1
|
Mitro SD, Xu F, Lee C, Zaritsky E, Waetjen LE, Wise LA, Hedderson MM. Long-Term Risk of Reintervention After Surgical Leiomyoma Treatment in an Integrated Health Care System. Obstet Gynecol 2024; 143:619-626. [PMID: 38547478 PMCID: PMC11022990 DOI: 10.1097/aog.0000000000005557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To compare long-term risk of reintervention across four uterus-preserving surgical treatments for leiomyomas and to assess effect modification by sociodemographic factors in a prospective cohort study in an integrated health care delivery system. METHODS We studied a cohort of 10,324 patients aged 18-50 (19.9% Asian, 21.2% Black, 21.3% Hispanic, 32.5% White, 5.2% additional races and ethnicities) who had a first uterus-preserving procedure (abdominal, laparoscopic, or vaginal myomectomy [referred to as myomectomy]; hysteroscopic myomectomy; endometrial ablation; uterine artery embolization) after leiomyoma diagnosis in the 2009-2021 electronic health records of Kaiser Permanente Northern California. We followed up patients until reintervention (second uterus-preserving procedure or hysterectomy) or censoring. We used a Kaplan-Meier estimator to calculate the cumulative incidence of reintervention and Cox regression models to estimate hazard ratios and 95% CIs comparing rates of reintervention across procedures, adjusting for age, parity, race and ethnicity, body mass index (BMI), Neighborhood Deprivation Index, and year. We also assessed effect modification by demographic characteristics. RESULTS Median follow-up was 3.8 years (interquartile range 1.8-7.4 years). Index procedures were 18.0% (1,857) hysteroscopic myomectomies, 16.2% (1,669) uterine artery embolizations, 21.4% (2,211) endometrial ablations, and 44.4% (4,587) myomectomies. Accounting for censoring, the 7-year reintervention risk was 20.6% for myomectomy, 26.0% for uterine artery embolization, 35.5% for endometrial ablation, and 37.0% for hysteroscopic myomectomy; 63.2% of reinterventions were hysterectomies. Within each procedure type, reintervention rates did not vary by BMI, race and ethnicity, or Neighborhood Deprivation Index. However, rates of reintervention after uterine artery embolization, endometrial ablation, and hysteroscopic myomectomy decreased with age, and reintervention rates for hysteroscopic myomectomy were higher for parous than nulliparous patients. CONCLUSION Long-term reintervention risks for uterine artery embolization, endometrial ablation, and hysteroscopic myomectomy are greater than for myomectomy, with potential variation by patient age and parity but not BMI, race and ethnicity, or Neighborhood Deprivation Index.
Collapse
Affiliation(s)
- Susanna D Mitro
- Division of Research and Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, Oakland, and the Department of Obstetrics and Gynecology, University of California Davis School of Medicine, Davis, California; and the Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | | | | | | | | | | | | |
Collapse
|
2
|
Lee C, Buswell M, Coker J, Buckner S, Cowan A, Lhussier M. Addressing health inequalities in times of austerity: implementation of a place-based approach in multitiered local government. Perspect Public Health 2024:17579139241241194. [PMID: 38676341 DOI: 10.1177/17579139241241194] [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] [Indexed: 04/28/2024]
Abstract
AIMS This article focuses on how local authorities in England are tackling wider determinants of health and inequalities in their population's outcomes while budgets for public services are diminishing. METHODS It reports the experience from one case study engaged in rolling out a devolved, place- and asset-based strategy over multiple tiers of local government. Relating these findings to relevant social theory, we draw out aspects of context and mechanisms of change. We offer plausible hypotheses for the experiences observed, which supports transferability and implementation of place-based strategies in other local authority areas struggling with similar challenges. RESULTS Findings highlight the importance of high-level and political buy-in, as well as the role of the COVID-19 pandemic as a potential catalyst to rollout. Creating the foundations for a new, place-based working was important for achieving coherence among partners around what local government was trying to achieve. These included investment in infrastructure, both relational and tangible inputs such as organisational and human resources, to establish the conditions for systemic change towards early intervention and prevention. CONCLUSION This study identified clear foundations for place-based action, plus enablers and barriers to significant transformation of practice towards asset-based approaches between local authorities, partners and the public.
Collapse
Affiliation(s)
- C Lee
- Cambridge Public Health, Interdisciplinary Research Centre, Department of Engineering, University of Cambridge, and Cambridge Institute for Sustainability Leadership, Trumpington Street, Cambridge, CB2 1PZ, UK
| | - M Buswell
- Cambridge Public Health, Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK
| | - J Coker
- Cambridge Public Health, Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK
| | - S Buckner
- Cambridge Public Health, Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK
| | - A Cowan
- Cambridge Public Health, Interdisciplinary Research Centre, University of Cambridge, Cambridge, UK
| | - M Lhussier
- Director, Centre for Health and Social Equity (CHASE), Northumbria University, Newcastle upon Tyne, UK
| |
Collapse
|
3
|
Clark KL, Park K, Lee C. Exploring the cause of reduced production responses to feeding corn dried distillers' grains in lactating dairy cows. J Dairy Sci 2024:S0022-0302(24)00752-5. [PMID: 38642660 DOI: 10.3168/jds.2023-24356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/10/2024] [Indexed: 04/22/2024]
Abstract
An experiment was conducted to identify the factors that cause reduced production of cows fed a diet with high corn distiller's grains with solubles (DDGS). We hypothesized that the factors could be high S content in DDGS which may directly (S toxicity) or indirectly [dietary cation-anion difference (DCAD)] cause reduced production. We also hypothesized that high polyunsaturated fatty acids (PUFA) in DDGS could be another major factor. In a randomized complete block design, 60 lactating cows (15 primiparous and 45 multiparious; average ± SD at the beginning of the trial: milk yield, 44.0 ± 6.9 kg/d; DIM, 123 ± 50; BW, 672 ± 82 kg) were blocked and cows in each block were randomly assigned to one of the following treatments: SBM [4.7% fatty acids (FA), 0.22% S, and 178 mEq/kg DM of DCAD], a diet containing soybean meal as the main protein source; DG, SBM replacing mainly soybean byproducts and supplemental fat with DG at 30% dietary DM (4.7% FA, 0.44% S, and 42 mEq/kg DM of DCAD); SBM+S, SBM with sodium bisulfate for additional dietary S (4.8% FA, 0.37% S, and 198 mEq/kg DM of DCAD); SBM+CO, SBM with corn oil (4.7% FA, 0.23%, and 165 mEq/kg DM of DCAD); and DG+DCAD, DG with increased DCAD (4.7% FA, 0.40% S, and 330 mEq/kg DM of DCAD). Due to the limited tie stalls, the blocks of 1 to 6 started the experiment first as phase 1 and the rest of the blocks as phase 2 started the experiment after phase 1. All cows were fed the SBM diet for 10 d as a covariate period followed by the experimental period for 35 d. Data were analyzed using the PROC MIXED of SAS, block and phase were random effects and treatments, repeated wk, and interaction were fixed effects. There was an interaction of wk by treatment for DMI. While milk yield did not change, milk fat concentration tended to decrease (2.78 vs. 3.34%) for DG compared with SBM. Dry matter, OM, NDF, and CP digestibilities were lower when cows were fed the DG diet compared with SBM. Additionally, cows fed DG had lower blood concentrations of HCO3-, base excess, and tCO2 compared with SBM. The SBM+S diet did not affect production, nutrient digestibility, or blood parameters when compared with SBM. The SBM+CO diet decreased milk fat concentration and yield compared with SBM. The DG+DCAD diet tended to increase milk fat yield and concentration (1.24 vs. 1.47 kg/d; 2.78 vs. 3.37%) and increased ECM (40.9 vs. 45.1 kg/d) compared with DG but did not improve nutrient digestibility. However, blood HCO3-, base excess, and tCO2 were greater for DG+DCAD compared with DG. In conclusion, the indirect role of S-, altering DCAD, along with the high PUFA content in DDGS appears to be the factors causing reduced production responses to a high DDGS diet. Increasing DCAD to 300 mEq/kg DM in a high DDGS diet can be a feeding strategy to alleviate the reduced production responses.
Collapse
Affiliation(s)
- K L Clark
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691
| | - K Park
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691
| | - C Lee
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691.
| |
Collapse
|
4
|
Banack HR, Wactawski-Wende J, Ochs-Balcom HM, Feliciano EMC, Caan B, Lee C, Anderson G, Shankaran M, Evans WJ. A protocol for remote collection of skeletal muscle mass via D3-creatine dilution in community-dwelling postmenopausal women from the Women's Health Initiative. PLoS One 2024; 19:e0300140. [PMID: 38630732 PMCID: PMC11023459 DOI: 10.1371/journal.pone.0300140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 02/21/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND There is emerging evidence that cancer and its treatments may accelerate the normal aging process, increasing the magnitude and rate of decline in functional capacity. This accelerated aging process is hypothesized to hasten the occurrence of common adverse age-related outcomes in cancer survivors, including loss of muscle mass and decrease in physical function. However, there is no data describing age-related loss of muscle mass and its relation to physical function in the long-term in cancer survivors. METHODS This study protocol describes the use of a novel method of muscle mass measurement, D3-creatine dilution method (D3Cr), in a large sample (n~6000) of community dwelling postmenopausal women from the Women's Health Initiative (WHI). D3Cr will be used to obtain a direct measure of muscle mass remotely. Participants will be drawn from two sub-cohorts embedded within the WHI that have recently completed an in-home visit. Cancer survivors will be drawn from the Life and Longevity After Cancer (LILAC) cohort, and cancer-free controls will be drawn from the WHI Long Life Study 2. The overall objective of this study is to examine the antecedents and consequences of low muscle mass in cancer survivors. The study aims are to: 1) create age-standardized muscle mass percentile curves and z-scores to characterize the distribution of D3- muscle mass in cancer survivors and non-cancer controls, 2) compare muscle mass, physical function, and functional decline in cancer survivors and non- cancer controls, and 3) use machine learning approaches to generate multivariate risk-prediction algorithms to detect low muscle mass. DISCUSSION The D3Cr method will transform our ability to measure muscle mass in large-scale epidemiologic research. This study is an opportunity to advance our understanding of a key source of morbidity among older and long-term female cancer survivors. This project will fill knowledge gaps, including the antecedents and consequences of low muscle mass, and use innovative methods to overcome common sources of bias in cancer research. The results of this study will be used to develop interventions to mitigate the harmful effects of low muscle mass in older adults and promote healthy survivorship in cancer survivors in the old (>65) and oldest-old (>85) age groups.
Collapse
Affiliation(s)
- Hailey R. Banack
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, United States of America
| | - Heather M. Ochs-Balcom
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, United States of America
| | - Elizabeth M. Cespedes Feliciano
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States of America
| | - Bette Caan
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States of America
| | - Catherine Lee
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States of America
| | | | - Mahalakshmi Shankaran
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, United States of America
| | - William J. Evans
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, United States of America
- Division of Geriatrics, Duke University Medical Center, Durham, NC, United States of America
| |
Collapse
|
5
|
Hedderson MM, Capra A, Lee C, Habel LA, Lee J, Gold EB, Badon SE, Mitro SD, El Khoudary SR. Longitudinal Changes in Sex Hormone Binding Globulin (SHBG) and Risk of Incident Diabetes: The Study of Women's Health Across the Nation (SWAN). Diabetes Care 2024; 47:676-682. [PMID: 38320264 PMCID: PMC10973900 DOI: 10.2337/dc23-1630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/23/2023] [Indexed: 02/08/2024]
Abstract
OBJECTIVE To investigate the associations of longitudinal changes in sex hormone binding globulin (SHBG) and testosterone (T) over the menopause transition with the risk of diabetes. RESEARCH DESIGN AND METHODS We followed 2,952 participants in the Study of Women's Health Across the Nation (SWAN) who were premenopausal or early perimenopausal and diabetes-free at baseline. SHBG,T, and estradiol (E2) levels were measured at up to 13 follow-up visits (over up to 17 years). We used complementary log-log-based discrete-time survival models anchored at baseline. RESULTS Diabetes developed in 376 women. A 5-unit increase in time-varying SHBG was associated with a 10% reduced risk of diabetes (hazard ratio [HR] 0.91, 95% CI 0.87-0.95), adjusting for covariates, and baseline SHBG,T, and E2 levels. Time-varying T was not associated with diabetes risk. Compared with the lowest quartile for annual rate of change of SHBG since baseline (quartile 1 [Q1] -92.3 to -1.5 nmol/L), all other quartiles were associated with a decreased risk of diabetes adjusting for covariates and baseline SHBG; associations persisted after adjusting for rate of change of T and E2 (Q2 [> -1.5 to -0.2 nmol/L] HR 0.33, 95% CI 0.23-0.48; Q3 [> -0.2 to 1.3 nmol/L] HR 0.37, 95% CI 0.25-0.55; Q4 [>1.3 to 82.0 nmol/L] HR 0.43, 95% CI 0.30-0.63). CONCLUSIONS Increasing levels of SHBG over the menopause transition were associated with a decreased risk of incident diabetes. Stable to increasing rates of change in SHBG were also independently associated with a decreased risk of diabetes compared with decreasing rates of change, suggesting SHBG may affect glucose through a mechanism beyond androgenicity.
Collapse
Affiliation(s)
| | - Angela Capra
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Laurel A. Habel
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | | | | | - Sylvia E. Badon
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Susanna D. Mitro
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | | |
Collapse
|
6
|
Mitro SD, Wise LA, Waetjen LE, Lee C, Zaritsky E, Harlow SD, Solomon DH, Thurston RC, El Khoudary SR, Santoro N, Hedderson MM. Hypertension, Cardiovascular Risk Factors, and Uterine Fibroid Diagnosis in Midlife. JAMA Netw Open 2024; 7:e246832. [PMID: 38625699 PMCID: PMC11022113 DOI: 10.1001/jamanetworkopen.2024.6832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/18/2024] [Indexed: 04/17/2024] Open
Abstract
Importance Fibroids are benign neoplasms associated with severe gynecologic morbidity. There are no strategies to prevent fibroid development. Objective To examine associations of hypertension, antihypertensive treatment, anthropometry, and blood biomarkers with incidence of reported fibroid diagnosis in midlife. Design, Setting, and Participants The Study of Women's Health Across the Nation is a prospective, multisite cohort study in the US. Participants were followed-up from enrollment (1996-1997) through 13 semiannual visits (1998-2013). Participants had a menstrual period in the last 3 months, were not pregnant or lactating, were aged 42 to 52 years, were not using hormones, and had a uterus and at least 1 ovary. Participants with prior fibroid diagnoses were excluded. Data analysis was performed from November 2022 to February 2024. Exposures Blood pressure, anthropometry, biomarkers (cholesterol, triglycerides, and C-reactive protein), and self-reported antihypertensive treatment at baseline and follow-up visits were measured. Hypertension status (new-onset, preexisting, or never [reference]) and hypertension treatment (untreated, treated, or no hypertension [reference]) were categorized. Main Outcomes and Measures Participants reported fibroid diagnosis at each visit. Discrete-time survival models estimated hazard ratios (HRs) and 95% CIs for associations of time-varying hypertension status, antihypertensive treatment, anthropometry, and biomarkers with incident reported fibroid diagnoses. Results Among 2570 participants without a history of diagnosed fibroids (median [IQR] age at screening, 45 [43-48] years; 1079 [42.1%] college educated), 526 (20%) reported a new fibroid diagnosis during follow-up. Risk varied by category of hypertension treatment: compared with those with no hypertension, participants with untreated hypertension had a 19% greater risk of newly diagnosed fibroids (HR, 1.19; 95% CI, 0.91-1.57), whereas those with treated hypertension had a 20% lower risk (HR, 0.80; 95% CI, 0.56-1.15). Among eligible participants with hypertension, those taking antihypertensive treatment had a 37% lower risk of newly diagnosed fibroids (HR, 0.63; 95% CI, 0.38-1.05). Risk also varied by hypertension status: compared with never-hypertensive participants, participants with new-onset hypertension had 45% greater risk of newly diagnosed fibroids (HR, 1.45; 95% CI, 0.96-2.20). Anthropometric factors and blood biomarkers were not associated with fibroid risk. Conclusions and Relevance Participants with untreated and new-onset hypertension had increased risk of newly diagnosed fibroids, whereas those taking antihypertensive treatment had lower risk, suggesting that blood pressure control may provide new strategies for fibroid prevention.
Collapse
Affiliation(s)
- Susanna D. Mitro
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Lauren A. Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - L. Elaine Waetjen
- Department of Obstetrics and Gynecology, University of California Davis School of Medicine, Davis
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Eve Zaritsky
- Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, Oakland
| | - Siobán D. Harlow
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor
| | | | - Rebecca C. Thurston
- Department of Psychology and Psychiatry, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Samar R. El Khoudary
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora
| | | |
Collapse
|
7
|
Volk JE, Leyden WA, Lea AN, Lee C, Donnelly MC, Krakower DS, Lee K, Liu VX, Marcus JL, Silverberg MJ. Using Electronic Health Records to Improve HIV Preexposure Prophylaxis Care: A Randomized Trial. J Acquir Immune Defic Syndr 2024; 95:362-369. [PMID: 38412047 DOI: 10.1097/qai.0000000000003376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/07/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Preexposure prophylaxis (PrEP) use remains limited and inequitable, and strategies are needed to improve PrEP provision in primary care. METHODS We conducted a cluster randomized trial at Kaiser Permanente, San Francisco, to evaluate the effectiveness of a clinical decision support intervention guided by an electronic health record (EHR)-based HIV risk prediction model to improve PrEP provision. Primary care providers (PCPs) were randomized to usual care or intervention, with PCPs who provide care to people with HIV balanced between arms. PCPs in the intervention arm received an EHR-based staff message with prompts to discuss HIV prevention and PrEP before upcoming in-person or video visits with patients whose predicted 3-year HIV risk was above a prespecified threshold. The main study outcome was initiation of PrEP care within 90 days, defined as PrEP discussions, referrals, or prescription fills. RESULTS One hundred twenty-one PCPs had 5051 appointments with eligible patients (2580 usual care; 2471 intervention). There was a nonsignificant increase in initiation of PrEP care in the intervention arm (6.0% vs 4.5%, HR 1.32, 95% CI: 0.84 to 2.1). There was a significant interaction by HIV provider status, with an intervention HR of 2.59 (95% CI: 1.30 to 5.16) for HIV providers and 0.89 (95% CI: 0.59 to 1.35) for non-HIV providers (P-interaction <0.001). CONCLUSION An EHR-based intervention guided by an HIV risk prediction model substantially increased initiation of PrEP care among patients of PCPs who also care for people with HIV. Higher-intensity interventions may be needed to improve PrEP provision among PCPs less familiar with PrEP and HIV care.
Collapse
Affiliation(s)
- Jonathan E Volk
- Department of Infectious Diseases, Kaiser Permanente San Francisco, San Francisco, CA
| | - Wendy A Leyden
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Alexandra N Lea
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | | | - Douglas S Krakower
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA; and
| | - Kristine Lee
- Department of Adult and Family Medicine, Kaiser Permanente San Francisco, San Francisco, CA
| | - Vincent X Liu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Julia L Marcus
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | | |
Collapse
|
8
|
Rebelo LR, Lee C. Measuring bioavailability, utilization, and excretion of rumen-protected lysine in lactating cows using an isotope technique. Animal 2024; 18:101127. [PMID: 38574452 DOI: 10.1016/j.animal.2024.101127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
Supplementing a diet with rumen-protected amino acids (AAs) is a common feeding strategy for efficient production. For a cost-effective use of rumen-protected AA, the accurate bioavailability of rumen-protected amino acids should be known and their metabolism after absorption needs to be well understood. The current study determined the bioavailability, absorption, utilization, and excretion of rumen-protected Lys (RP-Lys). Four ruminally cannulated cows in a 4 × 4 Latin square design (12 d for diet adaptation; 5 or 6 d for total collections) received the following treatments: L0, a basal diet; L25, the basal diet and L-Lys infused into the abomasum to provide 25.9 g/d L-Lys; L50, the basal diet and L-Lys infused into the abomasum to provide 51.8 g/d L-Lys; and RPL, the basal diet supplemented with 105 g/d (as-is) of RP-Lys to provide 26.7 g of digestible Lys. During the last 5 or 6 d in each period, 15N-Lys (0.38 g/d) was infused into the abomasum for all cows to label the pool of AA, and the total collection of milk, urine, and feces were conducted. 15N enrichment of samples on d 4 and 5 were used to calculate the bioavailability and Lys metabolism. We used a model containing a fast AA turnover (≤ 5 d) and slow AA turnover pool (> 5 d) to calculate fluxes of Lys. The Lys flux to the fast AA turnover pool (absorbed Lys + Lys from the slow AA turnover pool to fast AA turnover pool) was calculated using 15N enrichment of milk Lys. The flux of Lys from the fast AA turnover pool to milk and urine was calculated using 15N transfer into milk and urine. Then, absorbed Lys was estimated by the sum of Lys flux to milk and urine assuming no net utilization of Lys by body tissues. Duodenal Lys flow was estimated by 15N enrichment of fecal Lys. The bioavailability of RP-Lys was calculated from duodenal Lys flows and Lys absorption for RPL. Increasing Lys supply from L25 to L50 increased Lys utilization for milk by 9 g/d but also increased urinary excretion by 10 g/d. For RPL, absorbed Lys was estimated to be 136 g/d where 28 g of absorbed Lys originated from RP-Lys. In conclusion, 68% of bioavailability was obtained for RP-Lys. The Lys provided from RP-Lys was not only utilized for milk protein (48%) but also excreted in urine (20%) after oxidation.
Collapse
Affiliation(s)
- L R Rebelo
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691, USA
| | - C Lee
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691, USA.
| |
Collapse
|
9
|
Lee C, Schwimmer JB, Gunderson EP, Goyal NP, Darbinian JA, Greenspan LC, Lo JC. Alanine aminotransferase elevation varies by ethnicity among Asian and Pacific Islander children with overweight or obesity. Pediatr Obes 2024:e13110. [PMID: 38444225 DOI: 10.1111/ijpo.13110] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/29/2023] [Accepted: 01/04/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Limited research on alanine aminotransferase (ALT) screening for metabolic dysfunction-associated steatotic liver disease (MASLD) among US Asian/Pacific Islander (PI) children necessitates investigation in this heterogeneous population. OBJECTIVE Examine ALT elevation among Asian/PI children with overweight or obesity. METHODS Elevated ALT prevalence (clinical threshold) and association with body mass index ≥85th percentile were compared among 18 402 Asian/PI and 25 376 non-Hispanic White (NHW) children aged 9-17 years using logistic regression. RESULTS ALT elevation was more prevalent among Asian/PI (vs. NHW) males with overweight (4.0% vs. 2.7%), moderate (7.8% vs. 5.3%) and severe obesity (16.6% vs. 11.5%), and females with moderate (5.1% vs. 3.0%) and severe obesity (10.2% vs. 5.2%). Adjusted odds of elevated ALT were 1.6-fold and ~2-fold higher for Asian/PI (vs. NHW) males and females (with obesity), respectively. Filipino, Chinese and Southeast Asian males had 1.7-2.1-fold higher odds, but Native Hawaiian/PI (NHPI) and South Asian males did not significantly differ (vs. NHW). Filipina and Chinese females with obesity had >2-fold higher odds, Southeast and South Asian females did not differ and NHPI findings were mixed (vs. NHW). CONCLUSION High elevated ALT prevalence among Asian/PI children with overweight and obesity emphasizes the need for MASLD risk assessment and examination of ethnic subgroups.
Collapse
Affiliation(s)
- Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
| | - Jeffrey B Schwimmer
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California San Diego School of Medicine, San Diego, California, USA
- Department of Gastroenterology, Rady Children's Hospital, San Diego, California, USA
| | - Erica P Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
| | - Nidhi P Goyal
- Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, University of California San Diego School of Medicine, San Diego, California, USA
- Department of Gastroenterology, Rady Children's Hospital, San Diego, California, USA
| | - Jeanne A Darbinian
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Louise C Greenspan
- The Permanente Medical Group, Oakland, California, USA
- Department of Pediatrics, Division of Pediatric Endocrinology, Kaiser Permanente San Francisco Medical Center, San Francisco, California, USA
| | - Joan C Lo
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
- The Permanente Medical Group, Oakland, California, USA
| |
Collapse
|
10
|
Lee DR, Lo JC, Chandra M, Lee C, Gilsanz P. Racial and Ethnic Variation in Dementia Prevalence in a Diverse Cohort of Adults with Hip Fracture. J Gen Intern Med 2024; 39:716-719. [PMID: 38142461 PMCID: PMC10973300 DOI: 10.1007/s11606-023-08578-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/08/2023] [Indexed: 12/26/2023]
Affiliation(s)
- David R Lee
- Department of Hospital Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
- The Permanente Medical Group, Oakland, CA, USA
- UCLA Multicampus Program in Geriatric Medicine and Gerontology, Los Angeles, CA, USA
| | - Joan C Lo
- The Permanente Medical Group, Oakland, CA, USA.
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
| | - Malini Chandra
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Paola Gilsanz
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| |
Collapse
|
11
|
Lo JC, Chandra M, Yang W, Thompson N, Lee C, Ramaswamy M, Khan M, Wheeler A. Challenges of fracture risk assessment in Asian and Black women. Am J Manag Care 2024; 30:140-144. [PMID: 38457822 PMCID: PMC11034894 DOI: 10.37765/ajmc.2024.89515] [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] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
OBJECTIVES Bone mineral density (BMD) and fracture risk calculators (eg, the Fracture Risk Assessment Tool [FRAX]) guide primary prevention care in postmenopausal women. BMD scores use non-Hispanic White (NHW) reference data for T-score classification, whereas FRAX incorporates BMD, clinical risk factors, and population differences when calculating risk. This study compares findings among Asian, Black, and NHW women who underwent osteoporosis screening in a US health care system. STUDY DESIGN Retrospective cross-sectional study. METHODS Asian, Black, and NHW women aged 65 to 75 years who underwent BMD testing (with no recent fracture, osteoporosis therapy, metastatic cancer, multiple myeloma, metabolic bone disorders, or kidney replacement therapy) were compared across the following measures: femoral neck BMD (FN-BMD) T-score (normal ≥ -1, osteoporosis ≤ -2.5), high FRAX 10-year hip fracture risk (FRAX-Hip ≥ 3%), FRAX risk factors, and diabetes status. RESULTS Among 3640 Asian women, 23.8% had osteoporosis and 8.7% had FRAX-Hip scores of at least 3% (34.5% among those with osteoporosis). Among 11,711 NHW women, 12.3% had osteoporosis and 17.2% had FRAX-Hip scores of at least 3% (84.8% among those with osteoporosis). Among 1711 Black women, 68.1% had normal FN-BMD, 4.1% had BMD-defined osteoporosis, and 1.8% had FRAX-Hip scores of at least 3% (32.4% among those with osteoporosis). Fracture risk factors differed by group. Diabetes was 2-fold more prevalent in Black and Asian (35% and 36%, respectively) vs NHW (16%) women. CONCLUSIONS A large subset of Asian women have discordant BMD and FRAX scores, presenting challenges in osteoporosis management. Furthermore, FN-BMD and especially FRAX scores identified few Black women at high fracture risk warranting treatment. Studies should examine whether fracture risk assessment can be optimized in understudied racial minority populations, particularly when findings are discordant.
Collapse
Affiliation(s)
- Joan C Lo
- Kaiser Permanente Division of Research, 2000 Broadway, Oakland, CA 94612.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Martin P, Haroz EE, Lee C, Bolton P, Martin K, Meza R, McCarthy E, Dorsey S. A qualitative study of mental health problems among children living in New Delhi slums. Transcult Psychiatry 2024:13634615231202098. [PMID: 38389504 DOI: 10.1177/13634615231202098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Children living in urban slums in India are exposed to chronic stressors that increase their risk of developing mental disorders, but they remain a neglected group. Effective mental health interventions are needed; however, it is necessary to understand how mental health symptoms and needs are perceived and prioritized locally to tailor interventions for this population. We used an existing rapid ethnographic assessment approach to identify mental health problems from the perspective of children living in Indian slums, including local descriptions, perceived causes, impact, and coping behavior. Local Hindi-speaking interviewers conducted 77 free-list interviews and 33 key informant interviews with children and adults (N = 107) from two slums in New Delhi. Results identified a range of internalizing and externalizing symptoms consistent with depression, anxiety, and conduct problems in children. Findings included both common cross-cultural experiences and symptoms as well as uniquely described symptoms (e.g., "madness or anger," "pain in the heart and mind") not typically included on western standardized measures of psychopathology. Mental health problems appeared to be highly interconnected, with experiences such as harassment and fighting often described as both causes and impacts of mental health symptoms in children. Community perspectives indicated that even in the face of several unmet basic needs, mental health problems were important to the community and counseling interventions were likely to be acceptable. We discuss implications for adapting mental health interventions and assessing their effectiveness to reduce the burden of mental illness among children living in urban slums in India.
Collapse
Affiliation(s)
- Prerna Martin
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Emily E Haroz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Catherine Lee
- UNICEF New York Child Protection in Humanitarian Action, New York, NY, USA
| | - Paul Bolton
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- USAID, Washington, DC, USA
| | - Kiran Martin
- Asha Community Health and Development Society, New Delhi, India
| | - Rosemary Meza
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | | | - Shannon Dorsey
- Department of Psychology, University of Washington, Seattle, WA, USA
| |
Collapse
|
13
|
Porter NH, Clark KL, Rebelo LR, Copelin JE, Kwon IH, Lee C. Effects of saturated fatty acids with lysophospholipids on production and nutrient digestibility in lactating cows. J Dairy Sci 2024:S0022-0302(24)00505-8. [PMID: 38395396 DOI: 10.3168/jds.2023-24457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/19/2024] [Indexed: 02/25/2024]
Abstract
The objective of the experiment was to determine the effects of supplemental saturated fatty acid (SFA) sources, lysophospholipids (LPL), and their interaction on production and nutrient digestibility in lactating dairy cows. The experiment was conducted with 48 cows in a randomized complete block design. Cows were blocked (total 12 blocks) by parity and days in milk and randomly assigned to 4 dietary treatments in each block (2 × 2 factorial arrangement), i.e., 2 sources of fat supplements, C16:0 (palmitic acid, PA)- or C18:0 (stearic acid, SA)-enriched fat, with or without LPL. The experiment was conducted for 6 wk to measure daily dry matter intake and milk yield and weekly milk composition. During the last week of the experiment, spot fecal and urine samples were collected to determine total-tract nutrient digestibility. Milk samples in the last week were also collected to analyze for milk fatty acid (FA) profile. All data were analyzed using the mixed procedure of SAS where block was used as a random effect and FA, LPL, and the interaction of FA by LPL were used as fixed effects. Week and interactions of week by FA or LPL were included for production measures. Different sources of SFA did not affect dry matter intake and milk yield. However, PA increased (39.7 vs. 36.8 kg) energy-corrected milk compared with SA due to increased milk fat yield. No effect of LPL on production measures was observed. Total-tract digestibilities of dry matter, organic matter, crude protein, and total FA were not different between PA and SA, but PA increased (41.4 vs. 38.8%) neutral detergent fiber digestibility compared with SA. Supplementation of LPL increased (64.7 vs. 60.5%) total FA digestibility, especially 18-carbon FA (74.1 vs. 68.2%). An interaction of SFA by LPL was found for 16-carbon FA digestibility. The PA diet increased the concentration of 16-carbon FA in milk fat and SA increased the concentration of preformed FA (≥18 carbons). Supplementation of LPL decreased the concentration of trans-10 C18:1. No difference in N utilization and excretion among treatments was observed. In conclusion, PA was more effective in improving milk fat yield of lactating cows compared with SA. Supplementation of LPL increased digestibility of total FA, especially 18-carbon FA but did not affect production.
Collapse
Affiliation(s)
- N H Porter
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691
| | - K L Clark
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691
| | - L R Rebelo
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691
| | - J E Copelin
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691
| | - I H Kwon
- Easy Bio Inc., Seoul, South Korea 06253
| | - C Lee
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691.
| |
Collapse
|
14
|
Chen YK, Kanouni T, Arnold LD, Cox JM, Gardiner E, Grandinetti K, Jiang P, Kaldor SW, Lee C, Li C, Martin ES, Miller N, Murphy EA, Timple N, Tyhonas JS, Vassar A, Wang TS, Williams R, Yuan D, Kania RS. The Discovery of Exarafenib (KIN-2787): Overcoming the Challenges of Pan-RAF Kinase Inhibition. J Med Chem 2024; 67:1747-1757. [PMID: 38230963 DOI: 10.1021/acs.jmedchem.3c01830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
RAF, a core signaling component of the MAPK kinase cascade, is often mutated in various cancers, including melanoma, lung, and colorectal cancers. The approved inhibitors were focused on targeting the BRAFV600E mutation that results in constitutive activation of kinase signaling through the monomeric protein (Class I). However, these inhibitors also paradoxically activate kinase signaling of RAF dimers, resulting in increased MAPK signaling in normal tissues. Recently, significant attention has turned to targeting RAF alterations that activate dimeric signaling (class II and III BRAF and NRAS). However, the discovery of a potent and selective inhibitor with biopharmaceutical properties suitable to sustain robust target inhibition in the clinical setting has proven challenging. Herein, we report the discovery of exarafenib (15), a highly potent and selective inhibitor that intercepts the RAF protein in the dimer compatible αC-helix-IN conformation and demonstrates anti-tumor efficacy in preclinical models with BRAF class I, II, and III and NRAS alterations.
Collapse
Affiliation(s)
- Young K Chen
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Toufike Kanouni
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Lee D Arnold
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Jason M Cox
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Elisabeth Gardiner
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Kathryn Grandinetti
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Ping Jiang
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Stephen W Kaldor
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Catherine Lee
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Chun Li
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Eric S Martin
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Nichol Miller
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Eric A Murphy
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Noel Timple
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - John S Tyhonas
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Angie Vassar
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Tim S Wang
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Richard Williams
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Ding Yuan
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| | - Robert S Kania
- Kinnate Biopharma, 12830 El Camino Real, Suite 150, San Diego, California 92130, United States
| |
Collapse
|
15
|
Locke FL, Filosto S, Chou J, Vardhanabhuti S, Perbost R, Dreger P, Hill BT, Lee C, Zinzani PL, Kröger N, López-Guillermo A, Greinix H, Zhang W, Tiwari G, Budka J, Marincola FM, To C, Mattie M, Schupp M, Cheng P, Bot A, Shen R, Bedognetti D, Miao H, Galon J. Impact of tumor microenvironment on efficacy of anti-CD19 CAR T cell therapy or chemotherapy and transplant in large B cell lymphoma. Nat Med 2024; 30:507-518. [PMID: 38233586 PMCID: PMC10878966 DOI: 10.1038/s41591-023-02754-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 12/05/2023] [Indexed: 01/19/2024]
Abstract
The phase 3 ZUMA-7 trial in second-line large B cell lymphoma demonstrated superiority of anti-CD19 CAR T cell therapy (axicabtagene ciloleucel (axi-cel)) over standard of care (SOC; salvage chemotherapy followed by hematopoietic transplantation) ( NCT03391466 ). Here, we present a prespecified exploratory analysis examining the association between pretreatment tumor characteristics and the efficacy of axi-cel versus SOC. B cell gene expression signature (GES) and CD19 expression associated significantly with improved event-free survival for axi-cel (P = 0.0002 for B cell GES; P = 0.0165 for CD19 expression) but not SOC (P = 0.9374 for B cell GES; P = 0.5526 for CD19 expression). Axi-cel showed superior event-free survival over SOC irrespective of B cell GES and CD19 expression (P = 8.56 × 10-9 for B cell GES high; P = 0.0019 for B cell GES low; P = 3.85 × 10-9 for CD19 gene high; P = 0.0017 for CD19 gene low). Low CD19 expression in malignant cells correlated with a tumor GES consisting of immune-suppressive stromal and myeloid genes, highlighting the inter-relation between malignant cell features and immune contexture substantially impacting axi-cel outcomes. Tumor burden, lactate dehydrogenase and cell-of-origin impacted SOC more than axi-cel outcomes. T cell activation and B cell GES, which are associated with improved axi-cel outcome, decreased with increasing lines of therapy. These data highlight differences in resistance mechanisms to axi-cel and SOC and support earlier intervention with axi-cel.
Collapse
Affiliation(s)
| | | | - Justin Chou
- Kite, a Gilead Company, Santa Monica, CA, USA
| | | | | | - Peter Dreger
- Heidelberg University Hospital, Heidelberg, Germany
| | | | - Catherine Lee
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Pier L Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia Seràgnol and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università di Bologna, Bologna, Italy
| | | | | | | | | | | | | | | | | | - Mike Mattie
- Kite, a Gilead Company, Santa Monica, CA, USA
| | | | - Paul Cheng
- Kite, a Gilead Company, Santa Monica, CA, USA
| | - Adrian Bot
- Kite, a Gilead Company, Santa Monica, CA, USA
| | - Rhine Shen
- Kite, a Gilead Company, Santa Monica, CA, USA
| | | | - Harry Miao
- Kite, a Gilead Company, Santa Monica, CA, USA
| | - Jérôme Galon
- Veracyte, Marseille, France
- INSERM, Sorbonne Université, Université Paris Cité, Centre de Recherche des Cordeliers, Equipe Labellisée Ligue Contre le Cancer, Laboratory of Integrative Cancer Immunology F-75006, Paris, France
| |
Collapse
|
16
|
Pusic I, Lee C, Veeraputhiran M, Minor C, DiPersio JF. Belumosudil and ruxolitinib combination for treatment of refractory chronic graft-versus-host disease. Bone Marrow Transplant 2024; 59:282-284. [PMID: 38071272 DOI: 10.1038/s41409-023-02165-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 02/09/2024]
Affiliation(s)
- Iskra Pusic
- Washington University School of Medicine, Division of Oncology, St. Louis, MO, USA.
| | - Catherine Lee
- Fred Hutchinson Cancer Center, Clinical Research Division, Seattle, WA, USA
| | - Muthu Veeraputhiran
- University of Arkansas for Medical Sciences, Department of Hematology and Medical Oncology, Little Rock, AR, USA
| | - Chelsea Minor
- Washington University School of Medicine, Division of Oncology, St. Louis, MO, USA
| | - John F DiPersio
- Washington University School of Medicine, Division of Oncology, St. Louis, MO, USA
| |
Collapse
|
17
|
Caan BJ, Brown JC, Lee C, Binder AM, Weltzien E, Ross MC, Quesenberry CP, Campbell KL, Cespedes Feliciano EM, Castillo A, Quinney S, Yang S, Meyerhardt JA, Schmitz KH. Effect of home-based resistance training on chemotherapy relative dose intensity and tolerability in colon cancer: The FORCE randomized control trial. Cancer 2024. [PMID: 38265970 DOI: 10.1002/cncr.35204] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Many patients with colon cancer cannot fully adhere to postoperative chemotherapy due to dose-limiting toxicities, resulting in lower relative dose intensity (RDI) and potentially compromising overall survival. This study examined whether home-based resistance training (RT) during adjuvant chemotherapy improves RDI and patient-reported toxicities versus usual care (UC) in colon cancer patients. METHODS Multicenter, randomized control trial (RCT) conducted at community and academic practices. Enrollment of patients receiving postoperative chemotherapy for colon cancer occurred between February 23, 2018, and September 29, 2021; final follow-up was March 21, 2022. Participants were randomized to RT (n = 90) or UC (n = 91) for the duration of chemotherapy. Participants in the RT group engaged in twice weekly home-based progressive RT. At the end of the study, UC was given an online exercise program. RESULTS Among 181 randomized patients (mean age, 55.2 [SD, 12.8] years, 95 [52.5%] were men), there were no differences in the mean RDI among those in RT (79% [SD, 19%]) and those in UC (82% [SD, 19%]); (mean difference -0.04 [95% confidence interval (CI), -0.09 to 0.02]). Assignment to RT did not significantly reduce the number of moderate/severe symptoms per week across follow-up (relative rate: 0.94 [95% CI, 0.72-1.22]). Additionally, time since randomization did not significantly modify the effect of RT on the overall number of symptoms (p = .06). CONCLUSIONS Among patients with colon cancer, these results do not support home-based RT as an adjunct to chemotherapy specifically to improve planned treatment intensity.
Collapse
Affiliation(s)
- Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Justin C Brown
- Cancer Metabolism Program, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Alexandra M Binder
- Cancer Epidemiology, University of Hawaii Cancer Center, Honolulu, Hawaii, USA
- Department of Epidemiology, University of California, Los Angeles, California, USA
| | - Erin Weltzien
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Michelle C Ross
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Charles P Quesenberry
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Kristin L Campbell
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Adrienne Castillo
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Sara Quinney
- Indiana University School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Shengping Yang
- Cancer Metabolism Program, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - Kathryn H Schmitz
- Division of Hematology and Oncology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
18
|
Hook C, Chatterjee U, Sheng H, Zhu Q, Robinson T, Roh JM, Laurent CA, Lee C, Delmerico J, Lo JC, Ambrosone CB, Kushi LH, Kwan ML, Yao S. A polygenic score associated with fracture risk in breast cancer patients treated with aromatase inhibitors. NPJ Breast Cancer 2024; 10:9. [PMID: 38245540 PMCID: PMC10799916 DOI: 10.1038/s41523-024-00615-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 01/04/2024] [Indexed: 01/22/2024] Open
Abstract
Identifying women at high risk of osteoporotic fracture from aromatase inhibitor (AI) therapy for breast cancer is largely based on known risk factors for healthy postmenopausal women, which might not accurately reflect the risk in breast cancer patients post-AI therapy. To determine whether a polygenic score associated with fracture in healthy women is also significant in women treated with AIs for breast cancer, we used data from a prospective observational cohort of 2152 women diagnosed with hormonal receptor positive breast cancer treated with AIs as the initial endocrine therapy and examined a polygenic score of heel quantitative ultrasound speed of sound (gSOS) in relation to incident osteoporotic fracture after AI therapy during a median 6.1 years of follow up after AI initiation. In multivariable models, patients with the second and third highest tertiles (T) versus the lowest tertile of gSOS had significantly lower risk of fracture (T2: adjusted HR = 0.61, 95% CI: 0.46-0.80; T3: adjusted HR = 0.53, 95% CI: 0.40-0.70). The lower risk of fracture in patients with the highest tertile of gSOS remained significant after further adjustment for BMD at the hip (T3: adjusted HR = 0.62, 95% CI: 0.42-0.91). In conclusion, our analysis showed gSOS as a novel genetic predictor for fracture risk independent of BMD among breast cancer patients treated with AIs. Future studies are warranted to evaluate the performance of incorporating gSOS in prediction models for the risk of AI-related fracture in breast cancer patients.
Collapse
Affiliation(s)
- Christine Hook
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Udit Chatterjee
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Haiyang Sheng
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
- Department of Biostatistics, University at Buffalo, Buffalo, NY, USA
| | - Qianqian Zhu
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Timothy Robinson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Janise M Roh
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Cecile A Laurent
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Jennifer Delmerico
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Joan C Lo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Marilyn L Kwan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Song Yao
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
| |
Collapse
|
19
|
Campbell KL, Brown JC, Lee C, Weltzien E, Li J, Sternfeld B, Campbell N, Vaughan M, Fedric R, Meyerhardt JA, Caan BJ, Schmitz KH. Advances in Adherence Reporting of Resistance Training in a Clinical Trial during Adjuvant Chemotherapy for Colon Cancer. Med Sci Sports Exerc 2024:00005768-990000000-00458. [PMID: 38233992 DOI: 10.1249/mss.0000000000003395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE Detailed reporting of individually tailored exercise prescriptions (ExRx) used in clinical trials is essential to describe feasibility, tolerability, and efficacy of the intervention and to inform translation to clinical care. This paper outlines the methodology used to develop a resistance training (RT) ExRx for people with colon cancer receiving chemotherapy and reports adherence to the randomized controlled trial testing the impact of RT on relative dose intensity of chemotherapy and patient-reported toxicities. METHODS Participants randomized to the exercise arm (n = 90) were included. To promote muscle hypertrophy, the ExRx was twice-weekly, moderate to heavy loads (65-85% 1-RM), high sets (3-5), and intermediate repetitions (6-10) of five large multi-joint movements with adjustable dumbbells. Attendance (achieved frequency) and adherence (achieved volume) were calculated. Group-based trajectory modeling was used to identify clusters of individuals with similar adherence patterns and compared baseline characteristics across adherence groups. RESULTS The median attendance was 69.1%. Adherence was 60.6%, but higher for those receiving 3 versus 6 months of chemotherapy (80.4 vs. 47.4%; p < 0.05). Participants engaged in a median of 1.4 days of RT each week, lifting 62% of the 1-RM load, for 3.0 sets and 7.5 repetitions per set. Three distinct adherence groups were identified: 13% "non-starter", 37% "tapered off", and 50% "consistent exercisers". Females were more likely to be in the "non-starter" and "tapered off" groups. CONCLUSIONS This paper outlines suggested methods for reporting ExRx of RT in oncology clinical trials and provides insight into the tolerance of ExRx of RT during chemotherapy treatment for colon cancer. These findings aim to foster constructive dialogue, and offer a premise for designing future research to elucidate the benefits of exercise during chemotherapy.
Collapse
Affiliation(s)
| | | | | | | | - Jia Li
- Kaiser Permanente Northern California, Oakland, CA
| | | | | | | | - Regan Fedric
- Kaiser Permanente Northern California, Oakland, CA
| | | | - Bette J Caan
- Kaiser Permanente Northern California, Oakland, CA
| | | |
Collapse
|
20
|
Ames JL, Anderson MC, Cronbach E, Lee C, Onaiwu MG, Vallerie AM, Croen LA. Reproductive healthcare in adolescents with autism and other developmental disabilities. Am J Obstet Gynecol 2024:S0002-9378(24)00013-9. [PMID: 38218512 DOI: 10.1016/j.ajog.2024.01.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND Adults with developmental disabilities often have less access to reproductive health services than adults without these disabilities. However, little is known about how adolescents with developmental disabilities, including autism, access reproductive healthcare. OBJECTIVE We aimed to characterize the use of reproductive healthcare services among adolescents with autism and those with other developmental disabilities in comparison with adolescents with typical development, to be consistent with person-first language. STUDY DESIGN We conducted a cohort study of a sample of adolescents who were continuously enrolled members of Kaiser Permanente Northern California, an integrated healthcare system, from ages 14 to 18 years. The final analytical sample included 700 adolescents with autism, 836 adolescents with other developmental disabilities, and 2187 typically developing adolescents who sought care between 2000 and 2017. Using the electronic health record, we obtained information on menstrual conditions, the use of obstetrical-gynecologic care, and prescriptions of hormonal contraception. We compared healthcare use between the groups using chi-square tests and covariate-adjusted risk ratios estimated using modified Poisson regression. RESULTS Adolescents with autism and those with other developmental disabilities were significantly more likely to have diagnoses of menstrual disorders, polycystic ovary syndrome, and premenstrual syndrome than typically developing adolescents. These 2 groups also were less likely than typically developing peers to visit the obstetrician-gynecologist or to use any form of hormonal contraception, including oral contraception, hormonal implants, and intrauterine devices. Adolescents in all 3 groups accessed hormonal contraception most frequently through their primary care provider, followed by an obstetrician-gynecologist. CONCLUSION Adolescents with autism and those with other developmental disabilities are less likely than their typically developing peers to visit the obstetrician-gynecologist and to use hormonal contraception, suggesting possible care disparities that may persist into adulthood. Efforts to improve access to reproductive healthcare in these populations should target care delivered in both the pediatric and obstetrics-gynecology settings.
Collapse
Affiliation(s)
- Jennifer L Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, CA.
| | | | - Emily Cronbach
- The Permanente Medical Group, Obstetrics and Gynecology, Kaiser Permanente Northern California Park Shadelands, Walnut Creek, CA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Morénike Giwa Onaiwu
- Autistic Women and Nonbinary Network, Lincoln, NE; Rice University Center for the Study of Women, Gender, and Sexuality, Houston, TX; AJ Drexel Autism Institute, Drexel University, Philadelphia, PA
| | - Amy M Vallerie
- The Permanente Medical Group, Obstetrics and Gynecology Kaiser Permanente Northern California, Oakland, CA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| |
Collapse
|
21
|
Myers LC, Lawson BL, Escobar GJ, Daly KA, Chen YFI, Dlott R, Lee C, Liu V. Evaluation of an outreach programme for patients with COVID-19 in an integrated healthcare delivery system: a retrospective cohort study. BMJ Open 2024; 14:e073622. [PMID: 38191255 PMCID: PMC10806839 DOI: 10.1136/bmjopen-2023-073622] [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: 03/14/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES In the first year of the COVID-19 pandemic, health systems implemented programmes to manage outpatients with COVID-19. The goal was to expedite patients' referral to acute care and prevent overcrowding of medical centres. We sought to evaluate the impact of such a programme, the COVID-19 Home Care Team (CHCT) programme. DESIGN Retrospective cohort. SETTING Kaiser Permanente Northern California. PARTICIPANTS Adult members before COVID-19 vaccine availability (1 February 2020-31 January 2021) with positive SARS-CoV-2 tests. INTERVENTION Virtual programme to track and treat patients with 'CHCT programme'. OUTCOMES The outcomes were (1) COVID-19-related emergency department visit, (2) COVID-19-related hospitalisation and (3) inpatient mortality or 30-day hospice referral. MEASURES We estimated the average effect comparing patients who were and were not treated by CHCT. We estimated propensity scores using an ensemble super learner (random forest, XGBoost, generalised additive model and multivariate adaptive regression splines) and augmented inverse probability weighting. RESULTS There were 98 585 patients with COVID-19. The majority were followed by CHCT (n=80 067, 81.2%). Patients followed by CHCT were older (mean age 43.9 vs 41.6 years, p<0.001) and more comorbid with COmorbidity Point Score, V.2, score ≥65 (1.7% vs 1.1%, p<0.001). Unadjusted analyses showed more COVID-19-related emergency department visits (9.5% vs 8.5%, p<0.001) and hospitalisations (3.9% vs 3.2%, p<0.001) in patients followed by CHCT but lower inpatient death or 30-day hospice referral (0.3% vs 0.5%, p<0.001). After weighting, there were higher rates of COVID-19-related emergency department visits (estimated intervention effect -0.8%, 95% CI -1.4% to -0.3%) and hospitalisation (-0.5%, 95% CI -0.9% to -0.1%) but lower inpatient mortality or 30-day hospice referral (-0.5%, 95% CI -0.7% to -0.3%) in patients followed by CHCT. CONCLUSIONS Despite CHCT following older patients with higher comorbidity burden, there appeared to be a protective effect. Patients followed by CHCT were more likely to present to acute care and less likely to die inpatient.
Collapse
Affiliation(s)
- Laura C Myers
- Division of Research, Kaiser Permanente, Oakland, California, USA
- The Permanente Medical Group Inc, Oakland, California, USA
| | - Brian L Lawson
- Division of Research, Kaiser Permanente, Oakland, California, USA
| | - Gabriel J Escobar
- Division of Research, Kaiser Permanente, Oakland, California, USA
- The Permanente Medical Group Inc, Oakland, California, USA
| | - Kathleen A Daly
- Division of Research, Kaiser Permanente, Oakland, California, USA
| | | | - Richard Dlott
- The Permanente Medical Group Inc, Oakland, California, USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente, Oakland, California, USA
| | - Vincent Liu
- Division of Research, Kaiser Permanente, Oakland, California, USA
- The Permanente Medical Group Inc, Oakland, California, USA
| |
Collapse
|
22
|
Xiao Y, Palmucc M, Carlin L, Lee C, O'Gorman MRG, Nair S, Yieh L, Leung EKY. Implementation and assessment of an electronic clinical decision support tool to notify clinicians of critical hyperbilirubinemia in preterm neonates less than 35 weeks' gestation. Am J Clin Pathol 2024; 161:83-88. [PMID: 37698998 DOI: 10.1093/ajcp/aqad112] [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: 03/27/2023] [Accepted: 08/03/2023] [Indexed: 09/14/2023] Open
Abstract
OBJECTIVES Critical hyperbilirubinemia in preterm neonates, a condition requiring greater attention, is treated with phototherapy or exchange transfusion when bilirubin results exceed gestational age and age-specific medical decision levels (MDLs) to prevent bilirubin-induced neurologic damage. Conventional evaluation involves multiple manual steps and is poised to inconsistencies and delays. METHODS We designed and implemented an electronic clinical decision support (CDS) tool to identify and alert neonatal intensive care unit clinicians of critical hyperbilirubinemia with a SmartZone alert. We evaluated the performance of our manual evaluation workflow, the accuracy of the electronic CDS tool, and the outcome of the electronic CDS tool to reduce the time to place orders for interventions. RESULTS Among the 22 patients who met the criteria to have phototherapy ordered before implementing the electronic CDS tool, 20 (90%) had phototherapy ordered. Fourteen (70%) phototherapy orders were placed less than 24 hours, 4 phototherapy orders were placed 24 to 72 hours, and 2 orders were placed more than 72 hours after bilirubin results exceeded the corresponding MDLs. Among the 15 patients who met the criteria to have phototherapy ordered after implementing the electronic CDS tool, all (100%) received phototherapy orders, with 14 (93%) placed less than 24 hours and 1 order placed less than 48 hours. The electronic CDS tool identified all eligible patients correctly. The proportion of phototherapy ordered less than 24 hours increased from 70% to 93% after the implementation of the electronic CDS tool. CONCLUSIONS The electronic CDS tool promoted more appropriate and timely intervention orders to manage critical hyperbilirubinemia in preterm neonates.
Collapse
Affiliation(s)
- Yi Xiao
- Department of Pathology and Laboratory Medicine, Children's Hospital of Los Angeles, Los Angeles, CA
| | - Mandy Palmucc
- Clinical Information Services, Children's Hospital of Los Angeles, Los Angeles, CA
| | - Lance Carlin
- Clinical Information Services, Children's Hospital of Los Angeles, Los Angeles, CA
| | - Catherine Lee
- Department of Pathology and Laboratory Medicine, Children's Hospital of Los Angeles, Los Angeles, CA
| | - Maurice R G O'Gorman
- Department of Pathology and Laboratory Medicine, Children's Hospital of Los Angeles, Los Angeles, CA
- Department of Pathology, University of Southern California, Los Angeles, CA
| | - Srikumar Nair
- Department of Pediatrics, Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital of Los Angeles, Los Angeles, CA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Leah Yieh
- Department of Pediatrics, Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital of Los Angeles, Los Angeles, CA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Edward Ki-Yun Leung
- Department of Pathology and Laboratory Medicine, Children's Hospital of Los Angeles, Los Angeles, CA
- Department of Pathology, University of Southern California, Los Angeles, CA
| |
Collapse
|
23
|
Roubinian NH, Greene J, Liu VX, Lee C, Mark DG, Vinson DR, Spencer BR, Bruhn R, Bravo M, Stone M, Custer B, Kleinman S, Busch MP, Norris PJ. Clinical outcomes in hospitalized plasma and platelet transfusion recipients prior to and following widespread blood donor SARS-CoV-2 infection and vaccination. Transfusion 2024; 64:53-67. [PMID: 38054619 PMCID: PMC10842807 DOI: 10.1111/trf.17616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND The safety of transfusion of SARS-CoV-2 antibodies in high plasma volume blood components to recipients without COVID-19 is not established. We assessed whether transfusion of plasma or platelet products during periods of increasing prevalence of blood donor SARS-CoV-2 infection and vaccination was associated with changes in outcomes in hospitalized patients without COVID-19. METHODS We conducted a retrospective cohort study of hospitalized adults who received plasma or platelet transfusions at 21 hospitals during pre-COVID-19 (3/1/2018-2/29/2020), COVID-19 pre-vaccine (3/1/2020-2/28/2021), and COVID-19 post-vaccine (3/1/2021-8/31/2022) study periods. We used multivariable logistic regression with generalized estimating equations to adjust for demographics and comorbidities to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Among 21,750 hospitalizations of 18,584 transfusion recipients without COVID-19, there were 697 post-transfusion thrombotic events, and oxygen requirements were increased in 1751 hospitalizations. Intensive care unit length of stay (n = 11,683) was 3 days (interquartile range 1-5), hospital mortality occurred in 3223 (14.8%), and 30-day rehospitalization in 4144 (23.7%). Comparing the pre-COVID, pre-vaccine and post-vaccine study periods, there were no trends in thromboses (OR 0.9 [95% CI 0.8, 1.1]; p = .22) or oxygen requirements (OR 1.0 [95% CI 0.9, 1.1]; p = .41). In parallel, there were no trends across study periods for ICU length of stay (p = .83), adjusted hospital mortality (OR 1.0 [95% CI 0.9-1.0]; p = .36), or 30-day rehospitalization (p = .29). DISCUSSION Transfusion of plasma and platelet blood components collected during the pre-vaccine and post-vaccine periods of the COVID-19 pandemic was not associated with increased adverse outcomes in transfusion recipients without COVID-19.
Collapse
Affiliation(s)
- Nareg H Roubinian
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, UCSF, San Francisco, California, USA
| | - John Greene
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
| | - Vincent X Liu
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
| | - Catherine Lee
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
| | - Dustin G Mark
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
| | - David R Vinson
- Kaiser Permanente Northern California Division of Research, Oakland, California, USA
| | - Bryan R Spencer
- American Red Cross, Scientific Affairs, Dedham, Massachusetts, USA
| | - Roberta Bruhn
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, UCSF, San Francisco, California, USA
| | | | - Mars Stone
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, UCSF, San Francisco, California, USA
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, UCSF, San Francisco, California, USA
| | - Steve Kleinman
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael P Busch
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, UCSF, San Francisco, California, USA
| | - Philip J Norris
- Vitalant Research Institute, San Francisco, California, USA
- Department of Laboratory Medicine, UCSF, San Francisco, California, USA
| |
Collapse
|
24
|
Shim VC, Baker RJ, Jing W, Puentes R, Agersborg SS, Lee TK, GoreaI W, Achacoso N, Lee C, Villasenor M, Lin A, Kapali M, Habel LA. Evaluation of the international Ki67 working group cut point recommendations for early breast cancer: comparison with 21-gene assay results in a large integrated health care system. Breast Cancer Res Treat 2024; 203:281-289. [PMID: 37847456 PMCID: PMC10787679 DOI: 10.1007/s10549-023-07118-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/24/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE The International Ki67 Working Group (IKWG) has developed training for immunohistochemistry (IHC) scoring reproducibility and recommends cut points of ≤ 5% and ≥ 30% for prognosis in ER+, HER2-, stage I/II breast cancer. We examined scoring reproducibility following IKWG training and evaluated these cut points for selecting patients for further testing with the 21-gene Recurrence Score (RS) assay. METHODS We included 307 women aged 50+ years with node-negative, ER+PR+HER2- breast cancer and with available RS results. Slides from the diagnostic biopsy were stained for Ki67 and scored using digital image analysis (IA). Two IHC pathologists underwent IKWG training and visually scored slides, blinded to each other and IA readings. Interobserver reproducibility was examined using intraclass correlation (ICC) and Kappa statistics. RESULTS Depending on reader, 8.8-16.0% of our cohort had Ki67 ≤ 5% and 11.4-22.5% had scores ≥ 30%. The ICC for Ki67 scores by the two pathologists was 0.82 (95% CI 0.78-0.85); it was 0.79 (95% CI 0.74-0.83) for pathologist 1 and IA and 0.76 (95% CI 0.71-0.80) for pathologist 2 and IA. For Ki67 scores ≤ 5%, the percentages with RS < 26 were 92.6%, 91.8%, and 90.9% for pathologist 1, pathologist 2, and IA, respectively. For Ki67 scores ≥ 30%, the percentages with RS ≥ 26 were 41.5%, 51.4%, and 27.5%, respectively. CONCLUSION The IKWG's Ki67 training resulted in moderate to strong reproducibility across readers but cut points had only moderate overlap with RS cut points, especially for Ki67 ≥ 30% and RS ≥ 26; thus, their clinical utility for a 21-gene assay testing pathway remains unclear.
Collapse
Affiliation(s)
- Veronica C Shim
- The Permanente Medical Group, Northern California Kaiser Permanente, Oakland, CA, USA
| | - Robin J Baker
- The Permanente Medical Group, Northern California Kaiser Permanente, San Francisco, CA, USA
| | - Wen Jing
- The Permanente Medicine, Northern California Kaiser Permanente, San Francisco, CA, USA
| | | | | | - Thomas K Lee
- NeoGenomics Laboratories, Inc., Aliso Viejo, CA, USA
| | - Wamda GoreaI
- NeoGenomics Laboratories, Inc., Aliso Viejo, CA, USA
| | - Ninah Achacoso
- The Division of Research, Northern California Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA
| | - Catherine Lee
- The Division of Research, Northern California Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA
| | - Marvella Villasenor
- The Division of Research, Northern California Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA
| | - Amy Lin
- The Permanente Medical Group, Northern California Kaiser Permanente, San Francisco, CA, USA
| | - Malathy Kapali
- The Permanente Medical Group, Northern California Kaiser Permanente, Sacramento, CA, USA
| | - Laurel A Habel
- The Division of Research, Northern California Kaiser Permanente, 2000 Broadway, Oakland, CA, 94612, USA.
| |
Collapse
|
25
|
Cao Y, Aryal M, Li P, Lee C, Schipper M, You D, Jaworski E, Gharzai L, Shah J, Eisbruch A, Mierzwa M. Diffusion MRI correlation with p16 status and prediction for tumor progression in locally advanced head and neck cancer. Front Oncol 2023; 13:998186. [PMID: 38188292 PMCID: PMC10771284 DOI: 10.3389/fonc.2023.998186] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/06/2023] [Indexed: 01/09/2024] Open
Abstract
Purpose To investigate p16 effects on diffusion image metrics and associations with tumor progression in patients with locally advanced head and neck cancers. Methods Diffusion images pretreatment and after 20 Gy (2wk) of RT were analyzed in patients with cT4/N3 p16+ oropharynx cancer (OPSCC) (N=51) and locoregionally advanced head and neck squamous cell carcinoma (LAHNSCC) (N=28), enrolled onto a prospective adaptive RT trial. Mean ADC values, subvolumes with ADC <1.2 um2/ms (TVLADC), and peak values of low (µL) and high (µH) components of ADC histograms in primary and total nodal gross tumor volumes were analyzed for prediction of freedom from local, distant, or any progression (FFLP, FFDP or FFLRDP) using multivariate Cox proportional-hazards model with clinical factors. P value with false discovery control <0.05 was considered as significant. Results With a mean follow up of 36 months, 18 of LAHNSCC patients and 16 of p16+ OPSCC patients had progression. After adjusting for p16, small µL and ADC values, and large TVLADC of primary tumors pre-RT were significantly associated with superior FFLRDP, FFLP and FFDP in the LAHNSCC (p<0.05), but no diffusion metrics were significant in p16+ oropharynx cancers. Post ad hoc analysis of the p16+ OPSCC only showed that large TVLADC of the total nodal burden pre-RT was significantly associated with inferior FFDP (p=0.05). Conclusion ADC metrics were associated with different progression patterns in the LAHNSCC and p16+ OPSCC, possibly explained by differences in cancer biology and morphology. A deep understanding of ADC metrics is warranted to establish imaging biomarkers for adaptive RT in HNSCC.
Collapse
Affiliation(s)
- Yue Cao
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
- Department of Radiology, University of Michigan, Ann Arbor, MI, United States
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, United States
| | - M. Aryal
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - P. Li
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - C. Lee
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - M. Schipper
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - D. You
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - E. Jaworski
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - L. Gharzai
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - J. Shah
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
- Department of Radiation Oncology, VA Ann Arbor Healthcare System, Ann Arbor, MI, United States
| | - A. Eisbruch
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| | - Michelle Mierzwa
- Departments of Radiation Oncology, University of Michigan, Ann Arbor, MI, United States
| |
Collapse
|
26
|
Solomon MD, Tabada G, Sung SH, Allen A, Mishell JM, Rassi AN, McNulty E, Philip F, Lange DC, Ambrosy AP, Zaroff JG, Krishnaswami A, Lee C, DeMaria A, Nishimura R, Go AS. Physician assessment of aortic stenosis severity, quantitative parameters, and long-term outcomes: Results from the KP-VALVE project. Am Heart J 2023; 266:32-47. [PMID: 37553045 DOI: 10.1016/j.ahj.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Contemporary outcomes for aortic stenosis (AS) and the association between physician-assessed AS severity and quantitative parameters is poorly understood. We aimed to evaluate AS natural history, compare outcomes for physicians' AS assessment vs. quantitative parameters, and identify AS parameters with the most explanatory power. METHODS We ascertained physician-assessed AS severity, echocardiographic parameters, and clinical data for 546,769 patients from 2008-2018, examined multivariable associations of physician-assessed AS severity and number of quantitative severe AS parameters with death, cardiovascular hospitalization, and aortic valve replacement, and estimated the relative contribution of different quantitative AS parameters on outcomes. RESULTS Among 49,604 AS patients (mean [SD] age 77 [11] years), 17.6% had moderate, 3.6% moderate-severe, and 9.4% severe AS. During median 3.7 [IQR 1.7-6.8] years, physician-assessed AS severity strongly correlated with outcomes, with moderate AS patients tracking closest to mild AS, and moderate-to-severe AS patients more comparable to severe AS. Although the number of quantitative severe AS parameters strongly predicted outcomes (adjusted HR [95% CI] for death 1.40 [1.34-1.46], 1.70 [1.56-1.85], and 1.78 [1.63-1.94] for 1, 2, and 3 parameters, respectively), aortic valve area <1.0 cm2 was the most frequent severe AS parameter, explained the largest relative contribution (67%), and was common in patients classified as moderate (21%) or moderate-severe (56%) AS. CONCLUSIONS Physician-assessed AS severity predicts outcomes, with cumulative effects for each severe AS parameter. Moderate AS includes a wide spectrum of patients, with discordant AVA <1.0 cm2 being both common and predictive. Better identification of non-classical severe AS phenotypes may improve outcomes.
Collapse
Affiliation(s)
- Matthew D Solomon
- Kaiser Permanente Northern California Division of Research, Oakland, CA; Department of Cardiology, Kaiser Permanente Oakland Medical Center, Oakland, CA.
| | - Grace Tabada
- Kaiser Permanente Northern California Division of Research, Oakland, CA
| | - Sue Hee Sung
- Kaiser Permanente Northern California Division of Research, Oakland, CA
| | - Amanda Allen
- Kaiser Permanente Northern California Division of Research, Oakland, CA
| | - Jacob M Mishell
- Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA
| | - Andrew N Rassi
- Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA
| | - Edward McNulty
- Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA
| | - Femi Philip
- Department of Cardiology, Kaiser Permanente Roseville Medical Center, Roseville, CA
| | - David C Lange
- Department of Cardiology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, CA
| | - Andrew P Ambrosy
- Kaiser Permanente Northern California Division of Research, Oakland, CA; Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA
| | - Jonathan G Zaroff
- Department of Cardiology, Kaiser Permanente San Francisco Medical Center, San Francisco, CA
| | - Ashok Krishnaswami
- Department of Cardiology, Kaiser Permanente San Jose Medical Center, San Jose, CA
| | - Catherine Lee
- Kaiser Permanente Northern California Division of Research, Oakland, CA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
| | - Anthony DeMaria
- Department of Cardiology, University of California at San Diego, San Diego, CA
| | - Rick Nishimura
- Department of Cardiology, The Mayo Clinic, Rochester, MN
| | - Alan S Go
- Kaiser Permanente Northern California Division of Research, Oakland, CA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA; Departments of Epidemiology, Biostatistics and Medicine, University of California, San Francisco, CA
| |
Collapse
|
27
|
Lee L, Hillier LM, Patel T, Lu SK, Lee M, Lee C. An innovative approach to recruiting participants for dementia research: primary care and researcher perspectives. Neurodegener Dis Manag 2023; 13:323-334. [PMID: 38284385 DOI: 10.2217/nmt-2022-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
Aim: To describe clinician and researcher perceptions of a new, patient preference focused approach to recruiting patients for research from primary care-based memory clinics. Methods: Memory clinic clinicians completed a survey and key informants completed an individual interview to gather their perceptions of this new program. Results: The majority of clinicians were 'satisfied' or 'very satisfied' with this recruitment approach and indicated that this approach would have minimal negative impact on patient care or create conflict of interest. Key informants valued the program for its patient-centred approach, the integration of research into care and potential for increased recruitment. Discussion: These findings are suggestive of support for this recruitment approach. Pilot testing will inform feasibility, effectiveness and process improvements.
Collapse
Affiliation(s)
- Linda Lee
- Centre for Family Medicine Family Health Team, 10 B Victoria Street South, Kitchener, Ontario, N2G 1C5, Canada
- Department of Family Medicine, McMaster University, 100 Main Street West, Hamilton, Ontario, L8P 1H6, Canada
- Schlegel-University of Waterloo Research Institute for Aging, 250 Laurelwood Drive, Waterloo, Ontario, N2J 0E2, Canada
| | - Loretta M Hillier
- GERAS Centre for Aging Research, 88 Maplewood Ave, Hamilton, Ontario, L8M 1W9, Canada
| | - Tejal Patel
- Centre for Family Medicine Family Health Team, 10 B Victoria Street South, Kitchener, Ontario, N2G 1C5, Canada
- School of Pharmacy, University of Waterloo, 10A Victoria Street South, Waterloo, Ontario, N2G 1C5, Canada
| | - Stephanie K Lu
- Centre for Family Medicine Family Health Team, 10 B Victoria Street South, Kitchener, Ontario, N2G 1C5, Canada
| | - Michael Lee
- Centre for Family Medicine Family Health Team, 10 B Victoria Street South, Kitchener, Ontario, N2G 1C5, Canada
| | - Catherine Lee
- Centre for Family Medicine Family Health Team, 10 B Victoria Street South, Kitchener, Ontario, N2G 1C5, Canada
| |
Collapse
|
28
|
Mitchell KE, Kienzle SL, Lee C, Socha MT, Kleinschmit DH, Firkins JL. Supplementing branched-chain volatile fatty acids in dual-flow cultures varying in dietary forage and corn oil concentrations. II: Biohydrogenation and incorporation into bacterial lipids. J Dairy Sci 2023; 106:7548-7565. [PMID: 37532628 DOI: 10.3168/jds.2022-23192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/17/2023] [Indexed: 08/04/2023]
Abstract
To maintain membrane homeostasis, ruminal bacteria synthesize branched-chain fatty acids (BCFA) or their derivatives (vinyl ethers) that are recovered during methylation procedures as branched-chain aldehydes (BCALD). Many strains of cellulolytic bacteria require 1 or more branched-chain volatile fatty acid (BCVFA). Therefore, the objective of this study was to investigate BCVFA incorporation into bacterial lipids under different dietary conditions. The study was an incomplete block design with 8 continuous culture fermenters used in 4 periods with treatments (n = 4) arranged as a 2 × 2 × 2 factorial. The factors were high (HF) or low forage (LF, 67 or 33% forage, 33:67 alfalfa:orchardgrass), without or with supplemental corn oil (CO; 3% dry matter, 1.5% linoleic fatty acid), and without or with 2.15 mmol/d (5 mg/d 13C each of isovalerate, isobutyrate, and 2-methylbutyrate). After methylation of bacterial pellets collected from each fermenter's effluent, fatty acids and fatty aldehydes were separated before analysis by gas chromatography and isotope ratio mass spectrometry. Supplementation of BCVFA did not influence biohydrogenation extent. Label was only recovered in branched-chain lipids. Lower forage inclusion decreased BCFA in bacterial fatty acid profile from 9.45% with HF to 7.06% with LF and decreased BCALD in bacterial aldehyde profile from 55.4% with HF to 51.4% with LF. Supplemental CO tended to decrease iso even-chain BCFA and decreased iso even-chain BCALD in their bacterial lipid profiles. The main 18:1 isomer was cis-9 18:1, which increased (P < 0.01) by 25% from CO (data not shown). Dose recovery in bacterial lipids was 43.3% lower with LF than HF. Supplemental CO decreased recovery in the HF diet but increased recovery with LF (diet × CO interaction). Recovery from anteiso odd-chain BCFA and BCALD was the greatest; therefore, 2-methylbutyrate was the BCVFA primer most used for branched-chain lipid synthesis. Recovery in iso odd-chain fatty acids (isovalerate as primer) was greater than label recovery in iso even-chain fatty acids (isobutyrate as primer). Fatty aldehydes were less than 6% of total bacterial lipids, but 26.0% of 13C recovered in lipids were recovered in BCALD because greater than 50% of aldehydes were branched-chain. Because BCFA and BCALD are important in the function and growth of bacteria, especially cellulolytics, BCVFA supplementation can support the rumen microbial consortium, increasing fiber degradation and efficiency of microbial protein synthesis.
Collapse
Affiliation(s)
| | | | - C Lee
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691
| | - M T Socha
- Zinpro Corporation, Eden Prairie, MN 55344
| | | | - J L Firkins
- Department of Animal Sciences, The Ohio State University, Columbus, OH 43035
| |
Collapse
|
29
|
Millman A, Huang J, Graetz I, Lee C, Shan J, Hsueh L, Muelly E, Gopalan A, Reed M. Patient-reported Primary Care Video and Telephone Telemedicine Preference Shifts During the COVID-19 Pandemic. Med Care 2023; 61:772-778. [PMID: 37733433 PMCID: PMC10592113 DOI: 10.1097/mlr.0000000000001916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
BACKGROUND Patient perceptions of primary care telephone and video telemedicine and whether COVID-19 pandemic-related telemedicine exposure shifted patients' visit preference is unknown. OBJECTIVES We examined patient surveys to understand the health care experience of patients seeking primary care through telemedicine and how patients expected their preferences to shift as a result of the COVID-19 pandemic. RESEARCH DESIGN/SUBJECTS In an integrated delivery system that shifted to a "telemedicine-first" health care model during the COVID-19 pandemic, we sampled monthly and collected 1000 surveys from adults with primary care telemedicine visits scheduled through the online patient portal between 3/16/2020 and 10/31/2020. MEASURES Participants reported their preferred primary care visit modality (telephone, video, or in-person visits) across 3 time points: before, during and (hypothetically) after the COVID-19 pandemic, and reported their general assessment of primary care visits during the pandemic. RESULTS The majority of participants preferred in-person visits before (69%) and after the COVID-19 pandemic (57%). However, most participants reported a preference for telemedicine visits during the pandemic and continue to prefer telemedicine visits at a 12% higher rate post-pandemic. Many participants (63%) expressed interest in using telemedicine at least some of the time. Among participants reporting a recent telemedicine visit, 85% agreed that the visit addressed their health needs. CONCLUSION As primary care visit modality preferences continue to evolve, patients anticipate that they will continue to prefer telemedicine visits, both video and telephone, at an increased rate than before the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - Jie Huang
- Kaiser Permanente Division of Research, Oakland, CA
| | - Ilana Graetz
- Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, GA
| | | | - Judy Shan
- School of Medicine, University of California San Francisco, San Francisco, CA
| | - Loretta Hsueh
- Department of Psychology, University of Illinois Chicago, Chicago, IL
| | | | | | - Mary Reed
- Kaiser Permanente Division of Research, Oakland, CA
| |
Collapse
|
30
|
Mitchell KE, Lee C, Socha MT, Kleinschmit DH, Firkins JL. Supplementing branched-chain volatile fatty acids in dual-flow cultures varying in dietary forage and corn oil concentrations. III: Protein metabolism and incorporation into bacterial protein. J Dairy Sci 2023; 106:7566-7577. [PMID: 37641344 DOI: 10.3168/jds.2022-23193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/11/2023] [Indexed: 08/31/2023]
Abstract
Some cellulolytic bacteria cannot transport branched-chain AA (BCAA) and do not express complete synthesis pathways, thus depending on cross-feeding for branched-chain volatile fatty acid (BCVFA) precursors for membrane lipids or for reductive carboxylation to BCAA. Our objective was to assess BCVFA uptake for BCAA synthesis in continuous cultures administered high forage (HF) and low forage (LF) diets without or with corn oil (CO). We hypothesized that BCVFA would be used for BCAA synthesis more in the HF than in LF diets. To help overcome bacterial inhibition by polyunsaturated fatty acids in CO, BCVFA usage for bacterial BCAA synthesis was hypothesized to decrease when CO was added to HF diets. The study was an incomplete block design with 8 dual-flow fermenters used in 4 periods with 8 treatments (n = 4) arranged as a 2 × 2 × 2 factorial. The factors were: HF or LF (67 or 33% forage, 33:67 alfalfa:orchardgrass pellets), without or with supplemental CO (3% of dry matter), and without or with 2.15 mmol/d (5 mg/d 13C) each of isovalerate, isobutyrate, and 2-methylbutyrate for one combined BCVFA treatment. The flow of bacterial BCAA increased by 10.7% by supplementing BCVFA and 9.14% with LF versus HF; similarly, dosing BCVFA versus without BCVFA increased BCAA by 1.98% in total bacterial AA, whereas LF increased BCAA by 1.92% versus HF. Additionally, BCVFA supplementation increased bacterial AA flow by 16.6% when supplemented in HF - CO and 12.4% in LF + CO diets, but not in the HF + CO (-1.5%) or LF - CO (+6.7%) diets (Diet × CO × BCVFA interaction). The recovery of 13C in bacterial AA flow was 31% lower with LF than with HF. Of the total 13C recovered in bacteria, 13.8, 17.3, and 30.2% were recovered in Val, Ile, and Leu, respectively; negligible 13C was recovered in other AA. When fermenters were dosed with BCVFA, nonbacterial and total effluent flows of AA, particularly of alanine and proline, suggest decreased peptidolysis. Increased ruminal outflow of bacterial AA, especially BCAA, but also nonbacterial AA could potentially support postabsorptive responses from BCVFA supplementation to dairy cattle.
Collapse
Affiliation(s)
| | - C Lee
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691
| | - M T Socha
- Zinpro Corporation, Eden Prairie, MN 55344
| | | | - J L Firkins
- Department of Animal Sciences, The Ohio State University, Columbus, OH 43035
| |
Collapse
|
31
|
Mitchell KE, Wenner BA, Lee C, Park T, Socha MT, Kleinschmit DH, Firkins JL. Supplementing branched-chain volatile fatty acids in dual-flow cultures varying in dietary forage and corn oil concentrations. I: Digestibility, microbial protein, and prokaryotic community structure. J Dairy Sci 2023; 106:7530-7547. [PMID: 37532627 DOI: 10.3168/jds.2022-23165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/17/2023] [Indexed: 08/04/2023]
Abstract
Branched-chain amino acids are deaminated by amylolytic bacteria to branched-chain volatile fatty acids (BCVFA), which are growth factors for cellulolytic bacteria. Our objective was to determine the dietary conditions that would increase the uptake of BCVFA by rumen bacteria. We hypothesized that increased forage would increase cellulolytic bacterial abundance and incorporation of BCVFA into their structure. Supplemental polyunsaturated fatty acids, supplied via corn oil (CO), should inhibit cellulolytic bacteria growth, but we hypothesized that additional BCVFA would alleviate that inhibition. Further, supplemental BCVFA should increase neutral detergent fiber degradation and efficiency of bacterial protein synthesis more with the high forage and low polyunsaturated fatty acid dietary combination. The study was an incomplete block design with 8 dual-flow continuous cultures used in 4 periods with 8 treatments (n = 4 per treatment) arranged as a 2 × 2 × 2 factorial. The factors were: high forage (HF) or low forage (LF; 67 or 33%), without or with supplemental CO (3% dry matter), and without or with 2.15 mmol/d (which included 5 mg/d of 13C each of BCVFA isovalerate, isobutyrate, and 2-methylbutyrate). The isonitrogenous diets consisted of 33:67 alfalfa:orchardgrass pellet, and was replaced with a concentrate pellet that mainly consisted of ground corn, soybean meal, and soybean hulls for the LF diet. The main effect of supplementing BCVFA increased neutral detergent fiber (NDF) degradability by 7.6%, and CO increased NDF degradability only in LF diets. Supplemental BCVFA increased bacterial N by 1.5 g/kg organic matter truly degraded (6.6%) and 0.05 g/g truly degraded N (6.5%). The relative sequence abundance decreased with LF for Fibrobacter succinogenes, Ruminococcus flavefaciens, and genus Butyrivibrio compared with HF. Recovery of the total 13C dose in bacterial pellets decreased from 144 µg/ mg with HF to 98.9 µg/ mg with LF. Although isotope recovery in bacteria was greater with HF, BCVFA supplementation increased NDF degradability and efficiency of microbial protein synthesis under all dietary conditions. Therefore, supplemental BCVFA has potential to improve feed efficiency in dairy cows even with dietary conditions that might otherwise inhibit cellulolytic bacteria.
Collapse
Affiliation(s)
| | - B A Wenner
- Elanco Animal Health, Greenfield, IN 46140
| | - C Lee
- Department of Animal Sciences, The Ohio State University, Wooster, OH 44691
| | - T Park
- Department of Animal Science and Technology, Chung-Ang University, Anseong, Gyeonggi-do, Korea 17546
| | - M T Socha
- Zinpro Corporation, Eden Prairie, MN 55344
| | | | - J L Firkins
- Department of Animal Sciences, The Ohio State University, Columbus, OH 43035
| |
Collapse
|
32
|
Sim A, Jirapramukpitak T, Eagling-Peche S, Lwin KZ, Melendez-Torres GJ, Gonzalez A, Oo NN, Castello Mitjans I, Soan M, Punpuing S, Lee C, Chuenglertsiri P, Moo T, Puffer E. A film-based intervention to reduce child maltreatment among migrant and displaced families from Myanmar: Protocol of a pragmatic cluster randomized controlled trial. PLoS One 2023; 18:e0293623. [PMID: 37903143 PMCID: PMC10615270 DOI: 10.1371/journal.pone.0293623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/11/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Child maltreatment is a global public health crisis with negative consequences for physical and mental health. Children in low- and middle-income countries (LMIC)-particularly those affected by poverty, armed conflict, and forced migration-may be at increased risk of maltreatment due to heightened parental distress and disruptions to social support networks. Parenting interventions have been shown to reduce the risk of child maltreatment as well as improve a range of caregiver and child outcomes, yet large-scale implementation remains limited in low-resource displacement settings. This study will examine the impact of an entertainment-education narrative film intervention on reducing physical and emotional abuse and increasing positive parenting among migrant and displaced families from Myanmar living in Thailand. METHOD The study is a pragmatic, superiority cluster randomized controlled trial with approximately 40 communities randomized to the intervention or treatment as usual arms in a 1:1 ratio. Participating families in the intervention arm will be invited to attend a community screening of the film intervention and a post-screening discussion, as well as receive a poster depicting key messages from the film. Primary outcomes are changes in physical abuse, emotional abuse, and positive parenting behaviour. Secondary outcomes include caregiver knowledge of positive parenting, caregiver attitudes towards harsh punishment, caregiver psychological distress, and family functioning. Outcomes will be assessed at 3 time points: baseline, 4 weeks post-intervention, and 4-month follow up. A mixed methods process evaluation will be embedded within the trial to assess intervention delivery, acceptability, perceived impacts, and potential mechanisms of change. DISCUSSION To our knowledge, this study will be the first randomized controlled trial evaluation of a film-based intervention to reduce child maltreatment among migrant and displaced families in a LMIC. An integrated knowledge translation approach will inform uptake of study findings and application to potential scale up pending evaluation results. TRIAL REGISTRATION The study was prospectively registered with the Thai Clinical Trials Registry on 22 February 2023 (TCTR20230222005).
Collapse
Affiliation(s)
- Amanda Sim
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Khaing Zar Lwin
- Institute for Population and Social Research, Mahidol University, Bangkok, Thailand
| | | | - Andrea Gonzalez
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Mary Soan
- Sermpanya Foundation, Mae Sot, Tak, Thailand
| | - Sureeporn Punpuing
- Institute for Population and Social Research, Mahidol University, Bangkok, Thailand
| | - Catherine Lee
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | | | - Th’Blay Moo
- Inclusive Education Foundation, Mae Sot, Tak, Thailand
| | - Eve Puffer
- Department of Psychology & Neuroscience, Duke Global Health Institute, Duke University, Durham, NC, United States of America
| |
Collapse
|
33
|
Chyi LJ, Li S, Lee C, Walsh EM, Kuzniewicz MW. Independent Impact of Eat, Sleep, Console Assessment on Neonatal Opioid Withdrawal Syndrome. Clin Pediatr (Phila) 2023:99228231204448. [PMID: 37798943 DOI: 10.1177/00099228231204448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Compared with the Finnegan Neonatal Abstinence Scoring System (FNASS), the Eat, Sleep, Console (ESC) approach reduces pharmacotherapy and length of stay (LOS) for neonatal opioid withdrawal syndrome (NOWS) infants. The independent outcome contribution of ESC is unknown as the approach combines ESC assessment with additional management changes. Our objective was to evaluate ESC assessment's independent impact on outcomes compared with FNASS. We conducted a retrospective cohort study of in utero opioid-exposed infants ≥35 weeks gestation managed with FNASS versus ESC. Outcomes included pharmacotherapy initiation, LOS, length of pharmacotherapy, and emergency department visit/readmissions. Among 151 FNASS and 100 ESC managed infants, pharmacotherapy initiation (P = .47), LOS for all infants (P = .49), and LOS for pharmacologically treated infants (P = .68) were similar. Length of pharmacotherapy did not differ (P = .84). Emergency department evaluation/NOWS readmission was equally rare (P = .65). Using equivalent models of care, comparison of ESC and FNASS assessment tools showed no difference in NOWS outcomes.
Collapse
Affiliation(s)
- Lisa J Chyi
- Division of Neonatology, Department of Pediatrics, Kaiser Permanente, Walnut Creek, CA, USA
| | - Sherian Li
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Eileen M Walsh
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Michael W Kuzniewicz
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Division of Neonatology, Department of Pediatrics, Kaiser Permanente, Santa Clara, CA, USA
| |
Collapse
|
34
|
Cheng E, Caan BJ, Cawthon PM, Evans WJ, Hellerstein MK, Shankaran M, Nyangau E, Campbell KL, Lee C, Binder AM, Meyerhardt JA, Schmitz KH, Cespedes Feliciano EM. Body Composition, Relative Dose Intensity, and Adverse Events among Patients with Colon Cancer. Cancer Epidemiol Biomarkers Prev 2023; 32:1373-1381. [PMID: 37450841 PMCID: PMC10592319 DOI: 10.1158/1055-9965.epi-23-0227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/10/2023] [Accepted: 07/13/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Despite evidence that low muscle increases the risk of chemotoxicity, most chemotherapies are dosed on body surface area without considering body composition. Among 178 patients with colon cancer, we assessed muscle and adipose tissue with multiple techniques and examined their associations with relative dose intensity (RDI) and adverse events. METHODS We estimated (i) cross-sectional skeletal muscle area (SMA) and total adipose tissue (TAT) area at L3 from computed tomography (CT); (ii) appendicular lean mass (ALM) and total body fat (TBF) mass from dual-energy X-ray absorptiometry (DXA); and (iii) total body skeletal muscle mass using D3-creatine (D3Cr) dilution. We standardized each measurement by its sex-specific standard deviation (SD). The primary outcome was reduced RDI (RDI <85%). The secondary outcome was the number of moderate and severe adverse events during each cycle of chemotherapy. We estimated the associations of muscle and adipose tissue measurements (per SD increase) with reduced RDI using logistic regression and adverse events using generalized estimating equations for repeated measures. RESULTS Higher CT SMA and DXA ALM were significantly associated with a lower risk of reduced RDI [odds ratios: 0.56 (0.38-0.81) for CT SMA; 0.56 (0.37-0.84) for DXA ALM]. No measurements of muscle or adipose tissue were associated with adverse events. CONCLUSIONS More muscle was associated with improved chemotherapy completion among patients with colon cancer, whereas muscle and adipose tissue were not associated with adverse events. IMPACT Considering body composition may help personalize dosing for colon cancer chemotherapy by identifying patients at risk for poor chemotherapy outcomes.
Collapse
Affiliation(s)
- En Cheng
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Bette J. Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Peggy M. Cawthon
- San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - William J. Evans
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
- Division of Geriatrics, Duke University Medical Center, Durham, NC, USA
| | - Marc K. Hellerstein
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Mahalakshmi Shankaran
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Edna Nyangau
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Kristin L. Campbell
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Alexandra M. Binder
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
- Department of Epidemiology, University of California, Los Angeles, CA, USA
| | | | - Kathryn H. Schmitz
- Division of Hematology and Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | | |
Collapse
|
35
|
Lee C, Ebrahimian S, Mabeza RM, Tran Z, Hadaya J, Benharash P, Moazzez A. Association of body mass index with 30-day outcomes following groin hernia repair. Hernia 2023; 27:1095-1102. [PMID: 37076751 DOI: 10.1007/s10029-023-02773-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 03/03/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Although groin hernia repairs are relatively safe, efforts to identify factors associated with greater morbidity and resource utilization following these operations are warranted. An emphasis on obesity has limited studies from a comprehensive evaluation of the association between body mass index (BMI) and outcomes following groin hernia repair. Thus, we aimed to ascertain the association between BMI class with 30-day outcomes following these operations. METHODS The 2014-2020 National Surgical Quality Improvement Program database was queried to identify adults undergoing non-recurrent groin hernia repair. Patient BMI was used to stratify patients into six groups: underweight, normal, overweight, and obesity classes I-III. Association of BMI with major adverse events (MAE), wound complication, and prolonged length of stay (pLOS) as well as 30-day readmission and reoperation were evaluated using multivariable regressions. RESULTS Of the 163,373 adults who underwent groin hernia repair, the majority of patients were considered overweight (44.4%). Underweight patients more commonly underwent emergent operations and femoral hernia repair compared to others. After adjustment of intergoup differences, obesity class III was associated with greater odds of an MAE (AOR 1.50), wound complication (AOR 4.30), pLOS (AOR 1.40), and 30-day readmission (AOR 1.50) and reoperation (AOR 1.75, all p < 0.05). Underweight BMI portended greater odds of pLOS and unplanned readmission. CONCLUSION Consideration of BMI in patients requiring groin hernia repair could help inform perioperative expectations. Preoperative optimization and deployment of a minimally invasive approach when feasible may further reduce morbidity in patients at the extremes of the BMI spectrum.
Collapse
Affiliation(s)
- C Lee
- Cardiovascular Outcomes Research Laboratories, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA.
| | - S Ebrahimian
- Cardiovascular Outcomes Research Laboratories, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - R M Mabeza
- Cardiovascular Outcomes Research Laboratories, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - Z Tran
- Cardiovascular Outcomes Research Laboratories, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - J Hadaya
- Cardiovascular Outcomes Research Laboratories, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - P Benharash
- Cardiovascular Outcomes Research Laboratories, Department of Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA, 90095, USA
| | - A Moazzez
- Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA
| |
Collapse
|
36
|
Kilby W, Lee C, Young P, Dewitt D, Torgov M, Martin TJ, Capo L, Ikeura M, Malinao CC, Morrison KJM, Morrison K. Superiority of BNCT Treatment Planning Metrics Achieved Using Novel vs. Reference (BPA-F) Pharmaceuticals in Head and Neck Locations. Int J Radiat Oncol Biol Phys 2023; 117:e678. [PMID: 37785996 DOI: 10.1016/j.ijrobp.2023.06.2136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Several novel boron delivery compounds currently under investigation by our group have demonstrated formulation, biodistribution, and dose response benefits in small animal models [1]. In this study we analyze the potential clinical impact of these compounds for boron neutron capture therapy (BNCT) in human patients. MATERIALS/METHODS Pharmacokinetic models were used to estimate the tumor and normal tissue boron concentrations after continuous infusion of the novel compounds and BPA-F. Patient model segmentation, material assignment, and alignment of one or more treatment beams were exported from a commercial treatment planning system (TPS) to a novel dose calculation tool. This information was used to generate a voxelized model that incorporated the source, beam shaping assembly, collimator, and patient materials so that the full albedo effect was included in each dose calculation. Physical dose from 10B(n,α), 14N(n,p), 1H(n,n') interactions plus gamma rays from 1H(n,γ) and other reactions within the patient and treatment equipment were calculated by Monte Carlo transport of particles originating in a pre-generated phase space at the cover surface. RBE and CBE weighting factors are applied to combine these four physical dose volumes into an equivalent dose volume, and these five dose volumes were passed back to the TPS for evaluation. RESULTS Tumor dose was increased by up to 2.6x for the novel compounds while normal tissue doses were constant or slightly reduced in comparison to BPA-F plans. Alternatively, for identical tumor dose the normal tissue doses and treatment time were reduced by up to 2.6x. In addition, in some cases it was possible to generate a single beam treatment plan using the new compounds that delivered higher tumor dose and lower normal tissues doses than a multiple beam plan using BPA-F. CONCLUSION This study demonstrates both dosimetric and practical benefits of the new compounds in comparison to BPA-F, including the potential to deliver treatment using fewer beam directions and correspondingly easier treatment setups and higher patient throughput. The potential of these compounds to extend the range of clinical indications for BNCT is also discussed. These results motivate upcoming experimental testing of the key assumptions involved in their calculation.
Collapse
Affiliation(s)
- W Kilby
- TAE Life Sciences, Foothill Ranch, CA
| | - C Lee
- TAE Life Sciences, Foothill Ranch, CA
| | - P Young
- TAE Life Sciences, Foothill Ranch, CA
| | - D Dewitt
- TAE Life Sciences, Foothill Ranch, CA
| | - M Torgov
- TAE Life Sciences, Foothill Ranch, CA
| | | | - L Capo
- TAE Life Sciences, Foothill Ranch, CA
| | - M Ikeura
- TAE Life Sciences, Foothill Ranch, CA
| | | | | | | |
Collapse
|
37
|
Lo JC, Lee DR, Chandra M, Zeltser DW, Chu CE, Gordon NP, Darbinian JA, Lee C. Differences in proximal humerus and wrist fracture incidence among US Asian subgroups. J Am Geriatr Soc 2023; 71:3303-3306. [PMID: 37224407 PMCID: PMC10592629 DOI: 10.1111/jgs.18408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 05/26/2023]
Affiliation(s)
- Joan C Lo
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- The Permanente Medical Group, Oakland, California, USA
| | - David R Lee
- The Permanente Medical Group, Oakland, California, USA
- Department of Hospital Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California, USA
- Division of Geriatrics, University of California Los Angeles, Los Angeles, California, USA
| | - Malini Chandra
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - David W Zeltser
- The Permanente Medical Group, Oakland, California, USA
- Department of Orthopedic Surgery, Kaiser Permanente South San Francisco Medical Center, South San Francisco, California, USA
| | - Clarence E Chu
- Department of Adult and Family Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California, USA
| | - Nancy P Gordon
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- The Permanente Medical Group, Oakland, California, USA
| | - Jeanne A Darbinian
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- The Permanente Medical Group, Oakland, California, USA
| |
Collapse
|
38
|
Cotter J, McManus H, Vickers T, Lee C, Davies SC. Increasing prevalence of gonorrhoea and chlamydia among female sex workers in northern Sydney, 2005-2019. Int J STD AIDS 2023; 34:869-875. [PMID: 37350164 DOI: 10.1177/09564624231173024] [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] [Indexed: 06/24/2023]
Abstract
BACKGROUND Recent reports indicate increasing gonorrhoea and chlamydia among female sex workers (FSWs) in Australia, with decreasing condom use for oral sex. METHODS We determined trends in prevalence and positivity of gonorrhoea and chlamydia among FSWs attending our clinic from 2005 to 2019, by analysing data from medical and pathology records. We conducted a sensitivity analysis by using an alternative prevalence definition of first test result only per calendar year. RESULTS Prevalence of gonorrhoea (all sites: pharynx, genital, rectal) increased from 1/130 (0.8%) in 2005 to 14/166 (8.4%) in 2012, to 31/257 (12.1%) in 2019; rate ratio (RR) 1.19, 95%CI 1.14-1.24, ptrend < 0.001. There were rising trends for pharyngeal (RR 1.11, 95% CI 1.05-1.17, ptrend = 0.001) and genital gonorrhoea (RR 1.17, 95% CI 1.08-1.26, ptrend < 0.001). Prevalence of chlamydia (all sites) increased from 4/130 (3.1%) in 2005 to 8/166 (4.8%) in 2012, to 20/257 (7.8%) in 2019; RR 1.05, 95%CI 1.01-1.09, ptrend = 0.006. This rise reflected predominately pharyngeal chlamydia (RR 1.16, 95%CI 1.04-1.29, ptrend = 0.004). Qualitatively similar trends with similar significant results, were seen for gonococcal and chlamydial infections in the sensitivity analyses, indicating robustness of results to potential changes in testing frequency. Gonorrhoea and chlamydia were significantly associated with FSWs born in China. Chlamydia was significantly associated with age group 18-25. In the 2015-2019 period, of 89 women with gonococcal infections, 56 (62.9%) were pharyngeal-only; of 93 with chlamydial infections, 32 (34.4%) were pharyngeal-only infections. CONCLUSIONS FSWs require screening for pharyngeal as well as genital infections. Enhanced and sustainable health promotion is required.
Collapse
Affiliation(s)
- J Cotter
- Northern Sydney Sexual Health Service, Northern Sydney Local Health District, Sydney, Australia
| | - H McManus
- The Kirby Institute, University of NSW, Sydney, Australia
| | - T Vickers
- The Kirby Institute, University of NSW, Sydney, Australia
| | - C Lee
- Northern Sydney Sexual Health Service, Northern Sydney Local Health District, Sydney, Australia
| | - S C Davies
- Northern Sydney Sexual Health Service, Northern Sydney Local Health District, Sydney, Australia
| |
Collapse
|
39
|
Karter AJ, Parker MM, Moffet HH, Lipska KJ, Laiteerapong N, Grant RW, Lee C, Huang ES. Development and Validation of the Life Expectancy Estimator for Older Adults with Diabetes (LEAD): the Diabetes and Aging Study. J Gen Intern Med 2023; 38:2860-2869. [PMID: 37254010 PMCID: PMC10228886 DOI: 10.1007/s11606-023-08219-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 04/21/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Estimated life expectancy for older patients with diabetes informs decisions about treatment goals, cancer screening, long-term and advanced care, and inclusion in clinical trials. Easily implementable, evidence-based, diabetes-specific approaches for identifying patients with limited life expectancy are needed. OBJECTIVE Develop and validate an electronic health record (EHR)-based tool to identify older adults with diabetes who have limited life expectancy. DESIGN Predictive modeling based on survival analysis using Cox-Gompertz models in a retrospective cohort. PARTICIPANTS Adults with diabetes aged ≥ 65 years from Kaiser Permanente Northern California: a 2015 cohort (N = 121,396) with follow-up through 12/31/2019, randomly split into training (N = 97,085) and test (N = 24,311) sets. Validation was conducted in the test set and two temporally distinct cohorts: a 2010 cohort (n = 89,563; 10-year follow-up through 2019) and a 2019 cohort (n = 152,357; 2-year follow-up through 2020). MAIN MEASURES Demographics, diagnoses, utilization and procedures, medications, behaviors and vital signs; mortality. KEY RESULTS In the training set (mean age 75 years; 49% women; 48% racial and ethnic minorities), 23% died during 5 years follow-up. A mortality prediction model was developed using 94 candidate variables, distilled into a life expectancy model with 11 input variables, and transformed into a risk-scoring tool, the Life Expectancy Estimator for Older Adults with Diabetes (LEAD). LEAD discriminated well in the test set (C-statistic = 0.78), 2010 cohort (C-statistic = 0.74), and 2019 cohort (C-statistic = 0.81); comparisons of observed and predicted survival curves indicated good calibration. CONCLUSIONS LEAD estimates life expectancy in older adults with diabetes based on only 11 patient characteristics widely available in most EHRs and claims data. LEAD is simple and has potential application for shared decision-making, clinical trial inclusion, and resource allocation.
Collapse
Affiliation(s)
- Andrew J. Karter
- Division of Research, Kaiser Permanente Northern California, Oakland, CA USA
- Department of General Internal Medicine, University of California, San Francisco, CA USA
- Department of Health Systems and Population Health, University of Washington, Seattle, WA USA
| | - Melissa M. Parker
- Division of Research, Kaiser Permanente Northern California, Oakland, CA USA
| | - Howard H. Moffet
- Division of Research, Kaiser Permanente Northern California, Oakland, CA USA
| | - Kasia J. Lipska
- Section of Endocrinology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT USA
| | - Neda Laiteerapong
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL USA
| | - Richard W. Grant
- Division of Research, Kaiser Permanente Northern California, Oakland, CA USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA USA
| | - Elbert S. Huang
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, IL USA
| |
Collapse
|
40
|
Soh Y, Eng CW, Mayeda ER, Whitmer RA, Lee C, Peterson RL, Mungas DM, Glymour MM, Gilsanz P. Association of primary lifetime occupational cognitive complexity and cognitive decline in a diverse cohort: Results from the KHANDLE study. Alzheimers Dement 2023; 19:3926-3935. [PMID: 37057753 PMCID: PMC10517075 DOI: 10.1002/alz.13038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 04/15/2023]
Abstract
INTRODUCTION Higher occupational complexity has been linked to favorable cognitive outcomes, but rarely examined in racially and ethnically diverse populations. METHODS In a diverse cohort (n = 1536), linear mixed-effects models estimated associations between main lifetime occupational complexity and domain-specific cognitive decline (z-standardized). Occupational complexity with data, people, and things were classified using the Dictionary of Occupational Titles. RESULTS For occupational complexity with data, highest tertile (vs. lowest) was associated with higher baseline executive function (β = 0.11; 95% confidence interval [CI] 0.00-0.22) and slower annual rate of decline (β = 0.03; 95% CI 0.01-0.06), and higher baseline semantic memory (β = 0.14; 95% CI 0.04-0.25). Highest tertile of occupational complexity with people was associated with higher baseline executive function (β = 0.29; 95% CI 0.18-0.40), verbal episodic memory (β = 0.12; 95% CI 0.00-0.24), and semantic memory (β = 0.23; 95% CI 0.12-0.34). DISCUSSION In a diverse cohort, higher occupational complexity is associated with better cognition. Findings should be verified in larger cohorts. HIGHLIGHT Few studies have examined associations of occupational complexity with cognition in diverse populations. Racial and ethnic minorities are disproportionately exposed to lower occupational complexity. Occupational complexity with data and people are associated with better cognition.
Collapse
Affiliation(s)
- Yenee Soh
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Chloe W Eng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Epidemiology and Population Health, Stanford University, Stanford, California, USA
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California, USA
| | - Rachel A Whitmer
- Department of Neurology, School of Medicine, University of California, Davis, Davis, California, USA
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Catherine Lee
- Kaiser Permanente Division of Research, Oakland, California, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA
| | - Rachel L Peterson
- University of Montana, School of Public and Community Health Sciences, Missoula, MT, USA
| | - Dan M Mungas
- Department of Neurology, School of Medicine, University of California, Davis, Davis, California, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Paola Gilsanz
- Kaiser Permanente Division of Research, Oakland, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| |
Collapse
|
41
|
Nichols HB, Wernli KJ, Chawla N, O’Meara ES, Gray MF, Green LE, Baggett CD, Casperson M, Chao C, Jones SMW, Kirchhoff AC, Kuo TM, Lee C, Malogolowkin M, Quesenberry CP, Ruddy KJ, Wun T, Zebrack B, Chubak J, Hahn EE, Keegan TH, Kushi LH. Challenges and Opportunities of Epidemiological Studies to Reduce the Burden of Cancers in Young Adults. CURR EPIDEMIOL REP 2023; 10:115-124. [PMID: 37700859 PMCID: PMC10495081 DOI: 10.1007/s40471-022-00286-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 11/03/2022]
Abstract
There are >1.9 million survivors of adolescent and young adult cancers (AYA, diagnosed at ages 15-39) living in the U.S. today. Epidemiologic studies to address the cancer burden in this group have been a relatively recent focus of the research community. In this article, we discuss approaches and data resources for cancer epidemiology and health services research in the AYA population. We consider research that uses data from cancer registries, vital records, healthcare utilization, and surveys, and the accompanying challenges and opportunities of each. To illustrate the strengths of each data source, we present example research questions or areas that are aligned with these data sources and salient to AYAs. Integrating the respective strengths of cancer registry, vital records, healthcare data, and survey-based studies sets the foundation for innovative and impactful research on AYA cancer treatment and survivorship to inform a comprehensive understanding of diverse AYA needs and experiences.
Collapse
Affiliation(s)
- Hazel B. Nichols
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Karen J. Wernli
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Neetu Chawla
- Veterans Health Administration, Greater Los Angeles, CA
| | - Ellen S. O’Meara
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | | | - Laura E. Green
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Christopher D. Baggett
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | | | - Chun Chao
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | | | - Anne C. Kirchhoff
- Huntsman Cancer Institute and Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Tzy-Mey Kuo
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Marcio Malogolowkin
- Division of Pediatric Hematology-Oncology, University of California Comprehensive Cancer Center, Sacramento, CA
| | | | | | - Ted Wun
- Center for Oncology Hematology Outcomes Research and Training (COHORT), University of California Comprehensive Cancer Center, Sacramento, CA
| | - Brad Zebrack
- University of Michigan School of Social Work, Ann Arbor, MI
| | - Jessica Chubak
- Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Erin E. Hahn
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Theresa H.M. Keegan
- Center for Oncology Hematology Outcomes Research and Training (COHORT), University of California Comprehensive Cancer Center, Sacramento, CA
| | - Lawrence H. Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| |
Collapse
|
42
|
Wang CC, Chen YL, Lu TC, Lee C, Chang YC, Chan YF, Mathew P, Lin XR, Hsieh WR, Huang TY, Huang HL, Hwang TL. Design and evaluation of oral formulation for apixaban. Heliyon 2023; 9:e18422. [PMID: 37534003 PMCID: PMC10391955 DOI: 10.1016/j.heliyon.2023.e18422] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023] Open
Abstract
Non-valvular atrial fibrillation (NVAF) is a common form of cardiac arrhythmia that affects 1-1.5% of adults and roughly 10% of elderly adults with dysphagia. Apixaban is an anticoagulant referred to as a factor Xa inhibitor, which has been shown to reduce the risk of stroke and systemic embolism in cases of NVAF. Our objective in the current study was to formulate an orally disintegrating film to facilitate the administration of apixaban to elderly patients who have difficulty swallowing. Researchers have used a wide variety of cellulose-based or non-cellulose-based polymers in a variety of combinations to achieve specific characteristics related to film formation, disintegration performance, drug content, in vitro drug release, and stability. One of the two formulations in this study was specify that bioequivalence criteria met with respect to Cmax of the reference drug (ELIQUIS®) in terms of pharmacokinetic profile. Further research will be required to assess the applicability of orodispersible films created using colloidal polymers of high and low molecular weights to other drugs with poor solubility in water.
Collapse
Affiliation(s)
- Chien-Chiao Wang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan City, 333, Taiwan
- TAHO Pharmaceuticals Ltd. Neihu Dist., Taipei City, 114, Taiwan
| | - Yu-Li Chen
- Research Center for Chinese Herbal Medicine, Graduate Institute of Healthy Industry Technology, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan City, 333, Taiwan
| | - Ta-Chien Lu
- TAHO Pharmaceuticals Ltd. Neihu Dist., Taipei City, 114, Taiwan
| | - Catherine Lee
- TAHO Pharmaceuticals Ltd. Neihu Dist., Taipei City, 114, Taiwan
| | - Yu-Chia Chang
- Research Center for Chinese Herbal Medicine, Graduate Institute of Healthy Industry Technology, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan City, 333, Taiwan
| | - Yen-Fan Chan
- Research Center for Chinese Herbal Medicine, Graduate Institute of Healthy Industry Technology, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan City, 333, Taiwan
| | - Philip Mathew
- Novum Pharmaceutical Research Inc. Toronto, ON, M1L 4S4, Canada
| | - Xing-Rong Lin
- TAHO Pharmaceuticals Ltd. Neihu Dist., Taipei City, 114, Taiwan
| | - Wen-Rung Hsieh
- TAHO Pharmaceuticals Ltd. Neihu Dist., Taipei City, 114, Taiwan
| | - Ting-Yun Huang
- TAHO Pharmaceuticals Ltd. Neihu Dist., Taipei City, 114, Taiwan
| | - Hsin-Lan Huang
- Research Center for Chinese Herbal Medicine, Graduate Institute of Healthy Industry Technology, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan City, 333, Taiwan
| | - Tsong-Long Hwang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan City, 333, Taiwan
- Research Center for Chinese Herbal Medicine, Graduate Institute of Healthy Industry Technology, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan City, 333, Taiwan
- Graduate Institute of Natural Products, College of Medicine, Chang Gung University, Taoyuan City, 333, Taiwan
- Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
- Department of Chemical Engineering, Ming Chi University of Technology, New Taipei City, 243, Taiwan
| |
Collapse
|
43
|
Aalbers J, Akerib DS, Akerlof CW, Al Musalhi AK, Alder F, Alqahtani A, Alsum SK, Amarasinghe CS, Ames A, Anderson TJ, Angelides N, Araújo HM, Armstrong JE, Arthurs M, Azadi S, Bailey AJ, Baker A, Balajthy J, Balashov S, Bang J, Bargemann JW, Barry MJ, Barthel J, Bauer D, Baxter A, Beattie K, Belle J, Beltrame P, Bensinger J, Benson T, Bernard EP, Bhatti A, Biekert A, Biesiadzinski TP, Birch HJ, Birrittella B, Blockinger GM, Boast KE, Boxer B, Bramante R, Brew CAJ, Brás P, Buckley JH, Bugaev VV, Burdin S, Busenitz JK, Buuck M, Cabrita R, Carels C, Carlsmith DL, Carlson B, Carmona-Benitez MC, Cascella M, Chan C, Chawla A, Chen H, Cherwinka JJ, Chott NI, Cole A, Coleman J, Converse MV, Cottle A, Cox G, Craddock WW, Creaner O, Curran D, Currie A, Cutter JE, Dahl CE, David A, Davis J, Davison TJR, Delgaudio J, Dey S, de Viveiros L, Dobi A, Dobson JEY, Druszkiewicz E, Dushkin A, Edberg TK, Edwards WR, Elnimr MM, Emmet WT, Eriksen SR, Faham CH, Fan A, Fayer S, Fearon NM, Fiorucci S, Flaecher H, Ford P, Francis VB, Fraser ED, Fruth T, Gaitskell RJ, Gantos NJ, Garcia D, Geffre A, Gehman VM, Genovesi J, Ghag C, Gibbons R, Gibson E, Gilchriese MGD, Gokhale S, Gomber B, Green J, Greenall A, Greenwood S, van der Grinten MGD, Gwilliam CB, Hall CR, Hans S, Hanzel K, Harrison A, Hartigan-O'Connor E, Haselschwardt SJ, Hernandez MA, Hertel SA, Heuermann G, Hjemfelt C, Hoff MD, Holtom E, Hor JYK, Horn M, Huang DQ, Hunt D, Ignarra CM, Jacobsen RG, Jahangir O, James RS, Jeffery SN, Ji W, Johnson J, Kaboth AC, Kamaha AC, Kamdin K, Kasey V, Kazkaz K, Keefner J, Khaitan D, Khaleeq M, Khazov A, Khurana I, Kim YD, Kocher CD, Kodroff D, Korley L, Korolkova EV, Kras J, Kraus H, Kravitz S, Krebs HJ, Kreczko L, Krikler B, Kudryavtsev VA, Kyre S, Landerud B, Leason EA, Lee C, Lee J, Leonard DS, Leonard R, Lesko KT, Levy C, Li J, Liao FT, Liao J, Lin J, Lindote A, Linehan R, Lippincott WH, Liu R, Liu X, Liu Y, Loniewski C, Lopes MI, Lopez Asamar E, López Paredes B, Lorenzon W, Lucero D, Luitz S, Lyle JM, Majewski PA, Makkinje J, Malling DC, Manalaysay A, Manenti L, Mannino RL, Marangou N, Marzioni MF, Maupin C, McCarthy ME, McConnell CT, McKinsey DN, McLaughlin J, Meng Y, Migneault J, Miller EH, Mizrachi E, Mock JA, Monte A, Monzani ME, Morad JA, Morales Mendoza JD, Morrison E, Mount BJ, Murdy M, Murphy ASJ, Naim D, Naylor A, Nedlik C, Nehrkorn C, Neves F, Nguyen A, Nikoleyczik JA, Nilima A, O'Dell J, O'Neill FG, O'Sullivan K, Olcina I, Olevitch MA, Oliver-Mallory KC, Orpwood J, Pagenkopf D, Pal S, Palladino KJ, Palmer J, Pangilinan M, Parveen N, Patton SJ, Pease EK, Penning B, Pereira C, Pereira G, Perry E, Pershing T, Peterson IB, Piepke A, Podczerwinski J, Porzio D, Powell S, Preece RM, Pushkin K, Qie Y, Ratcliff BN, Reichenbacher J, Reichhart L, Rhyne CA, Richards A, Riffard Q, Rischbieter GRC, Rodrigues JP, Rodriguez A, Rose HJ, Rosero R, Rossiter P, Rushton T, Rutherford G, Rynders D, Saba JS, Santone D, Sazzad ABMR, Schnee RW, Scovell PR, Seymour D, Shaw S, Shutt T, Silk JJ, Silva C, Sinev G, Skarpaas K, Skulski W, Smith R, Solmaz M, Solovov VN, Sorensen P, Soria J, Stancu I, Stark MR, Stevens A, Stiegler TM, Stifter K, Studley R, Suerfu B, Sumner TJ, Sutcliffe P, Swanson N, Szydagis M, Tan M, Taylor DJ, Taylor R, Taylor WC, Temples DJ, Tennyson BP, Terman PA, Thomas KJ, Tiedt DR, Timalsina M, To WH, Tomás A, Tong Z, Tovey DR, Tranter J, Trask M, Tripathi M, Tronstad DR, Tull CE, Turner W, Tvrznikova L, Utku U, Va'vra J, Vacheret A, Vaitkus AC, Verbus JR, Voirin E, Waldron WL, Wang A, Wang B, Wang JJ, Wang W, Wang Y, Watson JR, Webb RC, White A, White DT, White JT, White RG, Whitis TJ, Williams M, Wisniewski WJ, Witherell MS, Wolfs FLH, Wolfs JD, Woodford S, Woodward D, Worm SD, Wright CJ, Xia Q, Xiang X, Xiao Q, Xu J, Yeh M, Yin J, Young I, Zarzhitsky P, Zuckerman A, Zweig EA. First Dark Matter Search Results from the LUX-ZEPLIN (LZ) Experiment. Phys Rev Lett 2023; 131:041002. [PMID: 37566836 DOI: 10.1103/physrevlett.131.041002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/06/2023] [Accepted: 06/07/2023] [Indexed: 08/13/2023]
Abstract
The LUX-ZEPLIN experiment is a dark matter detector centered on a dual-phase xenon time projection chamber operating at the Sanford Underground Research Facility in Lead, South Dakota, USA. This Letter reports results from LUX-ZEPLIN's first search for weakly interacting massive particles (WIMPs) with an exposure of 60 live days using a fiducial mass of 5.5 t. A profile-likelihood ratio analysis shows the data to be consistent with a background-only hypothesis, setting new limits on spin-independent WIMP-nucleon, spin-dependent WIMP-neutron, and spin-dependent WIMP-proton cross sections for WIMP masses above 9 GeV/c^{2}. The most stringent limit is set for spin-independent scattering at 36 GeV/c^{2}, rejecting cross sections above 9.2×10^{-48} cm at the 90% confidence level.
Collapse
Affiliation(s)
- J Aalbers
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - D S Akerib
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - C W Akerlof
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - A K Al Musalhi
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - F Alder
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - A Alqahtani
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S K Alsum
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - C S Amarasinghe
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - A Ames
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - T J Anderson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - N Angelides
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - H M Araújo
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J E Armstrong
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - M Arthurs
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - S Azadi
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - A J Bailey
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Baker
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J Balajthy
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - S Balashov
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Bang
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J W Bargemann
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M J Barry
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Barthel
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Bauer
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Baxter
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - K Beattie
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Belle
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - P Beltrame
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J Bensinger
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - T Benson
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - E P Bernard
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - A Bhatti
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - A Biekert
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - T P Biesiadzinski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - H J Birch
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - B Birrittella
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - G M Blockinger
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - K E Boast
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - B Boxer
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R Bramante
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - C A J Brew
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - P Brás
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - J H Buckley
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - V V Bugaev
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - S Burdin
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - J K Busenitz
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M Buuck
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - R Cabrita
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - C Carels
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - D L Carlsmith
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - B Carlson
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - M C Carmona-Benitez
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - M Cascella
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - C Chan
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Chawla
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - H Chen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J J Cherwinka
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - N I Chott
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - A Cole
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Coleman
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M V Converse
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - A Cottle
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - G Cox
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - W W Craddock
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - O Creaner
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Curran
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - A Currie
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J E Cutter
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - C E Dahl
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - A David
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - J Davis
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - T J R Davison
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J Delgaudio
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - S Dey
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - L de Viveiros
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - A Dobi
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J E Y Dobson
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - E Druszkiewicz
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - A Dushkin
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - T K Edberg
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - W R Edwards
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M M Elnimr
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - W T Emmet
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
| | - S R Eriksen
- University of Bristol, H.H. Wills Physics Laboratory, Bristol, BS8 1TL, United Kingdom
| | - C H Faham
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Fan
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - S Fayer
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - N M Fearon
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - S Fiorucci
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - H Flaecher
- University of Bristol, H.H. Wills Physics Laboratory, Bristol, BS8 1TL, United Kingdom
| | - P Ford
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - V B Francis
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - E D Fraser
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - T Fruth
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R J Gaitskell
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - N J Gantos
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Garcia
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Geffre
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - V M Gehman
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Genovesi
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - C Ghag
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R Gibbons
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - E Gibson
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - M G D Gilchriese
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - S Gokhale
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - B Gomber
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Green
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - A Greenall
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - S Greenwood
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | | | - C B Gwilliam
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - C R Hall
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - S Hans
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - K Hanzel
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Harrison
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - E Hartigan-O'Connor
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S J Haselschwardt
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M A Hernandez
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - S A Hertel
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - G Heuermann
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - C Hjemfelt
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - M D Hoff
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - E Holtom
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Y-K Hor
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M Horn
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Q Huang
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Hunt
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - C M Ignarra
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - R G Jacobsen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - O Jahangir
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R S James
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - S N Jeffery
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - W Ji
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J Johnson
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - A C Kaboth
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - A C Kamaha
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
- University of Califonia, Los Angeles, Department of Physics and Astronomy, Los Angeles, California 90095-1547
| | - K Kamdin
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - V Kasey
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - K Kazkaz
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - J Keefner
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Khaitan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - M Khaleeq
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Khazov
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - I Khurana
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - Y D Kim
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - C D Kocher
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Kodroff
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - L Korley
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - E V Korolkova
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - J Kras
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - H Kraus
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - S Kravitz
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - H J Krebs
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - L Kreczko
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - B Krikler
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - V A Kudryavtsev
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - S Kyre
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - B Landerud
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - E A Leason
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - C Lee
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J Lee
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - D S Leonard
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - R Leonard
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - K T Lesko
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - C Levy
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - J Li
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - F-T Liao
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - J Liao
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J Lin
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - A Lindote
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - R Linehan
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - W H Lippincott
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - R Liu
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - X Liu
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - Y Liu
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - C Loniewski
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - M I Lopes
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - E Lopez Asamar
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - B López Paredes
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - W Lorenzon
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - D Lucero
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - S Luitz
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - J M Lyle
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - P A Majewski
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Makkinje
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D C Malling
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Manalaysay
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - L Manenti
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R L Mannino
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - N Marangou
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - M F Marzioni
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - C Maupin
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - M E McCarthy
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - C T McConnell
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D N McKinsey
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J McLaughlin
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - Y Meng
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J Migneault
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E H Miller
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - E Mizrachi
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - J A Mock
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - A Monte
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - M E Monzani
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- Vatican Observatory, Castel Gandolfo, V-00120, Vatican City State
| | - J A Morad
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - J D Morales Mendoza
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - E Morrison
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - B J Mount
- Black Hills State University, School of Natural Sciences, Spearfish, South Dakota 57799-0002, USA
| | - M Murdy
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - A St J Murphy
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - D Naim
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - A Naylor
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - C Nedlik
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - C Nehrkorn
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - F Neves
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - A Nguyen
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J A Nikoleyczik
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - A Nilima
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J O'Dell
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - F G O'Neill
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - K O'Sullivan
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - I Olcina
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - M A Olevitch
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - K C Oliver-Mallory
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J Orpwood
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - D Pagenkopf
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - S Pal
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - K J Palladino
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Palmer
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - M Pangilinan
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - N Parveen
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - S J Patton
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - E K Pease
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - B Penning
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - C Pereira
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - G Pereira
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - E Perry
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - T Pershing
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - I B Peterson
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Piepke
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J Podczerwinski
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - D Porzio
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - S Powell
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R M Preece
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - K Pushkin
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - Y Qie
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - B N Ratcliff
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - J Reichenbacher
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - L Reichhart
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - C A Rhyne
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Richards
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - Q Riffard
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - G R C Rischbieter
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - J P Rodrigues
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - A Rodriguez
- Black Hills State University, School of Natural Sciences, Spearfish, South Dakota 57799-0002, USA
| | - H J Rose
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R Rosero
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - P Rossiter
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - T Rushton
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - G Rutherford
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Rynders
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - J S Saba
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Santone
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - A B M R Sazzad
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - R W Schnee
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - P R Scovell
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - D Seymour
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S Shaw
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - T Shutt
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J J Silk
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - C Silva
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - G Sinev
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - K Skarpaas
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - W Skulski
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - R Smith
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - M Solmaz
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - V N Solovov
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - P Sorensen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Soria
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - I Stancu
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M R Stark
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - A Stevens
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - T M Stiegler
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - K Stifter
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - R Studley
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - B Suerfu
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - T J Sumner
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - P Sutcliffe
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - N Swanson
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - M Szydagis
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - M Tan
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - D J Taylor
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - R Taylor
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - W C Taylor
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D J Temples
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - B P Tennyson
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
| | - P A Terman
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - K J Thomas
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D R Tiedt
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - M Timalsina
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - W H To
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - A Tomás
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - Z Tong
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - D R Tovey
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - J Tranter
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - M Trask
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M Tripathi
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - D R Tronstad
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - C E Tull
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - W Turner
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - L Tvrznikova
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - U Utku
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - J Va'vra
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - A Vacheret
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A C Vaitkus
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J R Verbus
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E Voirin
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - W L Waldron
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Wang
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - B Wang
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - J J Wang
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - W Wang
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - Y Wang
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - J R Watson
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - R C Webb
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - A White
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D T White
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - J T White
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - R G White
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - T J Whitis
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M Williams
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - W J Wisniewski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - M S Witherell
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - F L H Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - J D Wolfs
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - S Woodford
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - D Woodward
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - S D Worm
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - C J Wright
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - Q Xia
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - X Xiang
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - Q Xiao
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Xu
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - M Yeh
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - J Yin
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - I Young
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - P Zarzhitsky
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - A Zuckerman
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - E A Zweig
- University of Califonia, Los Angeles, Department of Physics and Astronomy, Los Angeles, California 90095-1547
| |
Collapse
|
44
|
Miao X, Guo R, Williams A, Lee C, Ma J, Wang PJ, Cui W. Replication Protein A1 is essential for DNA damage repair during mammalian oogenesis. bioRxiv 2023:2023.07.04.547725. [PMID: 37461444 PMCID: PMC10349974 DOI: 10.1101/2023.07.04.547725] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
Persistence of unrepaired DNA damage in oocytes is detrimental and may cause genetic aberrations, miscarriage, and infertility. RPA, an ssDNA-binding complex, is essential for various DNA-related processes. Here we report that RPA plays a novel role in DNA damage repair during postnatal oocyte development after meiotic recombination. To investigate the role of RPA during oogenesis, we inactivated RPA1 (replication protein A1), the largest subunit of the heterotrimeric RPA complex, specifically in oocytes using two germline-specific Cre drivers (Ddx4-Cre and Zp3-Cre). We find that depletion of RPA1 leads to the disassembly of the RPA complex, as evidenced by the absence of RPA2 and RPA3 in RPA1-deficient oocytes. Strikingly, severe DNA damage occurs in RPA1-deficient GV-stage oocytes. Loss of RPA in oocytes triggered the canonical DNA damage response mechanisms and pathways, such as activation of ATM, ATR, DNA-PK, and p53. In addition, the RPA deficiency causes chromosome misalignment at metaphase I and metaphase II stages of oocytes, which is consistent with altered transcript levels of genes involved in cytoskeleton organization in RPA1-deficient oocytes. Absence of the RPA complex in oocytes severely impairs folliculogenesis and leads to a significant reduction in oocyte number and female infertility. Our results demonstrate that RPA plays an unexpected role in DNA damage repair during mammalian folliculogenesis.
Collapse
Affiliation(s)
- Xiaosu Miao
- Department of Veterinary and Animal Sciences, University of Massachusetts, Amherst, MA, USA
| | - Rui Guo
- Department of Biomedical Sciences, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, Anhui, China
| | - Andrea Williams
- Department of Veterinary and Animal Sciences, University of Massachusetts, Amherst, MA, USA
| | - Catherine Lee
- Department of Veterinary and Animal Sciences, University of Massachusetts, Amherst, MA, USA
| | - Jun Ma
- Department of Biomedical Sciences, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA
| | - P. Jeremy Wang
- Department of Biomedical Sciences, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA
| | - Wei Cui
- Department of Veterinary and Animal Sciences, University of Massachusetts, Amherst, MA, USA
- Animal Models Core Facility, Institute for Applied Life Sciences (IALS), University of Massachusetts, Amherst, MA, USA
| |
Collapse
|
45
|
Lee C, Hammant C. Corporate social and community-oriented support by UK food retailers: a documentary review and typology of actions towards community wellbeing. Perspect Public Health 2023; 143:211-219. [PMID: 35506700 PMCID: PMC10466974 DOI: 10.1177/17579139221095326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM This article provides a comprehensive exploration of the varied Corporate Social Responsibility (CSR) actions in relation to supporting communities reported by the UK's leading food retailers. Findings are discussed against a backdrop of enduring inequalities, exacerbated by the on-going global Coronavirus pandemic, with actions considered for their potential contribution to community-based approaches to addressing local wellbeing and inequalities. METHOD This article presents the structure and key characteristics of community-oriented CSR in food retailing in the UK. A thematic analysis of comprehensive documentary evidence from the 11 principle UK food retailers was conducted, drawing on asset-based frameworks of community-centred actions towards wellbeing. FINDINGS The findings suggest an increasing acknowledgement in food retail that local community is of key importance. Initiatives were categorised according to a typology, comprising national partnerships, local store-based funding and support actions, targeted programmes on healthy lifestyles or employability, and changes to store operations, in the favour of priority groups, prompted by the pandemic. CONCLUSION The article combines an up to date overview of community-focused CSR agendas and support by food retailers at a time of significant economic and social challenge for the UK. It highlights the potential of the sector to contribute more strategically to reducing inequalities and supporting community wellbeing, alongside statutory and voluntary sector partners.
Collapse
Affiliation(s)
- C Lee
- Cambridge Institute for Sustainability Leadership, 1 Trumpington Street, Cambridge CB2 1QA, UK
- Cambridge Public Health, Interdisciplinary Research Centre, University of Cambridge, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK
| | - C Hammant
- Cambridge Institute for Sustainability Leadership, 1 Trumpington Street, Cambridge CB2 1QA, UK
| |
Collapse
|
46
|
El Atwani O, Vo HT, Tunes MA, Lee C, Alvarado A, Krienke N, Poplawsky JD, Kohnert AA, Gigax J, Chen WY, Li M, Wang YQ, Wróbel JS, Nguyen-Manh D, Baldwin JKS, Tukac OU, Aydogan E, Fensin S, Martinez E. Author Correction: A quinary WTaCrVHf nanocrystalline refractory high-entropy alloy withholding extreme irradiation environments. Nat Commun 2023; 14:3490. [PMID: 37311813 DOI: 10.1038/s41467-023-39294-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- O El Atwani
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA.
| | - H T Vo
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - M A Tunes
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - C Lee
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
- Department of Materials and Mechanical Engineering, Auburn University, Auburn, AL, USA
| | - A Alvarado
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM, USA
- Departments of Mechanical Engineering and Materials Science and Engineering, Clemson University, Clemson, SC, USA
| | - N Krienke
- Materials Science and Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - J D Poplawsky
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - A A Kohnert
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - J Gigax
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - W-Y Chen
- Division of Nuclear Engineering, Argonne National Laboratory, Lemon, IL, USA
| | - M Li
- Division of Nuclear Engineering, Argonne National Laboratory, Lemon, IL, USA
| | - Y Q Wang
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - J S Wróbel
- Faculty of Materials Science and Engineering, Warsaw University of Technology, ul. Wołoska, 02-507, Warsaw, Poland
| | - D Nguyen-Manh
- Culham Center for Fusion Energy, United Kingdom Atomic Energy Authority, Abingdon, OX14 3DB, UK
- Department of Materials, University of Oxford, Oxford, OX1 3PH, UK
| | - J K S Baldwin
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - O U Tukac
- Metallurgical and Materials Engineering, Middle East Technical University, Ankara, Turkey
| | - E Aydogan
- Metallurgical and Materials Engineering, Middle East Technical University, Ankara, Turkey
| | - S Fensin
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - E Martinez
- Departments of Mechanical Engineering and Materials Science and Engineering, Clemson University, Clemson, SC, USA
| |
Collapse
|
47
|
Arasu VA, Habel LA, Achacoso NS, Buist DSM, Cord JB, Esserman LJ, Hylton NM, Glymour MM, Kornak J, Kushi LH, Lewis DA, Liu VX, Lydon CM, Miglioretti DL, Navarro DA, Pu A, Shen L, Sieh W, Yoon HC, Lee C. Comparison of Mammography AI Algorithms with a Clinical Risk Model for 5-year Breast Cancer Risk Prediction: An Observational Study. Radiology 2023; 307:e222733. [PMID: 37278627 DOI: 10.1148/radiol.222733] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Background Although several clinical breast cancer risk models are used to guide screening and prevention, they have only moderate discrimination. Purpose To compare selected existing mammography artificial intelligence (AI) algorithms and the Breast Cancer Surveillance Consortium (BCSC) risk model for prediction of 5-year risk. Materials and Methods This retrospective case-cohort study included data in women with a negative screening mammographic examination (no visible evidence of cancer) in 2016, who were followed until 2021 at Kaiser Permanente Northern California. Women with prior breast cancer or a highly penetrant gene mutation were excluded. Of the 324 009 eligible women, a random subcohort was selected, regardless of cancer status, to which all additional patients with breast cancer were added. The index screening mammographic examination was used as input for five AI algorithms to generate continuous scores that were compared with the BCSC clinical risk score. Risk estimates for incident breast cancer 0 to 5 years after the initial mammographic examination were calculated using a time-dependent area under the receiver operating characteristic curve (AUC). Results The subcohort included 13 628 patients, of whom 193 had incident cancer. Incident cancers in eligible patients (additional 4391 of 324 009) were also included. For incident cancers at 0 to 5 years, the time-dependent AUC for BCSC was 0.61 (95% CI: 0.60, 0.62). AI algorithms had higher time-dependent AUCs than did BCSC, ranging from 0.63 to 0.67 (Bonferroni-adjusted P < .0016). Time-dependent AUCs for combined BCSC and AI models were slightly higher than AI alone (AI with BCSC time-dependent AUC range, 0.66-0.68; Bonferroni-adjusted P < .0016). Conclusion When using a negative screening examination, AI algorithms performed better than the BCSC risk model for predicting breast cancer risk at 0 to 5 years. Combined AI and BCSC models further improved prediction. © RSNA, 2023 Supplemental material is available for this article.
Collapse
Affiliation(s)
- Vignesh A Arasu
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Laurel A Habel
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Ninah S Achacoso
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Diana S M Buist
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Jason B Cord
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Laura J Esserman
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Nola M Hylton
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - M Maria Glymour
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - John Kornak
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Lawrence H Kushi
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Donald A Lewis
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Vincent X Liu
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Caitlin M Lydon
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Diana L Miglioretti
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Daniel A Navarro
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Albert Pu
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Li Shen
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Weiva Sieh
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Hyo-Chun Yoon
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| | - Catherine Lee
- From the Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 (V.A.A., L.A.H., N.S.A., L.H.K., V.X.L., C.M.L., C.L.); Department of Radiology, Kaiser Permanente Northern California, Vallejo Medical Center, Vallejo, Calif (V.A.A.); Kaiser Permanente Washington Health Research Institute, Seattle, Wash (D.S.M.B.); Department of Radiology, Southern California Permanente Medical Group, Orange County, Irvine, Calif (J.B.C.); Department of Surgery (L.J.E.), Department of Radiology and Biomedical Imaging (N.M.H.), and Department of Epidemiology and Biostatistics (M.M.G., J.K.), University of California-San Francisco, San Francisco, Calif; Department of Medical Imaging Technology and Informatics, Southern California Permanente Medical Group, Pasadena, Calif (D.A.L.); Department of Biostatistics, University of California-Davis, Davis, Calif (D.L.M.); The Technology Group, The Permanente Medical Group, Oakland, Calif (D.A.N.); KP Information Technology, Kaiser Foundation Health Plan Inc and Kaiser Foundation Hospitals, Oakland, Calif (A.P.); Department of Artificial Intelligence and Human Health and Nash Family Department of Neuroscience (L.S.) and Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences (W.S.), Icahn School of Medicine at Mount Sinai, New York, NY; and Department of Radiology, Hawaii Permanente Medical Group, Moanalua Medical Center, Honolulu, Hawaii (H.C.Y.)
| |
Collapse
|
48
|
Lo JC, Chandra M, Lee DR, Darbinian JA, Gordon NP, Zeltser DW, Grimsrud CD, Lee C. Sex- and ethnic-specific patterns in the incidence of hip fracture among older US Asian and non-Hispanic White adults. J Am Geriatr Soc 2023; 71:1910-1916. [PMID: 36789920 PMCID: PMC10258148 DOI: 10.1111/jgs.18242] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/14/2022] [Accepted: 12/26/2022] [Indexed: 02/16/2023]
Abstract
BACKGROUND Asian and Pacific Islander (Asian/PI) adults have lower hip fracture incidence than non-Hispanic White (NHW) adults, but data regarding Asian/PI subgroups are limited. We compared hip fracture incidence among older US Asian/PI and NHW populations, including ethnic subgroup differences. METHODS Using observational data from a California healthcare system, we identified Asian/PI and NHW adults aged ≥50 years (2000-2019) and followed subjects to 2021 for hip fracture determined by principal/primary hospital diagnosis or by secondary hospital diagnosis with hip/femur procedure codes. Age-adjusted hip fracture incidence was calculated with 95% confidence intervals (CIs). Log-Poisson regression was used to determine fracture incidence rate ratios (IRRs, [CI]; NHW or Chinese as reference) adjusting for age and year. RESULTS Among 215,359 Asian/PI and 776,839 NHW women, hip fracture incidence was 1.34 (1.28-1.40) and 2.97 (2.94-3.01) per 1000 person-years, respectively, with IRR 0.45 (0.43-0.47). Among 188,328 Asian/PI and 697,046 NHW men, hip fracture incidence was 0.62 (0.58-0.67) and 1.81 (1.78-1.84) per 1000 person-years, respectively, with IRR 0.34 (0.32-0.37). For the four largest Asian/PI subgroups, Filipina women (IRR 0.85 [0.75-0.96]) had lower, and Japanese (IRR 1.36 [1.20-1.54]) and South Asian (IRR 1.36 [1.07-1.72]) women had higher hip fracture incidence compared to Chinese women. Hip fracture incidence was only higher among South Asian (IRR 1.61 [1.21-2.14]) compared to Chinese men. CONCLUSION Hip fracture incidence among US Asian/PI adults was 55% (women) and 66% (men) lower than NHW adults, but incidence varied by Asian/PI subgroup. The heterogeneity among Asian/PI adults highlights the importance of examining fracture risk by ethnic subgroup.
Collapse
Affiliation(s)
- Joan C Lo
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- The Permanente Medical Group, Oakland, California, USA
| | - Malini Chandra
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - David R Lee
- The Permanente Medical Group, Oakland, California, USA
- Department of Hospital Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California, USA
- Division of Geriatrics, University of California Los Angeles, Los Angeles, California, USA
| | - Jeanne A Darbinian
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Nancy P Gordon
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- The Permanente Medical Group, Oakland, California, USA
| | - David W Zeltser
- The Permanente Medical Group, Oakland, California, USA
- Department of Orthopedic Surgery, Kaiser Permanente South San Francisco Medical Center, South San Francisco, California, USA
| | - Christopher D Grimsrud
- The Permanente Medical Group, Oakland, California, USA
- Department of Orthopedic Surgery, Kaiser Permanente Oakland Medical Center, Oakland, California, USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- The Permanente Medical Group, Oakland, California, USA
| |
Collapse
|
49
|
Lam JO, Hou CE, Gilsanz P, Lee C, Lea AN, Satre DD, Silverberg MJ. Undiagnosed Cognitive Impairment and Impact on Instrumental Activities of Daily Living Among People With HIV Infection in Primary Care. Open Forum Infect Dis 2023; 10:ofad284. [PMID: 37342311 PMCID: PMC10279416 DOI: 10.1093/ofid/ofad284] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/18/2023] [Indexed: 06/22/2023] Open
Abstract
Background Little is known about the prevalence of undiagnosed cognitive impairment and its impact on instrumental activities of daily living (IADL) among people with HIV (PWH) in primary care. Methods PWH were recruited from an integrated health care setting in the United States. PWH were eligible for recruitment if they were ≥50 years old, taking antiretroviral therapy (ie, ≥1 antiretroviral therapy [ART] prescription fill in the past year), and had no clinical diagnosis of dementia. Participants completed a cognitive screen (St. Louis University Mental Status exam) and a questionnaire on IADL (modified Lawton-Brody). Results Study participants (n = 47) were mostly male (85.1%), 51.1% White, 25.5% Black, 17.0% Hispanic, and the average age (SD) was 59.7 (7.0) years. Overall, 27 (57.5%) participants were categorized as cognitively normal, 17 (36.2%) as having mild cognitive impairment, and 3 (6.4%) as having possible dementia. Of the 20 participants with mild cognitive impairment or possible dementia, 85.0% were men, the average age (SD) was 60.4 (7.1) years; 45.0% were White, 40.0% were Black, 10.0% were Hispanic, and 30.0% reported difficulty with at least 1 IADL. Most (66.7%) attributed difficulty with IADL primarily (33.3%) or in part (33.3%) to cognitive problems. Conclusions Undiagnosed cognitive impairment is frequent among ART-treated PWH, with possible elevated risk among Black PWH, and may be accompanied by difficulty with IADL. Efforts are needed to optimize identification of factors contributing to cognitive and IADL difficulties among ART-treated PWH in primary care.
Collapse
Affiliation(s)
- Jennifer O Lam
- Correspondence: Jennifer Lam, PhD, MPH, Division of Research, Kaiser Permanente Northern California; 2000 Broadway, Oakland, CA 94612 (); or Michael Silverberg, PhD, MPH, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 ()
| | - Craig E Hou
- South San Francisco Medical Center, Kaiser Permanente Northern California, South San Francisco, California, USA
| | - Paola Gilsanz
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Alexandra N Lea
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, California, USA
| | - Michael J Silverberg
- Correspondence: Jennifer Lam, PhD, MPH, Division of Research, Kaiser Permanente Northern California; 2000 Broadway, Oakland, CA 94612 (); or Michael Silverberg, PhD, MPH, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 ()
| |
Collapse
|
50
|
Rebelo LR, Eastridge ML, Firkins JL, Lee C. Effects of corn silage and grain expressing α-amylase on ruminal nutrient digestibility, microbial protein synthesis, and enteric methane emissions in lactating cows. J Dairy Sci 2023; 106:3932-3946. [PMID: 37225579 DOI: 10.3168/jds.2022-22770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/23/2023] [Indexed: 05/26/2023]
Abstract
Increasing ruminal starch digestibility has the potential to improve microbial protein synthesis (MPS), milk production, and feed efficiency. Enogen corn (Syngenta Seeds LLC) expresses high α-amylase activity, and we evaluated effects of Enogen corn silage (CS) and grain (CG) on ruminal starch digestibility, MPS, and milk production in lactating dairy cows. Fifteen Holstein cows (6 ruminally cannulated and 9 noncannulated; average ± standard deviation at the beginning of the trial: 170 ± 40 d in milk; milk yield, 37.2 ± 7.73 kg/d; body weight, 714 ± 37 kg) were used in a replicated 3 × 3 Latin square design (28 d per period) with 3 treatments: a diet containing isoline CS and CG (control, CON); a diet with Enogen CS and isoline CG (ECS); and a diet with Enogen CS and CG (ECSCG). Dry matter (DM; 30%), starch (35% of DM), and particle size distribution of the isoline and Enogen CS were similar. However, the mean particle size of Enogen CG was larger (1.05 vs. 0.65 mm) than that of the isoline CG. Cannulated cows were used for digestibility and nutrient flow measurements, noncannulated cows were used for enteric CH4 measurements, and all cows were used for production evaluation. Dry matter intake (DMI) and milk yield were greater for ECS and ECSCG compared with CON (26.7 and 26.6 vs. 25.1 kg/d and 36.5 and 34.1 vs. 33.1 kg/d, respectively) without a difference between ECS and ECSCG. Milk protein yield was greater (1.27 vs. 1.14 and 1.17 kg/d) for ECS compared with CON and ECSCG. Milk fat content was greater (3.79 vs. 3.32%) for ECSCG compared with ECS. Milk fat yield and energy-corrected milk did not differ among treatments. Ruminal digestibilities of DM, organic matter, starch, and neutral detergent fiber were not different among treatments. However, ruminal digestibility of nonammonia, nonmicrobial N was greater (85 vs. 75%) for ECS compared with ECSCG. Total-tract apparent starch digestibility was lower (97.6 and 97.1 vs. 98.3%) for ECS and ECSCG compared with CON, respectively, and tended to be lower (97.1 vs. 98.3%) for ECSCG compared with ECS. Ruminal outflows of bacterial OM and nonammonia N tended to be greater for ECS than for ECSCG. Efficiency of MPS tended to be greater (34.1 vs. 30.6 g of N/kg of organic matter truly digested) for ECS versus ECSCG. Ruminal pH and total and individual short-chain fatty acid concentrations did not differ among treatments. Concentration of ruminal NH3 for ECS and ECSCG was lower (10.4 and 12.4 vs. 13.4 mmol/L, respectively) compared with CON. Methane per unit of DMI decreased for ECS and ECSCG compared with CON (11.4 and 12.2 vs. 13.5 g/kg of DMI, respectively) without a difference between ECS and ECSCG. In conclusion, ECS and ECSCG did not increase ruminal or total-tract starch digestibility. However, the positive effects of ECS and ECSCG on milk protein yield, milk yield, and CH4 per unit of DMI may show potential benefits of feeding Enogen corn. Effects of ECSCG were not apparent when compared with ECS, partly due to larger particle size of Enogen CG compared with its isoline counterpart.
Collapse
Affiliation(s)
- L R Rebelo
- Department of Animal Sciences, Ohio Agricultural Research and Development Center, The Ohio State University, Wooster 44691
| | - M L Eastridge
- Department of Animal Sciences, The Ohio State University, Columbus 43210
| | - J L Firkins
- Department of Animal Sciences, The Ohio State University, Columbus 43210
| | - C Lee
- Department of Animal Sciences, Ohio Agricultural Research and Development Center, The Ohio State University, Wooster 44691.
| |
Collapse
|