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Tam A, Ladbury CJ, Kassardjian A, Melstrom L, Modi B, Margolin K, Xing Y, Amini A. Synergistic Effect of TVEC and Radiotherapy in the Treatment of Advanced Melanoma. Int J Radiat Oncol Biol Phys 2023; 117:e342. [PMID: 37785193 DOI: 10.1016/j.ijrobp.2023.06.2405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Talimogene laherparepvec (TVEC) is a genetically modified herpes simplex virus (HSV-1) that has been approved by the US Food and Drug Administration (FDA) for intralesional treatment of melanoma. Recent reports have suggested that radiation treatment (RT) given in conjunction with TVEC, may provide synergistic immune enhancement at the site, and possibly systemically. However, the studies on combining RT with TVEC remain limited. Our study compares melanoma patients (pts) who received TVEC and RT in the same region of the body with pts whose RT field did not include the site of TVEC injection. We hypothesized that RT and TVEC to the same site would induce a more robust local tumor response, and possibly a systemic response, with improvement in clinical outcomes over those pts who had treatments in different regions. MATERIALS/METHODS This was a retrospective review of 20 melanoma pts from a single cancer center who were treated with TVEC and RT between January 2015 and September 2022. Overall survival (OS), progression-free survival (PFS), time to distant metastasis (DM), and time to locoregional recurrence (LRR) were compared using Kaplan-Meier analysis and the corresponding log-rank test. Skin toxicity was also tabulated. RESULTS Fourteen pts (stage III [71.4%]; stage IV [28.6%]) received TVEC and RT in the same region (left leg [5], right leg [5], back [1], left arm [1], and right arm [1], and scalp [1]), and six (stage III [66.7%]; stage IV [33.3%]) received treatments in separate regions. The overall median follow-up was 10.5 months (mos) (range 1.0 - 58.7 mos). The OS of pts who had TVEC and RT in the same region was 19.0 mos (95% confidence interval [CI], 4.1 - not reached [NR] mos), compared to 18.5 mos for those receiving RT in a different region (95% CI, 1.0 - NR mos) (p = 0.366). PFS with TVEC and RT in the same and different regions were 6.4 mos (95% CI, 2.4 - NR mos) and 2.8 mos (95% CI, 0.7 - 4.4 mos) respectively (p = 0.005). DM was 13.8 mos (95% CI, 4.6 - NR mos) with TVEC and RT in the same field and 2.8 mos (95% CI, 0.7 - 4.4 mos) in different fields (p = 0.001). Lastly, LRR of pts who had TVEC and RT in the same region was 26.0 mos (95% CI, 6.4 - 26.0 mos) compared to 4.4 mos in different regions (95% CI, 0.7 - NR mos) (p = 0.115). No grade 3 or higher skin toxicities were documented among pts who had TVEC and RT in the same region. CONCLUSION Comparing pts who had TVEC and RT to different regions of the body, there was an association with improvements in PFS and DM when both modalities were delivered to the same region of the body. However, we did not find a significant difference in locoregional recurrence or OS. Given some promise with the combined approach and potential immune enhancement from RT, larger trials are needed to better understand the potential positive signal from our study.
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Affiliation(s)
- A Tam
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - C J Ladbury
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - A Kassardjian
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
| | - L Melstrom
- Department of Surgery, City of Hope National Medical Center, Duarte, CA
| | - B Modi
- Department of Dermatology, City of Hope National Medical Center, Duarte, CA
| | - K Margolin
- Saint John's Cancer Institute, Santa Monica, CA
| | - Y Xing
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA
| | - A Amini
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA
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Modi B, Guardamagna M, Stella F, Griguoli M, Cherubini E, Battaglia FP. State-dependent coupling of hippocampal oscillations. eLife 2023; 12:e80263. [PMID: 37462671 PMCID: PMC10411970 DOI: 10.7554/elife.80263] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/17/2023] [Indexed: 08/10/2023] Open
Abstract
Oscillations occurring simultaneously in a given area represent a physiological unit of brain states. They allow for temporal segmentation of spikes and support distinct behaviors. To establish how multiple oscillatory components co-vary simultaneously and influence neuronal firing during sleep and wakefulness in mice, we describe a multivariate analytical framework for constructing the state space of hippocampal oscillations. Examining the co-occurrence patterns of oscillations on the state space, across species, uncovered the presence of network constraints and distinct set of cross-frequency interactions during wakefulness compared to sleep. We demonstrated how the state space can be used as a canvas to map the neural firing and found that distinct neurons during navigation were tuned to different sets of simultaneously occurring oscillations during sleep. This multivariate analytical framework provides a window to move beyond classical bivariate pipelines for investigating oscillations and neuronal firing, thereby allowing to factor-in the complexity of oscillation-population interactions.
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Affiliation(s)
| | - Matteo Guardamagna
- Donders Institute for Brain, Cognition and Behavior, Radboud UniversityNijmegenNetherlands
| | - Federico Stella
- Donders Institute for Brain, Cognition and Behavior, Radboud UniversityNijmegenNetherlands
| | - Marilena Griguoli
- European Brain Research InstituteRomeItaly
- CNR, Institute of Molecular Biology and PathologyRomeItaly
| | | | - Francesco P Battaglia
- Donders Institute for Brain, Cognition and Behavior, Radboud UniversityNijmegenNetherlands
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Lamichhane G, Acharya A, Marahatha R, Modi B, Paudel R, Adhikari A, Raut BK, Aryal S, Parajuli N. Microplastics in environment: global concern, challenges, and controlling measures. Int J Environ Sci Technol (Tehran) 2023; 20:4673-4694. [PMID: 35638092 PMCID: PMC9135010 DOI: 10.1007/s13762-022-04261-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 03/31/2022] [Accepted: 04/23/2022] [Indexed: 05/02/2023]
Abstract
Plastic pollution in various forms has emerged as the most severe environmental threat. Small plastic chunks, such as microplastics and nanoplastics derived from primary and secondary sources, are a major concern worldwide due to their adverse effects on the environment and public health. Several years have been spent developing robust spectroscopic techniques that should be considered top-notch; however, researchers are still trying to find efficient and straightforward methods for the analysis of microplastics but have yet to develop a viable solution. Because of the small size of these degraded plastics, they have been found in various species, from human brains to blood and digestive systems. Several pollution-controlling methods have been tested in recent years, and these methods are prominent and need to be developed. Bacterial degradation, sunlight-driven photocatalyst, fuels, and biodegradable plastics could be game-changers in future research on plastic pollution control. However, recent fledgling steps in controlling methods appear insufficient due to widespread contamination. As a result, proper regulation of environmental microplastics is a significant challenge, and the most equitable way to manage plastic pollution. Therefore, this paper discusses the current state of microplastics, some novel and well-known identification techniques, strategies for overcoming microplastic effects, and needed solutions to mitigate this planetary pollution. This review article, we believe, will fill a void in the field of plastic identification and pollution mitigation research.
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Affiliation(s)
- G. Lamichhane
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
| | - A. Acharya
- Department of Geoscience, Interdisciplinary Graduate School of Science and Engineering, Shimane University, Matsue, Japan
| | - R. Marahatha
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
| | - B. Modi
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
| | - R. Paudel
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
| | - A. Adhikari
- Kathmandu Research Institute for Biological Sciences, Lalitpur, Nepal
| | - B. K. Raut
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
| | - S. Aryal
- Kathmandu Research Institute for Biological Sciences, Lalitpur, Nepal
| | - N. Parajuli
- Biological Chemistry Lab, Central Department of Chemistry, Tribhuvan University, Kirtipur, 44618 Nepal
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Migden M, Schmults C, Khushanlani N, Guminski A, Chang A, Lewis K, Ansstas G, Bowyer S, Hughes B, Schadendorf D, Modi B, Dunn L, Flatz L, Hauschild A, Yoo SY, Booth J, Seebach F, Lowy I, Fury M, Rischin D. 814P Phase II study of cemiplimab in patients with advanced cutaneous squamous cell carcinoma (CSCC): Final analysis from EMPOWER-CSCC-1 groups 1, 2 and 3. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Basilico B, Ferrucci L, Ratano P, Golia MT, Grimaldi A, Rosito M, Ferretti V, Reverte I, Sanchini C, Marrone MC, Giubettini M, De Turris V, Salerno D, Garofalo S, St-Pierre MK, Carrier M, Renzi M, Pagani F, Modi B, Raspa M, Scavizzi F, Gross CT, Marinelli S, Tremblay MÈ, Caprioli D, Maggi L, Limatola C, Di Angelantonio S, Ragozzino D. Microglia control glutamatergic synapses in the adult mouse hippocampus. Glia 2021; 70:173-195. [PMID: 34661306 PMCID: PMC9297980 DOI: 10.1002/glia.24101] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [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: 02/21/2021] [Revised: 09/20/2021] [Accepted: 09/27/2021] [Indexed: 12/26/2022]
Abstract
Microglia cells are active players in regulating synaptic development and plasticity in the brain. However, how they influence the normal functioning of synapses is largely unknown. In this study, we characterized the effects of pharmacological microglia depletion, achieved by administration of PLX5622, on hippocampal CA3‐CA1 synapses of adult wild type mice. Following microglial depletion, we observed a reduction of spontaneous and evoked glutamatergic activity associated with a decrease of dendritic spine density. We also observed the appearance of immature synaptic features and higher levels of plasticity. Microglia depleted mice showed a deficit in the acquisition of the Novel Object Recognition task. These events were accompanied by hippocampal astrogliosis, although in the absence ofneuroinflammatory condition. PLX‐induced synaptic changes were absent in Cx3cr1−/− mice, highlighting the role of CX3CL1/CX3CR1 axis in microglia control of synaptic functioning. Remarkably, microglia repopulation after PLX5622 withdrawal was associated with the recovery of hippocampal synapses and learning functions. Altogether, these data demonstrate that microglia contribute to normal synaptic functioning in the adult brain and that their removal induces reversible changes in organization and activity of glutamatergic synapses.
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Affiliation(s)
- Bernadette Basilico
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Laura Ferrucci
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Patrizia Ratano
- Neurophysiology and Neuropharmacology Inflammaging Unit, IRCCS Neuromed, Mediterranean Neurological Institute, Pozzilli, IS, Italy
| | - Maria T Golia
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Alfonso Grimaldi
- Center for Life Nano- and Neuro-science, Istituto Italiano di Tecnologia, Rome, Italy
| | - Maria Rosito
- Center for Life Nano- and Neuro-science, Istituto Italiano di Tecnologia, Rome, Italy
| | - Valentina Ferretti
- Dipartimento di Biologia e Biotecnologie "Charles Darwin", Sapienza University of Rome, Rome, Italy
| | - Ingrid Reverte
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), Rome, Italy
| | - Caterina Sanchini
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Center for Life Nano- and Neuro-science, Istituto Italiano di Tecnologia, Rome, Italy
| | - Maria C Marrone
- European Brain Research Institute (EBRI) 'Rita Levi-Montalcini', Rome, Italy
| | - Maria Giubettini
- Center for Life Nano- and Neuro-science, Istituto Italiano di Tecnologia, Rome, Italy.,CrestOptics S.p.A, Rome, Italy
| | - Valeria De Turris
- Center for Life Nano- and Neuro-science, Istituto Italiano di Tecnologia, Rome, Italy
| | - Debora Salerno
- Center for Life Nano- and Neuro-science, Istituto Italiano di Tecnologia, Rome, Italy
| | - Stefano Garofalo
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Marie-Kim St-Pierre
- Centre de Recherche du CHU de Québec, Axe Neurosciences Québec, Quebec City, Canada.,Département de Médecine Moléculaire, Université Laval Québec, Quebec City, Canada
| | - Micael Carrier
- Centre de Recherche du CHU de Québec, Axe Neurosciences Québec, Quebec City, Canada.,Département de Médecine Moléculaire, Université Laval Québec, Quebec City, Canada
| | - Massimiliano Renzi
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Francesca Pagani
- Center for Life Nano- and Neuro-science, Istituto Italiano di Tecnologia, Rome, Italy
| | - Brijesh Modi
- European Brain Research Institute (EBRI) 'Rita Levi-Montalcini', Rome, Italy
| | - Marcello Raspa
- National Research Council, Institute of Biochemistry and Cell Biology (CNR-IBBC/EMMA/Infrafrontier/IMPC), International Campus "A. Buzzati-Traverso", Monterotondo (Rome), Italy
| | - Ferdinando Scavizzi
- National Research Council, Institute of Biochemistry and Cell Biology (CNR-IBBC/EMMA/Infrafrontier/IMPC), International Campus "A. Buzzati-Traverso", Monterotondo (Rome), Italy
| | - Cornelius T Gross
- Epigenetics and Neurobiology Unit, European Molecular Biology Laboratory (EMBL), Monterotondo, Italy
| | - Silvia Marinelli
- European Brain Research Institute (EBRI) 'Rita Levi-Montalcini', Rome, Italy
| | - Marie-Ève Tremblay
- Centre de Recherche du CHU de Québec, Axe Neurosciences Québec, Quebec City, Canada.,Département de Médecine Moléculaire, Université Laval Québec, Quebec City, Canada.,Division of Medical Sciences, University of Victoria, Victoria, Canada
| | - Daniele Caprioli
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), Rome, Italy
| | - Laura Maggi
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Cristina Limatola
- Neurophysiology and Neuropharmacology Inflammaging Unit, IRCCS Neuromed, Mediterranean Neurological Institute, Pozzilli, IS, Italy.,Department of Physiology and Pharmacology, Sapienza University, Laboratory affiliated to Istituto Pasteur Italia, Rome, Italy
| | - Silvia Di Angelantonio
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Center for Life Nano- and Neuro-science, Istituto Italiano di Tecnologia, Rome, Italy
| | - Davide Ragozzino
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy.,Santa Lucia Foundation (IRCCS Fondazione Santa Lucia), Rome, Italy
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Modi B, Pimpinella D, Pazienti A, Zacchi P, Cherubini E, Griguoli M. Possible Implication of the CA2 Hippocampal Circuit in Social Cognition Deficits Observed in the Neuroligin 3 Knock-Out Mouse, a Non-Syndromic Animal Model of Autism. Front Psychiatry 2019; 10:513. [PMID: 31379628 PMCID: PMC6659102 DOI: 10.3389/fpsyt.2019.00513] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/28/2019] [Indexed: 11/13/2022] Open
Abstract
Autism spectrum disorders (ASDs) comprise a heterogeneous group of neuro-developmental abnormalities with a strong genetic component, characterized by deficits in verbal and non-verbal communication, impaired social interactions, and stereotyped behaviors. In a small percentage of cases, ASDs are associated with alterations of genes involved in synaptic function. Among these, relatively frequent are mutations/deletions of genes encoding for neuroligins (NLGs). NLGs are postsynaptic adhesion molecules that, interacting with their presynaptic partners neurexins, ensure the cross talk between pre- and postsynaptic specializations and synaptic stabilization, a condition needed for maintaining a proper excitatory/inhibitory balance within local neuronal circuits. We have focused on mice lacking NLG3 (NLG3 knock-out mice), animal models of a non-syndromic form of autism, which exhibit deficits in social behavior reminiscent of those found in ASDs. Among different brain areas involved in social cognition, the CA2 region of the hippocampus has recently emerged as a central structure for social memory processing. Here, in vivo recordings from anesthetized animals and ex vivo recordings from hippocampal slices have been used to assess the dynamics of neuronal signaling in the CA2 hippocampal area. In vivo experiments from NLG3-deficient mice revealed a selective impairment of spike-related slow wave activity in the CA2 area and a significant reduction in oscillatory activity in the theta and gamma frequencies range in both CA2 and CA3 regions of the hippocampus. These network effects were associated with an increased neuronal excitability in the CA2 hippocampal area. Ex vivo recordings from CA2 principal cells in slices obtained from NLG3 knock-out animals unveiled a strong excitatory/inhibitory imbalance in this region accompanied by a strong reduction of perisomatic inhibition mediated by CCK-containing GABAergic interneurons. These data clearly suggest that the selective alterations in network dynamics and GABAergic signaling observed in the CA2 hippocampal region of NLG3 knock-out mice may account for deficits in social memory reminiscent of those observed in autistic patients.
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Affiliation(s)
- Brijesh Modi
- European Brain Research Institute (EBRI), Rome, Italy.,Department of Psychology, Sapienza University of Rome, Italy
| | - Domenico Pimpinella
- European Brain Research Institute (EBRI), Rome, Italy.,Department of Psychology, Sapienza University of Rome, Italy
| | - Antonio Pazienti
- European Brain Research Institute (EBRI), Rome, Italy.,National Center for Radiation Protection and Computational Physics, Italian National Institute of Health, Rome, Italy
| | - Paola Zacchi
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Enrico Cherubini
- European Brain Research Institute (EBRI), Rome, Italy.,Department of Neuroscience, International School for Advanced Studies (SISSA), Trieste, Italy
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Shewade HD, Shringarpure KS, Parmar M, Patel N, Kuriya S, Shihora S, Ninama N, Gosai N, Khokhariya R, Popat C, Thanki H, Modi B, Dave P, Baxi RK, Kumar AMV. Delay and attrition before treatment initiation among MDR-TB patients in five districts of Gujarat, India. Public Health Action 2018; 8:59-65. [PMID: 29946521 DOI: 10.5588/pha.18.0003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 03/24/2018] [Indexed: 12/26/2022] Open
Abstract
Setting: Gujarat, a state in west India. Background: Although treatment initiation has been improving among patients diagnosed with multidrug-resistant tuberculosis (MDR-TB) in programme settings, it has still not reached 100%. Objectives: To determine pre-treatment attrition (not initiated on treatment within 6 months of diagnosis), delay in treatment initiation (>7 days from diagnosis) and associated factors among MDR-TB patients diagnosed in 2014 in five selected districts served by two genotypic drug susceptibility testing (DST) facilities and a drug-resistant TB centre in Gujarat. Design: This was a retrospective cohort study involving record review. Results: Among 257 MDR-TB patients, pre-treatment attrition was seen in 20 (8%, 95%CI 5-12). Patients with 'follow-up sputum-positive' as their DST criterion and sputum smear microscopy status 'unknown' at the time of referral for DST were less likely to be initiated on treatment. The median delay to treatment initiation was 8 days (interquartile range 6-13). Patients referred for DST from medical colleges were more likely to face delays in treatment initiation. Conclusion: The Gujarat TB programme is performing well in initiating laboratory-confirmed MDR-TB patients on treatment. However, there is further scope for reducing delay.
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Affiliation(s)
- H D Shewade
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India.,The Union, Paris, France
| | - K S Shringarpure
- Department of Preventive and Social Medicine, Medical College, Vadodara, India
| | - M Parmar
- World Health Organization Country Office for India, New Delhi, India
| | - N Patel
- Department of Preventive and Social Medicine, Medical College, Vadodara, India
| | - S Kuriya
- Department of Preventive and Social Medicine, Medical College, Vadodara, India
| | - S Shihora
- Department of Preventive and Social Medicine, Medical College, Vadodara, India
| | - N Ninama
- Department of Preventive and Social Medicine, Medical College, Vadodara, India
| | - N Gosai
- Department of Preventive and Social Medicine, Medical College, Vadodara, India
| | - R Khokhariya
- Department of Preventive and Social Medicine, Medical College, Vadodara, India
| | - C Popat
- Department of Preventive and Social Medicine, Medical College, Vadodara, India
| | - H Thanki
- World Health Organization Country Office for India, New Delhi, India
| | - B Modi
- Department of Community Medicine, Gujarat Medical Education & Research Society Medical College and Hospital, Gandhinagar, India
| | - P Dave
- Department of Health and Family Welfare, Government of Gujarat, Gandhinagar, India
| | - R K Baxi
- Department of Preventive and Social Medicine, Medical College, Vadodara, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease, South-East Asia Office, New Delhi, India.,The Union, Paris, France
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Chawla S, Shringarpure K, Modi B, Sharma R, Rewari BB, Shah AN, Verma PB, Dongre AR, Kumar AMV. Why are HIV-infected people not started on antiretroviral therapy? A mixed-methods study from Gujarat, India. Public Health Action 2017; 7:183-192. [PMID: 29201653 DOI: 10.5588/pha.16.0108] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 05/24/2017] [Indexed: 12/20/2022] Open
Abstract
Setting: Five purposively selected antiretroviral therapy (ART) centres in Gujarat, India. Objectives: To assess the proportion of ART-eligible people living with the human immunodeficiency virus (PLHIV) who were not initiated on ART within 2 months of being recorded as eligible, to identify factors associated with non-initiation and to explore reasons from the provider's perspective. Design: We used a mixed-methods design (triangulation) of 1) a quantitative phase involving record reviews and cohort analysis (Poisson regression) of PLHIV registered during April 2014-March 2015, and 2) a qualitative phase involving one-to-one interviews with 25 providers. Results: Of 2079 ART-eligible PLHIV, 339 (16%) were not started on ART within 2 months. PLHIV with CD4 counts of <350 cells/μl and patients who were labourers, hospitalised, bedridden or registered with certain ART centres were more likely not to be initiated on ART. Qualitative results were categorised into two broad themes: government health system- and patient-related challenges, which validated and complemented the quantitative findings. Conclusion: Several patient subgroups at greater risk of ART non-initiation were identified, along with reasons for risk; this has important programme implications for achieving the UNAIDS 90-90-90 goal, and particularly the second 90 component of having 90% of diagnosed PLHIV start ART.
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Affiliation(s)
- S Chawla
- Gujarat State AIDS Control Society, Health and Family Welfare Department, Government of Gujarat, Ahmedabad, India
| | - K Shringarpure
- Department of Community Medicine, Government Medical College and SSG Hospital, Vadodara, India
| | - B Modi
- Department of Community Medicine, Gujarat Medical Education and Research Society (GMERS) Medical College, Gandhinagar, India
| | - R Sharma
- Department of Community Medicine, GMERS Medical College, Sola, Ahmedabad, India
| | - B B Rewari
- World Health Organization India Country Office, New Delhi, India
| | - A N Shah
- Department of Medicine, BJ Medical College and Civil Hospital, Ahmedabad, India
| | - P B Verma
- Gujarat State AIDS Control Society, Health and Family Welfare Department, Government of Gujarat, Ahmedabad, India.,Department of Community Medicine, Gujarat Medical Education and Research Society (GMERS) Medical College, Gandhinagar, India
| | - A R Dongre
- Department of Community Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India.,The Union, Paris, France
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Modi B, Chattersingh A, Ryan M, Ellis H, Lee J, Gaddum N, Chowienczyk P, Perera D. P3322Optimising physiological assessment of serial coronary artery lesions using an in vitro model of tandem stenoses. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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10
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Patel P, Desai K, Modi B, Bansal R. Urban Slums are New and Important Areas for Inequalities in Maternal and Newborn Health in Many Areas. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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11
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Wilson J, Akhtar MM, Modi B, Emmanuel J. The failing heart: a bad case of the 'flu'. Case Reports 2015; 2015:bcr-2014-204772. [DOI: 10.1136/bcr-2014-204772] [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: 11/03/2022] Open
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12
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Akhtar MM, Jones DA, Rathod KS, Modi B, Lim P, Virdi G, Bromage D, Jain AJ, Singh Kalra S, Crake T, Meier P, Astroulakis Z, Dollery C, Ozkur M, Rakhit R, Knight CJ, Dalby MC, Malik IS, Bunce N, Whitbread M, Mathur A, Redwood S, MacCarthy PA, Wragg A. 041 CORONARY ARTERY BYPASS GRAFT PATIENTS TREATED WITH PRIMARY PERCUTANEOUS CORONARY INTERVENTION HAVE HIGH LONG-TERM ADVERSE EVENT RATES (10 920 STEMI PATIENTS FROM THE LONDON HEART ATTACK GROUP). Heart 2013. [DOI: 10.1136/heartjnl-2013-304019.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Elf JL, Modi B, Stillman F, Dave P, Apelberg B. Tobacco sales and marketing within 100 yards of schools in Ahmedabad City, India. Public Health 2013; 127:442-8. [PMID: 23608024 DOI: 10.1016/j.puhe.2013.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2012] [Revised: 01/02/2013] [Accepted: 02/06/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The Government of India passed the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COPTA 2003), which prohibits the sale of tobacco products within 100 yards of educational institutions and regulates tobacco advertising. The aim of this research was to monitor compliance with the section of COPTA 2003 regarding the advertisement, display and sale of tobacco products around educational institutions in Ahmedabad City, India. STUDY DESIGN Observational study around 30 randomly selected schools. METHODS In March 2010, an observational study was conducted to assess compliance with COPTA 2003 in Ahmedabad City, India. All vendors within a 100-yard radius of 30 randomly selected schools were identified. At locations where tobacco was sold, information was collected regarding type of product sold, sale of tobacco in single units and advertising. RESULTS Twenty public schools and 10 private schools were sampled. Of these, 87% [n = 26, 95% confidence interval (CI) 69-95%] had tobacco sales within 100 yards of their entrance. Of the 771 vendors observed, 24% (n = 185, 95% CI 18-32%) sold tobacco products. Tobacco advertising in violation of the law was found around 57% of schools (n = 17, 95% CI 39-73%), product displays around 83% of schools (n = 25, 95% CI 65-93%) and single sales around 70% of schools (n = 21, 95% CI 51-84%). CONCLUSIONS Violation of the sections of COPTA 2003 regarding sale of tobacco products around educational institutions and advertising in general is widespread in Ahmedabad City, India. Effective enforcement of the existing law is necessary to protect the children in India from widespread exposure to the sale and marketing of tobacco products.
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Affiliation(s)
- J L Elf
- Johns Hopkins Bloomberg School of Public Health, Institute for Global Tobacco Control, Baltimore, MD 21205, USA.
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Patel ND, Rade K, Dave PV, Pujara K, Solanki RN, Vegad MM, Modi B, Shah A. Impact of the RNTCPIRL-EQA-OSE visits on quality of sputum smear microscopy services of Gujarat, India. Indian J Tuberc 2012; 59:12-17. [PMID: 22670506] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE On-site evaluation of laboratories with standard checklist is a first step to promote effective and consistent supervision. The present study was carried out to evaluate the impact of the RNTCP- Intermediate Reference Laboratory External Quality Assessment- On-Site Evaluation visits on quality of sputum smear microscopy services of Gujarat, India. Data of three IRL-EQA-OSE visit rounds, carried out between January 2005 and December 2010 are presented here. MATERIAL AND METHODS Within the Revised National Tuberculosis Control Programme EQA framework, the IRL, Ahmedabad visited all Gujarat District Tuberculosis Centres, and evaluated their sputum smear microscopy services. The study covered a cohort of 29 DTCs during each of the three IRL-EQA-OSE visits. The authors focused on section III of Annexure A to study and analyse the said impact. In order to convert qualitative data into quantitative one, the authors denoted a score of 1 to "Acceptable" (No Error) remark and 0 to "Not-Acceptable" (Error) one. RESULTS A larger degree of improvement was noted in Standard Operating Procedure practices, Disinfection practices, and Internal Quality Control practices. Many DTCs did not retrain their laboratory staff in EQA methodology. The Gujarat DTCs achieved an overall score of (820/957) 86% during the initial OSE visits which consistently improved to (842/957) 88% and (885/957) 92% during the two follow-up OSE visits along with sustenance and improvement in many important laboratory parameters. CONCLUSION The co-sponsoring organisation (IRL) recognises the challenges and therefore, is committed to supporting state-level implementation of EQA through additional training, technical assistance to districts, and improving this technical guidance. By periodic IRL-EQA-OSE visits, sputum smear microscopy services can be sustained and improved at field level.
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Affiliation(s)
- Nilesh D Patel
- Department of Medical Education, State Government of Gujarat.
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Chang J, Varghese DS, Gillam MC, Peyton M, Modi B, Schiltz RL, Girard L, Martinez ED. Differential response of cancer cells to HDAC inhibitors trichostatin A and depsipeptide. Br J Cancer 2011; 106:116-25. [PMID: 22158273 PMCID: PMC3251870 DOI: 10.1038/bjc.2011.532] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Over the last decade, several drugs that inhibit class I and/or class II histone deacetylases (HDACs) have been identified, including trichostatin A, the cyclic depsipeptide FR901228 and the antibiotic apicidin. These compounds have had immediate application in cancer research because of their ability to reactivate aberrantly silenced tumour suppressor genes and/or block tumour cell growth. Although a number of HDAC inhibitors are being evaluated in preclinical cancer models and in clinical trials, little is known about the differences in their specific mechanism of action and about the unique determinants of cancer cell sensitivity to each of these inhibitors. Methods: Using a combination of cell viability assays, HDAC enzyme activity measurements, western blots for histone modifications, microarray gene expression analysis and qRT–PCR, we have characterised differences in trichostatin A vs depsipeptide-induced phenotypes in lung cancer, breast cancer and skin cancer cells and in normal cells and have then expanded these studies to other HDAC inhibitors. Results: Cell viability profiles across panels of lung cancer, breast cancer and melanoma cell lines showed distinct sensitivities to the pan-inhibitor TSA compared with the class 1 selective inhibitor depsipeptide. In several instances, the cell lines most sensitive to one inhibitor were most resistant to the other inhibitor, demonstrating these drugs act on at least some non-overlapping cellular targets. These differences were not explained by the HDAC selectivity of these inhibitors alone since apicidin, which is a class 1 selective compound similar to depsipeptide, also showed a unique drug sensitivity profile of its own. TSA had greater specificity for cancer vs normal cells compared with other HDAC inhibitors. In addition, at concentrations that blocked cancer cell viability, TSA effectively inhibited purified recombinant HDACs 1, 2 and 5 and moderately inhibited HDAC8, while depsipeptide did not inhibit the activity of purified HDACs in vitro but did in cellular extracts, suggesting a potentially indirect action of this drug. Although both depsipeptide and TSA increased levels of histone acetylation in cancer cells, only depsipeptide decreased global levels of transcriptionally repressive histone methylation marks. Analysis of gene expression profiles of an isogenic cell line pair that showed discrepant sensitivity to depsipeptide, suggested that resistance to this inhibitor may be mediated by increased expression of multidrug resistance genes triggered by exposure to chemotherapy as was confirmed by verapamil studies. Conclusion: Although generally thought to have similar activities, the HDAC modulators trichostatin A and depsipeptide demonstrated distinct phenotypes in the inhibition of cancer cell viability and of HDAC activity, in their selectivity for cancer vs normal cells, and in their effects on histone modifications. These differences in mode of action may bear on the future therapeutic and research application of these inhibitors.
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Affiliation(s)
- J Chang
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, 6000 Harry Hines Boulevard, Dallas, TX 75390-8593, USA
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Dave PV, Patel ND, Rade K, Solanki RN, Patel PG, Patel P, Joshi N, Modi B, Pujara K. Proficiency panel testing--a reliable tool in external quality assessment of sputum smear microscopy services in Gujarat, India. Indian J Tuberc 2011; 58:113-119. [PMID: 21941950] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To assess the proficiency of Senior TB Laboratory Supervisors (STLSs) and district level Laboratory Technicians (LTs) in sputum smear microscopy. METHOD Intermediate Reference Laboratory (IRL), Ahmedabad had manufactured and validated Proficiency Panel Testing slides from sputum samples, made On Site Evaluation (OSE) visits of District TB Centres (DTCs) in two rounds, and conducted Proficiency Panel Testing of STLSs & DTC-LTs from January 2005 to June 2009. RESULTS High level of concordance in Z-N smear grading was found between Microbiologist and district laboratory staff. DTC readers reported overall consistency level of more than 98% in Z-N grade agreement during both the IRL, EQA, OSE visits. The tendency to over-grade the panel slides was much higher (more than 22%) as compared to under-grade (less than 2%) them in "correct slides". High False Positive (HFP) error was not observed in the present study. CONCLUSION Laboratory supervisor's proficiency can be quickly assessed by Proficiency Panel Testing, under multi-level quality assurance network system of sputum smear microscopy in public health programmes like the RNTCP. Proficiency Panel Testing is highly replicable and reproducible tool for quick and reliable assessment of proficiency of the staff and it can be made more effective by raising the proportion of lower grade positive slides in panel set of each reader. DTC readers' overall agreement level of more than 98% in Z-N grade suggests high level of precision and excellent consistency during both the IRL, EQA, OSE rounds. It is concluded that even for a large network of sputum smear microscopy centres under public health programmes like the RNTCP in order to take corrective action, Proficiency Panel Testing can be effectively used for quick identification of suboptimal- technical performance of the supervisory staff.
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Affiliation(s)
- Paresh V Dave
- Department of Health & Family Welfare, State Government of Gujarat
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Machin J, Modi B, Ravichandran D. 614 Punch Biopsy: a useful adjunct in a rapid diagnosis breast clinic. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70635-2] [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: 10/19/2022] Open
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Azpurua H, Suh M, Kunisaki S, Modi B, Gutweiler J, Misra M, Exarhoupoulos A, Moses M, Kim H. P96. J Surg Res 2007. [DOI: 10.1016/j.jss.2006.12.325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mosier KM, Liu WC, Maldjian JA, Shah R, Modi B. Lateralization of cortical function in swallowing: a functional MR imaging study. AJNR Am J Neuroradiol 1999; 20:1520-6. [PMID: 10512240 PMCID: PMC7657739] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND AND PURPOSE While functional MR imaging and other techniques have contributed to our knowledge of functional brain localization, these methods have not been extensively applied to the complex and incompletely understood task of swallowing. We used functional MR imaging to investigate motor cortex activity during swallowing in healthy human adults. METHODS Eight subjects were imaged on a 1.5-T MR system using blood oxygen level-dependent contrast mechanisms. Subjects performed three swallowing tasks and a finger-tapping task. Areas of activation in the cortex and subcortical areas were tabulated, and a laterality index, defined as LI = [sigmas left - sigmas right]/[sigmas left + sigmas right] x 100, was computed for the three tasks. RESULTS Activation was observed in the primary motor and sensory cortices, motor processing and association areas, and subcortical sites. This activity was dominant for one hemisphere with left hemispheric dominance more prevalent among the subjects. Right hemispheric dominance, however, showed stronger lateralization than the left hemisphere. CONCLUSION Our data indicate that specific sites in the motor cortex and other cortical and subcortical areas are activated with swallowing tasks and that hemispheric dominance is a feature of swallowing under these conditions. In addition, we demonstrate the utility of functional MR imaging in the study of the cortical representation of swallowing and suggest a role for functional MR imaging in the diagnosis of dysphagia of cerebral origin.
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Affiliation(s)
- K M Mosier
- Department of Oral Pathology Biology, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark 07103, USA
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