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Boshoff M, Lopez-Villalobos N, Andrews C, Turner SA. Modeling daily yields of milk, fat, protein, and lactose of New Zealand dairy goats undergoing standard and extended lactations. J Dairy Sci 2024; 107:1500-1509. [PMID: 37863292 DOI: 10.3168/jds.2023-23926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/28/2023] [Indexed: 10/22/2023]
Abstract
This study aimed to assess the milk production data for New Zealand dairy goats in either a standard lactation (SL; ≤305 d in milk [DIM]) or extended lactation (EL; >305 and ≤670 DIM) using a random regression (RR) with third- and fifth-order Legendre polynomials, respectively. Persistency of EL was defined as (B/A) × 100, where A was the accumulated yield from d 1 to 305, and B was the accumulated yield from d 366 to 670. On average, goats in SL produced 1,183 kg of milk, 37 kg of fat, 37 kg of protein, and 54 kg of lactose. The average production of milk, fat, protein, and lactose in EL were 2,473 kg, 78 kg, 79 kg, and 112 kg, respectively. The average persistences for milk, fat, protein, and lactose yields during EL were 98%, 98%, 102%, and 96%, respectively. The relative prediction errors were close to 10% and the concordance correlation coefficients >0.92, indicating that the RR model with Legendre polynomials is adequate for modeling lactation curves for both SL and EL. Total yields and persistency were analyzed with a mixed model that included the fixed effects (year, month of kidding, parity, and proportion of Saanen) as covariates and the random effects of animal and residual errors. Effects of year, month of kidding, and parity were significant on the total yields of milk, fat, protein, and lactose for both SL and EL. The total milk yield of first-parity goats with SL was 946 kg and the total milk yield of second-parity goats with SL was 1,284 kg, making a total of 2,230 kg over 2 years. The total milk yield of a first-parity goat with EL was 2,140 kg. Thus, on average, a goat with SL for the first and second parity produced 90 kg more milk than a first-parity goat subjected to EL. However, a second-parity goat subjected to EL produced 43 kg more milk (2,639 kg) than a goat with SL following the second and third parity (1,284 kg + 1,312 kg). These data, along with the various other benefits of EL (e.g., fewer offspring born and reduced risk of mastitis, lameness, and metabolic problems in early lactation), indicate that EL as a management strategy holds the potential to improve dairy goat longevity and lifetime efficiency without compromising milk production.
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Affiliation(s)
- M Boshoff
- School of Agriculture and Environment, Massey University, Palmerston North 4410, New Zealand
| | - N Lopez-Villalobos
- School of Agriculture and Environment, Massey University, Palmerston North 4410, New Zealand.
| | - C Andrews
- School of Agriculture and Environment, Massey University, Palmerston North 4410, New Zealand
| | - S-A Turner
- Dairy Goat Co-operative (NZ) Limited, Hamilton 3206, New Zealand
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Andrews C, Pade A, Flenady V, Moore J, Tindal K, Farrant B, Stewart S, Loughnan S, Robinson N, Oba Y, Pollock D. Improving the capacity of researchers and bereaved parents to co-design and translate stillbirth research together. Women Birth 2024; 37:403-409. [PMID: 38155062 DOI: 10.1016/j.wombi.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/06/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Working with bereaved parents in co-designed stillbirth research, policy and practice is essential to improving care and outcomes. PROBLEM Effective parent engagement is often lacking. This may be due to bereaved parents not feeling adequately and appropriately supported to be involved. AIM To consult bereaved parents with the aim to understand their experiences, attitudes, and needs around involvement in stillbirth research and gain feedback about the usefulness and appropriateness of a proposed co-designed guide to support their involvement, including content and design aspects of this resource. METHODS An online co-designed survey was disseminated via Australian parent support organisations social media in August 2022. FINDINGS All 90 respondents were bereaved parents, 94% (n = 85) were female. Two-thirds (67%, n = 60) had never participated in stillbirth research, 80% (n = 72) agreed involvement of bereaved parents in research was important or extremely important and 81% (n = 73) were interested in future research involvement. Common motivations for involvement were wanting to leave a legacy for their baby and knowing research outcomes. Common barriers included not having been asked to participate or not knowing how. Most (89%, n = 80) agreed the proposed guide would be useful. Highly valued topics were the importance of bereaved parents' voices in stillbirth research and how they can make a difference. CONCLUSION The majority of bereaved parents we surveyed want to be involved in stillbirth research and would value a resource to support this. The proposed concept and content for a co-designed guide to aid engagement was well supported.
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Affiliation(s)
- C Andrews
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia.
| | - A Pade
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - J Moore
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - K Tindal
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia; The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
| | - B Farrant
- Telethon Kids Institute, The University of Western Australia, Nedlands, Australia
| | - S Stewart
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - S Loughnan
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - N Robinson
- The Phoebe Joan Foundation Australia, Stanthorpe, Australia
| | - Y Oba
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - D Pollock
- Health Evidence Synthesis, Recommendations and Impact (HESRI), School of Public Health, Faculty of Health and Medical Science, University of Adelaide, Australia
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Medeiros PB, Bailey C, Pollock D, Liley H, Gordon A, Andrews C, Flenady V. Neonatal near-miss audits: a systematic review and a call to action. BMC Pediatr 2023; 23:573. [PMID: 37978460 PMCID: PMC10655277 DOI: 10.1186/s12887-023-04383-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/24/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Neonatal near-miss (NNM) can be considered as an end of a spectrum that includes stillbirths and neonatal deaths. Clinical audits of NNM might reduce perinatal adverse outcomes. The aim of this review is to evaluate the effectiveness of NNM audits for reducing perinatal mortality and morbidity and explore related contextual factors. METHODS PubMed, Embase, Scopus, CINAHL, LILACS and SciELO were searched in February/2023. Randomized and observational studies of NNM clinical audits were included without restrictions on setting, publication date or language. PRIMARY OUTCOMES perinatal mortality, morbidity and NNM. SECONDARY OUTCOMES factors contributing to NNM and measures of quality of care. Study characteristics, methodological quality and outcome were extracted and assessed by two independent reviewers. Narrative synthesis was performed. RESULTS Of 3081 titles and abstracts screened, 36 articles had full-text review. Two studies identified, rated, and classified contributing care factors and generated recommendations to improve the quality of care. No study reported the primary outcomes for the review (change in perinatal mortality, morbidity and NNM rates resulting from an audit process), thus precluding meta-analysis. Three studies were multidisciplinary NNM audits and were assessed for additional contextual factors. CONCLUSION There was little data available to determine the effectiveness of clinical audits of NNM. While trials randomised at patient level to test our research question would be difficult or unethical for both NNM and perinatal death audits, other strategies such as large, well-designed before-and-after studies within services or comparisons between services could contribute evidence. This review supports a Call to Action for NNM audits. Adoption of formal audit methodology, standardised NNM definitions, evaluation of parent's engagement and measurement of the effectiveness of quality improvement cycles for improving outcomes are needed.
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Affiliation(s)
- P B Medeiros
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia.
- Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia.
| | - C Bailey
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - D Pollock
- JBI, School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - H Liley
- Mater Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - A Gordon
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- University of Sydney, Sydney, NSW, Australia
| | - C Andrews
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
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Pattnaik DP, Andrews C, Cropper MD, Gabbitas A, Balanov AG, Savel'ev S, Borisov P. Gamma radiation-induced nanodefects in diffusive memristors and artificial neurons. Nanoscale 2023; 15:15665-15674. [PMID: 37724437 DOI: 10.1039/d3nr01853a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Gamma photons with an average energy of 1.25 MeV are well-known to generate large amounts of defects in semiconductor electronic devices. Here we investigate the novel effect of gamma radiation on diffusive memristors based on metallic silver nanoparticles dispersed in a dielectric matrix of silica. Our experimental findings show that after exposure to radiation, the memristors and artificial neurons made of them demonstrate much better performance in terms of stable volatile resistive switching and higher spiking frequencies, respectively, compared to the pristine samples. At the same time we observe partial oxidation of silver and reduction of silicon within the switching silica layer. We propose nanoinclusions of reduced silicon distributed across the silica layer to be the backbone for metallic nanoparticles to form conductive filaments, as supported by our theoretical simulations of radiation-induced changes in the diffusion process. Our findings propose a new opportunity to engineer the required characteristics of diffusive memristors in order to emulate biological neurons and develop bio-inspired computational technology.
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Affiliation(s)
- D P Pattnaik
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
| | - C Andrews
- University of Manchester, Dalton Cumbrian Facility, Westlakes Science Park, Moor Row, CA24 3HA, UK
| | - M D Cropper
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
| | - A Gabbitas
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
| | - A G Balanov
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
| | - S Savel'ev
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
| | - P Borisov
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
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Guo H, Hamilton P, Enns E, Gupta M, Andrews C, Nasser Y, Bredenoord A, Dellon E, Ma C. A142 APPROPRIATENESS OF POST-ENDOSCOPY CARE IN PATIENTS PRESENTING WITH FOOD BOLUS IMPACTIONS OVERNIGHT: A POPULATION-BASED MULTICENTER COHORT STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991086 DOI: 10.1093/jcag/gwac036.142] [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: 03/09/2023] Open
Abstract
Background Appropriate management of esophageal food bolus impactions includes endoscopic evaluation and follow-up for potential underlying esophageal pathology. Patients who present with impactions at night may not receive optimal long-term post-endoscopy care due to patient-, physician-, or system-related factors. Purpose We aimed to evaluate the appropriateness of care for patients who present with food bolus impactions after regular daytime hours. Method We conducted a retrospective, population-based, multi-center cohort study of adult patients undergoing endoscopy for food impaction between 19:00-06:59 from 2016-2018 in the Calgary Health Zone, Canada. Appropriate post-endoscopy care was defined by a composite of a follow-up clinic visit, repeat endoscopy, other appropriate investigations (e.g., manometry), or appropriate medical treatment (e.g., proton pump inhibitor). Predictors of inappropriate care were assessed using multivariable logistic regression, expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Result(s) A total of 323 patients underwent an after-hours or overnight endoscopy for food bolus impaction. 25.4% (82/323) of patients did not receive appropriate post-endoscopy care. Predictors of inappropriate care included rural residence (aOR 2.66 [95% CI: 1.18-6.01], p=0.02), first food bolus presentation (aOR 2.38 [95% CI: 1.04-5.44], p=0.04), and absence of a specific pathology during the index procedure (aOR 3.01 [95% CI: 0.97-9.29], p=0.05), suggesting a potential association with clinician cognitive bias. Among patients who were followed, 18.9% (35/185) had a change in the original diagnosis. Image ![]()
Conclusion(s) One quarter of patients presenting with a food bolus impaction at night do not receive appropriate post-endoscopy care. System-based interventions should target this high-risk population as the diagnosis and management may change with follow-up. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
- H Guo
- Division of Gastroenterology and Hepatology
| | - P Hamilton
- Department of Medicine, University of Calgary
| | - E Enns
- Department of Medicine, Alberta Health Services
| | - M Gupta
- Division of Gastroenterology and Hepatology
| | - C Andrews
- Division of Gastroenterology and Hepatology
| | - Y Nasser
- Division of Gastroenterology and Hepatology,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Canada
| | - A Bredenoord
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, Netherlands
| | - E Dellon
- Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, United States
| | - C Ma
- Department of Medicine, Alberta Health Services,Department of Community Health Sciences, University of Calgary, Calgary, Canada
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Abunaser M, Sabri S, O'connor A, Arora P, Andrews C. 344 A Rare Case of Meckel's Diverticulitis With a 3 Cm Enterolith. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.128] [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
Meckel's diverticulum (MD) is a rare condition that affects only 2% of general population. Only 4 to 6% of those Meckel's diverticulea are symptomatic. Furthermore, having a MD containing enterolith is extremely rare, and herein we present a case of 55-year-old lady with Meckle's diverticulitis containing a 3 cm enterolith. The patient presented with symptoms mimic appendicitis; however, upon further evaluation with an enhanced abdomino-pelvic CT an MD containing enterolith was confirmed. An interval laparoscopically assisted diverticulectomy was performed and the patient recovery was un-eventful.
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Affiliation(s)
- M Abunaser
- Tameside and Glossop Integrated Care NHS Foundation Trust , Ashton-under-Lyne , United Kingdom
| | - S Sabri
- Tameside and Glossop Integrated Care NHS Foundation Trust , Ashton-under-Lyne , United Kingdom
| | - A O'connor
- Tameside and Glossop Integrated Care NHS Foundation Trust , Ashton-under-Lyne , United Kingdom
| | - P Arora
- Tameside and Glossop Integrated Care NHS Foundation Trust , Ashton-under-Lyne , United Kingdom
| | - C Andrews
- Wythenshawe Hospital, Manchester University Foundation Trust , Manchester , United Kingdom
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7
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Ballinger TJ, Djuric Z, Sardesai S, Hovey K, Andrews C, Braskey TM, Rohan TE, Saquib N, Shadyab AH, Simon M, Wactawski-Wende J, Wallace R, Kato I. Proton Pump Inhibitor Use and Obesity-Associated Cancers in the Women's Health Initiative. Cancer Epidemiol Biomarkers Prev 2022. [PMID: 35775214 DOI: 10.1158/1055-9965.epi-22-0475] [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: 11/16/2022] Open
Abstract
PURPOSE Proton pump inhibitors (PPIs) inhibit fatty acid synthase (FAS), a critical enzyme in lipogenesis, energy balance, and cancer cell survival. We aimed to evaluate the association of PPI use with incidence of common obesity- related cancers in women: postmenopausal breast, colorectal, and endometrial cancers. METHODS Our study included 124,931 postmenopausal who were enrolled in the Women's Health Initiative (WHI) observational study and clinical trials, and had responded to a year 3 follow-up assessment. We examined prescription and over the counter use of PPI and/or histamine 2 receptor antagonists (H2RA) at baseline and year 3, to isolate potential effects of FAS inhibition by PPI rather than simply acid suppression. Incident cancer cases were physician-adjudicated. Cox proportional hazard regression models were used to estimate multivariable hazard ratios (HR) and 95% confidence intervals (CI) for associations between PPI and/or H2RA use and cancer incidence after year 3. RESULTS There were 7956 PPI ever users (with or without H2RA use) and 9398 H2RA only users. PPI or H2RA use was not associated with risk of breast cancer (n=9186 cases), compared to women who did not use either agent (HR 1.01, 95% CI 0.93-1.10 and HR 0.95 95% CI 0.87-1.03, respectively). The incidence of colorectal cancer (n=2280) was significantly lower in PPI users (HR 0.75, 95% CI 0.61-0.92), but not in H2RA users (HR 1.13, 95% CI 0.97-1.31). This association was strengthened with increasing duration (p=0.006) and potency (p=0.005) of PPI use and held regardless of BMI or NSAID use. PPI or H2RA use was not associated with endometrial cancer (n=1231) (HR 0.81, 95% CI 0.61-1.07 and HR 1.13, 95% CI 0.91-1.40, respectively), but showed a trend in decreased risk with increasing PPI potency (P=0.048). CONCLUSIONS Among postmenopausal women, PPI use, but not H2RA use, demonstrated an inverse, dose-responsive association with colorectal cancer incidence. This was consistent with preclinical data that FAS inhibition prevents colon cancer progression and supports further investigation of this commonly used medication as a cancer preventive agent. PPI use was not associated with incidence of breast or endometrial cancer.
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Song JY, Chang CJ, Andrews C, Diez-Domingo J, Oh MD, Dagan R, Musey L, Buchwald UK, Hartzel J, Pedley A, Li J, Sterling T, Tamms G, Chiarappa JA, Lutkiewicz J, Tu Y. 930 SAFETY, TOLERABILITY AND IMMUNOGENICITY OF 15-VALENT PNEUMOCOCCAL CONJUGATE VACCINE + PPV23 12 MONTHS LATER IN HEALTHY ADULTS ≥ 50. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.003] [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: 11/15/2022] Open
Abstract
Abstract
Background
Older adults are at increased risk of pneumococcal disease (PD). V114, an investigational 15-valent Pneumococcal Conjugate Vaccine (PCV), contains all serotypes in 13-valent PCV (PCV13) plus serotypes 22F and 33F. This phase 3 trial evaluated the safety, tolerability and immunogenicity of V114 or PCV13 followed 12 months later by PPSV23 in healthy adults aged ≥50 years.
Materials/Method
652 eligible adults were randomised 1:1 to receive V114 or PCV13 followed by PPSV23 12 months later. Solicited and non-solicited adverse events (AEs) were collected after each vaccination. Serotype-specific opsonophagocytic activity (OPA) and immunoglobulin G (IgG) antibodies were measured at Day 1, Day 30, Month 12 and Month 13.
Results
The most common solicited AEs following PCV were injection-site pain, fatigue and myalgia; higher proportions of participants with solicited AEs were observed in the V114 group; however, the differences were not clinically significant, as most AEs were mild and of short duration. The most common solicited AEs following PPSV23 were injection-site pain, injection-site swelling, fatigue and myalgia; these events were comparable across both intervention groups. The proportion of participants with serious AEs were low in both groups and none reported to be vaccine related. No deaths occurred during the study. Serotype-specific OPA geometric mean titres (GMTs) and IgG geometric mean concentrations (GMCs) were comparable between the groups for all 15 serotypes 30 days post-vaccination with PPSV23. OPA GMTs and IgG GMCs were comparable between PCV groups for the 13 shared serotypes and higher in V114 than PCV13 for serotypes 22F and 33F 30 days and 12 months post-vaccination with PCV. V114 elicited an immune response that persisted for at least 12 months.
Conclusion
Sequential administration of V114 and PPSV23 is well tolerated, immunogenic and generally comparable to PCV13 followed by PPSV23 in healthy adults ≥50 years of age.
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Affiliation(s)
- J-Y Song
- Korea University College of Medicine , Seoul, South Korea
| | - C-J Chang
- National Cheng Kung University , Tainan, Taiwan
| | - C Andrews
- Diagnostics Research Group , San Antonio, Texas, USA
| | | | - M-d Oh
- Seoul National University College of Medicine , Seoul, South Korea
| | - R Dagan
- Ben-Gurion University , Beer-Sheva, Israel
| | - L Musey
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | | | - J Hartzel
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | - A Pedley
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | - J Li
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | - T Sterling
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | - G Tamms
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | | | | | - Y Tu
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
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Flenady V, Gardener G, Ellwood D, Coory M, Weller M, Warrilow KA, Middleton PF, Wojcieszek AM, Groom KM, Boyle FM, East C, Lawford H, Callander E, Said JM, Walker SP, Mahomed K, Andrews C, Gordon A, Norman JE, Crowther C. My Baby's Movements: a stepped-wedge cluster-randomised controlled trial of a fetal movement awareness intervention to reduce stillbirths. BJOG 2021; 129:29-41. [PMID: 34555257 DOI: 10.1111/1471-0528.16944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The My Baby's Movements (MBM) trial aimed to evaluate the impact on stillbirth rates of a multifaceted awareness package (the MBM intervention). DESIGN Stepped-wedge cluster-randomised controlled trial. SETTING Twenty-seven maternity hospitals in Australia and New Zealand. POPULATION Women with a singleton pregnancy without major fetal anomaly at ≥28 weeks of gestation from August 2016 to May 2019. METHODS The MBM intervention was implemented at randomly assigned time points, with the sequential introduction of eight groups of between three and five hospitals at 4-monthly intervals. Using generalised linear mixed models, the stillbirth rate was compared in the control and the intervention periods, adjusting for calendar time, study population characteristics and hospital effects. MAIN OUTCOME MEASURES Stillbirth at ≥28 weeks of gestation. RESULTS There were 304 850 births with 290 105 births meeting the inclusion criteria: 150 053 in the control and 140 052 in the intervention periods. The stillbirth rate was lower (although not statistically significantly so) during the intervention compared with the control period (2.2/1000 versus 2.4/1000 births; aOR 1.18, 95% CI 0.93-1.50; P = 0.18). The decrease in stillbirth rate was greater across calendar time: 2.7/1000 in the first versus 2.0/1000 in the last 18 months. No increase in secondary outcomes, including obstetric intervention or adverse neonatal outcome, was evident. CONCLUSIONS The MBM intervention did not reduce stillbirths beyond the downward trend over time. As a result of low uptake, the role of the intervention remains unclear, although the downward trend across time suggests some benefit in lowering the stillbirth rate. In this study setting, an awareness of the importance of fetal movements may have reached pregnant women and clinicians prior to the implementation of the intervention. TWEETABLE ABSTRACT The My Baby's Movements intervention to raise awareness of decreased fetal movement did not significantly reduce stillbirth rates.
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Affiliation(s)
- V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - G Gardener
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Department of Maternal Fetal Medicine, Mater Misericordiae Limited, Brisbane, Queensland, Australia
| | - D Ellwood
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Gold Coast University Hospital, Southport, Queensland, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - M Coory
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - M Weller
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - K A Warrilow
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - P F Middleton
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - A M Wojcieszek
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - K M Groom
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - F M Boyle
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | - C East
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Hls Lawford
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - E Callander
- Monash University, Melbourne, Victoria, Australia
| | - J M Said
- University of Melbourne, Melbourne, Victoria, Australia.,Sunshine Hospital, Western Health, St Albans, Victoria, Australia
| | - S P Walker
- University of Melbourne, Melbourne, Victoria, Australia
| | - K Mahomed
- Ipswich Hospital, Ipswich, Queensland, Australia
| | - C Andrews
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - A Gordon
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - J E Norman
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - C Crowther
- Liggins Institute, University of Auckland, Auckland, New Zealand
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Wells AU, Flaherty KR, Brown KK, Inoue Y, Devaraj A, Richeldi L, Moua T, Crestani B, Wuyts WA, Stowasser S, Quaresma M, Goeldner RG, Schlenker-Herceg R, Kolb M, Aburto M, Acosta O, Andrews C, Antin-Ozerkis D, Arce G, Arias M, Avdeev S, Barczyk A, Bascom R, Bazdyrev E, Beirne P, Belloli E, Bergna M, Bergot E, Bhatt N, Blaas S, Bondue B, Bonella F, Britt E, Buch K, Burk J, Cai H, Cantin A, Castillo Villegas D, Cazaux A, Cerri S, Chaaban S, Chaudhuri N, Cottin V, Crestani B, Criner G, Dahlqvist C, Danoff S, Dematte D'Amico J, Dilling D, Elias P, Ettinger N, Falk J, Fernández Pérez E, Gamez-Dubuis A, Giessel G, Gifford A, Glassberg M, Glazer C, Golden J, Gómez Carrera L, Guiot J, Hallowell R, Hayashi H, Hetzel J, Hirani N, Homik L, Hope-Gill B, Hotchkin D, Ichikado K, Ilkovich M, Inoue Y, Izumi S, Jassem E, Jones L, Jouneau S, Kaner R, Kang J, Kawamura T, Kessler R, Kim Y, Kishi K, Kitamura H, Kolb M, Kondoh Y, Kono C, Koschel D, Kreuter M, Kulkarni T, Kus J, Lebargy F, León Jiménez A, Luo Q, Mageto Y, Maher T, Makino S, Marchand-Adam S, Marquette C, Martinez R, Martínez M, Maturana Rozas R, Miyazaki Y, Moiseev S, Molina-Molina M, Morrison L, Morrow L, Moua T, Nambiar A, Nishioka Y, Nunes H, Okamoto M, Oldham J, Otaola M, Padilla M, Park J, Patel N, Pesci A, Piotrowski W, Pitts L, Poonyagariyagorn H, Prasse A, Quadrelli S, Randerath W, Refini R, Reynaud-Gaubert M, Riviere F, Rodríguez Portal J, Rosas I, Rossman M, Safdar Z, Saito T, Sakamoto N, Salinas Fénero M, Sauleda J, Schmidt S, Scholand M, Schwartz M, Shapera S, Shlobin O, Sigal B, Silva Orellana A, Skowasch D, Song J, Stieglitz S, Stone H, Strek M, Suda T, Sugiura H, Takahashi H, Takaya H, Takeuchi T, Thavarajah K, Tolle L, Tomassetti S, Tomii K, Valenzuela C, Vancheri C, Varone F, Veeraraghavan S, Villar A, Weigt S, Wemeau L, Wuyts W, Xu Z, Yakusevich V, Yamada Y, Yamauchi H, Ziora D. Nintedanib in patients with progressive fibrosing interstitial lung diseases-subgroup analyses by interstitial lung disease diagnosis in the INBUILD trial: a randomised, double-blind, placebo-controlled, parallel-group trial. Lancet Respir Med 2020; 8:453-460. [PMID: 32145830 DOI: 10.1016/s2213-2600(20)30036-9] [Citation(s) in RCA: 263] [Impact Index Per Article: 65.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/06/2020] [Accepted: 01/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The INBUILD trial investigated the efficacy and safety of nintedanib versus placebo in patients with progressive fibrosing interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF). We aimed to establish the effects of nintedanib in subgroups based on ILD diagnosis. METHODS The INBUILD trial was a randomised, double-blind, placebo-controlled, parallel group trial done at 153 sites in 15 countries. Participants had an investigator-diagnosed fibrosing ILD other than IPF, with chest imaging features of fibrosis of more than 10% extent on high resolution CT (HRCT), forced vital capacity (FVC) of 45% or more predicted, and diffusing capacity of the lung for carbon monoxide (DLco) of at least 30% and less than 80% predicted. Participants fulfilled protocol-defined criteria for ILD progression in the 24 months before screening, despite management considered appropriate in clinical practice for the individual ILD. Participants were randomly assigned 1:1 by means of a pseudo-random number generator to receive nintedanib 150 mg twice daily or placebo for at least 52 weeks. Participants, investigators, and other personnel involved in the trial and analysis were masked to treatment assignment until after database lock. In this subgroup analysis, we assessed the rate of decline in FVC (mL/year) over 52 weeks in patients who received at least one dose of nintedanib or placebo in five prespecified subgroups based on the ILD diagnoses documented by the investigators: hypersensitivity pneumonitis, autoimmune ILDs, idiopathic non-specific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, and other ILDs. The trial has been completed and is registered with ClinicalTrials.gov, number NCT02999178. FINDINGS Participants were recruited between Feb 23, 2017, and April 27, 2018. Of 663 participants who received at least one dose of nintedanib or placebo, 173 (26%) had chronic hypersensitivity pneumonitis, 170 (26%) an autoimmune ILD, 125 (19%) idiopathic non-specific interstitial pneumonia, 114 (17%) unclassifiable idiopathic interstitial pneumonia, and 81 (12%) other ILDs. The effect of nintedanib versus placebo on reducing the rate of FVC decline (mL/year) was consistent across the five subgroups by ILD diagnosis in the overall population (hypersensitivity pneumonitis 73·1 [95% CI -8·6 to 154·8]; autoimmune ILDs 104·0 [21·1 to 186·9]; idiopathic non-specific interstitial pneumonia 141·6 [46·0 to 237·2]; unclassifiable idiopathic interstitial pneumonia 68·3 [-31·4 to 168·1]; and other ILDs 197·1 [77·6 to 316·7]; p=0·41 for treatment by subgroup by time interaction). Adverse events reported in the subgroups were consistent with those reported in the overall population. INTERPRETATION The INBUILD trial was not designed or powered to provide evidence for a benefit of nintedanib in specific diagnostic subgroups. However, its results suggest that nintedanib reduces the rate of ILD progression, as measured by FVC decline, in patients who have a chronic fibrosing ILD and progressive phenotype, irrespective of the underlying ILD diagnosis. FUNDING Boehringer Ingelheim.
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Affiliation(s)
- Athol U Wells
- National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Kevin R Flaherty
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Kevin K Brown
- Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Yoshikazu Inoue
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Osaka, Japan
| | - Anand Devaraj
- Department of Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK; National Heart and Lung Institute, Imperial College, London, UK
| | - Luca Richeldi
- Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Teng Moua
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, Rochester, MN, USA
| | - Bruno Crestani
- Université de Paris, Inserm U1152, APHP, Hôpital Bichat, Centre de reference constitutif pour les maladies pulmonaires rares, Paris, France
| | - Wim A Wuyts
- Unit for Interstitial Lung Diseases, Department of Pulmonary Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Manuel Quaresma
- Boehringer Ingelheim International, Ingelheim am Rhein, Germany
| | | | | | - Martin Kolb
- McMaster University and St Joseph's Healthcare, Hamilton, Ontario, Canada
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Bellon J, Chen Y, Rees R, Taghian A, Wong J, Punglia R, Shiloh R, Krishnan M, Andrews C, Isakoff S, Winer E, Tolaney S. A Prospective Phase I trial of Concurrent Cisplatin (CIS) and Radiation Therapy (RT) in Women with Stage II and III Triple-negative Breast Cancer (TNBC). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Goel S, Spring L, Rees R, Andrews C, Tahara RK, Mayer EL, Bardia A, Winer EP, Tolaney SM. Abstract P6-18-10: A phase 1b/2 study of ribociclib plus trastuzumab for the treatment of advanced, treatment-refractory HER2-positive breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-10] [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
Introduction:
Despite the success of anti-HER2 therapy, acquired resistance usually develops in the metastatic setting. CDK4/6 pathway activity has been identified as a mediator of this resistance, and in preclinical studies the combination of CDK4/6 and HER2 blockade can be more effective than either therapy alone. We conducted a single-arm phase 1b/2 study of the CDK4/6 inhibitor ribociclib given with trastuzumab or T-DM1 to subjects with advanced, treatment-refractory HER2-positive breast cancer. The results of the trastuzumab cohort are presented below. The primary objective was to determine the clinical benefit rate (CBR) at 24 weeks, and secondary endpoints included objective response rate (ORR), progression-free survival (PFS), and adverse events.
Methods: Individuals with locally advanced or metastatic, measurable HER2-positive breast cancer were eligible. All subjects must have previously received trastuzumab, pertuzumab, and T-DM1 as (neo)adjuvant or metastatic therapy. There was no limit on the number of prior lines of treatment. Patients with previous CDK4/6 inhibitor exposure, QTcF > 450msec on EKG, or without stable brain metastases were excluded. An initial safety run-in phase (with dose-limiting toxicity (DLT) monitoring) included six subjects who received trastuzumab (8mg/kg loading then 6mg/kg IV three-weekly) and ribociclib 400mg PO daily on a continuous schedule (cycle length 21 days). The study had a two-stage design. The first stage required 20 patients, at least 6 of whom must have demonstrated clinical benefit (CR+PR+ SD>24 weeks) in order to recruit 15 more patients to the second stage. All patients with accessible disease underwent metastatic tumor biopsies at baseline and C2D1.
Results: 13 patients were enrolled (6 in the safety run-in and 7 in the expansion cohort). One patient was found to have HER2-negative disease and did not receive treatment. Patient characteristics are shown in Table 1 No DLTs were observed during the safety run-in phase, and ribociclib was thus used at 400mg po daily for the expansion cohort. Grade 3/4 toxicities were observed in 5 patients (41.7%) and included neutropenia (n=2), and fatigue, pain, and muscle weakness (all n=1). No patient demonstrated QTc prolongation >480 msec, or grade 3/4 LFTs. 1/12 patients ((8.3%); 95% CI 0.2%-38.5%) achieved stable disease>24 weeks; no objective responses were observed, and median PFS was 41.5 days. The trastuzumab portion of study was closed early due to limited clinical activity observed (the T-DM1 with ribociclib cohort remains open).
Table 1Age (median, range)50.5 (42 - 71)Number of prior lines of systemic therapy for metastatic disease (median, range)5.5 (0-14)Number with Hormone receptor-positive disease (%)8 (67 %)Number of metastatic sites (median, range)2.5 (2 - 5)
Conclusions: The combination of trastuzumab and ribociclib (400mg daily continuous schedule) is safe, with no new safety signals observed. The limited activity seen in this heavily pretreated population suggests that future efforts to incorporate CDK4/6 inhibition should be limited to a less extensively treat population.
Citation Format: Goel S, Spring L, Rees R, Andrews C, Tahara RK, Mayer EL, Bardia A, Winer EP, Tolaney SM. A phase 1b/2 study of ribociclib plus trastuzumab for the treatment of advanced, treatment-refractory HER2-positive breast cancer [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 P6-18-10.
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Affiliation(s)
- S Goel
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - L Spring
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - R Rees
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - C Andrews
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - RK Tahara
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - EL Mayer
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - A Bardia
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - EP Winer
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - SM Tolaney
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
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Andrews C, Mohar D, Jacobs R, Tantry S. OLOPATADINE/MOMETASONE COMBINATION NASAL SPRAY EFFECTIVELY IMPROVES SEASONAL ALLERGIC RHINITIS NASAL SYMPTOMS AND QUALITY OF LIFE. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Guerrero E, Legnick-Hall R, Andrews C. Underlying challenges of public health insurance enrollment and use among Latino adults: insights from the largest safety-net institution in Los Angeles. Public Health 2017; 152:47-50. [DOI: 10.1016/j.puhe.2017.06.006] [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] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 03/29/2017] [Accepted: 06/02/2017] [Indexed: 11/16/2022]
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Andrews C, Mohar D, Agarwal P, Salhi Y, Tantry S. P433 Efficacy and safety of once-daily and twice-daily olopatadine/mometasone nasal spray treatment in seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.09.029] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Netto K, Andrews C, Graus K, Manolas K, Neill M, Tejani S, Appleby B, Rosalie S. The effect of a return-to-play circuit on lower limb muscle activation. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.01.100] [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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Orchard GE, Shams M, Nwokie T, Fernando P, Bulut C, Quaye CJ, Gabriel J, Ramji Z, Georgaki A, Watt M, Cole Z, Stewart K, McTaggart V, Padayachy S, Long AM, Ogden A, Andrews C, Birchall A, Shams F, Neesam H, Haine N. A multicentre study of the precision and accuracy of the TruSlice and TruSlice Digital histological dissection devices. Br J Biomed Sci 2016; 73:163-167. [PMID: 27922431 DOI: 10.1080/09674845.2016.1233791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Five key factors enabling a good surgical grossing technique include a flat uniformly perpendicular specimen cutting face, appropriate immobilisation of the tissue specimen during grossing, good visualisation of the cutting tissue face, sharp cutting knives and the grossing knife action. TruSlice and TruSlice Digital are new innovative tools based on a guillotine configuration. The TruSlice has plastic inserts whilst the TruSlice Digital has an electronic micrometre attached: both features enable these dissection factors to be controlled. The devices were assessed in five hospitals in the UK. MATERIAL AND METHODS A total of 267 fixed tissue samples from 23 tissue types were analysed, principally the breast (n = 32) skin (30), rectum (28), colon (27) and cervix (17). Precision and accuracy were evaluated by measuring the defined thickness, and the consistency of achieving the defined thickness of tissue samples taken respectively. Both parameters were expressed as a total percentage of compliance for the cohort of samples accessed. RESULTS Overall, the mean (standard deviation) score for precision was 81 (11) % whilst the accuracy score was 82 (11) % (both p < 0.05, chi-squared test), although this varied with type of tissue. Accuracy and precision were strongly correlated (rp = 0.83, p < 0.001). CONCLUSION The TruSlice Digital devices offer an assured precision and accuracy performance which is reproducible across an assortment of tissue types. The use of a micrometre to set tissue slice thickness is innovative and should comply with laboratory accreditation requirements, alleviating concerns of how to tackle issues such as the 'measurement of uncertainty' at the grossing bench.
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Affiliation(s)
- G E Orchard
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - M Shams
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - T Nwokie
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - P Fernando
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - C Bulut
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - C J Quaye
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - J Gabriel
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - Z Ramji
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - A Georgaki
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - M Watt
- b Crosshouse Hospital , Kilmarnock , UK
| | - Z Cole
- b Crosshouse Hospital , Kilmarnock , UK
| | - K Stewart
- b Crosshouse Hospital , Kilmarnock , UK
| | | | - S Padayachy
- c Southampton General Hospital , Southampton , UK
| | - A M Long
- c Southampton General Hospital , Southampton , UK
| | - A Ogden
- c Southampton General Hospital , Southampton , UK
| | - C Andrews
- d Heartlands Hospital , Birmingham , UK
| | - A Birchall
- e Wythenshawe Hospital , Manchester , UK
| | - F Shams
- f Barts and the London School of Medicine, Queen Mary University of London , London , UK
| | | | - N Haine
- g CellPath Ltd. , Powys , UK
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Wadley P, Howells B, Železný J, Andrews C, Hills V, Campion RP, Novák V, Olejník K, Maccherozzi F, Dhesi SS, Martin SY, Wagner T, Wunderlich J, Freimuth F, Mokrousov Y, Kuneš J, Chauhan JS, Grzybowski MJ, Rushforth AW, Edmonds KW, Gallagher BL, Jungwirth T. Electrical switching of an antiferromagnet. Science 2016; 351:587-90. [PMID: 26841431 DOI: 10.1126/science.aab1031] [Citation(s) in RCA: 284] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 01/04/2016] [Indexed: 11/02/2022]
Abstract
Antiferromagnets are hard to control by external magnetic fields because of the alternating directions of magnetic moments on individual atoms and the resulting zero net magnetization. However, relativistic quantum mechanics allows for generating current-induced internal fields whose sign alternates with the periodicity of the antiferromagnetic lattice. Using these fields, which couple strongly to the antiferromagnetic order, we demonstrate room-temperature electrical switching between stable configurations in antiferromagnetic CuMnAs thin-film devices by applied current with magnitudes of order 10(6) ampere per square centimeter. Electrical writing is combined in our solid-state memory with electrical readout and the stored magnetic state is insensitive to and produces no external magnetic field perturbations, which illustrates the unique merits of antiferromagnets for spintronics.
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Affiliation(s)
- P Wadley
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK.
| | - B Howells
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - J Železný
- Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnická 10, 162 00 Praha 6, Czech Republic. Faculty of Mathematics and Physics, Charles University, Ke Karlovu 3, 121 16 Prague 2, Czech Republic
| | - C Andrews
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - V Hills
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - R P Campion
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - V Novák
- Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnická 10, 162 00 Praha 6, Czech Republic
| | - K Olejník
- Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnická 10, 162 00 Praha 6, Czech Republic
| | - F Maccherozzi
- Diamond Light Source, Chilton, Didcot, Oxfordshire, OX11 0DE, UK
| | - S S Dhesi
- Diamond Light Source, Chilton, Didcot, Oxfordshire, OX11 0DE, UK
| | - S Y Martin
- Hitachi Cambridge Laboratory, J. J. Thomson Avenue, Cambridge CB3 0HE, UK
| | - T Wagner
- Hitachi Cambridge Laboratory, J. J. Thomson Avenue, Cambridge CB3 0HE, UK. Department of Materials Science and Metallurgy, University of Cambridge, Cambridge CB3 0HE, UK
| | - J Wunderlich
- Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnická 10, 162 00 Praha 6, Czech Republic. Hitachi Cambridge Laboratory, J. J. Thomson Avenue, Cambridge CB3 0HE, UK
| | - F Freimuth
- Peter Grünberg Institut and Institute for Advanced Simulation, Forschungszentrum Jülich and JARA, 52425 Jülich, Germany
| | - Y Mokrousov
- Peter Grünberg Institut and Institute for Advanced Simulation, Forschungszentrum Jülich and JARA, 52425 Jülich, Germany
| | - J Kuneš
- Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, 182 21 Praha 8, Czech Republic
| | - J S Chauhan
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - M J Grzybowski
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK. Institute of Physics, Polish Academy of Sciences, al. Lotnikow 32/46, PL-02-668 Warsaw, Poland
| | - A W Rushforth
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - K W Edmonds
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - B L Gallagher
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - T Jungwirth
- Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnická 10, 162 00 Praha 6, Czech Republic. School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
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Abstract
Feline enteropathy-associated T-cell lymphoma (EATL) type II is characterized by infiltration of the small intestinal mucosa with small T-cells with variable epitheliotropism and is often difficult to differentiate from inflammation. Polymerase chain reaction (PCR) to assess antigen receptor rearrangements (PARR) amplifies the T- (T-cell receptor gamma, TCRG) or B-cell (immunoglobulin heavy chain, IGH) antigen receptor genes and is used to differentiate EATL from inflammation. However, PARR does not determine lymphocyte phenotype, and clonal rearrangement of either or both the TCRG or IGH genes may be detected in neoplastic T-cells. The purpose of this study was to determine the incidence of cross lineage rearrangement in feline EATL type II. Using a diagnostic algorithm combining histology, immunohistochemistry, and PARR testing, 8 of 92 cases diagnosed as EATL type II at Michigan State University between January 2013 and June 2014 showed cross lineage rearrangement (8.7%). PARR for the IGH gene facilitates the diagnosis of cases histologically highly suggestive of EATL type II in which polyclonal rearrangement of the TCRG gene is detected.
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Affiliation(s)
- C. Andrews
- Diagnostic Center for Population and Animal Health, Michigan State University, Lansing, MI, USA
- Cancer and Inflammation Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
| | - M. Operacz
- Diagnostic Center for Population and Animal Health, Michigan State University, Lansing, MI, USA
| | - R. Maes
- Diagnostic Center for Population and Animal Health, Michigan State University, Lansing, MI, USA
| | - M. Kiupel
- Diagnostic Center for Population and Animal Health, Michigan State University, Lansing, MI, USA
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Deloose E, Bisschops R, Holvoet L, Arts J, De Wulf D, Caenepeel P, Lannoo M, Vanuytsel T, Andrews C, Tack J. A pilot study of the effects of the somatostatin analog pasireotide in postoperative dumping syndrome. Neurogastroenterol Motil 2014; 26:803-9. [PMID: 24750284 DOI: 10.1111/nmo.12333] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [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: 10/28/2013] [Accepted: 02/24/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Dumping syndrome is characterized by distinct pathophysiological features such as postprandial increase in hematocrit (HT) and pulse rate (PR) and delayed hypoglycemia (HG). Treatment is based on dietary measures and somatostatin analogs (SA), but current SAs have incomplete efficacy, possibly through limited affinity for various somatostatin receptor subtypes. We evaluated the effect of pasireotide, a novel SA with high affinity for 4/5 human somatostatin receptors, on pathophysiological events and symptoms in dumping. METHODS Randomized double-blind placebo-controlled cross-over study of nine patients (six women, 47 ± 4 years) with postoperative dumping. Baseline measurements included oral glucose tolerance testing (OGTT), abdominal ultrasound, and dumping symptom severity score (DSSS). Patients were treated for 2 weeks with placebo or pasireotide 300 μg s.c. t.i.d. with a 1-week wash-out in a randomized fashion. On day 13 and 14 of each treatment OGTT, DSSS, and solid and liquid gastric emptying (GE) were obtained. KEY RESULTS Baseline OGTT was pathological in all patients based on PR (n = 5), HT (n = 1) or HG (n = 7). Compared to placebo, pasireotide suppressed the increase in PR (17.1 ± 2.8 vs 8.2 ± 3.5 bpm; p < 0.05) and late HG (nadir glycemia 55.6 ± 4.3 vs 83.3 ± 9.5 mg/dL; p = 0.007), increased peak glycemia (294.1 ± 33.3 vs 221.0 ± 23.1 mg/dL; p = 0.001) and delayed GE of solids (t1/2 83 ± 23 vs 43 ± 9 min; p = 0.05) and liquids (t1/2 70 ± 10 vs 40 ± 4 min, p = 0.05). The differences in DSSS did not reach statistical significance. Two patients dropped out because of adverse gastrointestinal events under pasireotide. CONCLUSIONS & INFERENCES Pasireotide affects pathophysiological features of both early and late dumping syndrome.
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Affiliation(s)
- E Deloose
- TARGID, University of Leuven, Leuven, Belgium
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Gattorno M, Obici L, Meini A, Tormey V, Abrams K, Davis N, Andrews C, Lachmann H. THU0396 Efficacy and safety of canakinumab in patients with TNF receptor associated periodic syndrome (TRAPS). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2012-eular.2361] [Citation(s) in RCA: 4] [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: 11/03/2022]
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Masson S, Lavigne S, Robitaille V, Andrews C. The XperCount, a fast and cost-effective method for the enumeration of organisms in environmental media. J Xenobiot 2013. [DOI: 10.4081/xeno.2013.s1.e10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
Not available
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Lachmann HJ, Obici L, Meini A, Tormey V, Abrams K, Davis N, Andrews C, Bhansali SG, Gattorno M. OR10-006 - Canakinumab in patients with TRAPS. Pediatr Rheumatol Online J 2013. [PMCID: PMC3953131 DOI: 10.1186/1546-0096-11-s1-a189] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Chawla S, Milano M, Nichols L, Dimitroff L, O'Loughlin R, Walker J, Andrews C, Nagel M, Maracle D, Mohile S. Geriatric Assessment in Radiation Oncology Clinic: A Pilot Study. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1516] [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: 11/15/2022]
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Shaaban S, Duzcan F, Yildirim C, Chan WM, Andrews C, Akarsu NA, Engle EC. Expanding the phenotypic spectrum of ECEL1-related congenital contracture syndromes. Clin Genet 2013; 85:562-7. [PMID: 23808592 DOI: 10.1111/cge.12224] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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: 05/10/2013] [Revised: 06/25/2013] [Accepted: 06/21/2013] [Indexed: 02/06/2023]
Abstract
Using a combination of homozygosity mapping and whole-exome sequencing (WES), we identified a novel missense c.1819G>A mutation (G607S) in the endothelin-converting enzyme-like 1 (ECEL1) gene in a consanguineous pedigree of Turkish origin presenting with a syndrome of camptodactyly, scoliosis, limited knee flexion, significant refractive errors and ophthalmoplegia. ECEL1 mutations were recently reported to cause recessive forms of distal arthrogryposis. This report expands on the molecular basis and the phenotypic spectrum of ECEL1-associated congenital contracture syndromes.
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Affiliation(s)
- S Shaaban
- Department of Neurology; F.B. Kirby Neurobiology Center; Program in Genomics; Manton Center for Orphan Disease Research, Boston Children's Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Dubai Harvard Foundation for Medical Research, Boston, MA, USA
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Hanif W, Malik W, Hassanein M, Kamal A, Geransar P, Andrews C, Azam M, Barnett AH. Treatment adherence with vildagliptin compared to sulphonylurea as add-on to metformin in Muslim patients with type 2 diabetes mellitus fasting during Ramadan. Curr Med Res Opin 2013; 29:807-11. [PMID: 23659561 DOI: 10.1185/03007995.2013.803054] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess treatment adherence to dipeptidyl peptidase-4 inhibitor vildagliptin compared with sulphonylureas (SU) in Muslim patients with type 2 diabetes mellitus who were fasting during Ramadan in the UK. RESEARCH DESIGN AND METHODS This prospective, observational cohort study was conducted in four UK centres. Patients already taking vildagliptin (50 mg twice a day) or an SU as add-on therapy to metformin were followed up for ≤16 weeks. They were asked to record all missed doses of anti-diabetes medications. RESULTS Of the 72 patients enrolled (vildagliptin, n = 30; SU, n = 41; not allocated to treatment, n = 1), 59 (81.9%) completed the study (vildagliptin, n = 23; SU, n = 36), including one patient in the SU arm who completed but failed to provide information on missed doses; all patients in the SU arm were taking gliclazide. In the vildagliptin arm one patient (4.3%) missed a total of four doses while in the SU arm 10 patients (27.8%) missed a total of 266 doses (mean [SD] number of doses missed per patient: 26.6 [16.5]). The mean (SD) proportions of doses missed during fasting were 0.2% (0.9) and 10.4% (21.7) in the vildagliptin and SU arms, respectively, with a significant mean between-group difference of -10.2% (95% CI: -19.3%, -1.1%; p = 0.0292). There were no patients in the vildagliptin arm who missed more than 20% of OAD doses compared with 19.4% in the SU arm (p = 0.0358). Of the patients receiving an SU, 15 (42%) collectively reported 34 hypoglycaemic events (HEs) and one grade 2 HE; of these, fewer were non-adherent (n = 6, 40%) than adherent (n = 9, 60%). No patients reported HEs in the vildagliptin arm. CONCLUSION During Ramadan fasting, treatment with vildagliptin resulted in better treatment adherence compared with SU in Muslim patients with type 2 diabetes mellitus. Study limitations are the sample size and the lack of diet and exercise data.
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Affiliation(s)
- W Hanif
- University of Birmingham, Birmingham, UK
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Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Erratum: Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013. [DOI: 10.1038/eye.2013.84] [Citation(s) in RCA: 4] [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: 11/09/2022] Open
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Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013. [PMID: 23449508 DOI: 10.1038/eye.2014.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIMS To evaluate the efficacy and safety of intravitreal ranibizumab in patients with choroidal neovascularisation secondary to pathological myopia (myopic CNV). Data are from a pre-planned, 6-month interim analysis. METHODS Phase II, open-label, single arm, multicentre, 12-month study, recruiting patients (aged ≥18 years) with active primary or recurrent subfoveal or juxtafoveal myopic CNV, with a best-corrected visual acuity (BCVA) score of 24-78 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the study eye and a diagnosis of high myopia of at least -6 dioptres. Patients received 0.5 mg ranibizumab administered intravitreally to the study eye, followed by monthly injections given as needed (based on a predefined algorithm) for up to 11 months. RESULTS At 6 months, mean BCVA improved from baseline by 12.2 letters, as did central macular thickness (in this interim analysis defined as a measure of either central subfield macular thickness or centre point macular thickness) from baseline by 108 μm in the 48 study eyes of 48 patients. Fewer patients had centre-involving intraretinal oedema (13.0% vs 91.5%), intraretinal cysts (10.9% vs 57.4%), or subretinal fluid (13.0% vs 66.0%) at 6 months than at baseline. Patients received a mean of 1.9 retreatments, were satisfied with ranibizumab treatment, and well being was maintained. No new safety signals were identified. CONCLUSIONS Results from the planned interim analysis support the role of ranibizumab in the treatment of myopic CNV, with excellent efficacy achieved with a low number of injections and few serious adverse events.
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Affiliation(s)
- A Tufail
- Moorfields Eye Hospital, London, UK.
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Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013; 27:709-15. [PMID: 23449508 DOI: 10.1038/eye.2013.8] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AIMS To evaluate the efficacy and safety of intravitreal ranibizumab in patients with choroidal neovascularisation secondary to pathological myopia (myopic CNV). Data are from a pre-planned, 6-month interim analysis. METHODS Phase II, open-label, single arm, multicentre, 12-month study, recruiting patients (aged ≥18 years) with active primary or recurrent subfoveal or juxtafoveal myopic CNV, with a best-corrected visual acuity (BCVA) score of 24-78 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the study eye and a diagnosis of high myopia of at least -6 dioptres. Patients received 0.5 mg ranibizumab administered intravitreally to the study eye, followed by monthly injections given as needed (based on a predefined algorithm) for up to 11 months. RESULTS At 6 months, mean BCVA improved from baseline by 12.2 letters, as did central macular thickness (in this interim analysis defined as a measure of either central subfield macular thickness or centre point macular thickness) from baseline by 108 μm in the 48 study eyes of 48 patients. Fewer patients had centre-involving intraretinal oedema (13.0% vs 91.5%), intraretinal cysts (10.9% vs 57.4%), or subretinal fluid (13.0% vs 66.0%) at 6 months than at baseline. Patients received a mean of 1.9 retreatments, were satisfied with ranibizumab treatment, and well being was maintained. No new safety signals were identified. CONCLUSIONS Results from the planned interim analysis support the role of ranibizumab in the treatment of myopic CNV, with excellent efficacy achieved with a low number of injections and few serious adverse events.
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Affiliation(s)
- A Tufail
- Moorfields Eye Hospital, London, UK.
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Monteith KM, Andrews C, Smiseth PT. Post-hatching parental care masks the effects of egg size on offspring fitness: a removal experiment on burying beetles. J Evol Biol 2012; 25:1815-22. [DOI: 10.1111/j.1420-9101.2012.02567.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 04/30/2012] [Accepted: 05/28/2012] [Indexed: 12/01/2022]
Affiliation(s)
- K. M. Monteith
- Institute of Evolutionary Biology, School of Biological Sciences; University of Edinburgh; Edinburgh; UK
| | - C. Andrews
- Institute of Evolutionary Biology, School of Biological Sciences; University of Edinburgh; Edinburgh; UK
| | - P. T. Smiseth
- Institute of Evolutionary Biology, School of Biological Sciences; University of Edinburgh; Edinburgh; UK
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Fakih MG, Andrews C, McMahon J, Muindi JR. A prospective clinical trial of cholecalciferol 2000 IU/day in colorectal cancer patients: evidence of a chemotherapy-response interaction. Anticancer Res 2012; 32:1333-1338. [PMID: 22493367] [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
BACKGROUND We have previously reported a negative correlation between the effect of chemotherapy and 25-hydroxy vitamin D(3) (25-D(3)) levels in patients with colorectal cancer. Based on this finding, we hypothesized that the response to vitamin D(3) supplementation may be attenuated in patients with colorectal cancer. AIM To determine 25-D(3) response to 2000 IU/day vitamin D(3) supplementation in patients with colorectal cancer. MATERIALS AND METHODS Fifty evaluable colorectal cancer patients were treated with vitamin D(3) at 2000 IU/day for 6 months. Serum 25-D(3) levels were measured at baseline, 3, and 6 months of supplementation. RESULTS The mean 25-D(3) level was 17.5 ng/ml at baseline, 31.6 ng/ml at 3 months, and 33.8 ng/ml at 6 months. The most important factor in determining 25-D(3) response was chemotherapy status. A rise in 25-D(3) of ≥10 ng/ml at the 3-month interval was observed in 92% of chemotherapy-free patients vs. 39% of chemotherapy patients. Similar differences in response were noted at the 6-month interval. CONCLUSION Depressed 25-D(3) levels are common in patients with colorectal cancer. Active chemotherapy is associated with an attenuated response to 2000 IU of D(3) supplementation in this patient population. Alternative vitamin D(3) dosing schedules need further investigation in colorectal cancer patients undergoing chemotherapy.
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Affiliation(s)
- M G Fakih
- Division of Hematology and Oncology, Department of Medicine, University of Michigan Cancer Center, Ann Arbor, MI 48109-5843, USA.
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Kulkarni S, Fetterly GJ, Morrison CD, Adjei AA, Andrews C, Edge SP, Mukhopadhyay UK, Swetzig WM, Das GM. OT1-03-03: Effect of Tamoxifen Therapy on Inhibition of Tumor Suppressor p53 by Estrogen Receptor. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-ot1-03-03] [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
Background: A large number of patients with estrogen receptor (ER)-positive tumors are resistant to tamoxifen (TAM). Although several plausible reasons for such resistance have been suggested, the mechanisms remain unclear. ER mediates effects of estrogen by promoting proliferation of breast cancer cells. Tumor suppressor protein p53 guards against tumorigenesis by preventing proliferation of cells with genomic damage. Dr. Das's laboratory previously reported that ER binds and functionally suppresses wild type p53 in human breast cancer cells and xenograft tumor tissue, and TAM is capable of inhibiting this interaction. We hypothesize that relieving suppression of wild type p53 by ER could be an important mechanism underlying TAM action in breast cancer. To test this hypothesis, we have initiated a pilot randomized clinical trial of 50 women with newly diagnosed ERa-positive breast cancer.
Specific Aims: 1) To investigate the effect of a short pre-surgical intervention with TAM on the ER-p53 interaction in ER-positive, p53 wild type breast tumors and 2) To confirm the wild type status of p53 and analyze the functional status of the p53 pathway by monitoring expression of selected p53 target genes in tumors that have and have not been treated with TAM.
Trial design: A randomized clinical trial in the pre-surgical setting was proposed with either TAM 20mg for four weeks vs. no intervention. Patients randomized to the TAM arm will undergo multiple pharmacokinetic and phamacodynamic measurements of TAM metabolites and genotyping for common polymorphisms of TAM metabolism genes, CYP2D6 and CYP3A4/5. Fresh tumor tissue will be harvested from all patients at the time of surgery for analysis of ER-p53 protein interaction using tissue chromatin immunoprecipitation (tissue ChIP) assay. p53 gene status will be determined by sequencing. RNA and protein expression of ER, p53, and a selected group of ER and p53 target genes in the diagnostic core biopsy and surgical specimens will be analyzed by quantitative real-time PCR (qRTPCR) and immunohistochemistry (IHC). TAM metabolites will also be measured in the tumor and the surrounding benign tissue.
Eligibility criteria: Women greater or equal to eighteen years of age diagnosed with ER-positive invasive breast cancer (approximately 1cm in size) who will undergo primary surgical excision for their initial therapy are eligible. Women must not be pregnant, be on current hormonal therapy, or have a history of hypercoagulable syndrome or prior arterial or venous thrombosis.
Statistical methods: Descriptive statistics such as frequencies and relative frequencies will be computed for all categorical variables. Numeric variables will be summarized using simple descriptive statistics such as mean, standard deviation, and quartiles. Ninety-five percent confidence intervals will be computed. ChIP data will be subjected to Fisher's Exact Test. IHC date will be analyzed by Wilcoxon-Mann-Whitney test.
Present accrual and target accrual: We have accrued 17 patients to date and plan to accrue a total of 50 patients, 25 in each arm.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr OT1-03-03.
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Affiliation(s)
- S Kulkarni
- 1Roswell Park Cancer Institute, Buffalo, NY
| | | | | | - AA Adjei
- 1Roswell Park Cancer Institute, Buffalo, NY
| | - C Andrews
- 1Roswell Park Cancer Institute, Buffalo, NY
| | - SP Edge
- 1Roswell Park Cancer Institute, Buffalo, NY
| | | | - WM Swetzig
- 1Roswell Park Cancer Institute, Buffalo, NY
| | - GM Das
- 1Roswell Park Cancer Institute, Buffalo, NY
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Howland W, Ratner P, Martin B, Andrews C, Huang H, Desai S, Bode F. A Study Evaluating the Efficacy and Safety of Ciclesonide Hydrofluoroalkane Nasal Aerosol in the Relief of Nasal Symptoms of Seasonal Allergic Rhinitis. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.800] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Andrews C, Ratner P, Martin B, Howland W, Huang H, Desai S, Bode F. Results of the Rhinoconjunctivitis Related Quality of Life Questionnaire Administered to Subjects with Seasonal Allergic Rhinitis Following Treatment with Ciclesonide Hydrofluoroalkane Nasal Aerosol. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.797] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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McNicholas S, Andrews C, Boland K, Shields M, Doherty G, Murray F, Smyth E, Humphreys H, Fitzpatrick F. P06.05 A point prevalence study of healthcare-associated infection in patients with delayed discharge in an acute tertiary referral hospital. J Hosp Infect 2010. [DOI: 10.1016/s0195-6701(10)60060-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Diffuse esophageal spasm is a primary esophageal motility disorder. The prevalence is 3-10% in patients with dysphagia and treatment options are limited. This review summarizes the treatment of diffuse esophageal spasm, including pharmacotherapy, endoscopic treatment, and surgical treatment with a special focus on botulinum toxin injection. A PubMed search was performed to identify the literature using the search items diffuse esophageal spasm and treatment. Pharmacotherapy with smooth muscle relaxants, proton pump inhibitors, and antidepressants was suggested from small case series and uncontrolled clinical trials. Endoscopic injection of botulinum toxin is a well-studied treatment option and results in good symptomatic benefit in patients with diffuse esophageal spasm. Surgical treatment was reported in patients with very severe symptoms refractory to pharmacologic treatment. This article summarizes the present knowledge on the treatment of diffuse esophageal spasm with a special emphasis on botulinum toxin injection. Endoscopic injection of botulinum toxin is presently the best studied treatment option but many questions remain unanswered.
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Affiliation(s)
- M Bashashati
- Division of Gastroenterology, Department of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, Canada
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Carpenter R, Doughty JC, Cordiner C, Moss N, Gandhi A, Wilson C, Andrews C, Gui G, Skene A. A multicenter study to determine the optimum duration of neoadjuvant letrozole on tumor regression to permit breast-conserving surgery: Final analyses. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Carpenter R, Doughty J, Cordiner C, Moss N, Gandhi A, Wilson C, Andrews C, Gui G. A Multi-Center Study To Determine the Optimum Duration of Neoadjuvant Letrozole on Tumour Regression To Permit Breast Conserving Surgery – An Interim Analysis. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-1082] [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
Background: Neoadjuvant letrozole is an attractive alternative to chemotherapy for post menopausal women with large, ER positive breast cancer, who are destined for mastectomy but would prefer breast conservation. Prospective studies have not investigated treatment duration beyond 6 months and retrospective studies suggest useful responses can occur after this period.Materials and Methods: This trial is a prospective, UK centrally quality assured, multi-centre, longitudinal study to assess the optimal duration of neoadjuvant letrozole treatment to allow breast conserving surgery for a period of up to12 months. Post menopausal women with large (≥T2), ER and/or PgR positive primary tumours, not considered eligible for breast conservation, were commenced on neoadjuvant letrozole and response was assessed every 2 months with clinical and ultrasound examination until sufficient shrinkage for breast conservation, progression or 12 months had been reached. Ultrasound and Mammography were undertaken at baseline and end-point. We present the initial analysis for time to response and breast conservation.Results: By January 2009, 103 women were available for analysis. 23 (22.3%) had undergone a mastectomy, 60 (58.3%) had achieved breast conservation and 20 (19.4%) remained under evaluation within the trial. The mean age of the group was 74.1 years (52-92). 25 (24.3%) had invasive lobular cancer and 13 (12.6%) had grade 3 tumours. 22 (21.4%) were node positive.Figure 1. Kaplan-Meier plot for time (days) to response sufficient for breast conservation.25% had breast conservation by 5.8 months, 50% by 8.2 months and 75% by 12 months. Median time to breast conservation was 8.2 months (95% CI 6.4-9.3)Figure 2. Median change in tumour volume from baselineAfter an initial rapid response in the first 4 months, the rate of response was slower and constant for a further 6 months. Tumour volume reduction to permit breast conservation varied between 65 and 80% .Discussion: This interim analysis indicates that the conventional treatment period of 4 to 6 months of neoadjuvant letrozole should be revised. For most women longer duration will increase the likelihood of achieving sufficient volume reduction to allow breast conserving surgery.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1082.
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Affiliation(s)
| | | | | | - N. Moss
- 2 Western Infirmary, United Kingdom
| | - A. Gandhi
- 4 University Hospital of South Manchester, United Kingdom
| | | | - C. Andrews
- 3 Novartis Pharmaceuticals UK Ltd, United Kingdom
| | - G. Gui
- 5 Royal Marsden Hospital, United Kingdom
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Low TB, Harty L, Murray M, Andrews C, O'Neill SJ. Panton Valentine leukocidin MSSA leading to multi-organ failure. Ir Med J 2009; 102:185. [PMID: 19722357] [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] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report a case of a 15-year-old boy who developed multiple organ failure secondary to a sport injury leading to infection with a Panton Valentine Leukocidin (PVL) secreting Community-Acquired Methicillin Sensitive Staphylococcus Aureus (CA MSSA). Aggressive antibiotic therapy eventually led to recovery.
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Affiliation(s)
- T B Low
- Department of Respiratory Medicine, RCSI Education & Research Center, Smurfit Building, Beaumont Hospital, Dublin 9.
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Abstract
Highly pathogenic avian influenza A (HPAI) viruses, specifically H5N1 strains, cause widespread morbidity and mortality in domestic and wild bird populations, and recent outbreaks have resulted in severe economic losses. Although still largely confined to birds, more than 300 human cases resulting in deaths have been reported to the World Health Organization. These sporadic human cases result from direct transmission from infected birds; however, a sustained outbreak of HPAI H5N1 increases the potential for the emergence of a human pandemic strain. One approach to the containment of HPAI H5N1 is the development of vaccines for use in poultry. Currently, the majority of avian influenza vaccines for poultry are traditional whole-virus vaccines produced in eggs. Although highly efficacious, these vaccines are hindered by long production times, inflexibility in quickly altering antigenic composition, and limited breadth of protection. Newer vaccines with more efficient manufacturing processes, enhanced efficacy, and cross-protection against multiple strains would improve preparedness. Reverse genetics technology has provided one such method, and emerging gene-based vaccines offer another approach that reduces dependence on egg-based production and human exposure to pathogenic viruses. Gene-based vaccines also provide rapid manufacturing, enhanced precision and versatility, and the capacity to protect against a broad range of viral subtypes. Vectors for these vaccines include replication-defective viruses, bacterial vectors, and DNA. Here we review the features of gene-based vaccination that may facilitate the control of HPAI H5N1 in poultry, and highlight the development of a hemagglutinin-based multivalent DNA vaccine that confers protection in mice and chickens.
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Affiliation(s)
- S S Rao
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 40 Convent Drive, Bethesda, MD 20892, USA.
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Vandewalker M, Jacobs R, Andrews C, Yun Kirby S, Ellsworth A, Philpot E. Once-Daily Fluticasone Furoate Nasal Spray (FFNS) Significantly Improves Nasal Congestion in Subjects with Seasonal Allergic Rhinitis (SAR). J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kyle C, Zachariah J, Kinch H, Ellis G, Andrews C, Adekunle F. A randomised, double-blind study comparing lumiracoxib with naproxen for acute musculoskeletal pain. Int J Clin Pract 2008; 62:1684-92. [PMID: 19143855 DOI: 10.1111/j.1742-1241.2008.01906.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Some selective cyclooxygenase-2 (COX-2) inhibitors have been shown to provide analgesic efficacy in patients with acute pain. AIM To compare the efficacy and safety of the COX-2 inhibitor lumiracoxib 400 mg once daily (qd) and naproxen 500 mg twice daily (bid) in patients with acute musculoskeletal pain caused by uncomplicated soft tissue injury. METHODS This was a randomised, double-blind, parallel-group, non-inferiority study set in 39 primary care centres in the UK. Patients were randomised to lumiracoxib 400 mg qd or naproxen 500 mg bid and took the study medication for as long as they felt that it was needed, up to day 7. The primary efficacy analysis was the sum of the pain intensity difference (0-100 mm visual analogue scale) determined morning and evening over the first 5 days of treatment (SPID-5). RESULTS The intention-to-treat population comprised 406 patients [lumiracoxib 400 mg qd (n = 207); naproxen 500 mg bid (n = 199)]. Both treatments were effective in reducing pain intensity over 5 days. The mean SPID-5 scores were 117.0 mm.day for lumiracoxib and 118.2 mm.day for naproxen [the treatment difference based on adjusted means from the ANCOVA was -2.78 mm.day, 95% confidence interval (CI) -17.4, 11.9]. The lower margin of the 95% CI was above the predetermined non-inferiority margin (-50 mm.day) for SPID-5, indicating non-inferiority of lumiracoxib compared with naproxen. Both treatments were well tolerated. CONCLUSION Lumiracoxib 400 mg qd is as effective as naproxen 500 mg bid for the management of moderate-to-severe acute musculoskeletal pain.
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Affiliation(s)
- C Kyle
- Glengormley Practice, Belfast, Northern Ireland, UK
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Mhawech-Fauceglia P, Allal A, Odunsi K, Andrews C, Herrmann F, Huard B. Role of the tumour necrosis family ligand APRIL in solid tumour development: Retrospective studies in bladder, ovarian and head and neck carcinomas. Eur J Cancer 2008; 44:2097-100. [DOI: 10.1016/j.ejca.2008.07.007] [Citation(s) in RCA: 16] [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] [Received: 05/07/2008] [Revised: 06/23/2008] [Accepted: 07/01/2008] [Indexed: 01/23/2023]
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Garst J, Datto M, Herndon JE, Barry WT, Shoemaker D, Bjurstrom A, Andrews C, Ginsburg G, Nevins JR, Potti A. A phase II prospective study evaluating the role of pemetrexed plus gemcitabine (Pem/Gem) chemotherapy as intial treatment in patients with stage IIIB/IV non-small cell lung cancer (NSCLC) using a genomic predictor of cisplatin-resistance to guide therapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.8108] [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: 11/20/2022] Open
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Tchabo NE, Beck AF, Miliotto AJ, Sato E, Andrews C, Lele S, Odunsi K. Correlation of Wilms' tumor 1 (WT1) expression with infiltration by regulatory T cells (Tregs) in epithelial ovarian cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5578] [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: 11/20/2022] Open
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Mhawech-Fauceglia P, Herrmann FR, Andrews C, Lele S, Odunsi K. 14-3-3 sigma expression and prognostic value in patients with epithelial ovarian carcinoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16597] [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: 11/20/2022] Open
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Odunsi K, Tchabo NE, Beck AF, Miliotto AJ, Cabellero O, Sato E, Mhawech-Fauceglia P, Andrews C, Lele S. Developmentally restricted differentiation antigens in human ovarian cancer. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.16523] [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: 11/20/2022] Open
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Mhawech-Fauceglia P, Smiraglia DJ, Bshara W, Andrews C, Schwaller J, South S, Higgs D, Lele S, Herrmann F, Odunsi K. Prostate-Specific Membrane Antigen Expression Is a Potential Prognostic Marker in Endometrial Adenocarcinoma. Cancer Epidemiol Biomarkers Prev 2008; 17:571-7. [DOI: 10.1158/1055-9965.epi-07-0511] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Current KW, Yuk K, McConaghy C, Gascoyne PRC, Schwartz JA, Vykoukal JV, Andrews C. A High-Voltage SOI CMOS Exciter Chip for a Programmable Fluidic Processor System. IEEE Trans Biomed Circuits Syst 2007; 1:105-115. [PMID: 23851665 DOI: 10.1109/tbcas.2007.908110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A high-voltage (HV) integrated circuit has been demonstrated to transport fluidic droplet samples on programmable paths across the array of driving electrodes on its hydrophobically coated surface. This exciter chip is the engine for dielectrophoresis (DEP)-based micro-fluidic lab-on-a-chip systems, creating field excitations that inject and move fluidic droplets onto and about the manipulation surface. The architecture of this chip is expandable to arrays of N X N identical HV electrode driver circuits and electrodes. The exciter chip is programmable in several senses. The routes of multiple droplets may be set arbitrarily within the bounds of the electrode array. The electrode excitation waveform voltage amplitude, phase, and frequency may be adjusted based on the system configuration and the signal required to manipulate a particular fluid droplet composition. The voltage amplitude of the electrode excitation waveform can be set from the minimum logic level up to the maximum limit of the breakdown voltage of the fabrication technology. The frequency of the electrode excitation waveform can also be set independently of its voltage, up to a maximum depending upon the type of droplets that must be driven. The exciter chip can be coated and its oxide surface used as the droplet manipulation surface or it can be used with a top-mounted, enclosed fluidic chamber consisting of a variety of materials. The HV capability of the exciter chip allows the generated DEP forces to penetrate into the enclosed chamber region and an adjustable voltage amplitude can accommodate a variety of chamber floor thicknesses. This demonstration exciter chip has a 32 x 32 array of nominally 100 V electrode drivers that are individually programmable at each time point in the procedure to either of two phases: 0deg and 180deg with respect to the reference clock. For this demonstration chip, while operating the electrodes with a 100-V peak-to-peak periodic waveform, the maximum HV electrode waveform frequency is about 200 Hz; and standard 5-V CMOS logic data communication rate is variable up to 250 kHz. This HV demonstration chip is fabricated in a 130-V 1.0-mum SOI CMOS fabrication technology, dissipates a maximum of 1.87 W, and is about 10.4 mm x 8.2 mm.
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Chan WM, Traboulsi EI, Arthur B, Friedman N, Andrews C, Engle EC. Horizontal gaze palsy with progressive scoliosis can result from compound heterozygous mutations in ROBO3. J Med Genet 2006; 43:e11. [PMID: 16525029 PMCID: PMC2563249 DOI: 10.1136/jmg.2005.035436] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Horizontal gaze palsy with progressive scoliosis (HGPPS) is an autosomal recessive disorder characterised by congenital absence of horizontal gaze, progressive scoliosis, and failure of the corticospinal and somatosensory axon tracts to decussate in the medulla. We previously reported that HGPPS patients from consanguineous pedigrees harbour homozygous mutations in the axon guidance molecule ROBO3. METHODS We now report two sporadic HGPPS children of non-consanguineous parents who harbour compound heterozygous mutations in ROBO3. The mother of one of the children also had scoliosis DNA was extracted from a blood sample from each participant using a standard protocol, and the coding exons of ROBO3 were amplified and sequenced as previously described. RESULTS Each patient harboured two unique heterozygous mutations in ROBO3, having inherited one mutation from each parent. CONCLUSIONS HGPPS can result from compound heterozygous mutations. More comprehensive examinations of parents and siblings of HGPPS patients are required to determine if the incidence of scoliosis in individuals harbouring heterozygous ROBO3 mutations is greater than in the general population.
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