patients’ knowledge about immunotherapy with a 9-item knowledge questionnaire (score range 0-100; higher score represents greater knowledge). We used the Perception of Treatment and Prognosis Questionnaire to assess patients’ understanding of the goal of their treatment. We used the two-sample t-test to compare knowledge scores and chi-square test to compare goals of therapy between patients with melanoma and lung cancer. Results: A total of 105 patients (57 with melanoma, 48 with lung cancer) completed the study questionnaire. Participants had a median age of 69 years (range 36-89), and 33% (35/105) were female. Participants’ mean knowledge score was 69.0 (SD = 23.3). Overall, 91% (96/105) of patients endorsed that immunotherapy works by turning on the body’s immune system to recognize and attack cancer cells and 33% (35/105) correctly identified that immunotherapy does not kill all rapidly dividing cells. With respect to immunotherapy side effects, 68% (71/105) of patients reported that immunotherapy side effects can affect any organ in the body and 65% (68/105) endorsed that side effects from immunotherapy can occur at any time, even after the treatment ends. Overall, 34% (36/105) of participants reported that the primary goal of their treatment is to cure their cancer. Participants with melanoma had higher mean knowledge scores compared to those with lung cancer (74.7 vs. 62.3, P = 0.003). Participants with melanoma were also more likely to report that the goal of their immunotherapy was to cure compared to those with lung cancer (58% [33/57] vs. 6% [3/48], P < 0.001) and that their oncologist had said that immunotherapy would cure their cancer (19% [11/57] vs. 0% [0/48], p = 0.005). Conclusions: We observed substantial knowledge deficits about immunotherapy and perceptions that immunotherapy is a cure for advanced cancer, particularly among patients with melanoma. These findings underscore the need for interventions to enhance patients’ knowledge about immunotherapy and to help them understand the goal of immunotherapy for patients with advanced cancer.
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Affiliation(s)
- Laura A Petrillo
- Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | | | | | - Joseph A. Greer
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Petrillo LA, Zhou A, Volandes AE, Sullivan RJ, El-Jawahri A, Greer JA, Temel JS. Improving patient and caregiver understanding of risks and benefits of immunotherapy for melanoma or lung cancer. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps6596] [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
TPS6596 Background: Immune checkpoint inhibitors (ICI) extend survival for patients with advanced cancer, particularly melanoma and lung cancer, though responses are heterogeneous and treatment may be complicated by immune-related adverse events that are important for patients and their caregivers to recognize. The aim of this trial is to evaluate the feasibility and preliminary efficacy of an educational video and question prompt list (QPL) in improving patients’ and caregivers’ understanding of what to expect from immunotherapy. Methods: In this randomized controlled trial of a novel educational intervention to improve immunotherapy knowledge, we will enroll 140 adult patients with advanced melanoma or lung cancer (small cell or non-small cell) who have a plan to initiate therapy with an ICI and their caregivers. Patients assigned to the intervention will receive a link to a video about the risks and benefits of ICI treatment developed by the study team as well as an ICI-focused QPL that includes questions about the goal and likelihood of benefit of ICIs. We will enroll the first ten patients in an open pilot and we will refine the intervention and study procedures based on pilot findings. We will randomize the remaining 130 patients to receive either the intervention or a usual care control. Randomization will be carried out using the permuted block approach with stratification by cancer type, and patient-caregiver dyads will be assigned to the same study arm. Participants on both arms will complete surveys at enrollment (baseline), 72 hours post-enrollment, and 6 weeks post-enrollment. The primary outcome of the study is feasibility of intervention delivery, defined as 70% of approached patients enrolling in the trial and 80% of enrolled patients watching the video, reviewing the QPL and completing the first assessment. We will also evaluate the preliminary efficacy of the intervention in 1) improving patient and caregiver knowledge, measured by a survey of knowledge questions that we developed and previously pilot tested with a sample of 105 patients; 2) enhancing patient-clinician communication, assessed by evaluating the number of questions patients asked in audio-recorded visits with their oncology clinicians after reviewing the QPL; and 3) reducing anxiety, measured by the State and Trait Anxiety Index. We will assess change in knowledge scores and anxiety from baseline to 72 hours post-enrollment and 6-weeks post-enrollment using the analysis of covariance model, adjusting for baseline scores and relevant covariates. The number of questions asked by patients and caregivers will be assessed by coding transcripts of oncology visits and comparing between arms using the negative binomial model. Study accrual to the open pilot phase began in February 2021. Current enrollment: n = 5. Clinical trial information: 04670445.
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Affiliation(s)
- Laura A Petrillo
- Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | | | | | | | - Joseph A. Greer
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
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Xu X, Wang C, Wu Y, Houck K, Hilton T, Zhou A, Wu X, Han C, Yang M, Yang W, Shi FD, Stolla M, Cruz MA, Li M, Zhang J, Dong JF. Conformation-dependent blockage of activated VWF improves outcomes of traumatic brain injury in mice. Blood 2021; 137:544-555. [PMID: 33507292 PMCID: PMC7845006 DOI: 10.1182/blood.2020007364] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 06/01/2020] [Accepted: 07/27/2020] [Indexed: 12/22/2022] Open
Abstract
Traumatic brain injury-induced coagulopathy (TBI-IC) causes life-threatening secondary intracranial bleeding. Its pathogenesis differs mechanistically from that of coagulopathy arising from extracranial injuries and hemorrhagic shock, but it remains poorly understood. We report results of a study designed to test the hypothesis that von Willebrand factor (VWF) released during acute TBI is intrinsically hyperadhesive because its platelet-binding A1-domain is exposed and contributes to TBI-induced vascular leakage and consumptive coagulopathy. This hyperadhesive VWF can be selectively blocked by a VWF A2-domain protein to prevent TBI-IC and to improve neurological function with a minimal risk of bleeding. We demonstrated that A2 given through intraperitoneal injection or IV infusion reduced TBI-induced death by >50% and significantly improved the neurological function of C57BL/6J male mice subjected to severe lateral fluid percussion injury. A2 protected the endothelium from extracellular vesicle-induced injury, reducing TBI-induced platelet activation and microvesiculation, and preventing a TBI-induced hypercoagulable state. A2 achieved this therapeutic efficacy by specifically blocking the A1 domain exposed on the hyperadhesive VWF released during acute TBI. These results suggest that VWF plays a causal role in the development of TBI-IC and is a therapeutic target for this life-threatening complication of TBI.
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Affiliation(s)
- Xin Xu
- Bloodworks Research Institute, Seattle, WA
- Departments of Neurosurgery, Neurology, and Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Chenyu Wang
- Institute of Pathology, School of Medical Sciences, and the Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Yingang Wu
- Department of Neurosurgery, the First Affiliated Hospital, University of Science and Technology, Hefei, China
| | | | | | | | | | - Cha Han
- Departments of Neurosurgery, Neurology, and Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mengchen Yang
- Departments of Neurosurgery, Neurology, and Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Yang
- Bloodworks Research Institute, Seattle, WA
- NanoString Technologies, Seattle, WA
| | - Fu-Dong Shi
- Departments of Neurosurgery, Neurology, and Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | | | - Miguel A Cruz
- Cardiovascular Research Section, Department of Medicine, Baylor College of Medicine, Houston, TX
- Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center, Houston, TX; and
| | - Min Li
- Institute of Pathology, School of Medical Sciences, and the Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Jianning Zhang
- Departments of Neurosurgery, Neurology, and Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing-Fei Dong
- Bloodworks Research Institute, Seattle, WA
- Division of Hematology, Department of Medicine, University of Washington, School of Medicine, Seattle, WA
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Huang Y, Luo S, Zhao P, Tan L, Fu G, Zhou A, He X. A novel STS mutation and an Xp22.31 microdeletion in a Chinese family with X-linked ichthyosis. Clin Exp Dermatol 2020; 46:614-617. [PMID: 33336383 DOI: 10.1111/ced.14525] [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] [Received: 07/29/2020] [Revised: 10/22/2020] [Accepted: 11/02/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Y Huang
- Precision Medical Center, Wuhan Children's Hospital, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - S Luo
- Precision Medical Center, Wuhan Children's Hospital, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - P Zhao
- Precision Medical Center, Wuhan Children's Hospital, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - L Tan
- Precision Medical Center, Wuhan Children's Hospital, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - G Fu
- Dermatology Department, Wuhan Children's Hospital, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - A Zhou
- Prenatal Diagnosis Center, Wuhan Children's Hospital, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - X He
- Precision Medical Center, Wuhan Children's Hospital, Wuhan Maternal and Child Healthcare Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Tan J, Shen S, Zhou A, Wang Z, Lyu H. Laboratory data on long-term sealing behaviors of two water-swelling materials for shield tunnel gasket. Data Brief 2020; 30:105609. [PMID: 32395581 PMCID: PMC7210418 DOI: 10.1016/j.dib.2020.105609] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 11/25/2022] Open
Abstract
This article provides comprehensive experimental data of two water-swelling materials, water swelling rubber (WSR) and water-swelling polyurethane (WSP). Swelling tests, Dynamic Mechanical Analyzer (DMA) and Scanning Electron Microscope (SEM) were performed. Sealing properties of WSR and WSP were characterized by the data of swelling ratios (Sw and Sa), storage moduli (E') and images of micro-damage morphologies. These data can be useful for the prediction of the long-term waterproof performance of water-swelling materials and provide reference for material selection. The data presented herein was used for the article, titled "Laboratory evaluation of long-term sealing behaviors of two water-swelling materials for shield tunnel gasket" [1].
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Affiliation(s)
- J.S. Tan
- Department of Civil Engineering, School of Naval Architecture, Ocean, and Civil Engineering, Shanghai Jiao Tong University, 800 Dong Chuan Road, Minhang District, Shanghai 200240, China
| | - S.L. Shen
- Key Laboratory of Intelligent Manufacturing Technology (Shantou University), Ministry of Education, and Department of Civil and Environmental Engineering, College of Engineering, Shantou University, Shantou, Guangdong 515063, China
- Discipline of Civil and Infrastructure, School of Engineering, Royal Melbourne Institute of Technology (RMIT), Victoria 3001, Australia
| | - A. Zhou
- Discipline of Civil and Infrastructure, School of Engineering, Royal Melbourne Institute of Technology (RMIT), Victoria 3001, Australia
| | - Z.N. Wang
- Department of Civil Engineering, School of Naval Architecture, Ocean, and Civil Engineering, Shanghai Jiao Tong University, 800 Dong Chuan Road, Minhang District, Shanghai 200240, China
| | - H.M. Lyu
- State Key Laboratory of Internet of Things for Smart City, University of Macau, Macau S.A.R., China
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Chen P, Hsu WH, Chang A, Tan Z, Lan Z, Zhou A, Spring DJ, Lang FF, Wang YA, DePinho RA. Circadian Regulator CLOCK Recruits Immune-Suppressive Microglia into the GBM Tumor Microenvironment. Cancer Discov 2020; 10:371-381. [PMID: 31919052 PMCID: PMC7058515 DOI: 10.1158/2159-8290.cd-19-0400] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [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: 04/01/2019] [Revised: 11/26/2019] [Accepted: 01/06/2020] [Indexed: 01/11/2023]
Abstract
Glioblastoma (GBM) is a lethal brain tumor containing a subpopulation of glioma stem cells (GSC). Pan-cancer analyses have revealed that stemness of cancer cells correlates positively with immunosuppressive pathways in many solid tumors, including GBM, prompting us to conduct a gain-of-function screen of epigenetic regulators that may influence GSC self-renewal and tumor immunity. The circadian regulator CLOCK emerged as a top hit in enhancing stem-cell self-renewal, which was amplified in about 5% of human GBM cases. CLOCK and its heterodimeric partner BMAL1 enhanced GSC self-renewal and triggered protumor immunity via transcriptional upregulation of OLFML3, a novel chemokine recruiting immune-suppressive microglia into the tumor microenvironment. In GBM models, CLOCK or OLFML3 depletion reduced intratumoral microglia density and extended overall survival. We conclude that the CLOCK-BMAL1 complex contributes to key GBM hallmarks of GSC maintenance and immunosuppression and, together with its downstream target OLFML3, represents new therapeutic targets for this disease. SIGNIFICANCE: Circadian regulator CLOCK drives GSC self-renewal and metabolism and promotes microglia infiltration through direct regulation of a novel microglia-attracting chemokine, OLFML3. CLOCK and/or OLFML3 may represent novel therapeutic targets for GBM.This article is highlighted in the In This Issue feature, p. 327.
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Affiliation(s)
- Peiwen Chen
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wen-Hao Hsu
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Andrew Chang
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zhi Tan
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zhengdao Lan
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ashley Zhou
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Denise J Spring
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Frederick F Lang
- Department of Neurosurgery and Brain Tumor Center, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Y Alan Wang
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Ronald A DePinho
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Solomon A, Kolarich A, Zhou A, Hoyer M, England R, Moreland A, Fabre M, Holly B. 3:27 PM Abstract No. 102 Infectious complications and postprocedural antibiotics following initial percutaneous biliary drainage for patients with endoscopically placed stents. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.131] [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] Open
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Zhou A, Porosnicu Rodriguez K, Morkos J, Kolarich A, Frangakis C, Georgiades C. 3:54 PM Abstract No. 270 Percutaneous cryoablation for stage 1 renal cell carcinoma: 10-year prospective oncologic outcomes and comparison with matched surgical cohorts from the National Cancer Database. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Keim J, Zhang W, Liu Y, Rutigliano H, Zhou A, Polejaeva I. 87 Analyzing metabolomic profile of bovine IVF and somatic cell nuclear transfer embryos through Raman spectroscopy. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
While knowledge of early embryo development and viability has continually increased, there is still a need for noninvasive methods to identify embryos with the highest chances of development to term when transferred. The most widely used technique, morphological assessment, is highly subjective and limited by personnel experience. Spent media from invitro culture could be used as a valuable noninvasive marker for embryo quality assessment. Raman spectroscopy has proven to be a powerful tool for identifying the molecular characteristics of spent culture media by measuring vibration of chemical bonds, allowing for metabolomic profiling of varying stages and quality of embryos. It is well documented that embryos produced through somatic cell nuclear transfer (SCNT) result in lower pregnancy rates and higher incidences of pregnancy loss when compared with embryos produced through IVF (Heyman et al. 2002 Biol. Reprod. 66, 1-13). This study was designed to examine differences in spent media between bovine embryos produced by IVF and SCNT. The SCNT embryos with a metabolomic profile more similar to IVF embryos may have a higher developmental competence. Bovine cumulus-oocyte complexes (COCs) were retrieved from abattoir-derived ovaries and matured for 21h in maturation medium. After IVM, COCs were either used for IVF or SCNT and cultured in 50μL droplets of synthetic oviductal fluid medium + fetal bovine serum in groups of 45 from Day 0-5. On Day 5, embryos that had reached morula stage were placed in individual droplets of 13μL of synthetic oviductal fluid + bovine serum albumin until Day 7. All embryos were cultured at 38.5°C and 5% CO2. On Day 7 embryos were assessed for developmental stage and quality and 10μL of medium from individual culture drops was collected for Raman spectroscopy. Samples were loaded on an MgF2 optical window, dried, and analysed using a 785nm near-infrared laser in the spectral range of 600 to 1800cm−1. Raw Raman data were first pre-processed by baseline correction (asymmetric least-squares smoothing) and normalization. Principal component analysis and partial least squares were then applied to reduce data dimensions. The score of the most significant principal components from principal component analysis and the optimum number of scores from partial least squares were used for linear discriminant analysis. Spent media samples from 4 SCNT embryos, 3 IVF embryos, and 3 empty media samples were analysed, with 50 spectra obtained from each sample. Preliminary data showed grouping of medium containing embryos developed to blastocyst from medium containing embryos arrested at morula or empty medium. We also saw grouping of medium containing SCNT embryos from medium containing IVF embryos within both the morula and blastocyst stage from empty medium. This shows evidence of metabolomic differences between embryos of different developmental potential and embryos produced by IVF and SCNT. Further investigation of the Raman profile of these groups can display specific differences in chemical components and help to identify candidate genes causing differing metabolism of these groups.
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Zhou A, Morris HA, Hyppönen E. Health effects associated with serum calcium concentrations: evidence from MR-PheWAS analysis in UK Biobank. Osteoporos Int 2019; 30:2343-2348. [PMID: 31392400 DOI: 10.1007/s00198-019-05118-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/30/2019] [Indexed: 12/15/2022]
Abstract
UNLABELLED We conducted a phenome-wide Mendelian randomization analysis (MR-PheWAS) to survey health effects associated with high normal serum calcium. We found causal evidence for conditions related to renal function, bone and joint health, and cardiovascular risk. These conditions collectively suggest that tissue calcification may be a key mechanism through which serum calcium influences health. INTRODUCTION Calcium is essential for the normal functioning of the cardiovascular system, muscles, and nerves. In this MR-PheWAS study, we sought to capture the totality of health effects associated with high normal serum calcium. METHODS We used data from up to 337,535 UK Biobank participants, and tested for associations between calcium genetic score (calcium-GS) and 925 disease outcomes, with follow-up analyses using complementary MR methods. RESULTS Calcium-GS was robustly associated with serum calcium concentration (F statistics = 349). After multiple testing correction (P < 1.62E-4), we saw genetic evidence for an association between high serum calcium and urinary calculus (OR per 1 mg/dl 3.5, 95%CI 1.3-9.2), renal colic (9.1, 95%CI 2.5-33.5), and allergy/adverse effect of penicillin (2.2, 95%CI 1.5-3.3). Secondary analyses with independent replication from consortia meta-analyses suggested further effects on myocardial infarction and osteoarthrosis. CONCLUSION We found causal evidence for effects of high normal serum calcium with conditions related to renal function, bone and joint health, and cardiovascular risk, which may collectively reflect influences on tissue calcification and immune function.
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Affiliation(s)
- A Zhou
- Australian Center for Precision Health, University of South Australia Cancer Research Institute, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - H A Morris
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia
| | - E Hyppönen
- Australian Center for Precision Health, University of South Australia Cancer Research Institute, GPO Box 2471, Adelaide, SA, 5001, Australia.
- Population, Policy and Practice, UCL Institute of Child Health, London, UK.
- South Australian Health and Medical Research Institute, Adelaide, Australia.
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Ye D, Liu J, Zhou A, Zou Q, Li H, Fu C, Hu H, Huang J, Zhu S, Jin J, Ma L, Guo J, Xiao J, Park S, Zhang D, Qiu X, Bao Y, Zhang L, Shen W, Feng B. First report of efficacy and safety from a phase II trial of tislelizumab, an anti-PD-1 antibody, for the treatment of PD-L1+ locally advanced or metastatic urothelial carcinoma (UC) in Asian patients. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zhou A, Sun Y, Zhang W, Jiang Z, Chen B, Zhao J, Li Z, Wang L. Anlotinib for advanced hepatocellular carcinoma: Interim results from the phase II ALTER0802 study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kislitsina O, Anderson A, Thomas J, Rich J, Wilcox J, Vorovich E, Zhou A, Andrei A, Harap R, McCarthy P, Yancy C, Pham D. What Happens to Right Ventricular Strain and Function Following Tricuspid Valve Repair in Patients Undergoing Implantation of a Left Ventricular Assist Device? J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.579] [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: 10/27/2022] Open
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Zhou A, Ping C. THE BEST TOOL TO EVALUATE THE RESPONSE TO TREATMENT IN PATIENTS WITH ACUTE EXACERBATION OF COPD. Chest 2019. [DOI: 10.1016/j.chest.2019.02.200] [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: 10/27/2022] Open
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Zhou A, Chen P. MICROARRAY ANALYSIS OF LONG NON-CODING RNA IN COPD LUNG TISSUE. Chest 2019. [DOI: 10.1016/j.chest.2019.02.205] [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] Open
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Goga A, Rohrberg J, Corella A, Taileb M, Kilinc S, Jokisch ML, Camarda R, Zhou A, Balakrishnan S, Chang AN, Klein-Connolly H. Abstract P3-09-01: MYC dysregulates mitotic spindle function in triple-negative breast cancer creating a dependency on TPX2. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p3-09-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Tumors that overexpress the MYC oncogene, including most receptor triple-negative breast cancers, frequently demonstrate aneuploidy, numerical chromosome alterations associated with highly aggressive cancers. Aneuploidy is also associated with rapid tumor evolution and poor patient outcome. We identify that MYC overexpression induces reversible defects in microtubule nucleation and mitotic spindle assembly, in TNBCs and other epithelial cells, promoting chromosome segregation defects, micronuclei and chromosomal instability (CIN). High TPX2 expression is permissive for mitotic spindle assembly and chromosome segregation in cells with MYC overexpression; whereas TPX2 depletion blocks mitotic progression, induces cell death and prevents tumor growth. Attenuating MYC expression reverses mitotic defects, even in established breast tumor cell lines, implicating an ongoing role for high MYC in the persistence of CIN in cancers. Our studies implicate the MYC oncogene as a regulator of spindle assembly and identify a new MYC-TPX2 synthetic-lethal interaction in TNBC that could represent a future therapeutic strategy in MYC-overexpressing cancers. Moreover, our studies suggest that blocking MYC activity can attenuate the emergence of CIN and tumor evolution.
Citation Format: Goga A, Rohrberg J, Corella A, Taileb M, Kilinc S, Jokisch M-L, Camarda R, Zhou A, Balakrishnan S, Chang AN, Klein-Connolly H. MYC dysregulates mitotic spindle function in triple-negative breast cancer creating a dependency on TPX2 [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P3-09-01.
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Affiliation(s)
- A Goga
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
| | - J Rohrberg
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
| | - A Corella
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
| | - M Taileb
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
| | - S Kilinc
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
| | - M-L Jokisch
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
| | - R Camarda
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
| | - A Zhou
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
| | - S Balakrishnan
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
| | - AN Chang
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
| | - H Klein-Connolly
- University of California, San Francisco, San Francisco; University of California, San Diego, San Diego
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Wang T, Wang N, Ren H, Zhou H, Zhou A, Jin J, Chen Y, Zhao D. Long-term results of conversion therapy for initially unresectable gastric cancer: Analysis of 122 patients at the National Cancer Center in China. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy432.029] [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: 11/12/2022] Open
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Gin Q, Zhou A, Yang L, Zhong D. Antiviral prophylaxis cannot reduce the risk of hepatitis B reactivation during chemotherapy for non-HCC solid tumor patients with lower HBV DNA titer: A retrospective cohort study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.101] [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: 11/13/2022] Open
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Jin J, Tang Y, Liu S, Zhu Y, Wang W, Li G, Wang X, Wang J, Yang J, Li S, Li N, Liu W, Li Y, Chi Y, Zhou A, Huang J, Wang X, Jiang L, Jiang J, Zou S. Short-term radiotherapy plus chemotherapy versus long-term chemoradiotherapy in locally advanced rectal cancer (STELLAR): A planned interim analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ondhia U, Conter H, Owen S, Zhou A, Nam J, Singh S, Abdulla A, Chu P, Felizzi F, Sangha R. P3.04-17 Cost-Effectiveness of Atezolizumab for Previously Treated Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) in Canada. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1724] [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: 10/28/2022]
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