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Stimson AM, Anderson C, Holt AM, Henderson AJ. Why don't women engage in muscle strength exercise? An integrative review. Health Promot J Austr 2024. [PMID: 38566279 DOI: 10.1002/hpja.857] [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: 08/16/2023] [Revised: 02/27/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
ISSUE ADDRESSED Women are 'at-risk' population for failing to meet muscle strengthening guidelines. Health benefits specific to this exercise mode include maintenance of muscle mass, which is associated with reduced risk of chronic disease and falls. Of significance is the progressive decline in muscle strength exercise participation in women aged 35-54 in Australia. This period is critical for maintaining muscle strength as it establishes foundations for older women's engagement. This integrative review examined available evidence regarding factors influencing muscle strength exercise participation, specifically in women aged 35-54. METHODS Seven databases were searched. Study inclusion criteria were: (1) peer reviewed, (2) English language, (3) sample populations of healthy female adults or general adult sample population differentiating females from males, (4) mean age between 35 and 54 years, (5) focused on muscle strength exercise and measured as the primary outcome factors of participation in muscle strength exercise. FINDINGS Five of 1895 studies met inclusion criteria. Five key factors were associated with participation in muscle strength exercise of women aged 35-54 years: perceived time constraints; knowledge and education; modality and intensity; social support and behavioural strategies. CONCLUSIONS Focused education on strength exercise and guidelines, plus initiatives and strategies that suit the needs of this cohort, are necessary to achieve health and wellbeing benefits. Responsive approaches by health professionals to these women's circumstances can potentially address current low participation levels. SO WHAT?: Creating conditions where health professionals respect a woman's exercise preferences can positively impact these women's musculoskeletal health into older age.
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Affiliation(s)
- A M Stimson
- School Nursing, Midwifery and Social Sciences, CQUniversity, Brisbane, Australia
| | - C Anderson
- School Nursing, Midwifery, University of Southern Queensland, Ipswich, Australia
| | - A-M Holt
- School of Medicine, University of Notre Dame, Freemantle, Australia
| | - A J Henderson
- School Nursing, Midwifery and Social Sciences, CQUniversity, Brisbane, Australia
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Khoury P, Makiya MA, Rahim R, Bowman A, Espinoza D, Schiffenbauer A, Koch M, Anderson C, Constantine G, Maric I, Sun X, Pittaluga S, Brown T, Ware JM, Wetzler L, Fay MP, Klion AD. Mepolizumab incompletely suppresses clinical flares in a pilot study of episodic angioedema with eosinophilia. J Allergy Clin Immunol 2024; 153:821-830.e6. [PMID: 37951310 PMCID: PMC10939939 DOI: 10.1016/j.jaci.2023.11.002] [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: 09/27/2023] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 11/13/2023]
Abstract
BACKGROUND Episodic angioedema with eosinophilia (EAE) is a rare multilineage cyclic syndrome of unknown etiology characterized by episodes of angioedema, myalgia, fatigue, and fever that occur every 3 to 8 weeks and resolve between episodes without therapy. Cyclic elevations in serum IL-5 levels and neutrophils precede the increase in absolute eosinophil count (AEC) in most patients. OBJECTIVE We sought to assess the role of IL-5-driven eosinophilia in the clinical manifestations of EAE. METHODS An open-label pilot study of mepolizumab (700 mg intravenously monthly for 3 months followed by sequential dose reduction to the Food and Drug Administration-approved dose of 300 mg subcutaneously monthly) was conducted. The primary end point was reduction in the number and severity of clinical symptoms as assessed by patient-reported symptom questionnaires. Secondary end points were greater than or equal to 75% reduction in peak AEC after 1 dose of mepolizumab and sustained reduction in AEC after 3 doses of mepolizumab. Exploratory end points included effects of mepolizumab treatment on other cell lineages (numbers and surface marker expression), levels of plasma mediators, and biomarkers of eosinophil activation. RESULTS Four female and 1 male (median age, 45 years) participants with EAE were enrolled. None of the 5 participants experienced a reduction in the number of symptomatic flares on mepolizumab therapy, and 1 participant withdrew before study completion because of lack of improvement. Peak AEC was reduced by 75% or more in 3 participants after the first dose of mepolizumab and in 4 participants after 3 doses. CONCLUSIONS In a small cohort of participants with EAE, mepolizumab was unsuccessful in substantially reducing clinical symptoms despite reduction in AEC.
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Affiliation(s)
- Paneez Khoury
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md; Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md.
| | - Michelle A Makiya
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Rodaba Rahim
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Abbie Bowman
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - David Espinoza
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Adam Schiffenbauer
- Environmental Autoimmunity Group, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, Md
| | - Megan Koch
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Charles Anderson
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Gregory Constantine
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Irina Maric
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, Md
| | - Xiaoping Sun
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, Md
| | - Stefania Pittaluga
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Md
| | - Thomas Brown
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - JeanAnne M Ware
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Lauren Wetzler
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Michael P Fay
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Amy D Klion
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
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Burzynska AZ, Anderson C, Arciniegas DB, Calhoun V, Choi IY, Mendez Colmenares A, Kramer AF, Li K, Lee J, Lee P, Thomas ML. Correlates of axonal content in healthy adult span: Age, sex, myelin, and metabolic health. Cereb Circ Cogn Behav 2024; 6:100203. [PMID: 38292016 PMCID: PMC10827486 DOI: 10.1016/j.cccb.2024.100203] [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] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/01/2024]
Abstract
As the emerging treatments that target grey matter pathology in Alzheimer's Disease have limited effectiveness, there is a critical need to identify new neural targets for treatments. White matter's (WM) metabolic vulnerability makes it a promising candidate for new interventions. This study examined the age and sex differences in estimates of axonal content, as well the associations of with highly prevalent modifiable health risk factors such as metabolic syndrome and adiposity. We estimated intra-axonal volume fraction (ICVF) using the Neurite Orientation Dispersion and Density Imaging (NODDI) in a sample of 89 cognitively and neurologically healthy adults (20-79 years). We showed that ICVF correlated positively with age and estimates of myelin content. The ICVF was also lower in women than men, across all ages, which difference was accounted for by intracranial volume. Finally, we found no association of metabolic risk or adiposity scores with the current estimates of ICVF. In addition, the previously observed adiposity-myelin associations (Burzynska et al., 2023) were independent of ICVF. Although our findings confirm the vulnerability of axons to aging, they suggest that metabolic dysfunction may selectively affect myelin content, at least in cognitively and neurologically healthy adults with low metabolic risk, and when using the specific MRI techniques. Future studies need to revisit our findings using larger samples and different MRI approaches, and identify modifiable factors that accelerate axonal deterioration as well as mechanisms linking peripheral metabolism with the health of myelin.
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Affiliation(s)
- Agnieszka Z Burzynska
- The BRAiN lab, Department of Human Development and Family Studies/Molecular, Cellular and Integrative Neurosciences, Colorado State University, Fort Collins, CO, USA
| | - Charles Anderson
- Department of Computer Science, Colorado State University, Fort Collins, CO, USA
| | - David B. Arciniegas
- Marcus Institute for Brain Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Vince Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, USA
| | - In-Young Choi
- Department of Neurology, Department of Radiology, Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Andrea Mendez Colmenares
- The BRAiN lab, Department of Human Development and Family Studies/Molecular, Cellular and Integrative Neurosciences, Colorado State University, Fort Collins, CO, USA
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology at the University of Illinois, IL, USA
- Center for Cognitive & Brain Health, Northeastern University, Boston, MA, USA
| | - Kaigang Li
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Jongho Lee
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea
| | - Phil Lee
- Department of Radiology, Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
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Doritchamou J, Nielsen MA, Chêne A, Viebig NK, Lambert LE, Sander AF, Semblat JP, Hundt S, Orr-Gonzalez S, Janitzek CM, Spiegel AJ, Clemmensen SB, Thomas ML, Nason MC, Snow-Smith M, Barnafo EK, Shiloach J, Chen BB, Nadakal S, Highsmith K, Ouahes T, Conteh S, Sharma A, Torano H, Butler B, Reiter K, Rausch KM, Scaria PV, Anderson C, Narum DL, Salanti A, Fried M, Theander TG, Gamain B, Duffy PE. Aotus nancymaae model predicts human immune response to the placental malaria vaccine candidate VAR2CSA. Lab Anim (NY) 2023; 52:315-323. [PMID: 37932470 PMCID: PMC10689237 DOI: 10.1038/s41684-023-01274-2] [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: 09/13/2022] [Accepted: 09/27/2023] [Indexed: 11/08/2023]
Abstract
Placental malaria vaccines (PMVs) are being developed to prevent severe sequelae of placental malaria (PM) in pregnant women and their offspring. The leading candidate vaccine antigen VAR2CSA mediates parasite binding to placental receptor chondroitin sulfate A (CSA). Despite promising results in small animal studies, recent human trials of the first two PMV candidates (PAMVAC and PRIMVAC) generated limited cross-reactivity and cross-inhibitory activity to heterologous parasites. Here we immunized Aotus nancymaae monkeys with three PMV candidates (PAMVAC, PRIMVAC and ID1-ID2a_M1010) adjuvanted with Alhydrogel, and exploited the model to investigate boosting of functional vaccine responses during PM episodes as well as with nanoparticle antigens. PMV candidates induced high levels of antigen-specific IgG with significant cross-reactivity across PMV antigens by enzyme-linked immunosorbent assay. Conversely, PMV antibodies recognized native VAR2CSA and blocked CSA adhesion of only homologous parasites and not of heterologous parasites. PM episodes did not significantly boost VAR2CSA antibody levels or serum functional activity; nanoparticle and monomer antigens alike boosted serum reactivity but not functional activities. Overall, PMV candidates induced functional antibodies with limited heterologous activity in Aotus monkeys, similar to responses reported in humans. The Aotus model appears suitable for preclinical downselection of PMV candidates and assessment of antibody boosting by PM episodes.
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Affiliation(s)
- Justin Doritchamou
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Morten A Nielsen
- Centre for Medical Parasitology at the Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Arnaud Chêne
- Université Paris Cité and Université des Antilles, INSERM, BIGR, Paris, France
| | - Nicola K Viebig
- European Vaccine Initiative, UniversitätsKlinikum Heidelberg, Heidelberg, Germany
| | - Lynn E Lambert
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Adam F Sander
- Centre for Medical Parasitology at the Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Sophia Hundt
- European Vaccine Initiative, UniversitätsKlinikum Heidelberg, Heidelberg, Germany
| | - Sachy Orr-Gonzalez
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Christoph Mikkel Janitzek
- Centre for Medical Parasitology at the Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Alicia J Spiegel
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | - Marvin L Thomas
- Division of Veterinary Resources, Office of Research Services, National Institutes of Health, Bethesda, MD, USA
| | - Martha C Nason
- Biostatistics Research Branch, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Maryonne Snow-Smith
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Emma K Barnafo
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Joseph Shiloach
- Biotechnology Unit, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Beth B Chen
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Steven Nadakal
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kendrick Highsmith
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Tarik Ouahes
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Solomon Conteh
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ankur Sharma
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Holly Torano
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Brandi Butler
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Karine Reiter
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Kelly M Rausch
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Puthupparampil V Scaria
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Charles Anderson
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - David L Narum
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Ali Salanti
- Centre for Medical Parasitology at the Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michal Fried
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Thor G Theander
- Centre for Medical Parasitology at the Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark
| | - Benoit Gamain
- Université Paris Cité and Université des Antilles, INSERM, BIGR, Paris, France
| | - Patrick E Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
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Pignata S, Bookman M, Sehouli J, Miller A, Penson RT, Taskiran C, Anderson C, Hietanen S, Myers T, Madry R, Willmott L, Lortholary A, Thomes-Pepin J, Aghajanian C, McCourt C, Stuckey A, Wu X, Nishio S, Copeland LJ, He Y, Molinero L, Patel S, Lin YG, Khor VK, Moore KN. Overall survival and patient-reported outcome results from the placebo-controlled randomized phase III IMagyn050/GOG 3015/ENGOT-OV39 trial of atezolizumab for newly diagnosed stage III/IV ovarian cancer. Gynecol Oncol 2023; 177:20-31. [PMID: 37625235 PMCID: PMC10986425 DOI: 10.1016/j.ygyno.2023.06.018] [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: 04/13/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVE To determine the impact on overall survival (OS) and patient-reported outcomes (PROs) of combining atezolizumab with standard therapy for newly diagnosed stage III/IV ovarian cancer. METHODS The placebo-controlled double-blind randomized phase III IMagyn050/GOG 3015/ENGOT-OV39 trial (NCT03038100) assigned eligible patients to 3-weekly atezolizumab 1200 mg or placebo for 22 cycles with platinum-based chemotherapy and bevacizumab. Coprimary endpoints were progression-free survival (already reported) and OS in the PD-L1-positive and intent-to-treat (ITT) populations, tested hierarchically. Prespecified PRO analyses focused on disease-related abdominal pain and bloating symptoms (European Organisation for Research and Treatment of Cancer QLQ-OV28), functioning, and health-related quality of life (HRQoL) (QLQ-C30). RESULTS After 38 months' median follow-up, the OS hazard ratio in the PD-L1-positive population was 0.83 (95% CI, 0.66-1.06; p = 0.13); median OS was not estimable with atezolizumab versus 49.2 months with placebo. The hazard ratio for OS in the ITT population was 0.92 (95% CI, 0.78-1.09; median 50.5 versus 46.6 months, respectively). At week 9, similar proportions of patients in both arms of the neoadjuvant cohort showed ≥10-point improvement from baseline in abdominal pain and bloating, functioning, and HRQoL. In the primary surgery cohort, similar proportions of patients in each arm had improved, stable, or worsened physical and role function and HRQoL from baseline over time. Neither cohort showed differences between arms in treatment-related symptoms or overall side-effect bother. CONCLUSIONS Incorporation of atezolizumab into standard therapy for newly diagnosed ovarian cancer does not significantly improve efficacy or impose additional treatment burden for patients. CLINICALTRIALS gov registration: NCT03038100.
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Affiliation(s)
- Sandro Pignata
- Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione G Pascale, Napoli, Italy.
| | - Michael Bookman
- Gynecologic Oncology Group Foundation (GOG-F) and Kaiser Permanente Northern California, San Francisco, CA, USA.
| | - Jalid Sehouli
- Arbeitsgemeinschaft Gynäkologische Onkologie Studiengruppe (AGO Study Group), Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie (North-Eastern German Society of Gynaecologic Oncology; NOGGO) and Charité-Medical University of Berlin (Campus Virchow Klinikum), Berlin, Germany.
| | - Austin Miller
- GOG-F and Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
| | | | - Cagatay Taskiran
- Turkish Society of Gynecologic Oncology (TRSGO) and Koç University School of Medicine, Istanbul, Turkey; Vehbi Koç Vakfı American Hospital, Istanbul, Turkey.
| | | | - Sakari Hietanen
- Nordic Society of Gynaecological Oncology (NSGO), Copenhagen, Denmark and Turku University Hospital, Turku, Finland.
| | - Tashanna Myers
- GOG-F and Baystate Medical Center, Springfield, MA, USA.
| | - Radoslaw Madry
- Department of Oncology, Poznań University of Medical Sciences, Poznań, Poland.
| | | | - Alain Lortholary
- Groupe d'Investigateurs National des Etudes des Cancers Ovariens et du sein (GINECO) and Hôpital Privé du Confluent, Nantes, France.
| | | | - Carol Aghajanian
- GOG-F and Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Carolyn McCourt
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, Saint Louis, MO, USA.
| | - Ashley Stuckey
- The Warren Alpert Medical School, Brown University, Providence, RI, USA.
| | - Xiaohua Wu
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
| | - Shin Nishio
- Department of Obstetrics and Gynecology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Larry J Copeland
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Comprehensive Cancer Center/James Cancer Hospital, Columbus, OH, USA.
| | - Yvette He
- Global Data Operations, Functional Service Provider, Parexel International, Chengdu, China.
| | - Luciana Molinero
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, CA, USA.
| | - Sheetal Patel
- Patient-Centered Outcomes Research, Genentech, Inc., South San Francisco, CA, USA.
| | - Yvonne G Lin
- Product Development Oncology, Genentech, Inc., South San Francisco, CA, USA.
| | - Victor K Khor
- Product Development Oncology, Genentech, Inc., South San Francisco, CA, USA.
| | - Kathleen N Moore
- GOG-F and Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Sarah Cannon Research Institute, Nashville, TN, USA.
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Pena LC, Anderson C, Agarwal MS, Galvan E, Kelly W, Wagner TD. Retrospective Review of the Factors Limiting Optune Initiation in GBM patients. Int J Radiat Oncol Biol Phys 2023; 117:e93. [PMID: 37786216 DOI: 10.1016/j.ijrobp.2023.06.854] [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) Tumor Treating Fields (TTFields) are a proven treatment that prolongs survival in Glioblastoma Multiforme (GBM) patients. The duration of usage of TTFields correlates with its effectiveness. This study aims to identify socioeconomic and clinical factors that prevent GBM patients at a single institution from starting and remaining on TTFields treatment. MATERIALS/METHODS This is a retrospective review from a single institution. Data were analyzed for each patient with a diagnosis of GBM that was seen in new patient consultation with a radiation oncologist. Data from 2015 to present were available. 178 patients were included in the study. Insurance status (private vs Medicare/Medicaid vs uninsured), zip code, expected income status, race, ethnicity, preferred primary language, work status, performance status (KPS) at time of diagnosis, and family support at home (Spouse vs Other) were analyzed. For those that initiated TTFields, we examined the duration of treatment, usage rates, patient reported tolerability, and reasons for discontinuation. Early termination of treatment was defined as treatment with TTFields for less than 3 months. RESULTS Of the 178 diagnosed GBM patients, 96 (54%) were offered TTFields and 48 (27%) agreed to treatment, with 46 actually starting. Of 89 Non-Hispanic patients, 53 were offered TTFields (60%) whereas of 73 Hispanic patients, 35 were offered TTFields (48%) (no statistically significant difference). The number one reason for refusing TTFields treatment was rapid deterioration (14/48 patients). The next most common reason was the patient feeling overwhelmed by managing or wearing the device (10/48) as well as the patient's decision to participate in any other clinical trial (10/48). The 3-month dropout rate for patients who received TTFields was 35% (17/48). 5 of the 17 stopped early due to skin rash or annoyance with the device. Patient's median income and insurance status did not predict whether they would start TTFields. 33 out of 109 (31%) patients with spousal support at home started treatment with TTFields compared to 13 of 69 (19%) of those without spousal support (p = .0895, Chi-Square test). CONCLUSION TTFields were offered to more patients each successive year, but many patients had no documented discussion offering TTFields, which may indicate room for improvement at our institution. Median income and insurance status did not play a role in patient access to TTFields, most likely due to Novocure sponsorship of un- or under-insured patients. Among those who declined treatment, 21% did so because of perceived difficulty managing the device. The strongest single trend predictive of successful initiation of TTFields is spousal support at home. Further interventions may focus on improving patient support at home, such as home health nursing visits or community support.
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Affiliation(s)
- L Carranza Pena
- University of Texas Health Science Center San Antonio Joe R. & Teresa Lozano Long School of Medicine, San Antonio, TX
| | - C Anderson
- Department of Radiation Oncology, UT Health San Antonio, San Antonio, TX
| | - M S Agarwal
- Department of Radiation Oncology, UT Health San Antonio, San Antonio, TX
| | - E Galvan
- Department of Radiation Oncology, UT Health San Antonio, San Antonio, TX
| | - W Kelly
- Mays Cancer Center, UT Health San Antonio, San Antonio, TX
| | - T D Wagner
- Department of Radiation Oncology, UT Health San Antonio, San Antonio, TX
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7
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Dack K, Wilson A, Turner C, Anderson C, Hughes GJ. COVID-19 associated with universities in England, October 2020-February 2022. Public Health 2023; 224:106-112. [PMID: 37742583 DOI: 10.1016/j.puhe.2023.08.025] [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: 02/02/2023] [Revised: 08/20/2023] [Accepted: 08/22/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES The aim of this study was to describe the epidemiology of COVID-19 cases at universities in England (October 2020-February 2022) and investigate factors associated with rates of COVID-19 among students during autumn/winter of 2021/22. STUDY DESIGN The study was an observational retrospective study using routine contact tracing data. METHODS Estimates of COVID-19 cases among students and staff at universities were described. Student cases aged 18-24 years were calculated as a percentage of all cases within that age group. Count regression was used to explore university characteristics associated with case numbers. RESULTS We identified 102,382 cases among students and 28,639 among staff. Student cases reflected trends in the wider population of the same age group, but the observed fraction aged 18-24 years who were students was consistently below the expected level (32%). Phased reopening of universities in March-May 2021 was associated with small peaks but low absolute numbers. Russell group membership, campus universities, and higher student proportions in halls of residence were all associated with increased case numbers. CONCLUSIONS COVID-19 case numbers among students in England varied considerably. At no time were the observed case numbers as high as expected from community prevalence. Characteristics of universities associated with higher case rates can inform future guidance for higher education settings.
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Affiliation(s)
- K Dack
- Field Service, United Kingdom Health Security Agency, London, UK
| | - A Wilson
- Field Service, United Kingdom Health Security Agency, London, UK
| | - C Turner
- Field Service, United Kingdom Health Security Agency, London, UK
| | - C Anderson
- Field Service, United Kingdom Health Security Agency, London, UK
| | - G J Hughes
- Field Service, United Kingdom Health Security Agency, Leeds, UK.
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Wilson A, Anderson C, Mindlin M, Sawyer C, Verlander NQ, Hiironen I, Forde J, Paranthaman K, Chandra NL. Characteristics of women presenting with hepatitis B at antenatal care services in London, 2008-2018. J Public Health (Oxf) 2023; 45:584-592. [PMID: 37061977 DOI: 10.1093/pubmed/fdad031] [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: 07/07/2022] [Revised: 02/17/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND To support interventions to prevent mother-to-child transmission of hepatitis B and fill gaps in surveillance, the Enhanced Surveillance of Antenatal Hepatitis B (ESAHB) programme was implemented in London from 2008 to 2018 to collect demographic information on women who tested positive for hepatitis B during antenatal screening. We describe the epidemiology of hepatitis B in pregnancy, as reported to ESAHB. METHODS The characteristics of pregnant women living with hepatitis B were described and rates were calculated by year, local authority and residence deprivation decile (1 being most deprived). Poisson regression tested the association between pregnant women living with hepatitis B and deprivation decile. RESULTS Between 2008 and 2018, 8879 women living with hepatitis B in London (0.35 per 1000 women) reported 11 193 pregnancies. Annual hepatitis B rates remained stable, but there was strong evidence for an inverse association between rate and deprivation decile (P < 0.001). The majority of women in the cohort presented late to antenatal care, were born outside the UK in a hepatitis B endemic area or required an interpreter for consultations. CONCLUSIONS ESAHB provided important data to inform service quality improvements for women living with hepatitis B. This analysis highlights the link between deprivation and hepatitis B.
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Affiliation(s)
- A Wilson
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - C Anderson
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - M Mindlin
- South London Health Protection Team, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - C Sawyer
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - N Q Verlander
- Statistics, Modelling and Economics Department, Data, Analytics and Surveillance Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - I Hiironen
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - J Forde
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - K Paranthaman
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
| | - N L Chandra
- Field Service South East and London, Health Protections Operations Group, UK Health Security Agency, London, SW1P 3HX, UK
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Burzynska AZ, Anderson C, Arciniegas DB, Calhoun V, Choi IY, Colmenares AM, Hiner G, Kramer AF, Li K, Lee J, Lee P, Oh SH, Umland S, Thomas ML. Metabolic syndrome and adiposity: Risk factors for decreased myelin in cognitively healthy adults. Cereb Circ Cogn Behav 2023; 5:100180. [PMID: 38162292 PMCID: PMC10757180 DOI: 10.1016/j.cccb.2023.100180] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/11/2023] [Accepted: 08/17/2023] [Indexed: 01/03/2024]
Abstract
Metabolic syndrome (MetS) is a cluster of conditions that affects ∼25% of the global population, including excess adiposity, hyperglycemia, dyslipidemia, and elevated blood pressure. MetS is one of major risk factors not only for chronic diseases, but also for dementia and cognitive dysfunction, although the underlying mechanisms remain poorly understood. White matter is of particular interest in the context of MetS due to the metabolic vulnerability of myelin maintenance, and the accumulating evidence for the importance of the white matter in the pathophysiology of dementia. Therefore, we investigated the associations of MetS risk score and adiposity (combined body mass index and waist circumference) with myelin water fraction measured with myelin water imaging. In 90 cognitively and neurologically healthy adults (20-79 years), we found that both high MetS risk score and adiposity were correlated with lower myelin water fraction in late-myelinating prefrontal and associative fibers, controlling for age, sex, race, ethnicity, education and income. Our findings call for randomized clinical trials to establish causality between MetS, adiposity, and myelin content, and to explore the potential of weight loss and visceral adiposity reduction as means to support maintenance of myelin integrity throughout adulthood, which could open new avenues for prevention or treatment of cognitive decline and dementia.
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Affiliation(s)
- Agnieszka Z Burzynska
- The BRAiN lab, Department of Human Development and Family Studies/Molecular, Cellular and Integrative Neurosciences, Colorado State University, Fort Collins, CO, USA
| | - Charles Anderson
- Department of Computer Science, Colorado State University, Fort Collins, CO, USA
| | - David B Arciniegas
- Marcus Institute for Brain Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Vince Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State, Georgia Tech, Emory, Atlanta, GA, USA
| | - In-Young Choi
- Department of Neurology, Department of Radiology, Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Andrea Mendez Colmenares
- The BRAiN lab, Department of Human Development and Family Studies/Molecular, Cellular and Integrative Neurosciences, Colorado State University, Fort Collins, CO, USA
| | - Grace Hiner
- The BRAiN lab, Department of Human Development and Family Studies/Molecular, Cellular and Integrative Neurosciences, Colorado State University, Fort Collins, CO, USA
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology at the University of Illinois, IL, USA
- Center for Cognitive & Brain Health, Northeastern University, Boston, MA, USA
| | - Kaigang Li
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, USA
| | - Jongho Lee
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea
| | - Phil Lee
- Department of Radiology, Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Se-Hong Oh
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Gyeonggi-do, Republic of Korea
| | - Samantha Umland
- The BRAiN lab, Department of Human Development and Family Studies/Molecular, Cellular and Integrative Neurosciences, Colorado State University, Fort Collins, CO, USA
| | - Michael L Thomas
- Michael Thomas, Department of Psychology, Colorado State University, Fort Collins, CO, USA
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Rausch KM, Barnafo EK, Lambert LE, Muratova O, Gorres JP, Anderson C, Narum DL, Wu Y, Morrison RD, Zaidi I, Duffy PE. Preclinical evaluations of Pfs25-EPA and Pfs230D1-EPA in AS01 for a vaccine to reduce malaria transmission. iScience 2023; 26:107192. [PMID: 37485364 PMCID: PMC10359932 DOI: 10.1016/j.isci.2023.107192] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 02/15/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Malaria transmission-blocking vaccine candidates Pfs25-EPA and Pfs230D1-EPA target sexual stage development of Plasmodium falciparum parasites in the mosquito host, thereby reducing mosquito infectivity. When formulated on Alhydrogel, Pfs25-EPA has demonstrated safety and immunogenicity in a phase 1 field trial, while Pfs230D1-EPA has shown superior activity to Pfs25-EPA in a phase 1 US trial and has entered phase 2 field trials. Development continues to enhance immunogenicity of these candidates toward producing a vaccine to reduce malaria transmission (VRMT) with both pre-erythrocytic (i.e., anti-infection) and transmission-blocking components. GSK Adjuvant Systems have demonstrated successful potency in pre-erythrocytic vaccine trials and might offer a common platform for VRMT development. Here, we describe preclinical evaluations of Pfs25-EPA and Pfs230D1-EPA nanoparticles with GSK platforms. Formulations were stable after a series of assessments and induced superior antibody titers and functional activity in CD-1 mice, compared to Alhydrogel formulations of the same antigens.
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Affiliation(s)
- Kelly M. Rausch
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Emma K. Barnafo
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Lynn E. Lambert
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Olga Muratova
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - J. Patrick Gorres
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Charles Anderson
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - David L. Narum
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Yimin Wu
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Robert D. Morrison
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Irfan Zaidi
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Patrick E. Duffy
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
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Mohanna M, Roberts E, Whitty L, Gritzfeld JF, Pain CE, Girschick HJ, Preston J, Hadjittofi M, Anderson C, Ferguson PJ, Theos A, Hedrich CM. Priorities in Chronic nonbacterial osteomyelitis (CNO) - results from an international survey and roundtable discussions. Pediatr Rheumatol Online J 2023; 21:65. [PMID: 37391782 DOI: 10.1186/s12969-023-00851-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/16/2023] [Indexed: 07/02/2023] Open
Abstract
OBJECTIVE Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disorder that predominantly affects children and young people. The pathophysiology and molecular mechanisms of CNO remain poorly understood, and diagnostic criteria and biomarkers are lacking. As a result, treatment is empiric and follows personal experience, case series and expert consensus plans. METHODS A survey was designed to gain insight on clinician and patient experiences of diagnosing and treating CNO and to collate opinions on research priorities. A version containing 24 questions was circulated among international expert clinicians and clinical academics (27 contacted, 21 responses). An equivalent questionnaire containing 20 questions was shared to explore the experience and priorities of CNO patients and family members (93 responses). RESULTS Responses were used to select topics for four moderated roundtable discussions at the "International Conference on CNO and autoinflammatory bone disease" (Liverpool, United Kingdom, May 25-26th, 2022). The group identified deciphering the pathophysiology of CNO to be the highest priority, followed by clinical trials, necessary outcome measures and classification criteria. Surprisingly, mental wellbeing scored behind these items. CONCLUSIONS Agreement exists among clinicians, academics, patients and families that deciphering the pathophysiology of CNO is of highest priority to inform clinical trials that will allow for the approval of medications for the treatment of CNO by regulatory agencies.
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Affiliation(s)
- M Mohanna
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - E Roberts
- Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - L Whitty
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - J F Gritzfeld
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - C E Pain
- Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - H J Girschick
- Klinik Für Kinder- Und Jugendmedizin, Vivantes Netzwerk Für Gesundheit GmbH, Klinikum Im Friedrichshain, Berlin, Germany
| | - J Preston
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - M Hadjittofi
- Clinical Health Psychology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - C Anderson
- Royal Hospital for Children and Young People, Edinburgh, UK
| | - P J Ferguson
- Department of Pediatrics, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA
| | - A Theos
- Department of Human Science, CRMO Patient/Parent Partner, Georgetown University, Washington, DC, USA
| | - C M Hedrich
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
- Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
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Landen CN, Molinero L, Hamidi H, Sehouli J, Miller A, Moore KN, Taskiran C, Bookman M, Lindemann K, Anderson C, Berger R, Myers T, Beiner M, Reid T, Van Nieuwenhuysen E, Green A, Okamoto A, Aghajanian C, Thaker PH, Blank SV, Khor VK, Chang CW, Lin YG, Pignata S. Influence of Genomic Landscape on Cancer Immunotherapy for Newly Diagnosed Ovarian Cancer: Biomarker Analyses from the IMagyn050 Randomized Clinical Trial. Clin Cancer Res 2023; 29:1698-1707. [PMID: 36595569 PMCID: PMC10150250 DOI: 10.1158/1078-0432.ccr-22-2032] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 07/04/2022] [Revised: 09/30/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE To explore whether patients with BRCA1/2-mutated or homologous recombination deficient (HRD) ovarian cancers benefitted from atezolizumab in the phase III IMagyn050 (NCT03038100) trial. PATIENTS AND METHODS Patients with newly diagnosed ovarian cancer were randomized to either atezolizumab or placebo with standard chemotherapy and bevacizumab. Programmed death-ligand 1 (PD-L1) status of tumor-infiltrating immune cells (IC) was determined centrally (VENTANA SP142 assay). Genomic alterations, including deleterious BRCA1/2 alterations, genomic loss of heterozygosity (gLOH), tumor mutation burden (TMB), and microsatellite instability (MSI), were evaluated using the FoundationOne assay. HRD was defined as gLOH ≥ 16%, regardless of BRCA1/2 mutation status. Potential associations between progression-free survival (PFS) and genomic biomarkers were evaluated using standard correlation analyses and log-rank of Kaplan-Meier estimates. RESULTS Among biomarker-evaluable samples, 22% (234/1,050) harbored BRCA1/2 mutations and 46% (446/980) were HRD. Median TMB was low irrespective of BRCA1/2 or HRD. Only 3% (29/1,024) had TMB ≥10 mut/Mb, and 0.3% (3/1,022) were MSI-high. PFS was better in BRCA2-mutated versus BRCA2-non-mutated tumors and in HRD versus proficient tumors. PD-L1 positivity (≥1% expression on ICs) was associated with HRD but not BRCA1/2 mutations. PFS was not improved by adding atezolizumab in BRCA2-mutated or HRD tumors; there was a trend toward enhanced PFS with atezolizumab in BRCA1-mutated tumors. CONCLUSIONS Most ovarian tumors have low TMB despite BRCA1/2 mutations or HRD. Neither BRCA1/2 mutation nor HRD predicted enhanced benefit from atezolizumab. This is the first randomized double-blind trial in ovarian cancer demonstrating that genomic instability triggered by BRCA1/2 mutation or HRD is not associated with improved sensitivity to immune checkpoint inhibitors. See related commentary by Al-Rawi et al., p. 1645.
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Affiliation(s)
- Charles N. Landen
- Gynecologic Oncology Group Foundation (GOG-F) and Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, Virginia
| | - Luciana Molinero
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, California
| | - Habib Hamidi
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, California
| | - Jalid Sehouli
- Arbeitsgemeinschaft Gynaekologische Onkologie (AGO)/Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie (North-Eastern German Society of Gynaecologic Oncology; NOGGO) and Charité-Medical University of Berlin (Campus Virchow Klinikum), Berlin, Germany
| | - Austin Miller
- GOG-F and Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Kathleen N. Moore
- GOG-F and Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, and Sarah Cannon Research Institute, Nashville, Tennessee
| | - Cagatay Taskiran
- Turkish Society of Gynecologic Oncology (TRSGO) and Koc University School of Medicine and VKV American Hospital, Istanbul, Turkey
| | - Michael Bookman
- GOG-F and Kaiser Permanente Northern California, San Francisco, California
| | - Kristina Lindemann
- Nordic Society of Gynaecological Oncology (NSGO) and Department of Gynecological Oncology, Division of Cancer Medicine, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Regina Berger
- AGO-Austria and Department for Gynecology and Obstetrics, Innsbruck Medical University, Innsbruck, Austria
| | - Tashanna Myers
- GOG-F and Baystate Medical Center, Springfield, Massachusetts
| | - Mario Beiner
- Israeli Society of Gynecologic Oncology (ISGO) and Gynecologic Oncology Division, Meir Medical Center, Tel Aviv University, Kfar Saba, Israel
| | - Thomas Reid
- GOG-F and Kettering Medical Center, Kettering, Ohio
| | - Els Van Nieuwenhuysen
- Belgium and Luxembourg Gynaecological Oncology Group (BGOG) and UZ Leuven Gasthuisberg, Leuven, Belgium
| | - Andrew Green
- GOG-F and Northeast Georgia Medical Center, Gainesville, Georgia
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan
| | - Carol Aghajanian
- GOG-F and Memorial Sloan Kettering Cancer Center, New York, New York
| | - Premal H. Thaker
- GOG-F and Washington University School of Medicine, St. Louis, Missouri
| | | | - Victor K. Khor
- Product Development Oncology, Genentech, Inc., South San Francisco, California
| | - Ching-Wei Chang
- Personalized Healthcare and Early Development Oncology Biostatistics, Genentech, Inc., South San Francisco, California
| | - Yvonne G. Lin
- Product Development Oncology, Genentech, Inc., South San Francisco, California
| | - Sandro Pignata
- Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Istituto Nazionale Tumori IRCCS Fondazione G Pascale, Napoli, Italy
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Saroha B, Hendricks N, Thatiparthi B, Al-Shaikhli S, Rey K, Anderson C. Abstract No. 229 Clinical Outcomes and Safety of Percutaneous Lung Biopsy in Outpatient Setting. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Tan N, Sri D, Tsang D, Nitkunan T, Anderson C, Qazi H, Issa R, Walker R, Seth J. Robotic colposuspension for female stress urinary incontinence: A prospective series. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00925-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Tan N, Sri D, Tsang D, Nitkunan T, Anderson C, Qazi H, Issa R, Walker R, Seth J. Robotic-assisted laparoscopic colposuspension for female stress urinary incontinence: a prospective series. J Robot Surg 2023; 17:125-129. [PMID: 35384594 DOI: 10.1007/s11701-022-01409-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/22/2022] [Indexed: 11/30/2022]
Abstract
The suspension of use of sub-urethral mesh in the UK in 2018 has seen the resurgence of colposuspension in female SUI surgery. Open and laparoscopic colposuspension techniques are well recognised. We present data from 28 robotic-assisted laparoscopic colposuspension (RALCp) procedures, reporting on technique, safety and efficacy. Approval was obtained from the hospital New and Novel Procedures Committee. All patients had urodynamic assessment prior to surgery. Data was prospectively gathered and 24-h pad usage and Urinary Incontinence Short Form Questionnaire (ICIQ-UI-SF) scores were used to assess symptom severity and quality of life. PGII scores were used to assess patient satisfaction after the procedure. Paired T test analysis was conducted. Since May 2019, robotic colposuspension has been performed in 28 patients. The mean age and BMI were 49 and 27 (kg/m2), respectively, with a mean follow-up period of 12 months. 67.9% of patients had pure urodynamic SUI and 32.1% of patients had previous anti-SUI surgery. Average operating time was 127 min, blood loss 20 ml and length of stay 2 days. There was a significant 73% improvement in mean 24-h pad usage (p = 0.001) and an improvement in mean ICIQ-UI-SF scores from 18.1 to 9.4 (p = 0.0001). Day 1 mean pain score was 5/10. This is the largest series of its kind. Robotic colposuspension is safe and feasible with significant improvements seen in quality of life scores and number of pads used per day. It presents a minimally invasive treatment option in female SUI, however needs larger volume evaluation and longer follow-up for further evaluation.
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Affiliation(s)
- Nataniel Tan
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK.
| | - D Sri
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - D Tsang
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - T Nitkunan
- Epsom and St Helier NHS Trust, Dorking Rd, Epsom, KT18 7EG, UK
| | - C Anderson
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - H Qazi
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - R Issa
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
| | - R Walker
- Epsom and St Helier NHS Trust, Dorking Rd, Epsom, KT18 7EG, UK
| | - J Seth
- St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK
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Elliott DL, Anderson C. The Wisdom of the Crowd: Reliable Deep Reinforcement Learning Through Ensembles of Q-Functions. IEEE Trans Neural Netw Learn Syst 2023; 34:43-51. [PMID: 34185651 DOI: 10.1109/tnnls.2021.3089425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Reinforcement learning (RL) agents learn by exploring the environment and then exploiting what they have learned. This frees the human trainers from having to know the preferred action or intrinsic value of each encountered state. The cost of this freedom is that RL is slower and more unstable than supervised learning. We explore the possibility that ensemble methods can remedy these shortcomings by investigating a novel technique which harnesses the wisdom of crowds by combining Q-function approximator estimates utilizing a simple combination scheme similar to the supervised learning approach known as bagging. Bagging approaches have not yet found widespread adoption in the RL literature nor has a comprehensive look at its performance been performed. Our results show that the proposed approach improves all three tasks and RL approaches attempted. The primary contribution of this work is a demonstration that the improvement is a direct result of the increased stability of the action portion of the state-action-value function. Subsequent experimentation demonstrates that the stability in learning allows an actor-critic method to find more efficient solutions. Finally we show that this approach can be used to decrease the amount of time necessary to solve problems which require a deep Q-learning (DQN) approach.
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Gipson DS, Pal M, Desmond H, Anderson C, Walsh L, Trachtman H, Massengill SF, Gipson P, Rao PS, Thurman J, Kopp J, Kamil E, Lamothe J, Mariani LH, LaFleur P, Vento S, O'Shaughnessy M, Farag YMK, Simon C, Carlozzi NE. Developing an Edema Clinician-Reported Outcome Measure for Nephrotic Syndrome. Glomerular Dis 2023; 3:132-139. [PMID: 37901701 PMCID: PMC10601938 DOI: 10.1159/000531505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/09/2023] [Indexed: 10/31/2023]
Abstract
Introduction Edema is a common manifestation of proteinuric kidney diseases, but there is no consensus approach for reliably evaluating edema. The objective of this study was to develop an edema clinician-reported outcome measure for use in patients with nephrotic syndrome. Methods A literature review was conducted to assess existing clinician-rated measures of edema. Clinical experts were recruited from internal medicine, nephrology, and pediatric nephrology practices to participate in concept elicitation using semi-structured interviews and cognitive debriefing. Qualitative analysis methods were used to collate expert input and inform measurement development. In addition, training and assessment modules were developed using an iterative process that also utilized expert input and cognitive debriefing to ensure interrater reliability. Results While several clinician-rated measures of edema have been proposed, our literature review did not identify any studies to support the reliability or validity of these measures. Fourteen clinician experts participated in the concept elicitation interviews, and twelve participated in cognitive debriefing. A clinician-reported outcome measure for edema was developed. The measure assesses edema severity in multiple individual body parts. An online training module and assessment tool were generated and refined using additional clinician input and investigative team expertise. Conclusion The Edema ClinRO (V1) measure is developed specifically to measure edema in nephrotic syndrome. The tool assesses edema across multiple body parts, and it includes a training module to ensure standardized administration across raters. Future examination of this measure is ongoing to establish its reliability and validity.
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Affiliation(s)
- Debbie S Gipson
- Department of Pediatrics/Pediatric Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Maisha Pal
- Department of Pediatrics/Pediatric Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Hailey Desmond
- Department of Pediatrics/Pediatric Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Charles Anderson
- Department of Pediatrics/Pediatric Nephrology, Levine Children's Hospital at Atrium Health, Charlotte, NC, USA
| | | | - Howard Trachtman
- Department of Pediatrics/Pediatric Nephrology, University of Michigan, Ann Arbor, MI, USA
- Langone Medical Center, New York University, New York, NY, USA
| | - Susan F Massengill
- Department of Pediatrics/Pediatric Nephrology, Levine Children's Hospital at Atrium Health, Charlotte, NC, USA
| | - Patrick Gipson
- Department of Pediatrics/Pediatric Nephrology, University of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine/Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Panduranga S Rao
- Department of Internal Medicine/Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Joshua Thurman
- Department of Internal Medicine/Nephrology, University of Colorado, Aurora, CO, USA
| | - Jeffrey Kopp
- National Institutes of Health, National Institute of Diabetes, Digestive, and Kidney Disease, Bethesda, MD, USA
| | - Elaine Kamil
- Department of Pediatrics, Cedars-Sinai Medical Center and the David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jennifer Lamothe
- Department of Pediatrics/Pediatric Nephrology, Levine Children's Hospital at Atrium Health, Charlotte, NC, USA
| | - Laura H Mariani
- Department of Internal Medicine/Nephrology, University of Michigan, Ann Arbor, MI, USA
| | | | | | | | | | - Christine Simon
- Department of Pediatrics/Pediatric Nephrology, University of Michigan, Ann Arbor, MI, USA
| | - Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
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Drummond S, Lim J, Boardman J, Anderson C, Dickinson D. Sleep Restriction impairs the ability to integrate multiple pieces of information into a decision. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Monk BJ, Parkinson C, Lim MC, O'Malley DM, Oaknin A, Wilson MK, Coleman RL, Lorusso D, Bessette P, Ghamande S, Christopoulou A, Provencher D, Prendergast E, Demirkiran F, Mikheeva O, Yeku O, Chudecka-Glaz A, Schenker M, Littell RD, Safra T, Chou HH, Morgan MA, Drochýtek V, Barlin JN, Van Gorp T, Ueland F, Lindahl G, Anderson C, Collins DC, Moore K, Marme F, Westin SN, McNeish IA, Shih D, Lin KK, Goble S, Hume S, Fujiwara K, Kristeleit RS. A Randomized, Phase III Trial to Evaluate Rucaparib Monotherapy as Maintenance Treatment in Patients With Newly Diagnosed Ovarian Cancer (ATHENA-MONO/GOG-3020/ENGOT-ov45). J Clin Oncol 2022; 40:3952-3964. [PMID: 35658487 PMCID: PMC9746782 DOI: 10.1200/jco.22.01003] [Citation(s) in RCA: 106] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE ATHENA (ClinicalTrials.gov identifier: NCT03522246) was designed to evaluate rucaparib first-line maintenance treatment in a broad patient population, including those without BRCA1 or BRCA2 (BRCA) mutations or other evidence of homologous recombination deficiency (HRD), or high-risk clinical characteristics such as residual disease. We report the results from the ATHENA-MONO comparison of rucaparib versus placebo. METHODS Patients with stage III-IV high-grade ovarian cancer undergoing surgical cytoreduction (R0/complete resection permitted) and responding to first-line platinum-doublet chemotherapy were randomly assigned 4:1 to oral rucaparib 600 mg twice a day or placebo. Stratification factors were HRD test status, residual disease after chemotherapy, and timing of surgery. The primary end point of investigator-assessed progression-free survival was assessed in a step-down procedure, first in the HRD population (BRCA-mutant or BRCA wild-type/loss of heterozygosity high tumor), and then in the intent-to-treat population. RESULTS As of March 23, 2022 (data cutoff), 427 and 111 patients were randomly assigned to rucaparib or placebo, respectively (HRD population: 185 v 49). Median progression-free survival (95% CI) was 28.7 months (23.0 to not reached) with rucaparib versus 11.3 months (9.1 to 22.1) with placebo in the HRD population (log-rank P = .0004; hazard ratio [HR], 0.47; 95% CI, 0.31 to 0.72); 20.2 months (15.2 to 24.7) versus 9.2 months (8.3 to 12.2) in the intent-to-treat population (log-rank P < .0001; HR, 0.52; 95% CI, 0.40 to 0.68); and 12.1 months (11.1 to 17.7) versus 9.1 months (4.0 to 12.2) in the HRD-negative population (HR, 0.65; 95% CI, 0.45 to 0.95). The most common grade ≥ 3 treatment-emergent adverse events were anemia (rucaparib, 28.7% v placebo, 0%) and neutropenia (14.6% v 0.9%). CONCLUSION Rucaparib monotherapy is effective as first-line maintenance, conferring significant benefit versus placebo in patients with advanced ovarian cancer with and without HRD.
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Affiliation(s)
- Bradley J. Monk
- GOG Foundation, HonorHealth Research Institute, University of Arizona College of Medicine, Creighton University School of Medicine, Phoenix, AZ
| | | | - Myong Cheol Lim
- Gynecologic Oncology, National Cancer Center Korea, Goyang-si, Gyeonggi-do, South Korea
| | - David M. O'Malley
- Division of Gynecologic Oncology, The Ohio State University, James Cancer Center, Columbus, OH
| | - Ana Oaknin
- Gynaecologic Cancer Programme, Vall d'Hebron Institute of Oncology (VHIO), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Michelle K. Wilson
- Department of Cancer and Blood, Auckland City Hospital, Auckland, New Zealand
| | | | - Domenica Lorusso
- MITO and Gynecologic Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS and Catholic University of Sacred Heart, Rome, Italy
| | - Paul Bessette
- Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sharad Ghamande
- Department of Obstetrics and Gynecology, Augusta University, Augusta, GA
| | | | - Diane Provencher
- Princess Margaret Consortium and Department of Obstetrics-Gynaecology, Centre Hospitalier de l'Université de Montréal (CHUM), Institut du Cancer de Montréal, Montréal, Canada
| | - Emily Prendergast
- Gynecologic Oncology, Minnesota Oncology and Metro-Minnesota Community Oncology Research Consortium, Minneapolis, MN
| | - Fuat Demirkiran
- Gynecologic Oncology Department, Medical Faculty, Istanbul University, Cerrahpaşa, Istanbul, Turkey
| | - Olga Mikheeva
- Limited Liability Company MedPomosch, Saint Petersburg, Russia
| | - Oladapo Yeku
- Gynecologic Cancers Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Anita Chudecka-Glaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Michael Schenker
- Department of Medical Oncology, Sfantul Nectarie Oncology Center, Dolj, Romania
| | - Ramey D. Littell
- Kaiser Permanente Northern California Gynecologic Cancer Program, San Francisco, CA
| | - Tamar Safra
- Oncology Department, Tel Aviv Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hung-Hsueh Chou
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital (Linkou), Tao-Yuan, Taiwan
- College of Life Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Mark A. Morgan
- Division of Gynecologic Oncology, University of Pennsylvania Health System, Philadelphia, PA
| | - Vít Drochýtek
- Department of Obstetrics and Gynaecology, Faculty Hospital Kralovske Vinohrady, 3rd Medical Faculty, Charles University, Prague, Czech Republic
| | - Joyce N. Barlin
- Women's Cancer Care Associates, Division of Gynecologic Oncology, Albany Medical College, Albany, NY
| | - Toon Van Gorp
- Division of Gynaecological Oncology, Department of Obstetrics and Gynecology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Fred Ueland
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, College of Medicine, University of Kentucky, Lexington, KY
| | - Gabriel Lindahl
- Nordic Society of Gynaecological Oncology, Copenhagen, Denmark
- Department of Oncology, Linköping University, Linköping, Sweden
| | - Charles Anderson
- Department of Gynecologic Oncology, Willamette Valley Cancer Institute and Research Center, Eugene, OR
| | - Dearbhaile C. Collins
- Cancer Trials Ireland and Department of Medical Oncology, Cork University Hospital, Cork, Ireland
| | - Kathleen Moore
- Stevenson Cancer Center at the University of Oklahoma Health Sciences Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Frederik Marme
- AGO and Department Obstetrics and Gynecology, University Hospital Mannheim, Mannheim, Germany
| | - Shannon N. Westin
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Iain A. McNeish
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Danny Shih
- Clinical Operations, Clovis Oncology Inc, Boulder, CO
| | - Kevin K. Lin
- Molecular Diagnostics, Clovis Oncology Inc, Boulder, CO
| | | | | | - Keiichi Fujiwara
- Department of Gynecologic Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Rebecca S. Kristeleit
- Department of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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Werner TL, Lakhani N, Edenfield W, Hays J, Zarwan C, Buscema J, Burns T, Carrington C, Keeton EK, Burger RA, Anderson C. 32 UPGRADE: phase 1 combination trial of the NaPi2b-directed antibody drug conjugate (ADC) upifitamab rilsodotin (UpRi; XMT-1536) in patients with ovarian cancer. Gynecol Oncol Rep 2022. [DOI: 10.1016/s2352-5789(22)00244-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Anderson C, Burriss-West M, Lipford EH, Trovillion EM. Acute promyelocytic leukemia presenting with acute appendicitis and coagulopathy in a pediatric patient: A previously unreported site of extramedullary disease. Pediatr Blood Cancer 2022; 69:e29703. [PMID: 35451549 DOI: 10.1002/pbc.29703] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/15/2022] [Accepted: 03/16/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Charles Anderson
- Department of Pediatrics, Atrium Health at Charlotte, Charlotte, North Carolina, USA
| | - Marybeth Burriss-West
- Department of Pediatrics, Atrium Health at Charlotte, Charlotte, North Carolina, USA
| | - Edward H Lipford
- Department of Pathology, Atrium Health at Charlotte, Charlotte, North Carolina, USA
| | - Erin M Trovillion
- Department of Pediatrics, Division of Hematology and Oncology, Atrium Health at Charlotte, Charlotte, North Carolina, USA
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Barretina-Ginesta MP, Monk BJ, Han S, Pothuri B, Auranen A, Chase DM, Lorusso D, Anderson C, Abadie-Lacourtoisie S, Cloven N, Braicu EI, Amit A, Redondo A, Shah R, Kebede N, Hawkes C, Gupta D, Woodward T, O'Malley DM, González-Martín A. Quality-adjusted time without symptoms of disease or toxicity and quality-adjusted progression-free survival with niraparib maintenance in first-line ovarian cancer in the PRIMA trial. Ther Adv Med Oncol 2022; 14:17588359221126149. [PMID: 36172173 PMCID: PMC9511290 DOI: 10.1177/17588359221126149] [Citation(s) in RCA: 4] [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: 06/10/2022] [Accepted: 08/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background: The PRIMA phase 3 trial showed niraparib significantly prolongs median progression-free survival (PFS) versus placebo in patients with advanced ovarian cancer (OC) responsive to first-line platinum-based chemotherapy, including those who had tumors with homologous recombination deficiency (HRd). This analysis of PRIMA examined the quality-adjusted PFS (QA-PFS) and quality-adjusted time without symptoms of disease or toxicity (Q-TWiST) of patients on maintenance niraparib versus placebo. Methods: Patients were randomized 2:1 to receive once-daily maintenance niraparib (n = 487) or placebo (n = 246). QA-PFS was defined as the PFS of patients adjusted for their health-related quality of life (HRQoL) prior to disease progression, measured using European Quality of Life Five-Dimension (EQ-5D) questionnaire index scores from the PRIMA trial. Q-TWiST was calculated by combining data on PFS, duration of symptomatic grade ⩾2 adverse events (fatigue or asthenia, nausea, vomiting, abdominal pain, and abdominal bloating) prior to disease progression, and EQ-5D index scores. Analyses used data collected up to the last date of PFS assessment (May 17, 2019). Results: The restricted mean QA-PFS was significantly longer with niraparib versus placebo in the HRd (n = 373) and overall intention-to-treat (ITT; n = 733) populations (mean gains of 6.5 [95% confidence interval; CI, 3.9–8.9] and 4.1 [95% CI, 2.2–5.8] months, respectively). There were also significant improvements in restricted mean Q-TWiST for niraparib versus placebo (mean gains of 5.9 [95% CI, 3.5–8.6] and 3.5 [95% CI, 1.7–5.6] months, respectively) in the HRd and ITT populations. Conclusions: In patients with advanced OC, first-line niraparib maintenance was associated with significant gains in QA-PFS and Q-TWiST versus placebo. These findings demonstrate that niraparib maintenance treatment is associated with a PFS improvement and that treatment benefit is maintained even when HRQoL and/or toxicity data are combined with PFS in a single measure. Trial registration: ClinicalTrials.gov: NCT02655016; trial registration date: January 13, 2016 Plain language summary Background: In a large clinical trial called PRIMA, patients with advanced cancer of the ovary (ovarian cancer) were given either niraparib (a type of cancer medicine) or placebo (a pill containing no medicine/active substances) after having chemotherapy (another type of cancer medicine). Taking niraparib after chemotherapy is called maintenance therapy and aims to give patients more time before their cancer returns or gets worse than if they were not given any further treatment. In the PRIMA trial, patients who took niraparib did have more time before their cancer progressed than if they took placebo. However, it is important to consider patients’ quality of life, which can be made worse by cancer symptoms and/or side effects of treatment. Here, we assessed the overall benefit of niraparib for patients in PRIMA. Methods: Both the length of time before disease progression (or survival time) and quality of life were considered using two different analyses: ● The first analysis was called quality-adjusted PFS (QA-PFS) and looked at how long patients survived with good quality of life. ● The second analysis was called quality-adjusted time without symptoms of disease or toxicity (Q-TWiST) and looked at how long patients survived without cancer symptoms or treatment side effects. Results: The PRIMA trial included 733 patients; 487 took niraparib and 246 took placebo. Around half of the patients in both groups had a type of ovarian cancer that responds particularly well to drugs like niraparib – they are known as homologous recombination deficiency (HRd) patients. ● When information on quality of life (collected from patient questionnaires) and survival was combined in the QA-PFS analysis, HRd patients who took niraparib had approximately 6.5 months longer with a good quality of life before disease progression than those who took placebo. In the overall group of patients (including HRd patients and non-HRd patients), those who took niraparib had approximately 4 months longer than with placebo. ● Using the second analysis (Q-TWiST) to combine information on survival with cancer symptoms and treatment side effects, the HRd patients taking niraparib had approximately 6 months longer without cancer symptoms or treatment side effects (such as nausea or vomiting) than patients taking placebo. In the overall group of patients, those taking niraparib had approximately 3.5 months longer without these cancer symptoms/side effects than patients receiving placebo. Conclusions: These results show that the survival benefits of niraparib treatment remain when accounting for patients’ quality of life. These benefits were seen not only in HRd patients who are known to respond better to niraparib, but in the overall group of patients who took niraparib.
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Affiliation(s)
- Maria-Pilar Barretina-Ginesta
- GEICO and Medical Oncology Department, Institut Català d'Oncologia, Sant Ponç, Avinguda de França, Girona 17007, SpainGirona Biomedical Research Institute, Girona University, Girona, Spain
| | - Bradley J Monk
- GOG Foundation and Arizona Oncology (US Oncology Network), University of Arizona, Creighton University, Phoenix, AZ, USA
| | - Sileny Han
- BGOG and Department of Gynaecology and Obstetrics,University Hospitals Leuven, Leuven, Belgium
| | - Bhavana Pothuri
- GOG Foundation and Department of Obstetrics/Gynecology, Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Annika Auranen
- NSGO and Department of Obstetrics and Gynecology and Tays Cancer Centre, Tampere University Hospital, Tampere, Finland
| | - Dana M Chase
- GOG Foundation and Arizona Oncology (US Oncology Network), University of Arizona, Creighton University, Phoenix, AZ, USA
| | - Domenica Lorusso
- MITO and Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | | | - Sophie Abadie-Lacourtoisie
- GINECO and Oncologie Médicale Gynécologique, Institut de Cancérologie de l'Ouest - Site Paul Papin, Angers, France
| | - Noelle Cloven
- GOG and Division of Gynecologic Oncology, Texas Oncology (US Oncology Network), Fort Worth, TX, USA
| | - Elena I Braicu
- AGO and Department for Gynaecology, Campus Virchow Clinic, Charité - Universitätsmedizin Berlin, Berlin, GermanyDepartment of Obstetrics and Gynecology, Stanford University, Palo Alto, CA, USA
| | - Amnon Amit
- ISGO and Division of Obstetrics and Gynecology, Rambam Medical Centre, Haifa, Israel
| | - Andrés Redondo
- GEICO and Medical Oncology Department, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
| | - Ruchit Shah
- Open Health Evidence and Access, Bethesda, MD, USAHealth Economics and Outcomes Research, Daiichi Sankyo, Basking Ridge, NJ, USA
| | - Nehemiah Kebede
- Open Health Evidence and Access, Bethesda, MD, USAReal World Evidence Science, Oncology Business Unit, AstraZeneca, Gaithersburg, MD, USA
| | | | | | - Tatia Woodward
- GSK, Philadelphia, PA, USAGlobal Value and Evidence Strategy, Pfizer, Baltimore, MD, USA
| | - David M O'Malley
- GOG and Division of Gynecologic Oncology, Ohio State University COM - James CCC, Columbus, OH, USA
| | - Antonio González-Martín
- GEICO and Medical Oncology Department, Clínica Universidad de Navarra, Madrid, SpainCIMA-University of Navarra, Program in Solid Tumors, Pamplona, Spain
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Gantchoff MG, Conlee L, Boudreau MR, Iglay RB, Anderson C, Belant JL. Spatially-explicit population modeling to predict large carnivore recovery and expansion. Ecol Modell 2022. [DOI: 10.1016/j.ecolmodel.2022.110033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lakhani N, Burns T, Barve M, Edenfield J, Hays J, Zarwan C, Werner T, Anderson C, Buscema J, Bernardo P, Keeton E, Carrington C, Burger R. Upgrade: Phase 1 combination trial of the NaPi2b-directed dolaflexin antibody drug conjugate (ADC) upifitamab rilsodotin (UpRi; XMT-1536) in patients with ovarian cancer (588). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01808-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Anderson C, Lund JL, Park J, Brewster W, Bae-Jump V, Olshan AF, Nichols HB. Adverse Urinary System Outcomes among Older Women with Endometrial Cancer. Cancer Epidemiol Biomarkers Prev 2022; 31:1508. [PMID: 35775217 DOI: 10.1158/1055-9965.epi-22-0467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE OF THE STUDY Endometrial cancer and its treatment may cause damage to the urinary system, but few large-scale studies have examined the incidence of urinary-related outcomes among endometrial cancer survivors. We investigated the risk of several urinary disease diagnoses among older women with endometrial cancer compared to women without a cancer history. METHODS Women ages 66 years and older with an endometrial cancer diagnosis during 2004-2017 (N=44,386) and women without a cancer history (N=221,219) matched 5:1 on age, race/ethnicity, and state were identified in the Surveillance, Epidemiology, and End Results-Medicare linked data. ICD-9 and -10 diagnosis codes were used to identify urinary outcomes in the Medicare claims data. Cumulative incidences (IP) of urinary outcomes were estimated among women with and without endometrial cancer. Multivariable Cox proportional hazards regression models were used to estimate hazards ratios (HR) for urinary outcomes comparing women with and without endometrial cancer. HRs were also used to identify characteristics associated with urinary outcomes among endometrial cancer survivors. RESULTS Relative to women without cancer, endometrial cancer survivors had an increased risk of urinary system diagnoses, including renal failure (5-year IP: 25% vs 14%; HR=1.50; 95% CI: 1.47-1.53), chronic kidney disease (5-year IP: 20% vs 14%; HR=1.25; 95% CI: 1.22-1.28), calculus of the urinary tract (5-year IP: 7% vs 4%; HR=1.55; 95% CI: 1.50-1.61), lower urinary tract infection (5-year IP: 55% vs 33%; HR=1.75; 95% CI: 1.72, 1.78), and bladder diseases (5-year IP: 10% vs 6%; HR=1.57; 95% CI: 1.52, 1.62). These associations persisted in analyses limited to 1+ and 5+ years after endometrial cancer diagnosis. Non-Hispanic Black or Hispanic race/ethnicity, higher comorbidity index, higher stage or grade cancer, non-endometrioid histology, and treatment with chemotherapy and/or radiation were often predictors of urinary outcomes among women with endometrial cancer. CONCLUSIONS Our results suggest that, among older women, the risk of urinary outcomes is elevated after endometrial cancer. Monitoring for urinary diseases may be a critical part of long-term survivorship care for older women with an endometrial cancer history.
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Crosby L, Lewer D, Appleby Y, Anderson C, Hayward A, Story A. Outcomes of a residential respite service for homeless people with tuberculosis in London, UK: a cross-sectional study. Perspect Public Health 2022; 143:89-96. [PMID: 35506684 PMCID: PMC10068400 DOI: 10.1177/17579139221093544] [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: 11/17/2022]
Abstract
BACKGROUND Many countries are seeking to eliminate tuberculosis (TB), but incidence remains high in socially excluded groups such as people experiencing homelessness. There is limited research into the effectiveness of residential respite services (RRS), which provide accomodation and social and clinical support for homeless people with active TB. METHODS We used a register of all cases of TB diagnosed in London between 1 January 2010 and 3 October 2019 to compare characteristics and outcomes of patients treated in an RRS with patients receiving standard care. The primary outcome was successful treatment completion. We used logistic regression to compare likelihood of completing treatment, and simulation to estimate the absolute change in treatment completion resulting from this service. RESULTS A total of 78 homeless patients finished an episode of TB treatment at the RRS. Patients treated in the RRS were more likely than patients treated in standard care to have clinical and social risk factors including drug resistance, history of homelessness, drug or alcohol use, and need for directly observed therapy. After adjusting for these factors, patients treated in the RRS had 2.97 times the odds of completing treatment (95% CI = 1.44-6.96). Treatment ended in failure for 8/78 patients treated in the RRS (10%, 95% CI = 5%-20%). We estimated that in the absence of the RRS, treatment would have ended in failure for 17/78 patients (95% CI = 11-25). CONCLUSION The residential respite service for homeless TB patients with complex social needs was associated with better treatment outcomes.
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Affiliation(s)
- L Crosby
- Collaborative Centre for Inclusion Health, UCL, London, UK.,Research Department of Primary Care and Population Health, UCL, London, UK
| | - D Lewer
- Collaborative Centre for Inclusion Health, University College London, London, UK.,National Infections Service, Public Health England, London, UK
| | - Y Appleby
- Find & Treat, University College London Hospitals, London, UK
| | - C Anderson
- National Infections Service, Public Health England, London, UK
| | - A Hayward
- Collaborative Centre for Inclusion Health, UCL, London, UK
| | - A Story
- Collaborative Centre for Inclusion Health, UCL, London, UK.,Find & Treat, University College London Hospitals, London, UK
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Schnabel A, Nashawi M, Anderson C, Felsenstein S, Lamoudi M, Poole-Cowley J, Lindell E, Oates B, Fowlie P, Walsh J, Ellis T, Hahn G, Goldspink A, Martin N, Mahmood K, Hospach T, Lj M, Hedrich CM. TNF-inhibitors or bisphosphonates in chronic nonbacterial osteomyelitis? - Results of an international retrospective multicenter study. Clin Immunol 2022; 238:109018. [PMID: 35460903 DOI: 10.1016/j.clim.2022.109018] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 12/26/2022]
Abstract
Chronic nonbacterial osteomyelitis (CNO) can cause significant morbidity, including bone pain and damage. In the absence of clinical trials, treatments include non-steroidal anti-inflammatory drugs, corticosteroids, TNF-inhibitors (TNFi) and/or bisphosphonates. In a retrospective chart review in the United Kingdom and Germany, we investigated response to TNFi and/or pamidronate. Ninety-one patients were included, receiving pamidronate (n = 47), TNFi (n = 22) or both sequentially (n = 22). Patients with fatigue [p = 0.003] and/or arthritis [p = 0.002] were more frequently treated with TNFi than pamidronate. Both therapies were associated with clinical remission at 6 months, and reduction of bone lesions on MRI at 12 months. While not reaching statistical significance, pamidronate resulted in faster resolution of MRI lesions. Fewer flares were observed with TNFi. Failure to respond to pamidronate was associated with female sex [p = 0.027], more lesions on MRI [p = 0.01] and higher CRP levels [p = 0.03]. Randomized clinical trials are needed to confirm observations and generate evidence.
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Affiliation(s)
- A Schnabel
- Pädiatrische Rheumatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.
| | - M Nashawi
- Pädiatrische Rheumatologie, Klinikum Stuttgart, Germany; Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - C Anderson
- Royal Hospital for Children and Young People, Edinburgh, United Kingdom
| | - S Felsenstein
- Department of Infectious Disease and Immunology, Alder Hey Children's NHS Foundation Trust, United Kingdom
| | - M Lamoudi
- Royal Hospital for Children and Young People, Edinburgh, United Kingdom
| | - J Poole-Cowley
- Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - E Lindell
- University Hospital Crosshouse, Kilmarnock, United Kingdom
| | - B Oates
- University Hospital Crosshouse, Kilmarnock, United Kingdom
| | - P Fowlie
- Ninewells Hospital, Dundee, United Kingdom
| | - J Walsh
- Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - T Ellis
- Pädiatrische Rheumatologie, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - G Hahn
- Department of Radiology, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - A Goldspink
- Raigmore Hospital, Inverness, United Kingdom
| | - N Martin
- Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - K Mahmood
- Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - T Hospach
- Pädiatrische Rheumatologie, Klinikum Stuttgart, Germany
| | - McCann Lj
- Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
| | - C M Hedrich
- Department of Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom; Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, United Kingdom.
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Scaria PV, Anderson C, Muratova O, Alani N, Trinh HV, Nadakal ST, Zaidi I, Lambert L, Beck Z, Barnafo EK, Rausch KM, Rowe C, Chen B, Matyas GR, Rao M, Alving CR, Narum DL, Duffy PE. Malaria transmission-blocking conjugate vaccine in ALFQ adjuvant induces durable functional immune responses in rhesus macaques. NPJ Vaccines 2021; 6:148. [PMID: 34887448 PMCID: PMC8660773 DOI: 10.1038/s41541-021-00407-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/03/2021] [Indexed: 12/14/2022] Open
Abstract
Malaria transmission-blocking vaccines candidates based on Pfs25 and Pfs230 have advanced to clinical studies. Exoprotein A (EPA) conjugate of Pfs25 in Alhydrogel® developed functional immunity in humans, with limited durability. Pfs230 conjugated to EPA (Pfs230D1-EPA) with liposomal adjuvant AS01 is currently in clinical trials in Mali. Studies with these conjugates revealed that non-human primates are better than mice to recapitulate the human immunogenicity and functional activity. Here, we evaluated the effect of ALFQ, a liposomal adjuvant consisting of TLR4 agonist and QS21, on the immunogenicity of Pfs25-EPA and Pfs230D1-EPA in Rhesus macaques. Both conjugates generated strong antibody responses and functional activity after two vaccinations though activity declined rapidly. A third vaccination of Pfs230D1-EPA induced functional activity lasting at least 9 months. Antibody avidity increased with each vaccination and correlated strongly with functional activity. IgG subclass analysis showed induction of Th1 and Th2 subclass antibody levels that correlated with activity.
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Affiliation(s)
- Puthupparampil V. Scaria
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Charles Anderson
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Olga Muratova
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Nada Alani
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Hung V. Trinh
- grid.507680.c0000 0001 2230 3166U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910 USA ,grid.201075.10000 0004 0614 9826Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Bethesda, MD 20817 USA
| | - Steven T. Nadakal
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Irfan Zaidi
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Lynn Lambert
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Zoltan Beck
- grid.507680.c0000 0001 2230 3166U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910 USA ,grid.201075.10000 0004 0614 9826Henry M. Jackson Foundation for the Advancement of Military Medicine, 6720A Rockledge Drive, Bethesda, MD 20817 USA ,grid.410513.20000 0000 8800 7493Present Address: Pfizer, Vaccine Research and Development, Pearl River, NY USA
| | - Emma K. Barnafo
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Kelly M. Rausch
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Chris Rowe
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Beth Chen
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Gary R. Matyas
- grid.507680.c0000 0001 2230 3166U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910 USA
| | - Mangala Rao
- grid.507680.c0000 0001 2230 3166U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910 USA
| | - Carl R. Alving
- grid.507680.c0000 0001 2230 3166U.S. Military HIV Research Program, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910 USA
| | - David L. Narum
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
| | - Patrick E. Duffy
- grid.419681.30000 0001 2164 9667Laboratory of Malaria Immunology and Vaccinology, NIAID/NIH, 29 Lincoln Drive, Building 29B, Bethesda, MD 20892-2903 USA
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Leung L, Sri D, Seth J, Sharma D, Tay A, Gonsalves M, Qazi H, Anderson C, Issa R. Robotic-Assisted Bladder Diverticulectomy (RABD): A safe alternative to open approach. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)02213-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Hussain F, Sonani H, Anderson C, Varshney N. Duodenal Duplication Cyst in adult male; An Extremely Rare Entity and a Diagnostic Pitfall leading to Whipple procedure. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction/Objective
Whipple procedure is a complex, invasive operation and has high morbidity and mortality. It is the most commonly indicated treatment for treating malignant tumors, however, it can be also used for benign entities as well including biliary stricture, chronic pancreatitis, choledochal cyst, inflammatory pseudotumour, and duodenal angiodysplasia.
Methods/Case Report
We report a case of a 50-year-old man who presented with symptoms of gastric outlet obstruction. Esophagogastroduodenoscopy and CT scan showed an obstruction at the level of the second part of the duodenum with proximal dilation. Subsequently, a Whipple procedure was performed based on high clinical suspicion of duodenal cancer. Gross examination revealed a unilocular thick walled cyst (4.2 cm) in the duodenum. Histopathologic examination showed a cyst lined by duodenal mucosa with thick smooth muscle wall and focal ectopic gastric tissue. This was finally diagnosed as a duodenal cyst consistent with duplication cyst.
Results (if a Case Study enter NA)
NA
Conclusion
Duplication cysts are rare congenital abnormality predominantly diagnosed in infancy and childhood. They are most commonly located in the distal ileum, followed by the esophagus and ileocecal region, and are extremely rare in duodenum. Differential diagnosis includes choledochocele, pancreatic pseudocyst, and cystic tumors of the pancreas, mesenteric cysts, and duodenal diverticulums. Treatment options include total excision, cystojejunostomy, and endoscopic marsupialization but occasionally may lead to more invasive measures such as the Whipple procedure. Although duodenal duplication cysts can have variable clinical presentation and radiological findings, making preoperative diagnosis very challenging, it is still pertinent to be aware of this entity for the optimal patient care.
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Affiliation(s)
- F Hussain
- Pathology, University of Mississippi Medical Center, Ridgeland, Mississippi, UNITED STATES
| | - H Sonani
- Pathology, University of Mississippi Medical Center, Ridgeland, Mississippi, UNITED STATES
| | - C Anderson
- Pathology, University of Mississippi Medical Center, Ridgeland, Mississippi, UNITED STATES
| | - N Varshney
- Pathology, University of Mississippi Medical Center, Ridgeland, Mississippi, UNITED STATES
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Fugar S, Deka K, Anderson C, Lama Von Buchwald C, Geroux R, Al-Amoodi M, White J, Kavinsky C. Invasive and Doppler Transvalvular gradients after transcatheter aortic valve replacement. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Differences in mean gradients after Transcatheter valve replacement (TAVR) vary depending on the valve type and the modality used to measure the gradients. Currently there is a paucity of data on the relationship between invasive and doppler derived gradients after TAVR.
Purpose
We sort to assess the difference in doppler, and catheter derived aortic valve gradients after TAVR
Methods
This is a single center retrospective study using consecutive patients who presented for TAVR on account of native aortic valve stenosis at our institution from May 2012 till December 2020. Patients with both intraoperative invasive and postoperative doppler derived pressure gradients were included in the analysis. Student T-test were used to compare mean gradients. Pearson's correlation test was used to examine the correlation between measured gradients.
Results
A total of 587 patients were included in our study. Fifty one percent were male and 462 (78.7%) underwent TAVR with a balloon expandable valve. In the entire cohort the mean gradient measured invasively was significantly lower than those measured by echo doppler (4.48±3.25 vs. 5.57±3.11, P<0.001). There, however, was a positive correlation between invasive and doppler measured gradients (figure 1). In those who received balloon expandable valves, the invasive gradient was 4.39±3.30 and the doppler derived gradient was 5.47±3.04 (P<0.001), while in those self-expanding valves, the invasive gradient was 4.81±3.04 and doppler derived gradient was 5.94±3.36 (P<0.001).
Conclusion
Post TAVR gradients were all significantly lower when measured invasively as compared to those measured using doppler. Self-expanding valves overall had higher residual gradients. Further studies are needed to assess the correlations between invasively measured gradients and clinical outcomes post TAVR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Fugar
- Rush University Medical Center, Chicago, United States of America
| | - K Deka
- Rush University Medical Center, Chicago, United States of America
| | - C Anderson
- Rush University Medical Center, Chicago, United States of America
| | | | - R Geroux
- Rush University Medical Center, Chicago, United States of America
| | - M Al-Amoodi
- Rush University Medical Center, Chicago, United States of America
| | - J White
- Rush University Medical Center, Chicago, United States of America
| | - C Kavinsky
- Rush University Medical Center, Chicago, United States of America
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Garweg C, Bordachar P, Boveda S, Roberts P, Johansen J, Iacopino S, Clementy N, Winter S, Anderson C, Butler K, El-Chami M. Real-world experience on the safety and effectiveness of Micra TPS in patients with pre-existing in situ CIEDs. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The Micra pre-market study showed that the Micra transcatheter pacing system could be safely implanted in patients with pacing indications. Patients with pre-existing cardiac implantable electronic devices (CIED) were excluded from this clinical trial; however, this group of patients might benefit from a leadless pacemaker especially when a lead fails or after incidence of system-related infections.
Objective
To determine the outcome of patients with a pre-existing CIED or lead that remains in situ at the time of Micra implant attempt.
Methods
Patients who had a pre-existing CIED and/or lead at the time of Micra implantation attempt were identified from the Micra Post-Approval Registry and Micra Acute Performance studies. Baseline characteristics were summarized, and a Fine-Gray competing risk model was used to compare risk for major complication through 24 months for patients with and without a pre-existing CIED.
Results
Of the 2323 patients included in the analysis, 111 patients had a pre-existing CIED or lead at the time of Micra implantation attempt that remained in situ. Types of pre-existing devices included 81 pacemakers (45 single chamber, 32 dual chamber, 4 of unknown type), 10 ICDs (2 single chamber, 2 dual chamber, 6 unknown type), 10 CRT devices (6 CRT-P, 4 CRT-D), 3 generators of unknown type, and 7 patients had only leads remaining. Patients with pre-existing devices were younger and less likely to have a pacing indication of bradyarrhythmia with atrial fibrillation compared to patients without pre-existing devices (p<0.001 for both). Patients with prior devices were more likely to have a condition precluding implant of a transvenous pacemaker (67.6% vs. 21.3%, p<0.001). The presence of a pre-existing CIED did not impact the outcome of the Micra TPS implant procedure: implant success was >99% for both cohorts. Mean follow-up duration was 21.2±14.3 months (range 0–56) for pre-existing devices patients and 23.3±15.8 months (range 0–62) for other patients. The rate of major complications through 24 months was 1.8% for patients with and 3.8% for patients without prior devices (p=0.36). There were no major complications related to device malfunction or device-device interaction. There were 6 system revisions in 4 patients with preexisting devices and 52 revisions in 51 patients without preexisting devices. Pacing thresholds for patients with and without prior devices were similar at implant (0.72 and 0.63, respectively; p=0.31) and remained stable through 12 months.
Conclusion
Micra can be safely and successfully implanted in patients with a pre-existing CIED remaining in situ. It should be considered a treatment option for patients in whom CIED extraction may be deemed high risk.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Medtronic, Inc. Risk of major complications
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Affiliation(s)
- C Garweg
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - P Bordachar
- University Hospital of Bordeaux, Bordeaux, France
| | - S Boveda
- Clinic Pasteur, Toulouse, France
| | - P.R Roberts
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | - S Iacopino
- Maria Cecilia Hospital, Cotignola, Italy
| | - N Clementy
- University Hospital of Tours, Tours, France
| | - S Winter
- St. Vinzenz-Hospital, Cologne, Germany
| | - C Anderson
- Medtronic, Mounds View, United States of America
| | - K Butler
- Medtronic, Mounds View, United States of America
| | - M.F El-Chami
- Emory University Hospital, Atlanta, United States of America
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Johnson DH, Anderson C, Applegate RD, Bailey L, Cooch E, Fieberg J, Franklin AB, Gutiérrez RJ, Miller KV, Nichols JD, Niemuth ND, Otis D, Ribic CA, Rowland MM, Shaffer TL. A Perspective on the Journal of Wildlife Management. J Wildl Manage 2021. [DOI: 10.1002/jwmg.22110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Douglas H. Johnson
- U.S. Geological Survey, Northern Prairie Wildlife Research Center, Department of Fisheries, Wildlife, and Conservation Biology University of Minnesota
| | | | | | - Larissa Bailey
- Department of Fish, Wildlife, and Conservation Biology Colorado State University
| | - Evan Cooch
- Department of Natural Resources and the Environment Cornell University
| | - John Fieberg
- Department of Fisheries, Wildlife, and Conservation Biology University of Minnesota
| | | | - R. J. Gutiérrez
- Department of Fisheries, Wildlife, and Conservation Biology University of Minnesota
| | - Karl V. Miller
- Warnell School of Forestry and Natural Resources, University of Georgia
| | | | - Neal D. Niemuth
- U.S. Fish and Wildlife Service, Habitat and Population Evaluation Team
| | - David Otis
- Department of Fish, Wildlife, and Conservation Biology Colorado State University
| | - Christine A. Ribic
- U.S. Geological Survey, Wisconsin Cooperative Wildlife Research Unit, Department of Forest and Wildlife Ecology University of Wisconsin
| | | | - Terry L. Shaffer
- U.S. Geological Survey, Northern Prairie Wildlife Research Center
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Landen C, Molinero L, Sehouli J, Miller A, Moore K, Taskiran C, Bookman M, Lindemann K, Anderson C, Berger R, Myers T, Beiner M, Reid T, Van Nieuwenhuysen E, Green A, Okamoto A, Aghajanian C, Thaker P, Blank S, Khor V, Wu F, Lin Y, Pignata S. Association of BRCA1/2, homologous recombination deficiency, and PD-L1 with clinical outcomes in patients receiving atezolizumab versus placebo combined with carboplatin, paclitaxel, and bevacizumab for newly diagnosed ovarian cancer: exploratory analyses of IMagyn050/GOG3015/ENGOT-ov39. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)00716-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Penson R, Patel S, Wenzel L, Miller A, Mangili G, Bookman M, Zola P, Anderson C, Zagouri F, Myers T, Herrero A, Robison K, Madry R, Buscema J, Cibula D, Ueland F, Lortholary A, Moxley K, Scroggins M, Khor V, Wu F, Lin Y, Moore K. Patient-reported outcomes in the randomized phase III IMagyn050/GOG3015/ENGOT-ov39 trial evaluating atezolizumab (atezo) with carboplatin/paclitaxel/bevacizumab for newly diagnosed ovarian cancer. Gynecol Oncol 2021. [DOI: 10.1016/s0090-8258(21)01088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Mathews G, Anderson C. The Lived Experience of Learning Mindfulness as Perceived by People Living With Long-Term Conditions: A Community-Based, Longitudinal, Phenomenological Study. Qual Health Res 2021; 31:1209-1221. [PMID: 33739175 PMCID: PMC8182297 DOI: 10.1177/1049732321997130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
While a considerable research base demonstrates the positive effects of 8-week secular mindfulness courses, it remains unclear to what degree their participants continue to engage with mindfulness practices; and there is a dearth of published reports on longer-term mindfulness interventions. Studies have also tended to focus on clinical "effectiveness," with less attention given to participants' own construal and expectations of mindfulness. To address these gaps, the study reported here implemented a year-long mindfulness program for a group of 20 individuals with long-standing health conditions who gradually transitioned to self-guiding. Their experiences, expectations, and understanding of mindfulness were investigated through the lens of descriptive phenomenology. The findings revealed that mindfulness practice did bring therapeutic improvement but that it was a multi-faceted process where an individual's intentionality toward practice was key, with a clear division between those pursuing an "embodied integrated" mindfulness and those viewing it as a stress management tool.
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37
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Barney J, Estee J, Lynch WG, Isobe T, Jhang G, Kurata-Nishimura M, McIntosh AB, Murakami T, Shane R, Tangwancharoen S, Tsang MB, Cerizza G, Kaneko M, Lee JW, Tsang CY, Wang R, Anderson C, Baba H, Chajecki Z, Famiano M, Hodges-Showalter R, Hong B, Kobayashi T, Lasko P, Łukasik J, Nakatsuka N, Olsen R, Otsu H, Pawłowski P, Pelczar K, Sakurai H, Santamaria C, Setiawan H, Taketani A, Winkelbauer JR, Xiao Z, Yennello SJ, Yurkon J, Zhang Y. The SπRIT time projection chamber. Rev Sci Instrum 2021; 92:063302. [PMID: 34243507 DOI: 10.1063/5.0041191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 05/23/2021] [Indexed: 06/13/2023]
Abstract
The Superconducting Analyzer for MUlti-particles from RAdioIsotope (SAMURAI) Pion-Reconstruction and Ion-Tracker Time Projection Chamber (SπRIT TPC) was designed to enable measurements of heavy ion collisions with the SAMURAI spectrometer at the RIKEN radioactive isotope beam factory and provides constraints on the equation of state of neutron-rich nuclear matter. The SπRIT TPC has a 50.5 cm drift length and an 86.4 × 134.4 cm2 pad plane with 12 096 pads that are equipped with the generic electronics for TPCs. The SπRIT TPC allows for an excellent reconstruction of particles and provides isotopic resolution for pions and other light charged particles across a wide range of energy losses and momenta. The details of the SπRIT TPC are presented, along with discussion of the TPC performance based on cosmic rays and charged particles emitted in heavy ion collisions.
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Affiliation(s)
- J Barney
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - J Estee
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - W G Lynch
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - T Isobe
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - G Jhang
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | | | - A B McIntosh
- Cyclotron Institute, Texas A&M University, College Station, Texas 77843, USA
| | - T Murakami
- Department of Physics, Kyoto University, Kita-shirakawa, Kyoto 606-8502, Japan
| | - R Shane
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - S Tangwancharoen
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - M B Tsang
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - G Cerizza
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - M Kaneko
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - J W Lee
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - C Y Tsang
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - R Wang
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - C Anderson
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - H Baba
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - Z Chajecki
- Department of Physics, Western Michigan University, Kalamazoo, Michigan 49008, USA
| | - M Famiano
- Department of Physics, Western Michigan University, Kalamazoo, Michigan 49008, USA
| | - R Hodges-Showalter
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - B Hong
- Department of Physics, Korea University, Seoul 02841, Republic of Korea
| | - T Kobayashi
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - P Lasko
- Institute of Nuclear Physics PAN, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - J Łukasik
- Institute of Nuclear Physics PAN, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - N Nakatsuka
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - R Olsen
- Gran Sasso National Laboratory-INFN, Via G. Acitelli 22, 67100 Assergi, L'Aquila AQ, Italy
| | - H Otsu
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - P Pawłowski
- Institute of Nuclear Physics PAN, ul. Radzikowskiego 152, 31-342 Kraków, Poland
| | - K Pelczar
- Gran Sasso National Laboratory-INFN, Via G. Acitelli 22, 67100 Assergi, L'Aquila AQ, Italy
| | - H Sakurai
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - C Santamaria
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - H Setiawan
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - A Taketani
- RIKEN Nishina Center, Hirosawa 2-1, Wako, Saitama 351-0198, Japan
| | - J R Winkelbauer
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - Z Xiao
- Department of Physics, Tsinghua University, Beijing 100084, People's Republic of China
| | - S J Yennello
- Cyclotron Institute, Texas A&M University, College Station, Texas 77843, USA
| | - J Yurkon
- National Superconducting Cyclotron Laboratory, East Lansing, Michigan 48824, USA
| | - Y Zhang
- Department of Physics, Tsinghua University, Beijing 100084, People's Republic of China
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Garweg C, Clementy N, Mondoloy P, Winter S, Bordachar P, Sharman D, Jung W, Eschalier R, Theis C, Defaye P, Anderson C, Pol A, Roberts PR. A leadless pacemaker in the real-world setting: Patient profile and performance over time. Europace 2021. [DOI: 10.1093/europace/euab116.389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Medtronic, Inc.
OnBehalf
Micra Acute Performance EMEA Investigators
Background
The first in-man implant of the Micra leadless pacemaker occurred in December 2013. While prior trials demonstrated a high implant success rate and favorable safety and efficacy results; whether the patient population and outcomes have changed over time is not well studied.
Purpose
To characterize the evolution of patient profile and outcomes for patients receiving a leadless pacemaker through the pre-market and post-market environment.
Methods
Patients undergoing a Micra leadless pacemaker implant attempt from the initial Micra Investigational Device Exemption [IDE] and current Micra studies (Micra post-approval registry [PAR], Micra acute performance [MAP] study) were analyzed. Patient characteristics and pericardial effusions regardless of severity were summarized.
Results
The 3466 patients included in the analysis underwent a Micra implant attempt and were enrolled during consecutive timeframes: patients from the Micra IDE study (n = 726) underwent a Micra implant attempt from 2013-2015, patients from the PAR (n = 1814) from 2015-2018, and patients from Micra MAP cohort (n = 926) from 2018 – 2020. Implant success was >99.0% in all 3 studies. Median age ranged from 78 – 79 years among the 3 studies without significant difference. There were more patients requiring dialysis in the MAP cohort compared to the PAR or IDE cohorts (10.3%, 7.9%, and 3.9%, respectively; P < 0.001), but fewer patients with congestive heart failure (8.3%, 13.1%, and 18.0%; P < 0.001). Pacing indication was significantly different between the studies, with fewer patients in MAP having an indication of bradyarrhythmia associated with atrial fibrillation (AF) and more having an indication associated with atrioventricular block without AF (P < 0.001). The number of patients considered to be precluded for a transvenous pacemaker implant increased significantly from the initial IDE study to the PAR and MAP studies (6.2%, 23.9%, and 44.1%, respectively, P < 0.001). Implant site placement was mostly apical for the IDE but shifted to mostly septal placement in the PAR and MAP (septal placement: 33.3%, 64.0%, and 79.5%, respectively). The rate of pericardial effusion regardless of severity was 1.79% (n = 13) in the IDE, 0.83% (n = 15) in the PAR, and 0.97% (n = 9) in MAP (figure). Mean pacing thresholds among MAP EMEA patients were low (0.61 ± 0.40V) at implant and remained stable through 12 months (0.62 +/- 0.41V).
Conclusion
Despite patient differences over time, the Micra leadless pacemaker was implanted with a high success rate and a low perforation rate, in-line with prior reports. Abstract Figure. Pericardial effusion rate by study
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Affiliation(s)
- C Garweg
- University Hospitals (UZ) Leuven, Cardiology, Leuven, Belgium
| | - N Clementy
- Centre Hospitalier Régional Universitaire de Tours, France, Tours, France
| | - P Mondoloy
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - S Winter
- St. Vinzenz Hospital (Köln), Cologne, Germany
| | - P Bordachar
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - D Sharman
- Northampton General Hospital (Cliftonville), Cliftonville, Northampton, United Kingdom of Great Britain & Northern Ireland
| | - W Jung
- Schwarzwald-Baar Hospital, Villingen-Schwenningen, Germany
| | - R Eschalier
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - C Theis
- Robert Bosch Hospital, Stuttgart, Germany
| | | | - C Anderson
- Medtronic, Mounds View, United States of America
| | - A Pol
- Bakken Research Center, Maastricht, Netherlands (The)
| | - PR Roberts
- University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom of Great Britain & Northern Ireland
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Moore KN, Bookman M, Sehouli J, Miller A, Anderson C, Scambia G, Myers T, Taskiran C, Robison K, Mäenpää J, Willmott L, Colombo N, Thomes-Pepin J, Liontos M, Gold MA, Garcia Y, Sharma SK, Darus CJ, Aghajanian C, Okamoto A, Wu X, Safin R, Wu F, Molinero L, Maiya V, Khor VK, Lin YG, Pignata S. Atezolizumab, Bevacizumab, and Chemotherapy for Newly Diagnosed Stage III or IV Ovarian Cancer: Placebo-Controlled Randomized Phase III Trial (IMagyn050/GOG 3015/ENGOT-OV39). J Clin Oncol 2021; 39:1842-1855. [PMID: 33891472 PMCID: PMC8189598 DOI: 10.1200/jco.21.00306] [Citation(s) in RCA: 166] [Impact Index Per Article: 55.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
To evaluate the addition of the humanized monoclonal antiprogrammed death ligand-1 (PD-L1) antibody, atezolizumab, to platinum-based chemotherapy and bevacizumab in newly diagnosed stage III or IV ovarian cancer (OC).
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Affiliation(s)
- Kathleen N Moore
- Gynecologic Oncology Group Foundation (GOG-F) and Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, Oklahoma City, OK.,Sarah Cannon Research Institute, Nashville, TN
| | - Michael Bookman
- GOG-F and Kaiser Permanente Northern California, San Francisco, CA
| | - Jalid Sehouli
- Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie (North-Eastern German Society of Gynaecologic Oncology; NOGGO), Berlin, Germany and Charité-Medical University of Berlin (Campus Virchow Klinikum), Berlin, Germany
| | - Austin Miller
- GOG-F and Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | | | - Giovanni Scambia
- Mario Negri Gynecologic Oncology (MaNGO) and Fondazione Policlinico Universitario Gemelli Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | | | - Cagatay Taskiran
- Turkish Society of Gynecologic Oncology (TRSGO) and Koç University School of Medicine, Istanbul, Turkey.,Vehbi Koç Vakfı American Hospital, Istanbul, Turkey
| | | | - Johanna Mäenpää
- Nordic Society of Gynaecological Oncology (NSGO) and Tampere University and University Hospital, Tampere, Finland
| | | | - Nicoletta Colombo
- European Institute of Oncology, IRCCS, and University of Milan-Bicocca, Milan, Italy
| | | | - Michalis Liontos
- Hellenic Cooperative Oncology Group (HeCOG) and National & Kapodistrian University of Athens, Athens, Greece
| | | | - Yolanda Garcia
- Grupo Español de Investigación en Cáncer de Ovario (GEICO) and Parc Taulí University Hospital, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Sudarshan K Sharma
- GOG-F and Department of Obstetrics/Gynecology, Amita Adventist Hinsdale Hospital, Hinsdale, IL
| | - Christopher J Darus
- GOG-F and Maine Medical Center, Scarborough, ME; Current Affiliation: Earle A. Chiles Research Institute at Providence Cancer Institute, Portland, OR
| | | | - Aikou Okamoto
- The Jikei University School of Medicine, Tokyo, Japan
| | - Xiaohua Wu
- Department of Gynecological Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Rustem Safin
- Republican Clinical Oncology Dispensary of the Ministry of Health of Republic of Tatarstan, Kazan, Russian Federation
| | - Fan Wu
- Biostatistics, Roche (China) Holding Ltd, Shanghai, China
| | | | | | | | | | - Sandro Pignata
- Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies (MITO) and Istituto Nazionale Tumori IRCCS Fondazione G Pascale, Napoli, Italy
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Healy SA, Anderson C, Swihart BJ, Mwakingwe A, Gabriel EE, Decederfelt H, Hobbs CV, Rausch KM, Zhu D, Muratova O, Herrera R, Scaria PV, MacDonald NJ, Lambert LE, Zaidi I, Coelho CH, Renn JP, Wu Y, Narum DL, Duffy PE. Pfs230 yields higher malaria transmission-blocking vaccine activity than Pfs25 in humans but not mice. J Clin Invest 2021; 131:146221. [PMID: 33561016 PMCID: PMC8011888 DOI: 10.1172/jci146221] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [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: 11/18/2020] [Accepted: 02/03/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUNDVaccines that block human-to-mosquito Plasmodium transmission are needed for malaria eradication, and clinical trials have targeted zygote antigen Pfs25 for decades. We reported that a Pfs25 protein-protein conjugate vaccine formulated in alum adjuvant induced serum functional activity in both US and Malian adults. However, antibody levels declined rapidly, and transmission-reducing activity required 4 vaccine doses. Functional immunogenicity and durability must be improved before advancing transmission-blocking vaccines further in clinical development. We hypothesized that the prefertilization protein Pfs230 alone or in combination with Pfs25 would improve functional activity.METHODSTransmission-blocking vaccine candidates based on gamete antigen Pfs230 or Pfs25 were conjugated with Exoprotein A, formulated in Alhydrogel, and administered to mice, rhesus macaques, and humans. Antibody levels were measured by ELISA and transmission-reducing activity was assessed by the standard membrane feeding assay.RESULTSPfs25-EPA/Alhydrogel and Pfs230D1-EPA/Alhydrogel induced similar serum functional activity in mice, but Pfs230D1-EPA induced significantly greater activity in rhesus monkeys that was enhanced by complement. In US adults, 2 vaccine doses induced complement-dependent activity in 4 of 5 Pfs230D1-EPA/Alhydrogel recipients but no significant activity in 5 Pfs25-EPA recipients, and combination with Pfs25-EPA did not increase activity over Pfs230D1-EPA alone.CONCLUSIONThe complement-dependent functional immunogenicity of Pfs230D1-EPA represents a significant improvement over Pfs25-EPA in this comparative study. The rhesus model is more predictive of the functional human immune response to Pfs230D1 than is the mouse model.TRIAL REGISTRATIONClinicalTrials.gov NCT02334462.FUNDINGIntramural Research Program of the National Institute of Allergy and Infectious Diseases, National Institutes of Health.
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Affiliation(s)
- Sara A Healy
- Laboratory of Malaria Immunology and Vaccinology, and
| | | | - Bruce J Swihart
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | | | - Erin E Gabriel
- Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Hope Decederfelt
- Pharmacy Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | | | | | - Daming Zhu
- Laboratory of Malaria Immunology and Vaccinology, and
| | - Olga Muratova
- Laboratory of Malaria Immunology and Vaccinology, and
| | - Raul Herrera
- Laboratory of Malaria Immunology and Vaccinology, and
| | | | | | | | - Irfan Zaidi
- Laboratory of Malaria Immunology and Vaccinology, and
| | | | | | - Yimin Wu
- Laboratory of Malaria Immunology and Vaccinology, and
| | - David L Narum
- Laboratory of Malaria Immunology and Vaccinology, and
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Anderson C, Bae-Jump V, Broaddus RR, Olshan AF, Nichols HB. Long-term Patterns of Excess Mortality among Endometrial Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2021. [DOI: 10.1158/1055-9965.epi-21-0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Purpose of the study: Examining long-term patterns of mortality among cancer survivors compared to the general population may inform planning for surveillance and follow-up care. We investigated excess mortality after endometrial cancer using conditional relative survival estimates and standardized mortality ratios (SMRs). Methods: Women diagnosed with endometrial cancer during 2000–2017 (N = 183,153) were identified in the Surveillance, Epidemiology, and End Results (SEER) database. SMRs were calculated as observed deaths among endometrial cancer survivors over expected deaths among demographically similar women in the general U.S. population. Five-year relative survival was estimated at diagnosis and each additional year survived up to 12 years post-diagnosis, conditional on survival up to that year. Results: For the full cohort, 5-year relative survival was 87.7%, 96.2%, and 97.1% at 1, 5, and 10 years post- diagnosis. respectively. Conditional 5-year relative survival first exceeded 95%, reflecting minimal excess mortality compared to the general population, at 4 years post-diagnosis overall, but occurred later for Black women (8 years) compared to White (4 years), and also later for women with regional/distant stage, grade 3 disease, or non- endometrioid histology. The overall SMR for all-cause mortality decreased from 5.90 (95% CI: 5.81–5.99) in the first year after diagnosis to 1.16 (95% CI: 1.13–1.19) at 10+ years; SMRs were consistently higher for non-White women and those with higher stage or grade disease. Conclusions: Overall, endometrial cancer survivors had only a small survival deficit beyond 4 years post- diagnosis. However, excess mortality was greater in magnitude and persisted longer into survivorship for Black women and those with more advanced disease.
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Abstract
Abstract
Introduction
Significant alterations occur in human physiology and the way medications function in space (1). Understanding the efficacy and pitfalls of pharmacological intervention and developing space-related pharmacy services is therefore integral to ensuring a sustained presence for human spaceflight. In contemporary society, the pharmacist plays a significant role in a person’s health. However, pharmacist input towards the spaceflight participant’s health is minimal to nil.
Aim: T
o explore stakeholder perspectives towards the role of Astropharmacy in the space sector.
Methods
Pharmacists (n = 18) across the globe and space sector participants (n = 18) from governmental, commercial, and space tourism sectors participated, via 27 qualitative interviews and three focus groups. Participants were recruited via purposive and snowball sampling. A six-step thematic analysis was used and mapped into the Job Characteristics Model (JCM). JCM is a theory within work design, aiming to promote work experiences and personal outcomes. There are five job dimensions – skill variety, task identity, task significance, autonomy, and feedback which influence three psychological states required for a well-designed job. The three psychological states are meaningfulness, responsibility, and knowledge of work results, which lead to positive work and personal experiences (2).
Results
Three key themes were generated: medication management, medication research, and regulation/licensing. Medication management encompassed safeguarding the space traveller’s health, like space tourists, by conducting medication reviews (pre-and post-flight), medication advice (digital astro-telepharmacy information services during spaceflight) and developing personalised medication. Medication management also included ensuring shelf-life and continuous medication supply for deep space exploration. Medication research included novel drug development, innovative manufacturing, and understanding clinical applications of the pharmacokinetic and pharmacodynamic changes of medications in space. Innovative manufacturing like 3-D printing raises questions regarding the need for regulations/licensing of medications use and manufacturing in space. Based on the JCM our findings indicate that Astropharmacy possesses diverse duties eliciting meaningfulness, with clear responsibility and observable workplace results promoting task significance, and both the medication and patient focus promoting task identity. Autonomy was blurred within Astropharmacy as a degree of autonomy is needed due to the field’s novelty, but workforce regulations by governmental space agencies are expected. Lastly, workplace feedback can be achieved in Astropharmacy through performance reviews.
Conclusion
The Astropharmacy role is perceived to involve medication management, medication research and regulation/licensing of medications for space. The work design of astropharmacy is well-reflected in the JCM, implying that a novel and energising opportunity for the pharmacy profession is forthcoming. Although the data generated by qualitative research are not generalizable to other settings, these themes represent the first study to investigate the space sector qualitatively in the context of pharmacy, providing rich foundational data for future research. Consequently, the amalgamation of two previously distinct workplace domains may be a conceivable reality for the future of pharmacy practice.
References
1. Blue RS, Bayuse TM et al. Supplying a pharmacy for NASA exploration spaceflight: challenges and current understanding. Npj Microgravity. 2019;5(1):1–12.
2. Hackman RJ, Oldham G. Motivation through the design of work: Test of a theory. Organizational Behavior and Human Performance. 1976;16(2):250–279.
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Affiliation(s)
- L Sawyers
- University of Nottingham, School of Pharmacy
| | - C Anderson
- University of Nottingham, School of Pharmacy
| | - M Boyd
- University of Nottingham, School of Pharmacy
| | - P Williams
- University of Nottingham, School of Pharmacy
| | - L S Toh
- University of Nottingham, School of Pharmacy
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Iqbal A, Toh LS, Knaggs RD, Anderson C. Factors promoting self-medication and irrational use of opioids in chronic non-malignant pain management in Pakistan: A qualitative in-depth investigation. International Journal of Pharmacy Practice 2021. [DOI: 10.1093/ijpp/riab015.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
In many Lower and Middle-Income Countries (LMICs) people self-medicate, with non-prescription and prescription drugs both of which are easily available over the counter (1). One of the most common causes for self-medication is chronic pain (2). The role of community pharmacists becomes critical especially in LMICs where medicines are freely available and pharmacists are directly involved in supply of opioid medicines. Unresolved, prolonged chronic non-malignant pain (CNMP) may lead to self-medication with opioid analgesics and can cause irrational use of opioids. The complications of self-medication with opioids are vast in terms of both scarce resources and adverse clinical consequences such as adverse drug reactions, drug interactions and mortality associated with the diversion from intended use of opioid medicines. Self- medication with opioid analgesics in LMICs have not been explored before.
Aim
This study was designed to explore the factors that might contribute in promoting self-medication and irrational opioid medicine use in CNMP management and exploring potential roles of community pharmacists in stopping/avoiding self-medication with opioids in one LMIC, Pakistan.
Method
Qualitative interviews involving various stakeholders such as pharmacy policy makers (n=10) and people suffering from CNMP (n=12) were conducted. Additionally, focus groups were conducted with community pharmacists (n=38) and doctors (n=30). A semi-structured interview guide was drafted after an extensive literature review and was used for individual interviews and focus groups for each stakeholder respectively. The study duration was from December 2019 to July 2020. Critical case sampling, a type of purposive sampling, was done in order to promote applicability to other cases. Data was analysed using a CAQDAS software N-vivo 12, using thematic analysis. Ethical approval was obtained.
Results
Non-availability of community pharmacists in all pharmacies and lack of medication review services are amongst the major factors that are contributing towards self-medication of opioid medicines. Additionally, lack of awareness of people about opioid medicines and absence of strict laws regarding sale of opioid medicines under a valid prescription allows easy availability and promotes aberrant drug seeking behaviour. These factors contribute towards people not seeking professional health care services for the management of CNMP and continue self-medicating with opioid medicines. As a result, they do not get effective analgesic relief and waste limited financial resources. The major themes and sub-themes are presented in Table 1.
Conclusion
Self-medication with opioid medicines can cause irrational, inappropriate, and ineffective use of medicines and can additionally burden the limited financial resources available for health care needs. This in-depth exploratory study identifies many barriers that can promote self-medication with opioids and recognises a need for a multi-faceted intervention involving community pharmacists to promote rational opioid medicine use. However, major limitations of the proposed intervention identified from this study are the absence of integrated health systems and under-utilisation of community pharmacy workforce. The government needs to invest in infrastructure development, develop new health policies regarding medicine sale and build the role and capacity of pharmacy workforce to perform specialised roles in public safety especially in opioid medicines.
References
1. Bennadi D. Self-medication: A current challenge. Journal of basic and clinical pharmacy. 2013;5(1):19.
2. Kaushal J, Gupta MC, Jindal P, Verma S. Self-medication patterns and drug use behavior in housewives belonging to the middle income group in a city in northern India. Indian journal of community medicine: official publication of Indian association of preventive & social medicine. 2012;37(1):16.
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Affiliation(s)
- A Iqbal
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, United Kingdom
| | - L S Toh
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, United Kingdom
| | - R D Knaggs
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, United Kingdom
- Primary Integrated Community Solutions, Nottingham, United Kingdom
| | - C Anderson
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, United Kingdom
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Pendyala P, Almeldin D, Andrews T, Maloney-Patel N, August D, Anderson C, Jabbour S, Chundury A. Exploring the Dose-response Relationship in Locally Advanced Rectal Cancer Utilizing Dosimetric Parameters. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Schiavone S, Anderson C, Mons U, Winkler V. Prevalence of second-hand tobacco smoke in relation to smoke-free legislation in the European Union. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Second-hand smoke (SHS) is still an important public health problem. With joining the Framework Convention on Tobacco Control (FCTC), all parties acknowledged the health risks of SHS and agreed to implement policies to protect their populations from SHS in public places. The aim of this study was to explore the SHS exposure in restaurants and bars as well as its associations with smoke-free legislation in the European Union.
Methods
Data of Eurobarometer surveys 2014 and 2017 were used to estimate prevalence of SHS exposure. We also extracted data on individual confounders such as smoking status, gender, sex, age and information on social economic status. Additionally, we collected data on country specific data on smoking regulations in restaurants and bars from the Tobacco Control Scale to analyse associations with SHS exposure using multilevel logistic regression. Smoking regulations were categorized into the following three categories: partial ban, comprehensive ban with minor exceptions, and complete ban.
Results
Preliminary results on the prevalence of SHS in restaurants showed a decrease from 11.8% (95% confidence intervals (CI) 11.2-12.5) in 2014 to 8.8% (95% CI 8.3-9.3) in 2017. The crude multilevel model controlling only for smoking prevalence resulted in an odds ratio of 0.39 (95% CI 0.19-0.77) for comprehensive ban with minor exceptions and 0.28 (95% CI 0.16-0.50) for complete ban versus partial ban. Odds ratios remained at significant levels when controlling for all available confounders.
Conclusions
Between 2014 and 2017, SHS exposure in restaurants decreased significantly. Furthermore, strong associations with smoking regulations were observed suggesting a high compliance. Many tobacco control policies have been introduced during the last years but several countries need to strengthen their smoke-free tobacco control policies to further reduce SHS exposure preventing death, disease and disability.
Key messages
SHS exposure remains a significant public health challenge. The implementation of effective measures could be strengthened through a convergence of tobacco control strategies and policies among European Union member states.
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Affiliation(s)
- S Schiavone
- Department of Experimental Medicine, University of Campania, Naples, Italy
| | - C Anderson
- Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - U Mons
- Cancer Prevention Unit, German Cancer Research Center, Heidelberg, Germany
| | - V Winkler
- Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
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Moore K, Bookman M, Sehouli J, Miller A, Anderson C, Scambia G, Myers T, Taskiran C, Robison K, Maenpaa J, Willmott L, Colombo N, Thomes-Pepin J, Gold M, Aghajanian C, Wu F, Molinero L, Khor V, Lin Y, Pignata S. LBA31 Primary results from IMagyn050/GOG 3015/ENGOT-OV39, a double-blind placebo (pbo)-controlled randomised phase III trial of bevacizumab (bev)-containing therapy +/- atezolizumab (atezo) for newly diagnosed stage III/IV ovarian cancer (OC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2261] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abstract
A number of studies have investigated anticipatory behaviour in animals as a measure of sensitivity to reward or as an expression of emotional state. A common feature of many studies is that they base inferences on seemingly arbitrary measures, for example, the frequency of behavioural
transitions (ie number of times an animal switches between different behaviours). This paper critically reviews the literature and discusses various hypotheses for why specific behavioural responses occur in the anticipatory period between the signal and reward in conditioned animals. We argue
that the specific behaviours shown may be the result of superstitious learning and thus highly variable, leaving behavioural transitions as the only response that can be scored consistently, and that sometimes these responses may relate more to frustration than to a positive emotional state.
Finally, we propose new research approaches to avoid potential confounds and improve future studies on this topic.
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Ilson D, Moughan J, Safran H, Wigle D, Depetrillo T, Haddock M, Hong T, Leichman L, Rajdev L, Resnick M, Kachnic L, Seaward S, Mamon H, Pardo DD, Anderson C, Shen X, Sharma A, Katz A, Salo J, Leonard K, Crane C. O-10 Trastuzumab with trimodality treatment for esophageal adenocarcinoma with HER2 overexpression: NRG Oncology/RTOG 1010. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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White B, Billari W, Musiol J, Anderson C. 3:09 PM Abstract No. 43 Below-the-ankle interventions for critical limb ischemia: safety and efficacy in an office-based practice. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ramesh R, Kalin L, Hantush M, Rezaeinzadeh M, Anderson C. Challenges Calibrating Hydrology for Groundwater-Fed Wetlands: a Headwater Wetland Case Study. Environ Model Assess (Dordr) 2020; 25:355-371. [PMID: 35574564 PMCID: PMC9104761 DOI: 10.1007/s10666-019-09684-8] [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] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 10/10/2019] [Indexed: 06/15/2023]
Abstract
This study aims to adapt the Soil and Watershed Assessment Tool (SWAT), a ubiquitously used watershed model, for ground-water dominated surface waterbodies by accounting for recharge from the aquifers. Using measured flow to a headwater slope wetland in Alabama's coastal plain region as a case study, we present challenges and relatively simple approaches in using the SWAT model to predict flows from the draining watershed and relatively simple approaches to model groundwater upwelling. SWAT-simulated flow at the study watershed was limited by precipitation, and consequently, simulated flows were several times smaller in magnitude than observed flows. Thus, our first approach involved a separate stormflow and baseflow calibration which included the use of a regression relationship between observed and simulated baseflow (E NASH = 0.67). Our next approach involved adapting SWAT to simulate upwelling groundwater discharge instead of deep aquifer losses by constraining the range of deep losses, β deep parameter, to negative values (E NASH = 0.75). Finally, we also investigated the use of artificial neural networks (ANN) in conjunction with SWAT to further improve calibration performance. This approach used SWAT-calibrated flow, evapotranspiration, and precipitation as inputs to ANN (E NASH = 0.88). The methods investigated in this study can be used to navigate similar flow calibration challenges in other groundwater dominant watersheds which can be very useful tool for managers and modelers alike.
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Affiliation(s)
- R. Ramesh
- School of Forestry and Wildlife Sciences, Auburn University, 602 Duncan Drive, Auburn, AL 36849, USA
| | - L. Kalin
- School of Forestry and Wildlife Sciences, Auburn University, 602 Duncan Drive, Auburn, AL 36849, USA
| | - M. Hantush
- Center for Environmental Solutions and Emergency Response, U.S. Environmental Protection Agency, 26 West Martin Luther King Dr., Cincinnati, OH 45268, USA
| | | | - C. Anderson
- School of Forestry and Wildlife Sciences, Auburn University, 602 Duncan Drive, Auburn, AL 36849, USA
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