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Carter D, Bykhovsky D, Hasky A, Mamistvalov I, Zimmer Y, Ram E, Hoffer O. Convolutional neural network deep learning model accurately detects rectal cancer in endoanal ultrasounds. Tech Coloproctol 2024; 28:44. [PMID: 38561492 PMCID: PMC10984882 DOI: 10.1007/s10151-024-02917-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/06/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Imaging is vital for assessing rectal cancer, with endoanal ultrasound (EAUS) being highly accurate in large tertiary medical centers. However, EAUS accuracy drops outside such settings, possibly due to varied examiner experience and fewer examinations. This underscores the need for an AI-based system to enhance accuracy in non-specialized centers. This study aimed to develop and validate deep learning (DL) models to differentiate rectal cancer in standard EAUS images. METHODS A transfer learning approach with fine-tuned DL architectures was employed, utilizing a dataset of 294 images. The performance of DL models was assessed through a tenfold cross-validation. RESULTS The DL diagnostics model exhibited a sensitivity and accuracy of 0.78 each. In the identification phase, the automatic diagnostic platform achieved an area under the curve performance of 0.85 for diagnosing rectal cancer. CONCLUSIONS This research demonstrates the potential of DL models in enhancing rectal cancer detection during EAUS, especially in settings with lower examiner experience. The achieved sensitivity and accuracy suggest the viability of incorporating AI support for improved diagnostic outcomes in non-specialized medical centers.
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Affiliation(s)
- D Carter
- Department of Gastroenterology, Chaim Sheba Medical Center, Ramat Gan, Israel.
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - D Bykhovsky
- Electrical and Electronics Engineering Department, Shamoon College of Engineering, Beer-Sheba, Israel
| | - A Hasky
- School of Electrical Engineering, Afeka College of Engineering, Tel Aviv, Israel
| | - I Mamistvalov
- School of Electrical Engineering, Afeka College of Engineering, Tel Aviv, Israel
| | - Y Zimmer
- School of Medical Engineering, Afeka College of Engineering, Tel Aviv, Israel
| | - E Ram
- Department of Gastroenterology, Chaim Sheba Medical Center, Ramat Gan, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - O Hoffer
- School of Electrical Engineering, Afeka College of Engineering, Tel Aviv, Israel
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Paktunc D, Coumans JP, Carter D, Zagrtdenov N, Duguay D. Mechanism of the Direct Reduction of Chromite Process as a Clean Ferrochrome Technology. ACS Eng Au 2024; 4:125-138. [PMID: 38405365 PMCID: PMC10885147 DOI: 10.1021/acsengineeringau.3c00057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 02/27/2024]
Abstract
Direct reduction of chromite (DRC) is a promising alternative process for ferrochrome production with the potential to significantly reduce energy consumption and greenhouse gas emissions compared to conventional smelting. In DRC, chromium (Cr) and iron (Fe) from chromite ore incongruently dissolve into a molten salt, which facilitates mass transfer to a carbon (C) reductant where in situ metallization occurs. Consequently, ferrochrome is produced below the slag melting temperatures, achieving substantial energy savings relative to smelting. However, there are significant knowledge gaps in the kinetics, Cr solubility, speciation, and coordination environment which are critical to understanding the fundamental mechanisms of molten salt-assisted carbothermic reactions. To address these knowledge gaps, we performed pyrometallurgical experiments with variable temperature and residence times and analyzed the composition of chromite, ferrochrome, and slag products along with determining the speciation of Cr. Our results indicate that the DRC mechanism can be explained by the following sequential steps: (1) incongruent dissolution of chromite, (2) reduction of dissolved Cr in molten salt/slag, (3) transport of Cr and Fe species in molten media, and (4) reduction on C particles and metallization as Cr-Fe alloys. The discovery of four types of reduced Cr species in the slag indicates that the reduction of Cr3+ to Cr2+ and Cr0 occurred in the molten phase before metallization on solid carbon particles. Thermodynamically, the reduction of CrO(l) to Cr metal is more feasible at a lower temperature than it is for Cr2O3(l) corroborating the accelerated reduction efficiency of the DRC process.
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Affiliation(s)
- Dogan Paktunc
- CanmetMINING, Natural Resources Canada, 555 Booth Street, Ottawa, ON K1A 0G1, Canada
| | - Jason P. Coumans
- CanmetMINING, Natural Resources Canada, 555 Booth Street, Ottawa, ON K1A 0G1, Canada
| | - David Carter
- CanmetMINING, Natural Resources Canada, 555 Booth Street, Ottawa, ON K1A 0G1, Canada
| | - Nail Zagrtdenov
- CanmetMINING, Natural Resources Canada, 555 Booth Street, Ottawa, ON K1A 0G1, Canada
| | - Dominique Duguay
- CanmetMINING, Natural Resources Canada, 555 Booth Street, Ottawa, ON K1A 0G1, Canada
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D'Cunha R, Kupper H, Arikan D, Zhao W, Carter D, Blaes J, Ruzek M, Pang Y. A first-in-human study of the novel immunology antibody-drug conjugate, ABBV-3373, in healthy participants. Br J Clin Pharmacol 2024; 90:189-199. [PMID: 37596703 DOI: 10.1111/bcp.15888] [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: 01/24/2023] [Revised: 08/02/2023] [Accepted: 08/06/2023] [Indexed: 08/20/2023] Open
Abstract
AIMS ABBV-3373, an immunology antibody-drug conjugate composed of adalimumab conjugated to a proprietary glucocorticoid receptor modulator (the small-molecule payload), has the potential to treat immune-mediated inflammatory diseases. This first-in-human study investigated the pharmacokinetics (PK), immunogenicity, pharmacodynamics (PD) using a safety PD marker, and safety/tolerability of ABBV-3373 in healthy adults. METHODS Fifty-five participants were randomly assigned to single-dose subcutaneous (SC; 30, 100 or 300 mg) or intravenous (IV; 30, 300 or 900 mg) ABBV-3373 or placebo. Eight additional participants received a single dose of 10 mg oral prednisone for evaluation of systemic glucocorticoid effects. Blood samples were collected for up to 85 days postdose for PK, anti-drug antibody and serum cortisol (safety PD marker) assessments. RESULTS ABBV-3373 and total antibody displayed antibody-like SC/IV PK profiles and the unconjugated/free payload in circulation exhibited formation rate-limited kinetics with exposure several fold lower than ABBV-3373 or total antibody. Treatment-emergent anti-drug antibody incidence was 69%, with loss of exposure in 6% (SC) and 5% (IV) of participants, but without any impact on safety. ABBV-3373 up to 300 mg SC/IV had no apparent impact on serum cortisol, and only caused a transient decrease at 900 mg IV. Treatment-emergent adverse events were primarily mild in severity, and no pattern emerged with respect to dose or route of administration. CONCLUSIONS ABBV-3373 had favourable PK profiles, manageable immunogenicity, and was generally well-tolerated. Except for a transient effect at 900 mg IV, there was no apparent impact on serum cortisol. Study results supported further clinical development of ABBV-3373.
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Affiliation(s)
| | | | | | | | | | - Jonas Blaes
- AbbVie Deutschland GmbH & Co. KG, Ludwigshafen, Germany
| | - Melanie Ruzek
- AbbVie Bioresearch Center, Worcester, Massachusetts, USA
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Polzer S, Thompson S, Vittalbabu S, Ulu A, Carter D, Nordgren T, Eskandari M. MATLAB-Based Algorithm and Software for Analysis of Wavy Collagen Fibers. Microsc Microanal 2023; 29:2108-2126. [PMID: 37992253 DOI: 10.1093/micmic/ozad117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/15/2023] [Accepted: 09/25/2023] [Indexed: 11/24/2023]
Abstract
Knowledge of soft tissue fiber structure is necessary for accurate characterization and modeling of their mechanical response. Fiber configuration and structure informs both our understanding of healthy tissue physiology and of pathological processes resulting from diseased states. This study develops an automatic algorithm to simultaneously estimate fiber global orientation, abundance, and waviness in an investigated image. To our best knowledge, this is the first validated algorithm which can reliably separate fiber waviness from its global orientation for considerably wavy fibers. This is much needed feature for biological tissue characterization. The algorithm is based on incremental movement of local regions of interest (ROI) and analyzes two-dimensional images. Pixels belonging to the fiber are identified in the ROI, and ROI movement is determined according to local orientation of fiber within the ROI. The algorithm is validated with artificial images and ten images of porcine trachea containing wavy fibers. In each image, 80-120 fibers were tracked manually to serve as verification. The coefficient of determination R2 between curve lengths and histograms documenting the fiber waviness and global orientation were used as metrics for analysis. Verification-confirmed results were independent of image rotation and degree of fiber waviness, with curve length accuracy demonstrated to be below 1% of fiber curved length. Validation-confirmed median and interquartile range of R2, respectively, were 0.90 and 0.05 for curved length, 0.92 and 0.07 for waviness, and 0.96 and 0.04 for global orientation histograms. Software constructed from the proposed algorithm was able to track one fiber in about 1.1 s using a typical office computer. The proposed algorithm can reliably and accurately estimate fiber waviness, curve length, and global orientation simultaneously, moving beyond the limitations of prior methods.
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Affiliation(s)
- Stanislav Polzer
- Department of Applied Mechanics, VSB-Technical University of Ostrava, 17.listopadu 2172/15, 708 00 Ostrava, Czech Republic
| | - Sarah Thompson
- Department of Mechanical Engineering, University of California at Riverside, 3401 Watkins Drive, Riverside CA 92521, USA
| | - Swathi Vittalbabu
- Department of Mechanical Engineering, University of California at Riverside, 3401 Watkins Drive, Riverside CA 92521, USA
| | - Arzu Ulu
- BREATHE Center School of Medicine, University of California at Riverside, 3401 Watkins Drive, Riverside CA 92521USA
| | - David Carter
- Molecular Cell and Systems Biology, University of California at Riverside, 900 University Ave, Riverside CA 92521, USA
| | - Tara Nordgren
- BREATHE Center School of Medicine, University of California at Riverside, 3401 Watkins Drive, Riverside CA 92521USA
| | - Mona Eskandari
- Department of Mechanical Engineering, University of California at Riverside, 3401 Watkins Drive, Riverside CA 92521, USA
- BREATHE Center School of Medicine, University of California at Riverside, 3401 Watkins Drive, Riverside CA 92521USA
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Horesh N, Maman R, Zager Y, Anteby R, Weksler Y, Carter D, Nachmany I, Ram E. Surgical outcomes of minimally invasive trephine surgery for pilonidal sinus disease with and without laser therapy: a comparative study. Tech Coloproctol 2023; 28:13. [PMID: 38093161 DOI: 10.1007/s10151-023-02897-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Over the last decades, novel therapeutic options have emerged for the surgical treatment of pilonidal sinus disease (PSD). The aim of this study was to evaluate the outcomes of trephine/pit excision surgery with or without laser therapy in patients with PSD. METHODS A retrospective cohort study was conducted at a large tertiary medical center, including all adult patients with PNS who underwent trephine surgery with/without laser therapy between 2016 and 2021[AUTHORS TO INSERT MONTH]. Propensity score matching was used to address confounding factors, and the primary outcome was the 1-year recurrence rate. RESULTS The study included 221 patients with PSD, with a mean age of 23.73 years (87.7% male). In the unmatched cohort (130 trephine surgery alone, 91 trephine surgery + laser therapy), significant differences were observed in mean age (23 vs. 25 years; p < 0.01)[AUTHROS TO USE MEDIAN PLUS RANGE OR ADD SD] and surgeons' experience (p = 0.014). Propensity score matching was applied to overcome confounding factors, resulting in a matched cohort including 73 patients in each group. The addition of laser therapy demonstrated a significantly lower recurrence rate (8.2% vs. 32.9%; p < 0.001) compared to pit excision without laser therapy. Logistic regression analysis showed that the addition of laser was significantly associated with a lower risk for recurrence (OR 0.23; 95% CI 0.089-0.633; p < 0.01). CONCLUSION The incorporation of laser therapy along with trephine/pit excision surgery significantly reduces the recurrence rate in patients with PNS. Further prospective studies are needed to confirm our findings.
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Affiliation(s)
- N Horesh
- Department of General Surgery and Transplantations, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, FL, USA.
| | - R Maman
- Department of General Surgery and Transplantations, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y Zager
- Department of General Surgery and Transplantations, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - R Anteby
- Department of General Surgery and Transplantations, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y Weksler
- Department of General Surgery and Transplantations, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - D Carter
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - I Nachmany
- Department of General Surgery and Transplantations, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Ram
- Department of General Surgery and Transplantations, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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McAuley A, Palmateer N, Goldberg DJ, Shivaji T, Ritchie T, Licence K, Carter D, Hutchinson SJ. Increased risk of non-fatal overdose associated with non-prescribed benzodiazepine use in Scotland, UK. Int J Drug Policy 2023:104236. [PMID: 37865531 DOI: 10.1016/j.drugpo.2023.104236] [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: 07/28/2023] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND Drug-related deaths (DRDs) in Scotland increased for seven years in a row between 2014 and 2020, consolidating Scotland's place at the top of the United Kingdom and European drug-related mortality charts. One of the defining features of this recent and rapid rise has been the role of benzodiazepines, which are now involved in the majority of all DRDs. These deaths are linked to use of non-prescribed, benzodiazepine-type novel psychoactive substances (NPS) which have been identified by the United Nations as a global threat to public health. This study aimed to estimate the prevalence and determinants of non-prescribed benzodiazepine use and its association with recent non-fatal overdose among a national sample of people who inject drugs (PWID). METHODS Data from the 2019-20 Needle Exchange Surveillance Initiative (NESI) was analysed using logistic regression. NESI is a voluntary, anonymous, biennial, cross-sectional, bio-behavioural survey of PWID attending community-based services providing injecting equipment in mainland Scotland. RESULTS Prevalence of non-prescribed benzodiazepine use in the past six months was 52% and significantly associated with age (aOR 0.97, 0.96-0.98), frequent incarceration (aOR 1.29, 1.07-1.57), recent public injecting (aOR 3.25, 2.33-4.55), a recent methadone prescription (aOR 1.87, 1.51-2.33), and a history of benzodiazepine prescription (aOR 1.92, 1.47-2.52). In addition, non-prescribed benzodiazepine use was significantly associated with non-fatal overdose in the past year among PWID (aOR 2.47, 1.90-3.21). CONCLUSION This study found a high prevalence of non-prescribed benzodiazepine use among a national sample of PWID in Scotland. Prevalence was highest among populations known to be at increased risk of drug-related death and use was strongly associated with overdose. These novel findings highlight the scale of the non-prescribed benzodiazepine issue Scotland faces, and the urgency required to expand its harm reduction infrastructure to address this unique element of its overdose crisis.
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Affiliation(s)
- A McAuley
- Public Health Scotland, Glasgow, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
| | - N Palmateer
- Public Health Scotland, Glasgow, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - D J Goldberg
- Public Health Scotland, Glasgow, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - T Ritchie
- Glasgow Alcohol and Drug Recovery Services, Glasgow, UK
| | | | - D Carter
- Glasgow Alcohol and Drug Recovery Services, Glasgow, UK
| | - S J Hutchinson
- Public Health Scotland, Glasgow, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Pujara P, Carter D, Bolton K, Nicholson R. 20 Simultaneous development of acute acquired concomitant esotropia in two siblings during the COVID-19 pandemic: a case report. BMJ Open Ophthalmol 2023; 8:A7. [PMID: 37798005 DOI: 10.1136/bmjophth-2023-biposa.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
A 5-year-old boy (sibling one) and his 11-year-old sister (sibling two) were presented to the hospital eye service in early 2021, having both developed acute-onset large angle esotropia within three months of each other. Neither had any significant past medical, ophthalmic, or family history. The siblings lived in the same household, and both experienced lifestyle changes as a result of the UK lockdown in response to COVID-19.Sibling one had a moderate right esotropia, initially maintained straight by corneal light reflex. He measured 45/50 prism dioptres (Δ) base out at near and 45Δ base out at distance. Sibling two had esophoria which broke down into a right esotropia immediately on dissociation. The esotropia measured 30Δ base out at near and 20Δ base out at distance. At four month follow up, both siblings demonstrated a constant large angle esotropia (sibling one: 54Δ base out at near and 45Δ base out at distance, sibling two: 45Δ base out at near and 40/45Δ base out at distance).Each sibling was treated with right medial rectus recession (5.5 mm) and right lateral rectus resection (7 mm), and at a three-month follow-up, both were minimally esophoric with restored binocularity.The unusual and abrupt changes in lifestyle imposed by the COVID-19 pandemic highlight the likelihood of an environmental aetiology for some forms of esotropia and raise the possibility that extended screen time may be a contributory factor.
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Affiliation(s)
- P Pujara
- Portsmouth University Hospitals NHS Trust, UK
| | - D Carter
- Portsmouth University Hospitals NHS Trust, UK
| | - K Bolton
- Portsmouth University Hospitals NHS Trust, UK
| | - R Nicholson
- Portsmouth University Hospitals NHS Trust, UK
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Chakraborty M, Lara AG, Dang A, McCulloch KJ, Rainbow D, Carter D, Ngo LT, Solares E, Said I, Corbett-Detig RB, Gilbert LE, Emerson JJ, Briscoe AD. Sex-linked gene traffic underlies the acquisition of sexually dimorphic UV color vision in Heliconius butterflies. Proc Natl Acad Sci U S A 2023; 120:e2301411120. [PMID: 37552755 PMCID: PMC10438391 DOI: 10.1073/pnas.2301411120] [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: 01/26/2023] [Accepted: 06/16/2023] [Indexed: 08/10/2023] Open
Abstract
The acquisition of novel sexually dimorphic traits poses an evolutionary puzzle: How do new traits arise and become sex-limited? Recently acquired color vision, sexually dimorphic in animals like primates and butterflies, presents a compelling model for understanding how traits become sex-biased. For example, some Heliconius butterflies uniquely possess UV (ultraviolet) color vision, which correlates with the expression of two differentially tuned UV-sensitive rhodopsins, UVRh1 and UVRh2. To discover how such traits become sexually dimorphic, we studied Heliconius charithonia, which exhibits female-specific UVRh1 expression. We demonstrate that females, but not males, discriminate different UV wavelengths. Through whole-genome shotgun sequencing and assembly of the H. charithonia genome, we discovered that UVRh1 is present on the W chromosome, making it obligately female-specific. By knocking out UVRh1, we show that UVRh1 protein expression is absent in mutant female eye tissue, as in wild-type male eyes. A PCR survey of UVRh1 sex-linkage across the genus shows that species with female-specific UVRh1 expression lack UVRh1 gDNA in males. Thus, acquisition of sex linkage is sufficient to achieve female-specific expression of UVRh1, though this does not preclude other mechanisms, like cis-regulatory evolution from also contributing. Moreover, both this event, and mutations leading to differential UV opsin sensitivity, occurred early in the history of Heliconius. These results suggest a path for acquiring sexual dimorphism distinct from existing mechanistic models. We propose a model where gene traffic to heterosomes (the W or the Y) genetically partitions a trait by sex before a phenotype shifts (spectral tuning of UV sensitivity).
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Affiliation(s)
- Mahul Chakraborty
- Department of Ecology and Evolutionary Biology, University of California, Irvine, CA92697
- Department of Biology, Texas A&M University, College Station, TX77843
| | | | - Andrew Dang
- Department of Ecology and Evolutionary Biology, University of California, Irvine, CA92697
| | - Kyle J. McCulloch
- Department of Ecology and Evolutionary Biology, University of California, Irvine, CA92697
- Department of Ecology, Evolution and Behavior, University of Minnesota, St. Paul, MN55108
| | - Dylan Rainbow
- Department of Ecology and Evolutionary Biology, University of California, Irvine, CA92697
| | - David Carter
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, CA92521
| | - Luna Thanh Ngo
- Department of Ecology and Evolutionary Biology, University of California, Irvine, CA92697
| | - Edwin Solares
- Department of Ecology and Evolutionary Biology, University of California, Irvine, CA92697
| | - Iskander Said
- Department of Biomolecular Engineering and Genomics Institute, University of California, Santa Cruz, CA95064
| | - Russell B. Corbett-Detig
- Department of Biomolecular Engineering and Genomics Institute, University of California, Santa Cruz, CA95064
| | | | - J. J. Emerson
- Department of Ecology and Evolutionary Biology, University of California, Irvine, CA92697
| | - Adriana D. Briscoe
- Department of Ecology and Evolutionary Biology, University of California, Irvine, CA92697
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Mitjà O, Reis G, Boulware DR, Spivak AM, Sarwar A, Johnston C, Webb B, Hill MD, Smith D, Kremsner P, Curran M, Carter D, Alexander J, Corbacho M, Lee TC, Hullsiek KH, McDonald EG, Hess R, Hughes M, Baeten JM, Schwartz I, Metz L, Richer L, Chew KW, Daar E, Wohl D, Dunne M. Hydroxychloroquine for treatment of non-hospitalized adults with COVID-19: A meta-analysis of individual participant data of randomized trials. Clin Transl Sci 2023; 16:524-535. [PMID: 36601684 PMCID: PMC10014689 DOI: 10.1111/cts.13468] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 01/06/2023] Open
Abstract
Hydroxychloroquine (HCQ) was initially promoted as an oral therapy for early treatment of coronavirus disease 2019 (COVID-19). Conventional meta-analyses cannot fully address the heterogeneity of different designs and outcomes of randomized controlled trials (RCTs) assessing the efficacy of HCQ in outpatients with mild COVID-19. We conducted a pooled analysis of individual participant data from RCTs that evaluated the effect of HCQ on hospitalization and viral load reduction in outpatients with confirmed COVID-19. We evaluated the overall treatment group effect by log-likelihood ratio test (-2LL) from a generalized linear mixed model to accommodate correlated longitudinal binary data. The analysis included data from 11 RCTs. The outcome of virological effect, assessed in 1560 participants (N = 795 HCQ, N = 765 control), did not differ significantly between the two treatment groups (-2LL = 7.66; p = 0.18) when adjusting for cohort, duration of symptoms, and comorbidities. The decline in polymerase chain reaction positive tests from day 1 to 7 was 42.0 and 41.6 percentage points in the HCQ and control groups, respectively. Among the 2037 participants evaluable for hospitalization (N = 1058 HCQ, N = 979 control), we found no significant differences in hospitalization rate between participants receiving HCQ and controls (odds ratio 0.995; 95% confidence interval 0.614-1.610; -2LL = 0.0; p = 0.98) when adjusting for cohort, duration of symptoms, and comorbidities. This individual participant data meta-analysis of 11 HCQ trials that evaluated severe acute respiratory syndrome-coronavirus 2 viral clearance and COVID-19 hospitalization did not show a clinical benefit of HCQ. Our meta-analysis provides evidence to support the interruption in the use of HCQ in mild COVID-19 outpatients to reduce progression to severe disease.
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Affiliation(s)
- Oriol Mitjà
- Fight AIDS and Infectious Diseases Foundation, Barcelona, Spain
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
- Lihir Medical Center-International SOS, Lihir Island, Papua New Guinea
| | - Gilmar Reis
- Research Division, Cardresearch Cardiologia Assistencial e de Pesquisa, Pontifícia Universidade Católica de Minas Gerais, Bello Horizonte, Brazil
- Cytel Inc., Vancouver, British Columbia, Canada
| | - David R Boulware
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Ammar Sarwar
- Harvard Medical School, Boston, Massachusetts, USA
| | - Christine Johnston
- Department of Medicine and Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Brandon Webb
- Intermountain Health Care, University of Utah, Salt Lake City, Utah, USA
| | | | - Davey Smith
- Division of Infectious Diseases & Global Public Health, UC San Diego School of Medicine, San Diego, California, USA
| | - Peter Kremsner
- University Hospital of Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Marla Curran
- Bill & Melinda Gates Medical Research Institute, Cambridge, Massachusetts, USA
| | | | - Jim Alexander
- Bill & Melinda Gates Medical Research Institute, Cambridge, Massachusetts, USA
| | - Marc Corbacho
- Fight AIDS and Infectious Diseases Foundation, Barcelona, Spain
| | - Todd C Lee
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Katherine Huppler Hullsiek
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Emily G McDonald
- Division of General Internal Medicine, McGill University Health Center, Montreal, Quebec, Canada
| | - Rachel Hess
- University of Utah, Salt Lake City, Utah, USA
| | | | - Jared M Baeten
- Department of Medicine and Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | | | - Luanne Metz
- University of Calgary, Calgary, Alberta, Canada
| | | | - Kara W Chew
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Eric Daar
- Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California, USA
| | - David Wohl
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michael Dunne
- Bill & Melinda Gates Medical Research Institute, Cambridge, Massachusetts, USA
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Cooper B, Donner E, Crase L, Robertson H, Carter D, Short M, Drigo B, Leder K, Roiko A, Fielding K. Maintaining a social license to operate for wastewater-based monitoring: The case of managing infectious disease and the COVID-19 pandemic. J Environ Manage 2022; 320:115819. [PMID: 35930884 PMCID: PMC9304157 DOI: 10.1016/j.jenvman.2022.115819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Wastewater monitoring as a public health tool is well-established and the SARS-CoV-2 (COVID-19) pandemic has seen its widespread uptake. Given the significant potential of wastewater monitoring as a public health surveillance and decision support tool, it is important to understand what measures are required to allow the long-term benefits of wastewater monitoring to be fully realized, including how to establish and/or maintain public support. The potential for positive SARS-CoV-2 detections to trigger enforced, community-wide public health interventions (e.g., lockdowns and other impacts on civil liberties) further emphasises the need to better understand the role of public engagement in successful wastewater-based monitoring programs. This paper systematically reviews the processes of building and maintaining the social license to operate wastewater monitoring. We specifically explore the relationship between different stakeholder communities and highlight the information and actions that are required to establish a social license to operate and then prevent its loss. The paper adds to the literature on social license to operate by extending its application to new domains and offers a dynamic model of social license to help guide the agenda for researcher and practitioner communities.
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Affiliation(s)
- Bethany Cooper
- University of South Australia, School of Business, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Erica Donner
- University of South Australia, Future Industries Institute, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Lin Crase
- University of South Australia, School of Business, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Hamish Robertson
- University of Technology Sydney, Faculty of Health, 15 Broadway Ultimo, NSW, Australia.
| | - David Carter
- University of Technology Sydney, Faculty of Law, 15 Broadway Ultimo, NSW, Australia.
| | - Michael Short
- University of South Australia, Future Industries Institute, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Barbara Drigo
- University of South Australia, Future Industries Institute, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Karin Leder
- Monash University, School of Public Health and Preventive Medicine, 553 St Kilda Road, Melbourne, VIC 3004, Australia.
| | - Anne Roiko
- Griffith University, School of Pharmacy and Medical Sciences, Gold Coast, QLD, 4222, Australia.
| | - Kelly Fielding
- The University of Queensland, School of Communication and Arts, St Lucia, QLD, 4072, Australia.
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11
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Fontana F, Anselmi M, Carollo E, Sartori P, Procacci P, Carter D, Limonta P. Adipocyte-Derived Extracellular Vesicles Promote Prostate Cancer Cell Aggressiveness by Enabling Multiple Phenotypic and Metabolic Changes. Cells 2022; 11:cells11152388. [PMID: 35954232 PMCID: PMC9368412 DOI: 10.3390/cells11152388] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/28/2022] [Accepted: 07/30/2022] [Indexed: 12/12/2022] Open
Abstract
Background: In recent decades, obesity has widely emerged as an important risk factor for prostate cancer (PCa). Adipose tissue and PCa cells have been shown to orchestrate a complex interaction network to support tumor growth and evolution; nonetheless, the study of this communication has only been focused on soluble factors, although increasing evidence highlights the key role of extracellular vesicles (EVs) in the modulation of tumor progression. Methods and Results: In the present study, we found that EVs derived from 3T3-L1 adipocytes could affect PC3 and DU145 PCa cell traits, inducing increased proliferation, migration and invasion. Furthermore, conditioning of both PCa cell lines with adipocyte-released EVs resulted in lower sensitivity to docetaxel, with reduced phosphatidylserine externalization and decreased caspase 3 and PARP cleavage. In particular, these alterations were paralleled by an Akt/HIF-1α axis-related Warburg effect, characterized by enhanced glucose consumption, lactate release and ATP production. Conclusions: Collectively, these findings demonstrate that EV-mediated crosstalk exists between adipocytes and PCa, driving tumor aggressiveness.
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Affiliation(s)
- Fabrizio Fontana
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milano, Italy; (M.A.); (P.L.)
- Correspondence:
| | - Martina Anselmi
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milano, Italy; (M.A.); (P.L.)
| | - Emanuela Carollo
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford OX3 0BP, UK; (E.C.); (D.C.)
| | - Patrizia Sartori
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (P.S.); (P.P.)
| | - Patrizia Procacci
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milano, Italy; (P.S.); (P.P.)
| | - David Carter
- Department of Biological and Medical Sciences, Oxford Brookes University, Oxford OX3 0BP, UK; (E.C.); (D.C.)
| | - Patrizia Limonta
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20133 Milano, Italy; (M.A.); (P.L.)
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12
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Barnes A, Carter D, Kaazan P, Walsh A, Connor S, Andrews JM. Novel inflammatory bowel disease (IBD) specific electronic medical record allows scalable auditing of IBD severity, therapy and complications to show the current unmet need in IBD care. Intest Res 2022; 20:506-508. [PMID: 35462527 DOI: 10.5217/ir.2022.00003] [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: 01/04/2022] [Accepted: 03/23/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- Alex Barnes
- Department of Gastroenterology, Flinders Medical Centre, Flinders University, Adelaide, Australia
| | - David Carter
- Stratos Technology Partners, Christchurch, New Zealand
| | - Patricia Kaazan
- IBD Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia
| | - Alissa Walsh
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK.,Crohn's Colitis Cure, Sydney, Australia
| | - Susan Connor
- Crohn's Colitis Cure, Sydney, Australia.,Department of Gastroenterology, Liverpool Hospital, University of NSW and Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Jane M Andrews
- IBD Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia.,Crohn's Colitis Cure, Sydney, Australia.,School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide, Australia
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13
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Carter D, Mazumder S, Simkins B, Sisneros E. The stock price reaction of the COVID-19 pandemic on the airline, hotel, and tourism industries. Financ Res Lett 2022; 44:102047. [PMID: 35013674 PMCID: PMC8733894 DOI: 10.1016/j.frl.2021.102047] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/24/2021] [Accepted: 04/02/2021] [Indexed: 05/07/2023]
Abstract
This paper investigates the stock market performance from the second half of February through the latter portion of March 2020 for U.S. travel-related firms (airlines, restaurants, and hotels) in response to the COVID-19 pandemic. Clearly the reduction in travel was negative news for the travel industry; however, we focus on the factors used by market participants to price the information into stock prices. We find that larger firms with greater cash reserves and higher market-to-book ratios experienced less negative returns, while firms with greater leverage were penalized more. Additionally, we find that cash reserves were particularly important for hotels.
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Affiliation(s)
- David Carter
- Department of Finance, Spears School of Business, Oklahoma State University, Stillwater, OK 74078, USA
| | - Sharif Mazumder
- Department of Finance, Spears School of Business, Oklahoma State University, Stillwater, OK 74078, USA
- Haile/US Bank College of Business, Northern Kentucky University, Highland Heights, KY, 41099, USA
| | - Betty Simkins
- Department of Finance, Spears School of Business, Oklahoma State University, Stillwater, OK 74078, USA
| | - Eric Sisneros
- Department of Finance, Spears School of Business, Oklahoma State University, Stillwater, OK 74078, USA
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14
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Al-Akwaa S, Carter D, Tezel F, Kruczek B. Characterization of defect-containing zeolite membranes by single gas permeation experiments before and after calcination. J Memb Sci 2021. [DOI: 10.1016/j.memsci.2021.119269] [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: 10/21/2022]
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15
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Rosa A, Dissanayake M, Carter D, Sibbald S. Community paramedicine to support palliative care. Progress in Palliative Care 2021. [DOI: 10.1080/09699260.2021.1912690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- A. Rosa
- Faculty of Health Sciences, Western University, London, Canada
| | - M. Dissanayake
- Faculty of Health Sciences, Western University, London, Canada
| | - D. Carter
- Middlesex-London Paramedic Service, London, Canada
| | - S. Sibbald
- Faculty of Health Sciences, Western University, London, Canada
- Department of Family Medicine Schulich School of Medicine and Dentistry, Western University, London, Canada
- Department of Medicine and The Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, Canada
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16
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Krishnaprasad K, Walsh A, Begun J, Bell S, Carter D, Grafton R, Sechi A, Sewell K, McMahon A, Connor S, Radford-Smith G, Andrews JM. Crohn's Colitis Care (CCCare): bespoke cloud-based clinical management software for inflammatory bowel disease. Scand J Gastroenterol 2020; 55:1419-1426. [PMID: 33161791 DOI: 10.1080/00365521.2020.1839960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Adherence to evidence-based management is variable in inflammatory bowel disease (IBD), which leads to worse patient outcomes and higher healthcare utilization. Solutions include electronic systems to enhance care, but these have often been limited by lack of clinician design input, poor usability, and low perceived value. A cloud-based IBD-specific clinical management software - 'Crohn's Colitis Care' (CCCare) was developed by Australia and New Zealand Inflammatory Bowel Disease Consortium clinicians and software developers to improve this. METHODS CCCare captures patient-reported disease activity and medical assessment, medication monitoring, cancer screening, preventative health, and facilitates communication with the IBD team and referring doctor. De-identified longitudinal data are stored separately in a clinical quality registry for research. CCCare was tested for feasibility and usability in routine clinical settings at two large Australian hospitals. Users' experience was evaluated with System Usability Scale (SUS). Value to clinicians and patients was assessed by qualitative feedback. Security was assessed by penetration testing. RESULTS Users (n = 13; doctors, nurses, patients) reported good usability and learnability (mean SUS score 75 (range 50-95), sub-scores were 77 (50-94) and 68 (38-100), respectively). Patients reported better communication with clinical team and greater ability to track disease. Clinicians highlighted structured management plans, medication adherence, and centralised data repository as positive features. Penetration testing was passed successfully. CONCLUSIONS Initial evaluation demonstrates CCCare is usable, secure, and valued in clinical use. It is designed to measure outcomes of clinical care, including efficacy, quality, cost, and complications for individuals, and to audit these at hospital and national level.
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Affiliation(s)
- Krupa Krishnaprasad
- Gut Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, Australia
| | - Alissa Walsh
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, UK
| | - Jakob Begun
- Department of Gastroenterology, Mater Hospital, Brisbane, Australia
| | - Sally Bell
- Department of Gastroenterology, Monash Health, Melbourne, Australia
| | - David Carter
- Stratos Technology Partners, Christchurch, New Zealand
| | - Rachel Grafton
- Department of Gastroenterology, Royal Adelaide Hospital & University of Adelaide, Adelaide, Australia
| | - Alexandra Sechi
- Department of Gastroenterology, Liverpool Hospital, University of NSW & Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Karen Sewell
- Department of Gastroenterology, Mater Hospital, Brisbane, Australia
| | - Anna McMahon
- Department of Gastroenterology, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Susan Connor
- Department of Gastroenterology, Liverpool Hospital, University of NSW & Ingham Institute of Applied Medical Research, Liverpool, Australia
| | - Graham Radford-Smith
- Gut Health, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Department of Gastroenterology, Royal Brisbane and Women's Hospital, Brisbane, Australia.,University of Queensland School of Medicine, Brisbane, Australia
| | - Jane M Andrews
- Department of Gastroenterology, Royal Adelaide Hospital & University of Adelaide, Adelaide, Australia
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17
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Butler AJ, Prior SJ, Mathew S, Carter D, Ellem BF. Utilising co-design to improve outpatient neurological care in a rural setting. Patient Experience Journal 2020. [DOI: 10.35680/2372-0247.1413] [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: 11/05/2022] Open
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18
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Oktay O, Nanavati J, Schwaighofer A, Carter D, Bristow M, Tanno R, Jena R, Barnett G, Noble D, Rimmer Y, Glocker B, O’Hara K, Bishop C, Alvarez-Valle J, Nori A. Evaluation of Deep Learning to Augment Image-Guided Radiotherapy for Head and Neck and Prostate Cancers. JAMA Netw Open 2020; 3:e2027426. [PMID: 33252691 PMCID: PMC7705593 DOI: 10.1001/jamanetworkopen.2020.27426] [Citation(s) in RCA: 28] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Personalized radiotherapy planning depends on high-quality delineation of target tumors and surrounding organs at risk (OARs). This process puts additional time burdens on oncologists and introduces variability among both experts and institutions. OBJECTIVE To explore clinically acceptable autocontouring solutions that can be integrated into existing workflows and used in different domains of radiotherapy. DESIGN, SETTING, AND PARTICIPANTS This quality improvement study used a multicenter imaging data set comprising 519 pelvic and 242 head and neck computed tomography (CT) scans from 8 distinct clinical sites and patients diagnosed either with prostate or head and neck cancer. The scans were acquired as part of treatment dose planning from patients who received intensity-modulated radiation therapy between October 2013 and February 2020. Fifteen different OARs were manually annotated by expert readers and radiation oncologists. The models were trained on a subset of the data set to automatically delineate OARs and evaluated on both internal and external data sets. Data analysis was conducted October 2019 to September 2020. MAIN OUTCOMES AND MEASURES The autocontouring solution was evaluated on external data sets, and its accuracy was quantified with volumetric agreement and surface distance measures. Models were benchmarked against expert annotations in an interobserver variability (IOV) study. Clinical utility was evaluated by measuring time spent on manual corrections and annotations from scratch. RESULTS A total of 519 participants' (519 [100%] men; 390 [75%] aged 62-75 years) pelvic CT images and 242 participants' (184 [76%] men; 194 [80%] aged 50-73 years) head and neck CT images were included. The models achieved levels of clinical accuracy within the bounds of expert IOV for 13 of 15 structures (eg, left femur, κ = 0.982; brainstem, κ = 0.806) and performed consistently well across both external and internal data sets (eg, mean [SD] Dice score for left femur, internal vs external data sets: 98.52% [0.50] vs 98.04% [1.02]; P = .04). The correction time of autogenerated contours on 10 head and neck and 10 prostate scans was measured as a mean of 4.98 (95% CI, 4.44-5.52) min/scan and 3.40 (95% CI, 1.60-5.20) min/scan, respectively, to ensure clinically accepted accuracy. Manual segmentation of the head and neck took a mean 86.75 (95% CI, 75.21-92.29) min/scan for an expert reader and 73.25 (95% CI, 68.68-77.82) min/scan for a radiation oncologist. The autogenerated contours represented a 93% reduction in time. CONCLUSIONS AND RELEVANCE In this study, the models achieved levels of clinical accuracy within expert IOV while reducing manual contouring time and performing consistently well across previously unseen heterogeneous data sets. With the availability of open-source libraries and reliable performance, this creates significant opportunities for the transformation of radiation treatment planning.
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Affiliation(s)
- Ozan Oktay
- Health Intelligence, Microsoft Research, Cambridge, United Kingdom
| | - Jay Nanavati
- Health Intelligence, Microsoft Research, Cambridge, United Kingdom
| | | | - David Carter
- Health Intelligence, Microsoft Research, Cambridge, United Kingdom
| | - Melissa Bristow
- Health Intelligence, Microsoft Research, Cambridge, United Kingdom
| | - Ryutaro Tanno
- Health Intelligence, Microsoft Research, Cambridge, United Kingdom
| | - Rajesh Jena
- Health Intelligence, Microsoft Research, Cambridge, United Kingdom
| | - Gill Barnett
- Health Intelligence, Microsoft Research, Cambridge, United Kingdom
| | - David Noble
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, United Kingdom
- now with Edinburgh Cancer Centre, Western General Hospital, Edinburgh, United Kingdom
| | - Yvonne Rimmer
- Department of Oncology, Cambridge University Hospitals NHS Foundation Trust, United Kingdom
| | - Ben Glocker
- Health Intelligence, Microsoft Research, Cambridge, United Kingdom
| | - Kenton O’Hara
- Health Intelligence, Microsoft Research, Cambridge, United Kingdom
| | | | | | - Aditya Nori
- Health Intelligence, Microsoft Research, Cambridge, United Kingdom
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19
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Bystricky W, Maier C, Gintant G, Bergau D, Carter D. Identification of Drug-Induced Multichannel Block and Proarrhythmic Risk in Humans Using Continuous T Vector Velocity Effect Profiles Derived From Surface Electrocardiograms. Front Physiol 2020; 11:567383. [PMID: 33071822 PMCID: PMC7530300 DOI: 10.3389/fphys.2020.567383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/29/2020] [Accepted: 08/27/2020] [Indexed: 01/07/2023] Open
Abstract
We present continuous T vector velocity (TVV) effect profiles as a new method for identifying drug effects on cardiac ventricular repolarization. TVV measures the temporal change in the myocardial action potential distribution during repolarization. The T vector dynamics were measured as the time required to reach p percent of the total T vector trajectory length, denoted as Tr(p), with p in {1, …, 100%}. The Tr(p) values were individually corrected for heart rate at each trajectory length percentage p. Drug effects were measured by evaluating the placebo corrected changes from baseline of Tr(p)c jointly for all p using functional mixed effects models. The p-dependent model parameters were implemented as cubic splines, providing continuous drug effect profiles along the entire ventricular repolarization process. The effect profile distributions were approximated by bootstrap simulations. We applied this TVV-based analysis approach to ECGs available from three published studies that were conducted in the CiPA context. These studies assessed the effect of 10 drugs and drug combinations with different ion channel blocking properties on myocardial repolarization in a total of 104 healthy volunteers. TVV analysis revealed that blockade of outward potassium currents alone presents an effect profile signature of continuous accumulation of delay throughout the entire repolarization interval. In contrast, block of inward sodium or calcium currents involves acceleration, which accumulates during early repolarization. The balance of blocking inward versus outward currents was reflected in the percentage pzero of the T vector trajectory length where accelerated repolarization transitioned to delayed repolarization. Binary classification using a threshold pzero = 43% separated predominant hERG channel blocking drugs with potentially higher proarrhythmic risk (moxifloxacin, dofetilide, quinidine, chloroquine) from multichannel blocking drugs with low proarrhythmic risk (ranolazine, verapamil, lopinavir/ritonavir) with sensitivity 0.99 and specificity 0.97. The TVV-based effect profile provides a detailed view of drug effects throughout the entire ventricular repolarization interval. It enables the evaluation of drug-induced blocks of multiple cardiac repolarization currents from clinical ECGs. The proposed pzero parameter enhances identification of the proarrhythmic risk of a drug beyond QT prolongation, and therefore constitutes an important tool for cardiac arrhythmia risk assessment.
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Affiliation(s)
- Werner Bystricky
- Clinical Pharmacology and Pharmacometrics, AbbVie, Inc., North Chicago, IL, United States
| | - Christoph Maier
- Clinical Pharmacology and Pharmacometrics, AbbVie, Inc., North Chicago, IL, United States.,Department of Medical Informatics, Heilbronn University, Heilbronn, Germany
| | - Gary Gintant
- Integrated Sciences and Technology, AbbVie, Inc., North Chicago, IL, United States
| | - Dennis Bergau
- Clinical Pharmacology and Pharmacometrics, AbbVie, Inc., North Chicago, IL, United States
| | - David Carter
- Clinical Pharmacology and Pharmacometrics, AbbVie, Inc., North Chicago, IL, United States
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20
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Carter D, Tezel FH, Kruczek B, Kärger J, Chmelik C. Determination of the adsorption isotherms and transport diffusivities of gases in mixtures inside zeolitic crystals using Infra-Red Micro-imaging. MethodsX 2020; 7:100993. [PMID: 32742944 PMCID: PMC7387814 DOI: 10.1016/j.mex.2020.100993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/07/2020] [Accepted: 07/07/2020] [Indexed: 11/28/2022] Open
Abstract
Different regions of Infra-Red (IR) light absorption by guest molecules inside a zeolitic crystal are measured and quantified to determine binary adsorption isotherms and transport diffusivities. This has been achieved using a vacuum capable setup which includes an Infra-Red Microscope (IRM) and Fourier Transform Infra-Red (FTIR) Spectrometer. By utilizing IR light and FTIR spectroscopy, this method can be used to describe the behavior of low concentrations of relatively fast molecules inside zeolitic crystals as an alternative to chromatographic pulse methods. To demonstrate the capabilities of this method, binary adsorption isotherms and transport diffusivities of CO2 in mixtures composed of CO2 and N2 inside silicalite have been determined. From the fundamental measurements determined using this method, complex gas separation processes such as swing adsorption and multi stage membrane systems can be designed for novel zeolite materials. This method can also be used to develop models for complex adsorption and diffusion systems, and validate sophisticated molecular simulation models.•IR microimaging with static gas dosing system for measuring transient uptake, diffusion and chemical reactions of gases and their mixtures in individual crystals or particles of nanoporous materials•Using giant crystals the setup allows to study adsorption and transport of single components and mixtures in nanoporous materials also for fast diffusing guest molecules.
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21
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Chien I, Enrique A, Palacios J, Regan T, Keegan D, Carter D, Tschiatschek S, Nori A, Thieme A, Richards D, Doherty G, Belgrave D. A Machine Learning Approach to Understanding Patterns of Engagement With Internet-Delivered Mental Health Interventions. JAMA Netw Open 2020; 3:e2010791. [PMID: 32678450 PMCID: PMC7368176 DOI: 10.1001/jamanetworkopen.2020.10791] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE The mechanisms by which engagement with internet-delivered psychological interventions are associated with depression and anxiety symptoms are unclear. OBJECTIVE To identify behavior types based on how people engage with an internet-based cognitive behavioral therapy (iCBT) intervention for symptoms of depression and anxiety. DESIGN, SETTING, AND PARTICIPANTS Deidentified data on 54 604 adult patients assigned to the Space From Depression and Anxiety treatment program from January 31, 2015, to March 31, 2019, were obtained for probabilistic latent variable modeling using machine learning techniques to infer distinct patient subtypes, based on longitudinal heterogeneity of engagement patterns with iCBT. INTERVENTIONS A clinician-supported iCBT-based program that follows clinical guidelines for treating depression and anxiety, delivered on a web 2.0 platform. MAIN OUTCOMES AND MEASURES Log data from user interactions with the iCBT program to inform engagement patterns over time. Clinical outcomes included symptoms of depression (Patient Health Questionnaire-9 [PHQ-9]) and anxiety (Generalized Anxiety Disorder-7 [GAD-7]); PHQ-9 cut point greater than or equal to 10 and GAD-7 scores greater than or equal to 8 were used to define depression and anxiety. RESULTS Patients spent a mean (SD) of 111.33 (118.92) minutes on the platform and completed 230.60 (241.21) tools. At baseline, mean PHQ-9 score was 12.96 (5.81) and GAD-7 score was 11.85 (5.14). Five subtypes of engagement were identified based on patient interaction with different program sections over 14 weeks: class 1 (low engagers, 19 930 [36.5%]), class 2 (late engagers, 11 674 [21.4%]), class 3 (high engagers with rapid disengagement, 13 936 [25.5%]), class 4 (high engagers with moderate decrease, 3258 [6.0%]), and class 5 (highest engagers, 5799 [10.6%]). Estimated mean decrease (SE) in PHQ-9 score was 6.65 (0.14) for class 3, 5.88 (0.14) for class 5, and 5.39 (0.14) for class 4; class 2 had the lowest rate of decrease at -4.41 (0.13). Compared with PHQ-9 score decrease in class 1, the Cohen d effect size (SE) was -0.46 (0.014) for class 2, -0.46 (0.014) for class 3, -0.61 (0.021) for class 4, and -0.73 (0.018) for class 5. Similar patterns were found across groups for GAD-7. CONCLUSIONS AND RELEVANCE The findings of this study may facilitate tailoring interventions according to specific subtypes of engagement for individuals with depression and anxiety. Informing clinical decision needs of supporters may be a route to successful adoption of machine learning insights, thus improving clinical outcomes overall.
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Affiliation(s)
- Isabel Chien
- Microsoft Research Cambridge, Cambridge, United Kingdom
| | - Angel Enrique
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
- E-Mental Health Group, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Jorge Palacios
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
- E-Mental Health Group, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Tim Regan
- Microsoft Research Cambridge, Cambridge, United Kingdom
| | - Dessie Keegan
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
| | - David Carter
- Microsoft Research Cambridge, Cambridge, United Kingdom
| | | | - Aditya Nori
- Microsoft Research Cambridge, Cambridge, United Kingdom
| | - Anja Thieme
- Microsoft Research Cambridge, Cambridge, United Kingdom
| | - Derek Richards
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
- E-Mental Health Group, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Gavin Doherty
- Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
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22
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Ram E, Meyer R, Carter D, Gutman M, Rosin D, Horesh N. The efficacy of sacral neuromodulation in the treatment of low anterior resection syndrome: a systematic review and meta-analysis. Tech Coloproctol 2020; 24:803-815. [PMID: 32350733 DOI: 10.1007/s10151-020-02231-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 04/22/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Sacral neuromodulation (SNM) has become one of the main treatment options in patients with fecal incontinence. The aim of this study was to determine the efficacy of sacral neuromodulation in the treatment of low anterior resection syndrome (LARS). METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search was conducted using the Pubmed, Embase, Ovid, and Cochrane databases, restricted to the English language and to articles published from 2000 to November 2018. RESULTS A total of 434 articles on the efficacy of SNM in the treatment of LARS were retrieved, and 13 studies were included in the final analysis, with a total of 114 patients treated with SNM for LARS The overall success rate excluding study heterogeneity was 83.30% [95% CI (71.33-95.25%)]. Improvement in anal continence was seen in several clinical and functional parameters, including the Wexner Score [10.78 points, 95% CI (8.55-13.02), p < 0.0001], manometric maximum resting pressure [mean improvement of 6.37 mm/Hg, 95% CI (2.67-10.07), p = 0.0007], maximum squeeze pressure [mean improvement of 17.99 mm/Hg, 95% CI (17.42-18.56), p < 0.0001] and maximum tolerated volume [mean improvement of 22.74 ml, 95% CI (10.65-34.83), p = 0.0002]. Quality of life questionnaires also demonstrated significant improvement in patients' quality of life, but were reported only in a small group of included patients. CONCLUSIONS SNM significantly improves symptoms and quality of life in patients suffering from fecal incontinence following low anterior resection.
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Affiliation(s)
- E Ram
- Department of Surgery B, Sheba Medical Centre, Tel Hashomer, Israel.
- Tel Aviv University, Tel Aviv, Israel.
| | - R Meyer
- Tel Aviv University, Tel Aviv, Israel
- Department of Gynecology and Obstetrics, Sheba Medical Centre, Tel Hashomer, Israel
| | - D Carter
- Tel Aviv University, Tel Aviv, Israel
- Department of Gastroenterology, Sheba Medical Centre, Tel Hashomer, Israel
| | - M Gutman
- Department of Surgery B, Sheba Medical Centre, Tel Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - D Rosin
- Department of Surgery B, Sheba Medical Centre, Tel Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - N Horesh
- Department of Surgery B, Sheba Medical Centre, Tel Hashomer, Israel
- Tel Aviv University, Tel Aviv, Israel
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Hinchcliff R, Debono D, Carter D, Glennie M, Robertson H, Travaglia J. Options to enhance the veracity of Australian health service accreditation assessments. HEALTH INF MANAG J 2020; 51:59-62. [DOI: 10.1177/1833358320910890] [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: 11/15/2022]
Abstract
Background: Assessment processes applied within some health service accreditation programs have been criticised at times for being inaccurate, inconsistent or inefficient. Such criticism has inspired the development of innovative assessment methods. Objective: The Australian Commission on Safety and Quality in Health Care considered the use of three such methods: short-notice or unannounced methods; patient journey or tracer methods; and attestation by governing bodies. Method: A systematic search and synthesis of published peer-reviewed and grey literature associated with these methods. Results and Conclusion: The published literature demonstrates that the likely benefits of these three assessment methods warrant further evaluation, real-world trials and stakeholder consultation to determine the most appropriate models to introduce into national accreditation programs. Implications: The subsequent introduction of models of short-notice assessments and attestation by governing bodies into the Australian Health Service Safety and Quality Accreditation Scheme in January 2019 demonstrates how the findings presented in this article influenced the national change in assessment practice, providing an example of evidence-informed accreditation development.
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Affiliation(s)
- Reece Hinchcliff
- Queensland University of Technology, Australia
- University of Technology Sydney, Australia
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Pounder KC, Mukhida F, Brown RP, Carter D, Daltry JC, Fleming T, Goetz M, Halsey LG, Hughes G, Questel K, Saccheri IJ, Williams R, Soanes LM. Testing for hybridisation of the Critically Endangered Iguana delicatissima on Anguilla to inform conservation efforts. CONSERV GENET 2020. [DOI: 10.1007/s10592-020-01258-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractThe Caribbean Island of Anguilla in the north-eastern Lesser Antilles is home to one of the last populations of the Critically Endangered Lesser Antillean iguana Iguana delicatissima. This population is highly threatened primarily because of hybridisation with non-native Iguana iguana. This study assesses the degree of hybridisation between Anguilla’s Iguana species firstly using morphological characteristics and then genetic analysis to validate the genetic integrity of morphologically identified I. delicatissima. We also examined the genetic diversity of Anguilla’s I. delicatissima population, and that of a population on the nearby island of Îlet Fourchue, St Barthélemy. Forty-five iguanas were captured in Anguilla and 10 in St Barthélemy, and sequences from 3 nuclear and 1 mtDNA genes were obtained for each. Of the 45 iguanas captured in Anguilla, 22 were morphologically identified as I. delicatissima, 12 as I. iguana and the remainder were identified as hybrids. Morphological assignments were all confirmed by genetic analyses except for one I. iguana and one hybrid individual. These two individuals appeared likely to have originated following ancestral hybridisation events several generations ago. A significant paucity of genetic diversity was found within Anguillan and St Barthélemy I. delicatissima populations, with a single haplotype being identified for each of the three nuclear genes and the mtDNA sequence. This study highlights the urgency for immediate action to conserve Anguilla’s remnant I. delicatissima population. Protection from hybridisation will require translocation to I. iguana-free offshore cays, with supplementary individuals being sourced from neighbouring islands to enhance the genetic diversity of the population.
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Carter D, Hartzell CM. Experimental methodology for measuring in-vacuum granular tribocharging. Rev Sci Instrum 2019; 90:125105. [PMID: 31893812 DOI: 10.1063/1.5111983] [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: 06/01/2019] [Accepted: 11/16/2019] [Indexed: 06/10/2023]
Abstract
We have developed an experimental methodology for measuring the charge distribution in granular mixtures due solely to particle-to-particle triboelectric charge exchange. Our experiment isolates the charging process from common influencing factors such as particle-to-container contact and atmospheric effects, creating conditions ideal for studying charge exchange on airless, dusty extraterrestrial bodies like the Moon and Mars. Charged grains are observed using high-speed videography as they fall through a uniform electric field, and their charge and size are characterized from their trajectories. This no-contact measurement method does not influence the charge and allows for the characterization of the overall distribution of charge by grain size in an arbitrary mixture. Our preliminary results indicate that charging measured with this test stand agrees well with computational charging models.
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Affiliation(s)
- D Carter
- Department of Aerospace Engineering, A. James Clark School of Engineering, University of Maryland, College Park, Maryland 20742, USA
| | - C M Hartzell
- Department of Aerospace Engineering, A. James Clark School of Engineering, University of Maryland, College Park, Maryland 20742, USA
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Bystricky W, Maier C, Carter D. T vector velocity distribution: A new biomarker for identifying drug effects on cardiac myocyte ion channels. J Electrocardiol 2019. [DOI: 10.1016/j.jelectrocard.2019.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Akbar N, Corbin A, Hogg E, Banerjee A, Lee C, Melling G, Edgar L, Dragovic R, Carter D, Riley P, Udalova I, Anthony D, Choudhury R. 2379Endothelial cell derived extracellular vesicles mediate immune cell deployment from the spleen and transcriptional programming following acute myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0142] [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: 11/13/2022] Open
Abstract
Abstract
Background
Acute myocardial infarction (AMI) induces transcriptional activation of monocyte en route to the injured myocardium, possibly through interactions involving plasma liberated extracellular vesicles (EVs), which are enriched for proteins and microRNAs (miRNAs) post-AMI. Neutrophils are the first immune cells to arrive at sites of injury and mediate further damage to the ischaemic myocardium. Here, we describe neutrophil-deployment from the spleen in AMI and by endothelial cell (EC) derived-EVs.
Methods
Patients presenting AMI provided informed consent as part of the Oxford Acute Myocardial Infarction Study (OxAMI). Plasma EV were isolated by differential ultra-centrifugation (120,000g, 2 hours) followed by washing and characterised for: morphology using transmission electron microscopy (TEM), size and concentration profiling by Nanoparticle Tracking Analysis, EV markers (TSG101, ALIX, CD9, HSP70) by western blot, and miRNAs by RT-qPCR. Mouse and human EC were used in vitro to derive EC-EV under control conditions or after inflammatory stimulation with tumour necrosis factor-alpha (TNF-α) (10ng/mL) and from CRISPR-edited miRNA-126 knock-out ECs. EC-EVs were tail vein injected into wild-type mice or exposed to primary human peripheral blood neutrophils in vitro.
Results
Patients presenting with AMI (N=15) have significantly more plasma EV at time of injury vs a 6-month follow-up measurement (2.2-fold more, P=0.008). Plasma EVs at the time of AMI presentation correlate significantly with the extent of ischaemic injury (R=0.046, P=0.006) and plasma neutrophils (R=0.37, P=0.017). Experimental AMI in wild-type mice induced a significant increase in peripheral blood neutrophils and a simultaneous reduction in splenic-neutrophils, suggesting splenic-neutrophil deployment (P=0.004). Human plasma EV are enriched for vascular cell adhesion molecule-1 (VCAM-1) and EC-associated miR-126 post-AMI (Akbar et al 2017). miRNA-126-mRNA targets are significantly over represented when compared to neutrophil Gene Ontology terms for: degranulation (P<0.001), activation (P<0.001), chemotaxis (P=0.008) and migration (P=0.008). Human and mouse EC release more EV after inflammatory stimulation and show enrichment for miRNA-126. CRISPR-edited miRNA-126 deficient human EC express more VCAM-1 (P<0.001) and release more EC-EVs (P<0.001). EC-EV exposure to primary human neutrophils alters inflammatory gene expression (IL-6 (P<0.05), CCL7 (P<0.001) and CCL18 (P<0.001)). EC-EV tail vein injected into wild-type mice mobilise splenic-neutrophils to peripheral blood (P<0.001).
Conclusions
Neutrophil deployment from the spleen is a novel finding in acute injury and interactions with EC-EV may mediate their splenic liberation and transcriptional programming following AMI, en route to the injured myocardium. The splenic neutrophil reserve may be a novel therapeutic target in AMI to modulate the inflammatory response before recruitment of cells to sites of injury.
Acknowledgement/Funding
British Heart Foundation Project Grant and Centre for Research Excellence Awards (RE/13/1/30181), Nuffield Benefaction for Medicine and ISSF
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Affiliation(s)
- N Akbar
- University of Oxford, Oxford, United Kingdom
| | - A Corbin
- University of Oxford, Oxford, United Kingdom
| | - E Hogg
- University of Oxford, Oxford, United Kingdom
| | - A Banerjee
- University of Oxford, Oxford, United Kingdom
| | - C Lee
- University of Oxford, Oxford, United Kingdom
| | - G Melling
- Oxford Brookes University, Oxford, United Kingdom
| | - L Edgar
- University of Oxford, Oxford, United Kingdom
| | - R Dragovic
- University of Oxford, Oxford, United Kingdom
| | - D Carter
- Oxford Brookes University, Oxford, United Kingdom
| | - P Riley
- University of Oxford, Oxford, United Kingdom
| | - I Udalova
- University of Oxford, Oxford, United Kingdom
| | - D Anthony
- University of Oxford, Oxford, United Kingdom
| | - R Choudhury
- University of Oxford, Oxford, United Kingdom
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Hurley D, Carter D, Foong Ng LY, Davis M, Walker GM, Lyons JG, Higginbotham CL. An investigation of the inter-molecular interaction, solid-state properties and dissolution properties of mixed copovidone hot-melt extruded solid dispersions. J Drug Deliv Sci Technol 2019. [DOI: 10.1016/j.jddst.2019.101132] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bystricky W, Maier C, Gintant G, Bergau D, Kamradt K, Welsh P, Carter D. T vector velocity: A new ECG biomarker for identifying drug effects on cardiac ventricular repolarization. PLoS One 2019; 14:e0204712. [PMID: 31283756 PMCID: PMC6613676 DOI: 10.1371/journal.pone.0204712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Received: 09/03/2018] [Accepted: 06/04/2019] [Indexed: 11/23/2022] Open
Abstract
Background We present a new family of ECG biomarkers for assessing drug effects on ventricular repolarization. We show that drugs blocking inward (depolarizing) ion currents cause a relative increase of the T vector velocity (TVV) and accelerate repolarization, while drugs blocking outward ion currents cause a relative decrease of the TVV and delay repolarization. The results suggest a link between the TVV and the instantaneous change of the cellular action potentials that may contribute to bridge the gap between the surface ECG and myocardial cellular processes. Methods We measure TVV as the time required to reach X% of the total Trajectory length of the T vector loop, denoted as TrX. Applied to data from two FDA funded studies (22+22 subjects, 5232+4208 ECGs) which target ECG effects of various ion-channel blocking drugs, the TrX effect profiles indicate increasingly delayed electrical activity over the entire repolarization process for drugs solely reducing outward potassium current (dofetilide, moxifloxacin). For drugs eliciting block of the inward sodium or calcium currents (mexiletine, lidocaine), the TrX effect profiles were consistent with accelerated electrical activity in the initial repolarization phase. For multichannel blocking drugs (ranolazine) or drug combinations blocking multiple ion currents (dofetilide + mexiletine, dofetilide + lidocaine), the overall TrX effect profiles indicate a superposition of the individual TrX effect profiles. Results The parameter Tr40c differentiates pure potassium channel blocking drugs from multichannel blocking drugs with an area under the ROC curve (AUC) of 0.90, CI = [0.88 to 0.92]. This is significantly better than the performance of J-Tpeakc (0.81, CI = [0.78 to 0.84]) identified as the best parameter in the second FDA study. Combining the ten parameters Tr10c to Tr100c in a logistic regression model further improved the AUC to 0.94, CI = [0.92 to 0.96]. Conclusions TVV analysis substantially improves assessment of drug effects on cardiac repolarization, providing a plausible and improved mechanistic link between drug effects on ionic currents and overall ventricular repolarization reflected in the body surface ECG. TVV contributes to an enhanced appraisal of the proarrhythmic risk of drugs beyond QTc prolongation and J-Tpeakc.
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Affiliation(s)
- Werner Bystricky
- Clinical Pharmacology, AbbVie Inc., North Chicago, Illinois, United States of America
| | - Christoph Maier
- Clinical Pharmacology, AbbVie Inc., North Chicago, Illinois, United States of America.,Department of Medical Informatics, Heilbronn University, Heilbronn, Germany
| | - Gary Gintant
- Integrated Sciences and Technology, AbbVie Inc., North Chicago, Illinois, United States of America
| | - Dennis Bergau
- Clinical Pharmacology, AbbVie Inc., North Chicago, Illinois, United States of America
| | - Kent Kamradt
- Clinical Pharmacology, AbbVie Inc., North Chicago, Illinois, United States of America
| | - Patrick Welsh
- Clinical Pharmacology, AbbVie Inc., North Chicago, Illinois, United States of America
| | - David Carter
- Clinical Pharmacology, AbbVie Inc., North Chicago, Illinois, United States of America
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Minocha M, Li H, Chiu YL, Carter D, Othman AA. Models of Variability and Circadian Rhythm in Heart Rate, Blood Pressure, and QT Interval for Healthy Subjects Who Received Placebo in Phase I Trials. Clin Transl Sci 2019; 12:470-480. [PMID: 31021448 PMCID: PMC6742942 DOI: 10.1111/cts.12640] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/06/2019] [Indexed: 12/02/2022] Open
Abstract
This work characterized the time‐course, circadian rhythm, and inherent variability in key cardiovascular variables (heart rate, corrected QT interval, and systolic and diastolic blood pressure) that are routinely collected as part of safety monitoring in phase I trials. Longitudinal data from 1,035 healthy volunteers who received placebo in 65 single‐dose and multiple‐dose phase I trials conducted by AbbVie were compiled and analyzed using nonlinear mixed‐effects modeling. An independent nonlinear mixed‐effects model was developed for each variable, and combinations of cosine functions were used to capture circadian oscillations. Gender, race, age, and body weight were significant covariates for variability in baseline measures, and the contributions of these covariates were quantitatively characterized. Based on the extensive data set analyzed, the developed models represent valuable tools to help contextualize and differentiate inherent variability that can be expected in a typical phase I setting from true drug‐related cardiovascular safety signals. In addition, these placebo models can be used to support exposure–response analyses that estimate treatment‐related effects on the evaluated cardiovascular measures.
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Affiliation(s)
- Mukul Minocha
- Clinical Pharmacology and Pharmacometrics, AbbVie, North Chicago, Illinois, USA
| | - Hong Li
- Data and Statistical Sciences, AbbVie, North Chicago, Illinois, USA
| | - Yi-Lin Chiu
- Data and Statistical Sciences, AbbVie, North Chicago, Illinois, USA
| | - David Carter
- Clinical Pharmacology and Pharmacometrics, AbbVie, North Chicago, Illinois, USA
| | - Ahmed A Othman
- Clinical Pharmacology and Pharmacometrics, AbbVie, North Chicago, Illinois, USA
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Carter D, Bardan E, Maradey-Romero C. Clinical and physiological risk factors for fecal incontinence in chronically constipated women. Tech Coloproctol 2019; 23:429-434. [PMID: 31016549 DOI: 10.1007/s10151-019-01985-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 04/02/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Fecal incontinence (FI) and chronic constipation (CC) are disabling symptoms that cause a significant public health problem. The pathophysiology of combined constipation and FI is not fully understood. Our aim was to delineate the clinical, physiological and anatomical factors that may contribute to the association of FI and CC. METHODS A retrospective study was performed in a pelvic floor unit in a tertiary medical center. Consecutive female patients diagnosed with CC were included, and further divided into two groups according to the co-occurrence of FI. Demographic characteristics, anorectal physiology (obtained by manometry) and pelvic anatomical pathology (as assessed by dynamic pelvic ultrasound) were recorded and subsequently compared. RESULTS A total of 267 women were included in the study. Of those, 62 patients (23%) had an associated FI (CCFI). The CCFI group had higher body mass index (BMI) levels and a trend toward younger average age as compared to the group without FI (CCNFI). The number of vaginal and instrumental deliveries was similar in both groups. Anal resting and squeeze pressures were significantly lower in the CCFI group (64 ± 21 vs 48 ± 18, p = 0.004 and 141 ± 136.2 vs. 97.5 ± 38.6, p = 0.02, respectively). Rectal sensation abnormalities were common, but did not differ between both groups. Dyssynergic defecation and rectocele were more common in the CCNFI group (68% vs. 51%, p = 0.04 and 39% vs. 24%, p = 0/045, respectively. CONCLUSIONS Lower anal pressures and higher BMI were found among women with coexisting FI and CC. Pelvic floor anatomical and functional abnormalities are common in women diagnosed with CC and FI, but dyssynergia and diagnosis of significant rectocele, which cause obstructed defecation, were more common in the CCNFI group.
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Affiliation(s)
- D Carter
- Department of Gastroenterology, Chaim Sheba Medical Center, Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - E Bardan
- Department of Gastroenterology, Chaim Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - C Maradey-Romero
- Department of Gastroenterology, Chaim Sheba Medical Center, Ramat Gan, Israel
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Eapen A, Joing M, Kwon P, Tong J, Maneta E, De Santo C, Mussai F, Lissauer D, Carter D. Recombinant human granulocyte- colony stimulating factor in women with unexplained recurrent pregnancy losses: a randomized clinical trial. Hum Reprod 2019; 34:424-432. [PMID: 30776296 PMCID: PMC6389865 DOI: 10.1093/humrep/dey393] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/31/2018] [Indexed: 12/04/2022] Open
Abstract
STUDY QUESTION Does administration of recombinant human granulocyte colony stimulating factor (rhG-CSF) in the first trimester improve pregnancy outcomes, among women with a history of unexplained recurrent pregnancy loss? SUMMARY ANSWER rhG-CSF administered in the first trimester of pregnancy did not improve outcomes among women with a history of unexplained recurrent pregnancy loss. WHAT IS KNOWN ALREADY The only previous randomized controlled study of granulocyte colony stimulating factor in recurrent miscarriage in 68 women with unexplained primary recurrent miscarriage found a statistically significant reduction in miscarriage and improvement in live birth rates. A further four observational studies where G-CSF was used in a recurrent miscarriage population were identified in the literature, two of which confirmed statistically significant increase in clinical pregnancy and live birth rates. STUDY DESIGN, SIZE, DURATION A randomized, double-blind, placebo controlled clinical trial involving 150 women with a history of unexplained recurrent pregnancy loss was conducted at 21 sites with established recurrent miscarriage clinics in the United Kingdom between 23 June 2014 and 05 June 2016. The study was coordinated by University of Birmingham, UK. PARTICIPANTS/MATERIALS, SETTING, METHODS One hundred and fifty women with a history of unexplained recurrent pregnancy loss: 76 were randomized to rhG-CSF and 74 to placebo. Daily subcutaneous injections of recombinant human granulocyte - colony stimulating factor 130 μg or identical appearing placebo from as early as three to five weeks of gestation for a maximum of 9 weeks. The trial used central randomization with allocation concealment. The primary outcome was clinical pregnancy at 20 weeks of gestation, as demonstrated by an ultrasound scan. Secondary outcomes included miscarriages, livebirth, adverse events, stillbirth, neonatal birth weight, changes in clinical laboratory variables following study drug exposure, major congenital anomalies, preterm births and incidence of anti-drug antibody formation. Analysis was by intention to treat. MAIN RESULTS AND THE ROLE OF CHANCE A total of 340 participants were screened for eligibility of which 150 women were randomized. 76 women (median age, 32[IQR, 29-34] years; mean BMI, 26.3[SD, 4.2]) and 74 women (median age, 31[IQR, 26-33] years; mean BMI, 25.8[SD, 4.2]) were randomized to placebo. All women were followed-up to primary outcome, and beyond to live birth. The clinical pregnancy rate at 20 weeks, as well as the live birth rate, was 59.2% (45/76) in the rhG-CSF group, and 64.9% (48/74) in the placebo group, giving a relative risk of 0.9 (95% CI: 0.7-1.2; P = 0.48). There was no evidence of a significant difference between the groups for any of the secondary outcomes. Adverse events (AEs) occurred in 52 (68.4%) participants in rhG-CSF group and 43 (58.1%) participants in the placebo group. Neonatal congenital anomalies were observed in 1/46 (2.1%) of babies in the rhG-CSF group versus 1/49 (2.0%) in the placebo group (RR of 0.9; 95% CI: 0.1-13.4; P = 0.93). LIMITATIONS, REASONS FOR CAUTION This trial was conducted in women diagnosed with unexplained recurrent pregnancy loss and therefore no screening tests (commercially available) were performed for immune dysfunction related pregnancy failure/s. WIDER IMPLICATIONS OF THE FINDINGS To our knowledge, this is the first multicentre study and largest randomized clinical trial to investigate the efficacy and safety of granulocyte human colony stimulating factor in women with recurrent miscarriages. Unlike the only available single center RCT, our trial showed no significant increase in clinical pregnancy or live births with the use of rhG-CSF in the first trimester of pregnancy. STUDY FUNDING/COMPETING INTEREST(S) This study was sponsored and supported by Nora Therapeutics, Inc., 530 Lytton Avenue, 2nd Floor, Palo Alto, CA 94301, USA. Darryl Carter was the co-founder and VP of research, Nora Therapeutics, Inc. and held shares in the company. He holds a patent for the use of recombinant human granulocyte colony stimulating factor to reduce unexplained recurrent pregnancy loss. Mark Joing, Paul Kwon and Jeff Tong were or are employees of Nora Therapeutics, Inc. No other potential conflict of interest relevant to this article was reported. TRIAL REGISTRATION NUMBER EUDRACT No: 2014-000084-40; ClinicalTrials.gov Identifier: NCT02156063. TRIAL REGISTRATION DATE 31 Mar 2014. DATE OF FIRST PATIENT’S ENROLMENT 23 Jun 2014.
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Affiliation(s)
- A Eapen
- Tommy’s National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, UK
- University of Iowa Hospitals and Clinics, Carver college of Medicine, IA, USA
| | - M Joing
- Nora Therapeutics, Inc., 530 Lytton Avenue, 2nd Floor, Palo Alto, CA, USA
| | - P Kwon
- Nora Therapeutics, Inc., 530 Lytton Avenue, 2nd Floor, Palo Alto, CA, USA
| | - J Tong
- Nora Therapeutics, Inc., 530 Lytton Avenue, 2nd Floor, Palo Alto, CA, USA
| | - E Maneta
- Tommy’s National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, UK
| | - C De Santo
- Tommy’s National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, UK
| | - F Mussai
- Tommy’s National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, UK
| | - D Lissauer
- Tommy’s National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, UK
| | - D Carter
- Nora Therapeutics, Inc., 530 Lytton Avenue, 2nd Floor, Palo Alto, CA, USA
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Saunders C, Carter D, Brown JJ. Primary care experience of older Australians with chronic illness. Aust J Prim Health 2019; 25:13-18. [DOI: 10.1071/py18098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/11/2018] [Indexed: 11/23/2022]
Abstract
This large (>1000) cross-sectional study investigates patient-reported primary care experiences of older people with chronic illness. Previous research has found that approximately half of patients with chronic illness receive optimal chronic illness care and outcomes in Australian general practice. A survey was administered via a double opt-in panel method to people aged ≥55 years who have one or more self-reported major chronic diseases (diabetes and/or chronic heart, kidney, lung, mental health and/or musculoskeletal conditions). Health professionals were found to be important to the majority of Australians surveyed. Well-known chronic illness support resources such as care plans and recalls/reminders were reported to be wanting by up to 50 per cent of respondents. Across all chronic illness groups, <42 per cent of respondents reported the provision of information on community resources and 25 per cent reported not having a sound understanding about their medications. Regular local surveys for older people with chronic illness would allow a timely understanding of primary care experiences, needs and preferences of this group, to support quality improvement and drive enhanced patient outcomes.
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Macomber MW, Phillips M, Tarapov I, Jena R, Nori A, Carter D, Folgoc LL, Criminisi A, Nyflot MJ. Autosegmentation of prostate anatomy for radiation treatment planning using deep decision forests of radiomic features. ACTA ACUST UNITED AC 2018; 63:235002. [DOI: 10.1088/1361-6560/aaeaa4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Hinchcliff R, Debono D, Carter D, Banks M. ISQUA18-2585Systematic Reviews of the Evidence Supporting Three Methods of External Accreditation Assessment. Int J Qual Health Care 2018. [DOI: 10.1093/intqhc/mzy167.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - D Debono
- Centre for Health Services Management
| | - D Carter
- Faculty of Law, University of Technology Sydney
| | - M Banks
- Australian Commission on Safety and Quality in Health Care, Sydney, Australia
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Carter D, Papps B, Brook NR. Disseminated Intravascular Coagulation After Embolization to Treat Acutely Bleeding Bilateral Massive Angiomyolipoma: A Case Report. J Endourol Case Rep 2018; 4:117-119. [PMID: 30065960 PMCID: PMC6064195 DOI: 10.1089/cren.2018.0020] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Hemorrhage from an angiomyolipoma (AML) of the kidney can be life threatening and arterial embolization is the primary treatment. Embolization is less invasive than surgery, is well tolerated, and major complications are rare. We describe a case of disseminated intravascular coagulation (DIC) after embolization of a bleeding renal AML in a 44-year-old man with massive bilateral AMLs. This report aims to highlight the possibility that acute DIC could be a major complication of embolization itself and so should be considered and screened for because, if present, it requires early and aggressive management. Case Presentation: A 44-year-old man with a history of large bilateral renal AMLs associated with tuberous sclerosis complex presented with visible hematuria and abdominal pain. Renal CT revealed bleeding from the right kidney. Embolization with polyvinyl alcohol and lipiodol was urgently performed. The following day he required multiple blood transfusions and repeat embolization, this time with gelfoam and "tornado" coils. He suddenly developed DIC, cardiovascular collapse and acute renal failure requiring many days in the intensive care unit for inotropic support and renal replacement therapy. Conclusion: Arterial embolization may be associated with increased risk of DIC in the setting of treating large bleeding renal AMLs. DIC may be a direct or indirect complication of this. The clinician must act quickly to identify this and treat this complication aggressively.
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Affiliation(s)
- David Carter
- Department of Urology, The Royal Adelaide Hospital, Adelaide, Australia
| | - Bill Papps
- Department of Urology, The Royal Adelaide Hospital, Adelaide, Australia
| | - Nicholas R Brook
- Department of Urology, The Royal Adelaide Hospital, Adelaide, Australia
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Kennedy DA, Carter D, Wilson S, Kruczek B, Tezel FH. Pore plugging synthesis and characterization of silicalite-1 membranes using tubular TiO2supports: Effect of support pore size on membrane performance. CAN J CHEM ENG 2018. [DOI: 10.1002/cjce.23095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Dean A. Kennedy
- Department of Chemical and Biological Engineering; University of Ottawa; 161 Louis Pasteur, Ottawa ON K1N 6N5 Canada
| | - David Carter
- Department of Chemical and Biological Engineering; University of Ottawa; 161 Louis Pasteur, Ottawa ON K1N 6N5 Canada
| | - Sean Wilson
- Department of Chemical and Biological Engineering; University of Ottawa; 161 Louis Pasteur, Ottawa ON K1N 6N5 Canada
| | - Boguslaw Kruczek
- Department of Chemical and Biological Engineering; University of Ottawa; 161 Louis Pasteur, Ottawa ON K1N 6N5 Canada
| | - F. Handan Tezel
- Department of Chemical and Biological Engineering; University of Ottawa; 161 Louis Pasteur, Ottawa ON K1N 6N5 Canada
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Spritz RA, Arnold TD, Buonocore S, Carter D, Fingerlin T, Odero WW, Wambani JO, Tenge RK, Weatherley-White RC. Distribution of Orofacial Clefts and Frequent Occurrence of an Unusual Cleft Variant in the Rift Valley of Kenya. Cleft Palate Craniofac J 2017; 44:374-7. [PMID: 17608554 DOI: 10.1597/06-136.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective: To investigate the pattern and distribution of nonsyndromic orofacial clefts among patients in the Rift Valley region of northwestern Kenya. Methods: Subjects were categorized anatomically for occurrence of an atypical cleft lip variant (ACL), typical cleft lip (CL), cleft lip and palate (CLP), or cleft palate (CP), and family history of orofacial clefts. Tribal ethnicity data were obtained from both cleft and noncleft clinic attendees. Results: There were 194 patients with CL (52.7%), 153 with CLP (41.6%), and 21 with CP (5.7%). CL constitutes a greater fraction of orofacial clefts in the Rift Valley region than reported elsewhere in Africa, principally due to frequent occurrence of ACL (52.5% of all CL). Among noncleft clinic attendees there was a lower fraction of Bantu and larger fraction of Nilotic-Paranilotic tribal ethnicity than in Kenya overall. In contrast, among patients with orofacial clefts there was significant underrepresentation of Bantu and overrepresentation of Nilotic-Paranilotic tribes, particularly Kalenjin. Patients of Kalenjin origin had a much higher rate of positive family history of orofacial clefts than Bantu patients. Conclusions: There is an unusual anatomic distribution of orofacial clefts in the Kenya Rift Valley, with frequent occurrence of an atypical CL variant. Our findings indicate that Bantu tribes have lower risk of orofacial clefts than Nilotic-Paranilotic tribes, possibly due to inherited genetic differences, perhaps accounting for the relatively low prevalence of orofacial clefts through much of Africa.
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Affiliation(s)
- Richard A Spritz
- Human Medical Genetics Program, University of Colorado at Denver and Health Sciences Center, Aurora 80045, USA.
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Carter D, Tezel F, Kruczek B, Kalipcilar H. Investigation and comparison of mixed matrix membranes composed of polyimide matrimid with ZIF – 8, silicalite, and SAPO – 34. J Memb Sci 2017. [DOI: 10.1016/j.memsci.2017.08.068] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Yeh HW, Karmach O, Ji A, Carter D, Martins-Green MM, Ai HW. Red-shifted luciferase-luciferin pairs for enhanced bioluminescence imaging. Nat Methods 2017; 14:971-974. [PMID: 28869756 PMCID: PMC5678970 DOI: 10.1038/nmeth.4400] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [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] [Received: 02/02/2017] [Accepted: 07/23/2017] [Indexed: 12/14/2022]
Abstract
Red-shifted bioluminescence reporters are desirable for biological imaging. We describe the development of red-shifted luciferins based on synthetic coelenterazine analogs and corresponding mutants of NanoLuc that enable bright bioluminescence. One pair in particular shows superior sensitivity over other commonly used bioluminescence reporters in vitro and in vivo. This pair was adapted to develop a bioluminescence resonance energy-based Antares reporter called Antares2, which offers improved signal from deep tissues.
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Affiliation(s)
- Hsien-Wei Yeh
- Department of Chemistry, University of California Riverside, Riverside, California, USA.,Department of Molecular Physiology and Biological Physics and Center for Membrane and Cell Physiology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Omran Karmach
- Department of Cell Biology and Neuroscience, University of California Riverside, Riverside, California, USA
| | - Ao Ji
- Department of Chemistry, University of California Riverside, Riverside, California, USA
| | - David Carter
- Institute for Integrative Genome Biology, University of California Riverside, Riverside, California, USA
| | - Manuela M Martins-Green
- Department of Cell Biology and Neuroscience, University of California Riverside, Riverside, California, USA.,Institute for Integrative Genome Biology, University of California Riverside, Riverside, California, USA
| | - Hui-Wang Ai
- Department of Chemistry, University of California Riverside, Riverside, California, USA.,Department of Molecular Physiology and Biological Physics and Center for Membrane and Cell Physiology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.,Institute for Integrative Genome Biology, University of California Riverside, Riverside, California, USA
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Zecevic A, Carter D, Bauer M. CHARACTERISTICS OF LIFT-ASSISTS PROVIDED TO OLDER ADULTS BY PARAMEDIC SERVICES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A. Zecevic
- Western University, London, Ontario, Canada,
| | - D. Carter
- Middlesex-London EMS, London, Ontario, Canada
| | - M.A. Bauer
- Western University, London, Ontario, Canada,
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Karavana V, Smith I, Kanellis G, Sigala I, Kinsella T, Zakynthinos S, Liu L, Chen J, Zhang X, Liu A, Guo F, Liu S, Yang Y, Qiu H, Grimaldi DG, Kaya E, Acicbe O, Kayaalp I, Asar S, Dogan M, Eren G, Hergunsel O, Pavelescu D, Grintescu I, Mirea L, Guanziroli M, Gotti M, Marino A, Cressoni M, Vergani G, Chiurazzi C, Chiumello D, Gattinoni L, Guanziroli M, Gotti M, Vergani G, Cressoni M, Chiurazzi C, Marino A, Spano S, Chiumello D, Gattinoni L, Guanziroli M, Gotti M, Vergani G, Marino A, Cressoni M, Chiurazzi C, Chiumello D, Gattinoni L, Massaro F, Moustakas A, Johansson S, Larsson A, Perchiazzi G, Zhang XW, Guo FM, Chen JX, Xue M, Yang Y, Qiu HB, Chen JX, Liu L, Yang L, Zhang XW, Guo FM, Yang Y, Qiu HB, Fister M, Knafelj R, Suzer MA, Kavlak ME, Atalan HK, Gucyetmez B, Cakar N, Weller D, Grootendorst AF, Dijkstra A, Kuijper TM, Cleffken BI, Regli A, De Keulenaer B, Van Heerden P, Hadfield D, Hopkins PA, Penhaligon B, Reid F, Hart N, Rafferty GF, Grasselli G, Mauri T, Lazzeri M, Carlesso E, Cambiaghi B, Eronia N, Maffezzini E, Bronco A, Abbruzzese C, Rossi N, Foti G, Bellani G, Pesenti A, Bassi GL, Panigada M, Ranzani O, Kolobow T, Zanella A, Cressoni M, Berra L, Parrini V, Kandil H, Salati G, Livigni S, Livigni S, Amatu A, Girardis M, Barbagallo M, Moise G, Mercurio G, Costa A, Vezzani A, Lindau S, Babel J, Cavana M, Torres A, Panigada M, Bassi GL, Ranzani OT, Kolobow T, Zanella A, Cressoni M, Berra L, Parrini V, Kandil H, Salati G, Livigni S, Amatu A, Girardis M, Barbagallo M, Moise G, Mercurio G, Costa A, Vezzani A, Lindau S, Babel J, Cavana M, Torres A, Umbrello M, Taverna M, Formenti P, Mistraletti G, Vetrone F, Marino A, Vergani G, Baisi A, Chiumello D, Garnero AG, Novotni DN, Arnal JA, Urner M, Fan E, Dres M, Vorona S, Brochard L, Ferguson ND, Goligher EC, Leung C, Joynt G, Wong W, Lee A, Gomersall C, Poels S, Casaer M, Schetz M, Van den Berghe G, Meyfroidt G, Holzgraefe B, Von Kobyletzki LB, Larsson A, Cianchi G, Becherucci F, Batacchi S, Cozzolino M, Franchi F, Di Valvasone S, Ferraro MC, Peris A, Phiphitthanaban H, Wacharasint P, Wongsrichanalai V, Lertamornpong A, Pengpinij O, Wattanathum A, Oer-areemitr N, Boddi M, Cianchi G, Cappellini E, Ciapetti M, Batacchi S, Di Lascio G, Bonizzoli M, Cozzolino M, Peris A, Lazzeri C, Cianchi G, Bonizzoli M, Di Lascio G, Cozzolino M, Peris A, Katsin ML, Hurava MY, Dzyadzko AM, Hermann A, Schellongowski P, Bojic A, Riss K, Robak O, Lamm W, Sperr W, Staudinger T, Buoninsegni LT, Bonizzoli M, Cozzolino M, Parodo J, Ottaviano A, Cecci L, Corsi E, Ricca V, Peris A, de Garibay APR, Ende-Schneider B, Schreiber C, Kreymann B, Turani F, Resta M, Niro D, Castaldi P, Boscolo G, Gonsales G, Martini S, Belli A, Zamidei L, Falco M, Lamas T, Mendes J, Galazzi A, Mauri T, Benco B, Binda F, Masciopinto L, Lazzeri M, Carlesso E, Lissoni A, Grasselli G, Adamini I, Pesenti A, Thamjamrassri T, Watcharotayangul J, Numthavaj P, Kongsareepong S, Higuera J, Cabestrero D, Rey L, Narváez G, Blandino A, Aroca M, Saéz S, De Pablo R, Mohamed A, Sklar M, Munshi L, Mauri T, Lazzeri M, Alban L, Turrini C, Panigada M, Taccone P, Carlesso E, Marenghi C, Spadaro S, Grasselli G, Volta C, Pesenti A, Higuera J, Alonso DC, Blandino A, Narváez G, González LR, Aroca M, Saéz S, De Pablo R, Franci A, Stocchi G, Cappuccini G, Socci F, Cozzolino M, Guetti C, Rastrelli P, Peris A, Nestorowicz A, Glapinski J, Fijalkowska-Nestorowicz A, Wosko J, Fijalkowska-Nestorowicz A, Glapinski J, Wosko J, Duprez F, Bonus T, Cuvelier G, Mashayekhi S, Ollieuz S, Reychler G, Bonus T, Duprez F, Cuvelier G, Mashayekhi S, Ollieuz S, Reychler G, Kuchyn I, Bielka K, Sergienko A, Jones H, Day C, Park SC, Yeom SR, Myatra SN, Gupta S, Rajnala V, Divatia J, Silva JV, Olvera OA, Schulte RC, Bermudez MC, Zorrilla LP, Ferretis HL, García KT, Balciuniene N, Ramsaite J, Kriukelyte O, Krikscionaitiene A, Tamosuitis T, Terragni P, Brazzi L, Falco D, Pistidda L, Magni G, Bartoletti L, Mascia L, Filippini C, Ranieri V, Kyriakoudi A, Rovina N, Koltsida O, Konstantellou E, Kardara M, Kostakou E, Gavriilidis G, Vasileiadis I, Koulouris N, Koutsoukou A, Van Snippenburg W, Kröner A, Flim M, Buise M, Hemler R, Spronk P, Regli A, Noffsinger B, De Keulenaer B, Singh B, Hockings L, Van Heerden P, Spina C, Bronco A, Magni F, Di Giambattista C, Vargiolu A, Bellani G, Foti G, Citerio G, Scaramuzzo G, Spadaro S, Waldmann AD, Böhm SH, Ragazzi R, Volta CA, Heines SJ, Strauch U, Van de Poll MC, Roekaerts PM, Bergmans DC, Sosio S, Gatti S, Maffezzini E, Punzi V, Asta A, Foti G, Bellani G, Glapinski J, Mroczka J, Nestorowicz A, Fijalkowska-Nestorowicz A, Yaroshetskiy AI, Rezepov NA, Mandel IA, Gelfand BR, Ozen E, Karakoc E, Ayyildiz A, Kara S, Ekemen S, Yelken BB, Saasouh W, Freeman J, Turan A, Hajjej Z, Sellami W, Bousselmi M, Samoud W, Gharsallah H, Labbene I, Ferjani M, Vetrugno L, Barbariol F, Forfori F, Regeni I, Della Rocca G, Jansen D, Jonkman A, Doorduin J, Roesthuis L, Van der Hoeven J, Heunks L, Marocco SA, Bottiroli M, Pinciroli R, Galanti V, Calini A, Gagliardone M, Bellani G, Fumagalli R, Gatti S, Abbruzzese C, Ippolito D, Sala VL, Meroni V, Bronco A, Foti G, Bellani G, Elbanna M, Nassar Y, Abdelmohsen A, Yahia M, Mongodi S, Mojoli F, Via G, Tavazzi G, Fava F, Pozzi M, Iotti GA, Bouhemad B, Ruiz-Ferron F, Simón JS, Gordillo-Resina M, Chica-Saez V, Garcia MR, Vela-Colmenero R, Redondo-Orts M, Gontijo-Coutinho C, Ozahata T, Nocera P, Franci D, Santos T, Carvalho-Filho M, Fochi O, Gatti S, Nacoti M, Signori D, Bronco A, Bonacina D, Bellani G, Bonanomi E, Mongodi S, Bonvecchio E, Stella A, Roldi E, Orlando A, Luperto M, Bouhemad B, Iotti GA, Mojoli F, Trunfio D, Licitra G, Martinelli R, Vannini D, Giuliano G, Vetrugno L, Forfori F, Näslund E, Lindberg LG, Lund I, Larsson A, Frithiof R, Nichols A, Freeman J, Pentakota S, Kodali B, Pranskunas A, Kiudulaite I, Simkiene J, Damanskyte D, Pranskuniene Z, Arstikyte J, Vaitkaitis D, Pilvinis V, Brazaitis M, Pool R, Haugaa H, Botero A, Escobar D, Maberry D, Tønnessen T, Zuckerbraun B, Pinsky M, Gomez H, Lyons H, Trimmings A, Domizi R, Scorcella C, Damiani E, Pierantozzi S, Tondi S, Monaldi V, Carletti A, Zuccari S, Adrario E, Pelaia P, Donati A, Kazune S, Grabovskis A, Volceka K, Rubins U, Bol M, Suverein M, Delnoij T, Driessen R, Heines S, Delhaas T, Vd Poll M, Sels J, Jozwiak M, Chambaz M, Sentenac P, Richard C, Monnet X, Teboul JL, Bitar Z, Maadarani O, Al Hamdan R, Huber W, Malbrain M, Chew M, Mallat J, Tagami T, Hundeshagen S, Wolf S, Huber W, Mair S, Schmid R, Aron J, Adlam M, Dua G, Mu L, Chen L, Yoon J, Clermont G, Dubrawski A, Duhailib Z, Al Assas K, Shafquat A, Salahuddin N, Donaghy J, Morgan P, Valeanu L, Stefan M, Provenchere S, Longrois D, Shaw A, Mythen MG, Shook D, Hayashida D, Zhang X, Munson SH, Sawyer A, Mariyaselvam M, Blunt M, Young P, Nakwan N, Khwannimit B, Checharoen P, Berger D, Moller P, Bloechlinger S, Bloch A, Jakob S, Takala J, Van den Brule JM, Stolk R, Vinke E, Van Loon LM, Pickkers P, Van der Hoeven JG, Kox M, Hoedemaekers CW, Werner-Moller P, Jakob S, Takala J, Berger D, Bertini P, Guarracino F, Colosimo D, Gonnella S, Brizzi G, Mancino G, Baldassarri R, Pinsky MR, Bertini P, Gonnella S, Brizzi G, Mancino G, Amitrano D, Guarracino F, Goslar T, Stajer D, Radsel P, De Vos R, Dijk NBV, Stringari G, Cogo G, Devigili A, Graziadei MC, Bresadola E, Lubli P, Amella S, Marani F, Polati E, Gottin L, Colinas L, Hernández G, Vicho R, Serna M, Canabal A, Cuena R, Jozwiak M, Gimenez J, Teboul JL, Mercado P, Depret F, Richard C, Monnet X, Hajjej Z, Sellami W, Sassi K, Gharsallah H, Labbene I, Ferjani M, Herner A, Schmid R, Huber W, Abded N, Nassar Y, Elghonemi M, Monir A, Nikhilesh J, Apurv T, Uber AU, Grossestreuer A, Moskowitz A, Patel P, Holmberg MJ, Donnino MW, Graham CA, Hung K, Lo R, Leung LY, Lee KH, Yeung CY, Chan SY, Trembach N, Zabolotskikh I, Caldas J, Panerai R, Camara L, Ferreira G, Almeida J, de Oliveira GQ, Jardim J, Bor-Seng-Shu E, Lima M, Nogueira R, Jatene F, Zeferino S, Galas F, Robinson T, Hajjar LA, Caldas J, Panerai R, Ferreira G, Camara L, Zeferino S, Jardim J, Bor-Seng-Shu E, Oliveira M, Norgueira R, Groehs R, Ferreira-Santos L, Galas F, Oliveira G, Almeida J, Robinson T, Jatene F, Hajjar L, Ferreira G, Ribeiro J, Galas F, Gaiotto F, Lisboa L, Fukushima J, Rizk S, Almeida J, Jatene F, Osawa E, Franco R, Kalil R, Hajjar L, Chlabicz M, Sobkowicz B, Kaminski K, Kazimierczyk R, Musial W, Tycińska A, Siranovic M, Gopcevic A, Gavranovic ZG, Horvat AH, Krolo H, Rode B, Videc L, Trifi A, Abdellatif S, Ismail KB, Bouattour A, Daly F, Nasri R, Lakhal SB, Beurton A, Teboul JL, Girotto V, Galarza L, Richard C, Monnet X, Beurton A, Teboul JL, Girotto V, Galarza L, Richard C, Monnet X, Girotto V, Teboul JL, Beurton A, Galarza L, Guedj T, Monnet X, Galarza L, Mercado P, Teboul JL, Girotto V, Beurton A, Richard C, Monnet X, Iliæ MK, Sakic L, NN V, Stojcic L, Jozwiak M, Depret F, Teboul JL, Alphonsine J, Lai C, Richard C, Monnet X, Tapanwong N, Chuntupama P, Wacharasint P, Huber W, Hoellthaler J, Lahmer T, Schmid R, Latham H, Bengtson CD, Satterwhite L, Stites M, Simpson SQ, Latham H, Bengtson CD, Satterwhite L, Stites M, Simpson SQ, Skladzien T, Cicio M, Garlicki J, Serednicki W, Wordliczek J, Vargas P, Salazar A, Mercado P, Espinoza M, Graf J, Kongpolprom N, Sanguanwong N, Jonnada S, Gerrard C, Jones N, Morley T, Thorburn PT, Trimmings A, Musaeva T, Zabolotskikh I, Salazar A, Vargas P, Mercado P, Espinoza M, Graf J, Horst S, Lipcsey M, Kawati R, Pikwer A, Rasmusson J, Castegren M, Shilova A, Yafarova A, Gilyarov M, Shilova A, Yafarova A, Gilyarov M, Stojiljkovic DLL, Ulici A, Reidt S, Lam T, Jancik J, Ragab D, Taema K, Farouk W, Saad M, Liu X, Holmberg MJ, Uber A, Montissol S, Donnino M, Andersen LW, Perlikos F, Lagiou M, Papalois A, Kroupis C, Toumpoulis I, Osawa E, Carter D, Sardo S, Almeida J, Galas F, Rizk S, Franco R, Hajjar L, Landoni G, Kongsayreepong S, Sungsiri R, Wongsripunetit P, Marchio P, Guerra-Ojeda S, Gimeno-Raga M, Mauricio MD, Valles SL, Aldasoro C, Jorda A, Aldasoro M, Vila JM, Borg UB, Neitenbach AM, García M, González PG, Romero MG, Orduña PS, Cano AG, Rhodes A, Grounds RM, Cecconi M, Lee C, Hatib F, Jian Z, Rinehart J, De Los Santos J, Canales C, Cannesson M, García MIM, Hatib F, Jian Z, Scheeren T, Jian Z, Hatib F, Pinsky M, Chantziara V, Vassi A, Michaloudis G, Sanidas E, Golemati S, Bateman RM, Mokhtar A, Omar W, Aziz KA, El Azizy H, Nielsen DLL, Holler JG, Lassen A, Eriksson M, Strandberg G, Lipcsey M, Larsson A, Capoletto C, Almeida J, Ferreira G, Fukushima J, Nakamura R, Risk S, Osawa E, Park C, Oliveira G, Galas F, Franco R, Hajjar L, Dias F, D’Arrigo N, Fortuna F, Redaelli S, Zerman L, Becker L, Serrano T, Cotes L, Ramos F, Fadel L, Coelho F, Mendes C, Real J, Pedron B, Kuroki M, Costa E, Azevedo L. 37th International Symposium on Intensive Care and Emergency Medicine (part 1 of 3). Crit Care 2017. [PMCID: PMC5374603 DOI: 10.1186/s13054-017-1628-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Leonard CE, Sobus RD, Fryman S, Sedlacek S, Kercher J, Widner J, Asmar L, Wang Y, Howell K, Barke L, Carter D. Abstract P1-10-03: A randomized trial of accelerated breast radiotherapy utilizing either 3-dimensional radiotherapy versus intensity modulated radiotherapy. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-10-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
PURPOSE: Primary objective: patient self-assessment of breast pain between 3-dimensional radiotherapy (3D-CRT) versus intensity modulated radiotherapy (IMRT). Secondary objectives: breast cosmesis as well as local-regional recurrence and survival statistics.
METHODS AND MATERIALS: 656 patients (3D-CRT n=325; IMRT n=331) were prospectively randomized to either IMRT or 3D-CRT accelerated partial breast radiotherapy to 38.5 Gy in 10 BID 3.85 Gy fractions. Follow-up was: 1, 4, 8, 12, 16, 20, 24 months then yearly. At follow-up, patients completed a cosmesis/pain self-assessment form and physicians completed a cosmesis and disease-status form.
RESULTS: 636 patients completed treatment (3D-CRT n=316; IMRT n=320). Median age was 62. Mean tumor size was 1.1 cm. Mean margin was 7mm. Histology was: 74.5% IDCA, 7% ILCA, 17% DCIS, 0.5% Tubular, 1% Mucinous. 99% were ER+. HER2/neu status by IHC was 3+ in 16% of patients. Median follow-up is 2 years. Tables 1 and 2 show there is no significant difference in patient-assessed pain and cosmesis between the two treatment arms (p=0.14, =0.68 respectively). Decreasing pain and worsening cosmesis as reported by the patient were significantly related to time (p<0.01, =0.012 respectively). MD assessed cosmesis worsened significantly from baseline in the IMRT compared to 3D-CRT cohort (p=0.045). At 2 years Grade 3 and 4 toxicities were 1.5% and 3.9% respectively for 3D-CRT versus IMRT cohorts. Overall Survival at 2 years were 99.7% for both cohorts. There were 3/319 (0.9%) and 7/328 (2.1%) ipsilateral breast recurrences in the 3D-CRT and IMRT cohorts respectively.
Patient breast pain by follow-up interval12 Months (3D n=167 and IMRT n=163)Rx ModalityNoneMildModerate-Severep value3D50.9%47.3%1.8%0.44IMRT52.1%44.2%3.7% 24 Months (3D n=111 and IMRT n=109)3D52.3%47.7% 0.07IMRT66.1%33.9% 36 Months (3D n=50 and IMRT n=34)3D60.0%40.0% 0.37IMRT58.8%41.2% 48 Months (3D n=12 and IMRT n=123D25.0%75.0% 0.19IMRT58.3%41.7% Results from mixed model for pain gradeEffectEstimateSELowerUpperp value3D vs IMRT0.0810.055-0.0260.1890.14Visit (Baseline, 12, 24, 36, 48 month-0.1010.019-0.137-0.064<0.01Table 1.
Patient breast cosmesis by follow-up interval12 Months (3D n=162 and IMRT n=158)Rx ModalityNo changeSlight changeObvious changeDrastic changep value3D40.1%38.3%19.1%2.5%0.83IMRT41.8%40.5%15.2%2.5% 24 months (3D n=108 and IMRT n=108)3D38.9%40.7%18.5%1.9%0.30IMRT41.7%29.6%26.9%1.9% 36 Months (3D n=50 and IMRT n=34)3D38.0%34.0%28.0%0%0.37IMRT32.4%35.3%26.5%5.9% 48 Months (3D n=10 and IMRT n=12)3D10.0%30.0%60.0% 0.10IMRT50.0%8.3%41.7% Patient breast cosmoses by follow-up intervalEffectEstimateSELowerUpperp value3D vs IMRT0.0260.064-0.1000.1530.68All Visit (Baseline, 12, 24, 36, 48 month)-0.0530.021-0.095-0.0120.01Table 2.
Conclusion: T here were no significant differences in patient-assessed pain and cosmesis between the two treatment arms (p=0.14, =0.68 respectively) and no significant increase in pain over time. However, MD assessed cosmesis showed worsening cosmesis in the IMRT cohort compared to the 3D-CRT cohort wen compared to baseline.
Citation Format: Leonard CE, Sobus RD, Fryman S, Sedlacek S, Kercher J, Widner J, Asmar L, Wang Y, Howell K, Barke L, Carter D. A randomized trial of accelerated breast radiotherapy utilizing either 3-dimensional radiotherapy versus intensity modulated radiotherapy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-10-03.
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Affiliation(s)
- CE Leonard
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
| | - RD Sobus
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
| | - S Fryman
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
| | - S Sedlacek
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
| | - J Kercher
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
| | - J Widner
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
| | - L Asmar
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
| | - Y Wang
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
| | - K Howell
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
| | - L Barke
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
| | - D Carter
- Rocky Mountain Cancer Center, Denver, CO; Rocky Mountain Cancer Center, Aurora, CO; SurgOne, Littleton, CO; Linasmar Consulting, Houston, TX; Invision Sally Jobe Breast Network, Greenwood Village, CO
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Abstract
This study examined sport and interpersonal competitiveness between 92 tennis club players and 155 professional players (131 active and 24 retired) and also considered sex differences, differences in stage of career, and performance. Analysis indicated that tennis professionals scored higher on both sport and interpersonal measures of competitiveness than amateur tennis players and that competitiveness remains stable across stages of career. In addition, female tennis professionals scored higher on sport competitiveness than males. Neither measure of competitiveness was significantly related to professional ranking.
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Semo M, Haamedi N, Stevanato L, Carter D, Brooke G, Young M, Coffey P, Sinden J, Patel S, Vugler A. Efficacy and Safety of Human Retinal Progenitor Cells. Transl Vis Sci Technol 2016; 5:6. [PMID: 27486556 PMCID: PMC4959814 DOI: 10.1167/tvst.5.4.6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 10/21/2015] [Accepted: 05/11/2016] [Indexed: 01/08/2023] Open
Abstract
PURPOSE We assessed the long-term efficacy and safety of human retinal progenitor cells (hRPC) using established rodent models. METHODS Efficacy of hRPC was tested initially in Royal College of Surgeons (RCS) dystrophic rats immunosuppressed with cyclosporine/dexamethasone. Due to adverse effects of dexamethasone, this drug was omitted from a subsequent dose-ranging study, where different hRPC doses were tested for their ability to preserve visual function (measured by optokinetic head tracking) and retinal structure in RCS rats at 3 to 6 months after grafting. Safety of hRPC was assessed by subretinal transplantation into wild type (WT) rats and NIH-III nude mice, with analysis at 3 to 6 and 9 months after grafting, respectively. RESULTS The optimal dose of hRPC for preserving visual function/retinal structure in dystrophic rats was 50,000 to 100,000 cells. Human retinal progenitor cells integrated/survived in dystrophic and WT rat retina up to 6 months after grafting and expressed nestin, vimentin, GFAP, and βIII tubulin. Vision and retinal structure remained normal in WT rats injected with hRPC and there was no evidence of tumors. A comparison between dexamethasone-treated and untreated dystrophic rats at 3 months after grafting revealed an unexpected reduction in the baseline visual acuity of dexamethasone-treated animals. CONCLUSIONS Human retinal progenitor cells appear safe and efficacious in the preclinical models used here. TRANSLATIONAL RELEVANCE Human retinal progenitor cells could be deployed during early stages of retinal degeneration or in regions of intact retina, without adverse effects on visual function. The ability of dexamethasone to reduce baseline visual acuity in RCS dystrophic rats has important implications for the interpretation of preclinical and clinical cell transplant studies.
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Affiliation(s)
- Ma'ayan Semo
- Department of Ocular Biology and Therapeutics, UCL-Institute of Ophthalmology, London, UK
| | - Nasrin Haamedi
- Department of Ocular Biology and Therapeutics, UCL-Institute of Ophthalmology, London, UK
| | | | - David Carter
- Department of Ocular Biology and Therapeutics, UCL-Institute of Ophthalmology, London, UK
| | | | - Michael Young
- Massachusetts Eye and Ear, Schepens Eye Research Institute, Boston, MA, USA
| | - Peter Coffey
- Department of Ocular Biology and Therapeutics, UCL-Institute of Ophthalmology, London, UK
| | | | | | - Anthony Vugler
- Department of Ocular Biology and Therapeutics, UCL-Institute of Ophthalmology, London, UK
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Higley LG, Brosius TR, Reinhard KJ, Carter D. Cleaning Puparia for Forensic Analysis. J Forensic Sci 2016; 61:1356-8. [PMID: 27373193 DOI: 10.1111/1556-4029.13121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/10/2015] [Accepted: 11/23/2015] [Indexed: 11/28/2022]
Abstract
We tested procedures for removing adipocere from insect samples to allow identification. An acceptable procedure was determined: (i) Samples were sorted in petri dishes with 75% alcohol to remove any larvae, adult insects, or other soft-bodied material. (ii) Samples of up to 24 puparia were placed in a vial with 15 mL of 95% acetone, capped, and vortexed for a total of 30-90 sec in 10- to 15-sec bursts. This step removed large masses of adipocere or soil from specimen. (iii) Specimens were removed from acetone and placed in a vial of 15 mL of 2% potassium hydroxide (KOH) and vortexed in 10- to 15-sec bursts until all puparia appeared clean (with our samples this required a total of 60-120 sec). (iv) Specimens were removed from the 2% KOH, placed in 75% ethanol, and examined microscopically. (v) Material was stored in 75% ethanol for identification and long-term preservation.
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Affiliation(s)
- Leon G Higley
- School of Natural Resources, University of Nebraska-Lincoln, Hardin Hall, Lincoln, NE, 68583-0987.
| | - Tierney R Brosius
- Department of Biology, Augustana College, 639 38th Street, Rock Island, IL, 61201
| | - Karl J Reinhard
- School of Natural Resources, University of Nebraska-Lincoln, Hardin Hall, Lincoln, NE, 68583-0987
| | - David Carter
- Forensic Science Program, Chaminade University, 3140 Waialae Ave, Honolulu, HI, 96816
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Hurley M, Pearson J, Walsh N, Carter D. SAT0622 Co-Creating An Online Rehabilitation Programme for People with Chronic Knee/Hip Pain. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gunaratne A, Chan E, El-Chabib TH, Carter D, Di Guglielmo GM. aPKC alters the TGFβ response in NSCLC cells through both Smad-dependent and Smad-independent pathways. J Cell Sci 2016; 128:487–98. [PMID: 25501807 DOI: 10.1242/jcs.155440] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Transforming growth factor b (TGFb) signaling controls many cellular responses including proliferation, epithelial to mesenchymal transition and apoptosis, through the activation of canonical (Smad) as well as non-canonical (e.g., Par6) pathways. Previous studies from our lab have demonstrated that aPKC inhibition regulates TGFb receptor trafficking and signaling. Here, we report that downstream TGFb-dependent transcriptional responses in aPKC-silenced NSCLC cells were reduced compared with those of control cells, despite a temporal extension of Smad2 phosphorylation. We assessed SARA–Smad2–Smad4 association and observed that knockdown of aPKC increased SARA (also known as ZFYVE9) levels and SARA–Smad2 complex formation, increased cytoplasmic retention of Smad2 and reduced Smad2–Smad4 complex formation, which correlated with reduced Smad2 nuclear translocation. Interestingly, we also detected an increase in p38 MAPK phosphorylation and apoptosis in aPKC-silenced cells, which were found to be TRAF6-dependent. Taken together, our results suggest that aPKC isoforms regulate Smad and non-Smad TGFb pathways and that aPKC inhibition sensitizes NSCLC cells to undergo TGFb dependent apoptosis.
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Clayton A, Lawson C, Gardiner C, Harrison P, Carter D. The 2nd United Kingdom Extracellular Vesicle Forum Meeting Abstracts: 15 December 2015, Hadyn Ellis Building, Cardiff University. J Extracell Vesicles 2016; 5:30924. [PMID: 26928673 PMCID: PMC4770861 DOI: 10.3402/jev.v5.30924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The UK Extracellular Vesicles (UKEV) Forum meetings were born of the realization that there were a number of UK laboratories studying extracellular vesicle biology and using similar techniques but without a regular national meeting dedicated to EVs at which to share their findings. This was compounded by the fact that many of these labs were working in different fields and thus networking and sharing of ideas and best practice was sometimes difficult. The first workshop was organized in 2013 by Dr Charlotte Lawson, under the auspices of the Society for Endocrinology, led to the founding of the UKEV Forum and the organization of a British Heart Foundation sponsored 1-day conference held in London in December 2014. Although growing in size every year, the central aims of these workshops have remained the same: to provide a forum for discussion and exchange of ideas, to allow young scientists to present their data in the form of short talks and poster presentations and to discuss their work with more established scientists in the field. Here we include the presented abstracts for the 2015 1-day conference hosted by Cardiff University. This meeting was attended by approximately 130 delegates throughout the United Kingdom, but also attended by delegates from Belgium, Netherlands, France, Ireland and other nations. The day composed of plenary presentations from Prof Matthias Belting, Lund University, Sweden and Dr Guillaume van Niel, Institut Curie, Paris together with 10 short presentations from submitted abstracts. The topics covered were broad, with sessions on Mechanisms of EV production, EVs in Infection, EVs in Cancer and in Blood and Characterizing EVs in Biological fluids. This hopefully gives a reflection of the range of EV-related studies being conducted currently in the UK. There were also 33 poster presentations equally broad in subject matter. The organizers are grateful to the Life Science Research Network Wales - a Welsh government-funding scheme that part-sponsored the conference. We are also grateful to commercial sponsors, and 3 paid-presentations are included in the abstracts. The UK EV Forum is expected to become an established annual event held at different Universities across the UK and continue to attract increasing delegate numbers and abstract submissions. We look forward to the next planned conference, which will be hosted by David Carter and his colleagues at Oxford Brookes University on 13th December 2016.
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Affiliation(s)
- Aled Clayton
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - Charlotte Lawson
- Cardiovascular and Inflammation Biology, Comparative Biomedical Sciences, Royal Veterinary College, London, UK
| | - Chris Gardiner
- Haemostasis Research Unit, Research Department of Haematology, University College London, London, UK
| | - Paul Harrison
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, Birmingham University, Birmingham, UK
| | - David Carter
- Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
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