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Orlikova-Boyer B, Lorant A, Gajulapalli SR, Cerella C, Schnekenburger M, Lee JY, Paik JY, Lee Y, Siegel D, Ross D, Han BW, Nguyen TKY, Christov C, Kang HJ, Dicato M, Diederich M. Antileukemic potential of methylated indolequinone MAC681 through immunogenic necroptosis and PARP1 degradation. Biomark Res 2024; 12:47. [PMID: 38704604 DOI: 10.1186/s40364-024-00594-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 04/27/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Despite advancements in chronic myeloid leukemia (CML) therapy with tyrosine kinase inhibitors (TKIs), resistance and intolerance remain significant challenges. Leukemia stem cells (LSCs) and TKI-resistant cells rely on altered mitochondrial metabolism and oxidative phosphorylation. Targeting rewired energy metabolism and inducing non-apoptotic cell death, along with the release of damage-associated molecular patterns (DAMPs), can enhance therapeutic strategies and immunogenic therapies against CML and prevent the emergence of TKI-resistant cells and LSC persistence. METHODS Transcriptomic analysis was conducted using datasets of CML patients' stem cells and healthy cells. DNA damage was evaluated by fluorescent microscopy and flow cytometry. Cell death was assessed by trypan blue exclusion test, fluorescent microscopy, flow cytometry, colony formation assay, and in vivo Zebrafish xenografts. Energy metabolism was determined by measuring NAD+ and NADH levels, ATP production rate by Seahorse analyzer, and intracellular ATP content. Mitochondrial fitness was estimated by measurements of mitochondrial membrane potential, ROS, and calcium accumulation by flow cytometry, and morphology was visualized by TEM. Bioinformatic analysis, real-time qPCR, western blotting, chemical reaction prediction, and molecular docking were utilized to identify the drug target. The immunogenic potential was assessed by high mobility group box (HMGB)1 ELISA assay, luciferase-based extracellular ATP assay, ectopic calreticulin expression by flow cytometry, and validated by phagocytosis assay, and in vivo vaccination assay using syngeneic C57BL/6 mice. RESULTS Transcriptomic analysis identified metabolic alterations and DNA repair deficiency signatures in CML patients. CML patients exhibited enrichment in immune system, DNA repair, and metabolic pathways. The gene signature associated with BRCA mutated tumors was enriched in CML datasets, suggesting a deficiency in double-strand break repair pathways. Additionally, poly(ADP-ribose) polymerase (PARP)1 was significantly upregulated in CML patients' stem cells compared to healthy counterparts. Consistent with the CML patient DNA repair signature, treatment with the methylated indolequinone MAC681 induced DNA damage, mitochondrial dysfunction, calcium homeostasis disruption, metabolic catastrophe, and necroptotic-like cell death. In parallel, MAC681 led to PARP1 degradation that was prevented by 3-aminobenzamide. MAC681-treated myeloid leukemia cells released DAMPs and demonstrated the potential to generate an immunogenic vaccine in C57BL/6 mice. MAC681 and asciminib exhibited synergistic effects in killing both imatinib-sensitive and -resistant CML, opening new therapeutic opportunities. CONCLUSIONS Overall, increasing the tumor mutational burden by PARP1 degradation and mitochondrial deregulation makes CML suitable for immunotherapy.
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Affiliation(s)
- Barbora Orlikova-Boyer
- Laboratoire de Biologie Moléculaire du Cancer, BAM3 Pavillon 2, 6A Rue Nicolas-Ernest Barblé, L-1210, Luxembourg, Luxembourg
| | - Anne Lorant
- Laboratoire de Biologie Moléculaire du Cancer, BAM3 Pavillon 2, 6A Rue Nicolas-Ernest Barblé, L-1210, Luxembourg, Luxembourg
| | - Sruthi Reddy Gajulapalli
- Department of Pharmacy, Research Institute of Pharmaceutical Sciences & Natural Products Research Institute, College of Pharmacy, Seoul National University, 1, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | - Claudia Cerella
- Laboratoire de Biologie Moléculaire du Cancer, BAM3 Pavillon 2, 6A Rue Nicolas-Ernest Barblé, L-1210, Luxembourg, Luxembourg
| | - Michael Schnekenburger
- Laboratoire de Biologie Moléculaire du Cancer, BAM3 Pavillon 2, 6A Rue Nicolas-Ernest Barblé, L-1210, Luxembourg, Luxembourg
| | - Jin-Young Lee
- Department of Pharmacy, Research Institute of Pharmaceutical Sciences & Natural Products Research Institute, College of Pharmacy, Seoul National University, 1, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea
- Present address: Department of Biological Sciences, Keimyung University, Daegu, 42601, Republic of Korea
| | - Ji Yeon Paik
- Department of Pharmacy, Research Institute of Pharmaceutical Sciences & Natural Products Research Institute, College of Pharmacy, Seoul National University, 1, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | - Yejin Lee
- Department of Pharmacy, Research Institute of Pharmaceutical Sciences & Natural Products Research Institute, College of Pharmacy, Seoul National University, 1, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | - David Siegel
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - David Ross
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Byung Woo Han
- Department of Pharmacy, Research Institute of Pharmaceutical Sciences & Natural Products Research Institute, College of Pharmacy, Seoul National University, 1, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | - Thi Kim Yen Nguyen
- Department of Pharmacy, Research Institute of Pharmaceutical Sciences & Natural Products Research Institute, College of Pharmacy, Seoul National University, 1, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea
| | | | - Hyoung Jin Kang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Cancer Research Institute, Seoul National University Children's Hospital, Seoul, 03080, Republic of Korea
| | - Mario Dicato
- Laboratoire de Biologie Moléculaire du Cancer, BAM3 Pavillon 2, 6A Rue Nicolas-Ernest Barblé, L-1210, Luxembourg, Luxembourg
| | - Marc Diederich
- Department of Pharmacy, Research Institute of Pharmaceutical Sciences & Natural Products Research Institute, College of Pharmacy, Seoul National University, 1, Gwanak-Ro, Gwanak-Gu, Seoul, 08826, Republic of Korea.
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Cherian P, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Rettie A, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Laneth Acetates. Int J Toxicol 2024:10915818241249398. [PMID: 38653732 DOI: 10.1177/10915818241249398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in 1982 and a previous re-review in 2002, along with updated information regarding product types and concentrations of use. Considering this information, the Panel confirmed that Laneth-9 Acetate and Laneth-10 Acetate are safe for topical application to humans in the present practices of use and concentration as described in this report.
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Affiliation(s)
- Priya Cherian
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | - Alan Rettie
- Expert Panel for Cosmetic Ingredient Safety Member
| | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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Sabapathy K, Mwita FC, Dauya E, Bandason T, Simms V, Dziva Chikwari C, Doyle AM, Ross D, Shah A, Hayes RJ, Schutte AE, Kranzer K, Ferrand RA. Prevalence of hypertension and high-normal blood pressure among young adults in Zimbabwe: findings from a large, cross-sectional population-based survey. Lancet Child Adolesc Health 2024; 8:101-111. [PMID: 38070533 DOI: 10.1016/s2352-4642(23)00287-0] [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] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Hypertension is the greatest driver of cardiovascular mortality and onset might be in youth. We aimed to investigate the prevalence of and risk factors for elevated blood pressure (hypertension ≥140 mm Hg systolic, ≥90 mm Hg diastolic, or both) and high-normal blood pressure (130-139 mm Hg systolic, 85-89 mm Hg diastolic, or both) among youth in Zimbabwe. METHODS A population-based, cross-sectional survey of randomly sampled youth aged 18-24 years from 24 urban and peri-urban communities in three provinces (Harare, Bulawayo, and Mashonaland East) in Zimbabwe was conducted between Oct 4, 2021, and June 2, 2022. Standardised questionnaires were used by research assistants to collect sociodemographic, behavioural, and clinical data. Height, bodyweight, and blood pressure were recorded. Three seated blood pressure measurements were taken at standardised timepoints during participant interview using a digital sphygmomanometer and cuffs sized on mid-upper arm circumference. The association of potential risk factors with elevated blood pressure was examined using multivariable logistic regression. FINDINGS 17 682 (94·4%) of 18 729 eligible participants were recruited, 17 637 (99·7%) of whom had complete data, and 16 883 (95·7%) of whom were included in the final study sample after excluding 754 (4·3%) pregnant women. The median age was 20 years (IQR 19-22), 9973 (59·1%) participants were female, and 6910 (40·9%) were male. The prevalence of hypertension was 7·4% (95% CI 7·0-7·8) and high-normal blood pressure was 12·2% (11·7-12·7). Overall, prevalence of hypertension was higher in men (8·7% [95% CI 8·2-9·6]) than in women (6·6% [6·0-6·9]), but with age increased to similar levels (at age 18 years 7·3% [6·2-8·6] and 4·3% [3·5-5·2]; at age 23-24 years 10·9% [9·3-12·6] and 9·5% [8·4-10·7] in men and women, respectively). After adjusting for factors associated with hypertension in the crude analysis, hypertension was associated with male sex (adjusted odds ratio 1·53 [95% CI 1·36-1·74]), increasing age (age 19-20 years 1·20 [1·00-1·44]; age 21-22 years 1·45 [1·20-1·75]; age 23-24 years 1·90 [1·57-2·30], vs age 18 years), and BMI of 30·0 kg/m2 or more (1·94 [1·53-2·47] vs 18·5-24·9 kg/m2). A BMI of 18·5 kg/m2 or less (0·79 [0·63-0·98] vs 18·5-24·9 kg/m2) and living with HIV (0·71 [0·55-0·92]) were associated with lower odds of hypertension. INTERPRETATION Prevalence of elevated blood pressure is high among urban and peri-urban youth in Zimbabwe and increases rapidly with age. Further research is needed to understand drivers of blood pressure elevation and the extent of target organ damage in youth in Zimbabwe and similar sub-Saharan African settings, to guide implementation of prevention and management strategies. FUNDING Wellcome Trust.
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Affiliation(s)
- Kalpana Sabapathy
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK.
| | | | - Ethel Dauya
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Tsitsi Bandason
- The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Victoria Simms
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Chido Dziva Chikwari
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Aoife M Doyle
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - David Ross
- Institute for Life Course Health Research, Stellenbosch University, Tygerberg, South Africa
| | - Anoop Shah
- Department of Noncommunicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Richard J Hayes
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, Sydney, NSW, Australia; The George Institute for Global Health, Sydney, NSW, Australia
| | - Katharina Kranzer
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Rashida Abbas Ferrand
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe
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Nevin WD, Jones J, Tupper D, Dunbar JAT, Wilson D, Ross D, Woolley S, Dodd J, Biswas J, Lamb L, Beeching NJ, O’Shea MK, Fletcher TE. Gastrointestinal parasite infections in Nepalese Gurkha recruits arriving in the United Kingdom from 2012-2020. PLoS Negl Trop Dis 2024; 18:e0011931. [PMID: 38277403 PMCID: PMC10849272 DOI: 10.1371/journal.pntd.0011931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/07/2024] [Accepted: 01/21/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Gastrointestinal parasite (GIP) infections are a major cause of global morbidity, infecting hundreds of millions of people each year and potentially leading to lifelong infection and serious complications. Few data exist on screening for GIP infections in migrants entering the UK or on the current performance of different traditional diagnostic approaches. This study aimed to describe the prevalence of GIP infections in Nepalese Gurkha recruits screened on arrival in the UK. METHODOLOGY/PRINCIPAL FINDINGS We present a retrospective analysis of data from screening male adults (18-21 years) who arrived in the UK from Nepal between 2012 and 2020. Three separate faecal samples were obtained from participants at weekly intervals and processed for formalin-ethyl acetate (FEA) concentration/light microscopy and charcoal culture. Serum samples were analysed for IgG antibodies to Strongyloides stercoralis by ELISA. Results were available from 2,263 participants, of whom 463 (20.5%, 95% CI 18.8%-22.2%) had a positive diagnostic test for at least one GIP infection. A total of 525 potential infections were identified. Giardia duodenalis was most common (231/2263, 10.2%), followed by S. stercoralis (102/2263, 4.5%), and hookworm species (86/2263, 3.8%). Analysis (microscopy and culture) of the initial stool sample diagnosed only 244/427 (57.1%) faecally identified pathogens, including 41/86 (47.7%) hookworm infections. The proportion of participants infected with any GIP showed a downward trend over the study period. Log-binomial regression showed risk of infection decreasing by 6.1% year-on-year (95% CI 3.2% - 9.0%). This was driven predominantly by a fall in hookworm, S. stercoralis and Trichuris trichiura prevalence. CONCLUSIONS/SIGNIFICANCE The level of potentially pathogenic GIP infection in young Nepalese men migrating to the UK is high (20.5%) and requires a combined diagnostic approach including serology and analysis of multiple stool samples incorporating specialised parasitological methods. Advances in molecular approaches may optimise and simplify the intensive screening strategy required.
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Affiliation(s)
- William D. Nevin
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Infectious Diseases, Imperial College London, United Kingdom
| | - Jayne Jones
- Clinical Diagnostic Parasitology Laboratory, Liverpool School of Tropical Medicine, United Kingdom
| | - Donna Tupper
- Medical Centre, Infantry Training Centre, Catterick, United Kingdom
| | - James A. T. Dunbar
- Friarage Hospital, Northallerton, United Kingdom
- 212 Field Hospital, Royal Army Medical Corps, Defence Medical Services, United Kingdom
| | - Duncan Wilson
- Headquarters Defence Medical Services Group, Defence Medical Directorate, ICT Building, Edgbaston, Birmingham, United Kingdom
| | - David Ross
- Defence Public Health Unit, Defence Medical Services, United Kingdom
| | - Stephen Woolley
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - James Dodd
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Jason Biswas
- Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Lucy Lamb
- Department of Infectious Diseases, Imperial College London, United Kingdom
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, United Kingdom
- Department of Infectious Diseases, Royal Free Hospital, London, United Kingdom
| | - Nicholas J. Beeching
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Matthew K. O’Shea
- Centre of Defence Pathology, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, United Kingdom
- Institute of Immunology and Immunotherapy, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Thomas E. Fletcher
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
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5
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Zhang H, Ross D, Sucato DJ. A novel uniplanar clamp-hinge correction system for vertebral column resection of severe angular kyphosis: an experimental study using a sawbone model. Spine Deform 2024; 12:67-78. [PMID: 37805944 DOI: 10.1007/s43390-023-00770-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/16/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE To introduce a novel uniplanar clamp-hinge (Uni-CH) correction system designed for vertebral column resection (VCR) of severe angular kyphosis and test its efficacy using a sawbone simulating model. METHODS The Uni-CH was introduced and its functionality was demonstrated on a sawbone model simulating severe angular kyphosis. An 83° thoracolumbar angular kyphosis with the apex at T11 was simulated in the sawbone spine model. The deformity was then corrected using the Uni-CH to identify the optimal hinge position for VCR reduction of severe angular kyphosis. RESULTS The thoracolumbar angular kyphosis, initially measuring a mean of 82.7 ± 0.5°, was corrected to 0°, achieving a 100% correction rate. The optimal hinge position was identified to be at the level of the posterior vertebral body wall (PVBW), which allowed for the maintenance of the spinal cord with a slight shortening of 3%. In contrast, hinge positions located more posteriorly to the PVBW resulted in a greater 42% lengthening of the spinal cord, while positions located more anteriorly led to a greater 27% shortening of the spinal cord. CONCLUSIONS The Uni-CH proves its efficacy in providing consistent stability to the spinal segments and acts as an adjustable and controllable hinge for VCR correction of severe angular kyphosis in the sawbone model. Placing the hinge pivot at the level of the PVBW preserves the spinal cord, preventing excessive shortening or lengthening during VCR reduction of severe angular kyphosis.
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Affiliation(s)
- Hong Zhang
- Scottish Rite for Children, 2222 Welborn St., Dallas, TX75219, USA.
- Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
| | - David Ross
- Scottish Rite for Children, 2222 Welborn St., Dallas, TX75219, USA
| | - Daniel J Sucato
- Scottish Rite for Children, 2222 Welborn St., Dallas, TX75219, USA
- Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
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Raj PS, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Polyamino Sugar Condensate. Int J Toxicol 2023; 42:91S-92S. [PMID: 37753962 DOI: 10.1177/10915818231204239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1982, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Polyamino Sugar Condensate is safe for topical application to humans in the practices of use and concentration as described in this report.
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Affiliation(s)
- Preethi S Raj
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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7
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Tucker R, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Phytantriol. Int J Toxicol 2023; 42:86S-88S. [PMID: 37751605 DOI: 10.1177/10915818231204241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 2007, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Phytantriol is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
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Affiliation(s)
- Regina Tucker
- Cosmetic Ingredient Review Scientific Analyst/Writer
| | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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8
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Cherian P, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Fiume M, Heldreth B. Amyl Acetate and Isoamyl Acetate. Int J Toxicol 2023; 42:14S-16S. [PMID: 37773619 DOI: 10.1177/10915818231204262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in 1988, along with updated information regarding product types and concentrations of use, and confirmed that Amyl Acetate and Isoamyl Acetate are safe as cosmetic ingredients in the practices of use and concentration as described in this report.
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Affiliation(s)
- Pryia Cherian
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
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9
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Burnett CL, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. HC Yellow 5. Int J Toxicol 2023; 42:49S-50S. [PMID: 37766591 DOI: 10.1177/10915818231204272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 2007, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that HC Yellow 5 is safe as a hair dye ingredient in the practices of use and concentration as described in this report.
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Affiliation(s)
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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10
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Tucker R, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Glycol Stearate and Glycol Stearate SE. Int J Toxicol 2023; 42:45S-46S. [PMID: 37769693 DOI: 10.1177/10915818231204266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in 1982, along with updated information regarding product types and concentrations of use, and confirmed that Glycol Stearate and Glycol Stearate SE are safe as cosmetic ingredients in the practices of use and concentration as described in this report.
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Affiliation(s)
- Regina Tucker
- Cosmetic Ingredient Review Scientific Analyst/Writer
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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11
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Burnett CL, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Acid Orange 3. Int J Toxicol 2023; 42:10S-11S. [PMID: 37751626 DOI: 10.1177/10915818231204252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from year 2000, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Acid Orange 3 is safe for use in hair dye formulations at concentrations <.2%.
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Affiliation(s)
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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12
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Cherian P, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Hexamidine and Hexamidine Diisethionate. Int J Toxicol 2023; 42:51S-52S. [PMID: 37776172 DOI: 10.1177/10915818231204273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in 2007, along with updated information regarding product types and concentrations of use, and confirmed that Hexamidine and Hexamidine Diisethionate are safe as cosmetic ingredients in the practices of use and concentration as described in this report if used at concentrations less than or equal to .10%.
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Affiliation(s)
- Priya Cherian
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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13
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Raj PS, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Glyceryl Diesters. Int J Toxicol 2023; 42:40S-44S. [PMID: 37751399 DOI: 10.1177/10915818231204269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in 2002, along with updated information regarding product types and concentrations of use, and confirmed that these 17 glyceryl diesters are safe as cosmetic ingredients in the practices of use and concentration as described in this report.
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Affiliation(s)
- Preethi S Raj
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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14
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Raj PS, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Peanut Glycerides. Int J Toxicol 2023; 42:79S-80S. [PMID: 37784241 DOI: 10.1177/10915818231204277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 2001, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Peanut Glycerides is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
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Affiliation(s)
- Preethi S Raj
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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15
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Cherian P, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Choleth-24. Int J Toxicol 2023; 42:24S-26S. [PMID: 37755708 DOI: 10.1177/10915818231204278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1982, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Choleth-24 is safe for topical applications to humans in the practices of use and concentration as described in this report.
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Affiliation(s)
- Priya Cherian
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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16
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Cherian P, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. PEG Soy Sterols. Int J Toxicol 2023; 42:83S-85S. [PMID: 37751584 DOI: 10.1177/10915818231204279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in year 2000, along with updated information regarding product types and concentrations of use, and confirmed that PEG-5, -10, -16, -25, -30, and -40 Soy Sterol are safe as cosmetic ingredients in the practices of use and concentration as described in this report.
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Affiliation(s)
- Priya Cherian
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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17
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Burnett CL, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Prunus Amygdalus Dulcis (Sweet Almond) Seed Meal. Int J Toxicol 2023; 42:93S-95S. [PMID: 37773611 DOI: 10.1177/10915818231204244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1983, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Prunus Amygdalus Dulcis (Sweet Almond) Seed Meal is safe for topical application to humans in the practices of use and concentration as described in this report.
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Affiliation(s)
| | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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18
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Raj PS, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Methyl Alcohol. Int J Toxicol 2023; 42:74S-76S. [PMID: 37752772 DOI: 10.1177/10915818231204251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 2001, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Methyl Alcohol is safe as used to denature alcohol in the practices of use and concentration as described in this report.
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Affiliation(s)
- Preethi S Raj
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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19
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Raj PS, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Erythorbic Acid and Sodium Erythorbate. Int J Toxicol 2023; 42:37S-39S. [PMID: 37767701 DOI: 10.1177/10915818231204257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in 1999, along with updated information regarding product types and concentrations of use, and confirmed that Erythorbic Acid and Sodium Erythorbate are safe as cosmetic ingredients in the practices of use and concentration as described in this report.
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Affiliation(s)
- Preethi S Raj
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
| | - Monice Fiume
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
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20
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Burnett CL, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Sodium Lauryl Sulfoacetate. Int J Toxicol 2023; 42:100S-101S. [PMID: 37767974 DOI: 10.1177/10915818231204274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1987, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Sodium Lauryl Sulfoacetate is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
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Affiliation(s)
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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21
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Cherian P, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Fiume M, Heldreth B. PPG-11 and PPG-15 Stearyl Ether. Int J Toxicol 2023; 42:81S-82S. [PMID: 37767952 DOI: 10.1177/10915818231204265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in 2001, along with updated information regarding product types and concentrations of use, and confirmed that PPG-11 and PPG-15 Stearyl Ether are safe as cosmetic ingredients in the practices of use and concentration as described in this report.
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Affiliation(s)
- Pryia Cherian
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
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22
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Tucker R, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Mink Oil. Int J Toxicol 2023; 42:77S-78S. [PMID: 37751389 DOI: 10.1177/10915818231204255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1998, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Mink Oil is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
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Affiliation(s)
- Regina Tucker
- Cosmetic Ingredient Review Scientific Analyst/Writer
| | | | | | - David E Cohen
- Cosmetic Ingredient Review Scientific Analyst/Writer
| | | | | | | | - David Ross
- Cosmetic Ingredient Review Scientific Analyst/Writer
| | | | - Paul W Snyder
- Cosmetic Ingredient Review Scientific Analyst/Writer
| | - Susan Tilton
- Cosmetic Ingredient Review Scientific Analyst/Writer
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23
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Raj PS, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Polyacrylamide. Int J Toxicol 2023; 42:89S-90S. [PMID: 37766629 DOI: 10.1177/10915818231204573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1991, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Polyacrylamide is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
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Affiliation(s)
- Preethi S Raj
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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24
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Raj PS, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Cottonseed Glyceride and Hydrogenated Cottonseed Glyceride. Int J Toxicol 2023; 42:27S-28S. [PMID: 37769692 DOI: 10.1177/10915818231204275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed newly available studies since their original assessment in 2001, along with updated information regarding product types and concentrations of use, and confirmed that Cottonseed Glyceride and Hydrogenated Cottonseed Glyceride are safe as cosmetic ingredients in the practices of use and concentration as described in this report, provided that established and imposed limits on gossypol, heavy metals, and pesticide concentrations are not exceeded.
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Affiliation(s)
- Preethi S Raj
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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25
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Cherian P, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Liebler DC, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Chloroxylenol. Int J Toxicol 2023; 42:22S-23S. [PMID: 37769700 DOI: 10.1177/10915818231204263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1985, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Chloroxylenol is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
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Affiliation(s)
- Priya Cherian
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer, Washington, DC, USA
| | | | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
| | - Monice Fiume
- Cosmetic Ingredient Review Senior Director, Washington, DC, USA
| | - Bart Heldreth
- Cosmetic Ingredient Review Executive Director, Washington, DC, USA
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26
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Raj PS, Bergfeld WF, Belsito DV, Cohen DE, Klaassen CD, Rettie AE, Ross D, Slaga TJ, Snyder PW, Tilton S, Fiume M, Heldreth B. Dioscorea Villosa (Wild Yam) Root Extract. Int J Toxicol 2023; 42:29S-31S. [PMID: 37751575 DOI: 10.1177/10915818231204230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 2004, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Dioscorea Villosa (Wild Yam) Root Extract is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
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Affiliation(s)
- Preethi S Raj
- Cosmetic Ingredient Review Senior Scientific Analyst/Writer
| | | | | | | | | | | | - David Ross
- Expert Panel for Cosmetic Ingredient Safety Member
| | | | | | - Susan Tilton
- Expert Panel for Cosmetic Ingredient Safety Member
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27
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Domínguez A, Pacho G, Bowers L, Wild F, Alcock S, Chiazzese G, Farella M, Arrigo M, Ross D, Treacy R, Yegorina D, Mangina E, Masneri S. Dataset of user interactions across four large pilots on the use of augmented reality in learning experiences. Sci Data 2023; 10:823. [PMID: 38001128 PMCID: PMC10673890 DOI: 10.1038/s41597-023-02743-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Augmented Reality in education can support students in a wide range of cognitive tasks-fostering understanding, remembering, applying, analysing, evaluating, and creating learning-relevant information more easily. It can help keep up engagement, and it can render learning more fun. Within the framework of a multi-year investigation encompassing primary and secondary schools across Europe, the ARETE project developed several Augmented Reality applications, providing tools for user interaction and data collection in the education sector. The project developed innovative AR learning technology and methodology, validating these in four comprehensive pilot studies, in total involving more than 2,900 students and teachers. Each pilot made use of a different Augmented Reality application covering specific subjects (English literacy skills, Mathematics and Geography, Positive Behaviour, plus, additionally, an Augmented Reality authoring tool applied in a wide range of subjects). In this paper, we introduce the datasets collected during the pilots, describe how the data enabled the validation of the technology, and how the approach chosen could enhance existing augmented reality applications in data exploration and modelling.
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Affiliation(s)
- Ana Domínguez
- Vicomtech Foundation, Basque Research and Technology Alliance (BRTA), Digital Media, San Sebastián, 20009, Spain.
| | - Guillermo Pacho
- Vicomtech Foundation, Basque Research and Technology Alliance (BRTA), Digital Media, San Sebastián, 20009, Spain
| | - Lisa Bowers
- The Open University, Milton Keynes, MK7 6AA, United Kingdom
| | - Fridolin Wild
- The Open University, Milton Keynes, MK7 6AA, United Kingdom
| | - Sarah Alcock
- The Open University, Milton Keynes, MK7 6AA, United Kingdom
| | | | | | - Marco Arrigo
- Consiglio Nazionale delle Ricerche, Palermo, 90146, Italy
| | - David Ross
- Words Worth Learning, Nenagh, E45 F827, Ireland
| | - Rita Treacy
- Words Worth Learning, Nenagh, E45 F827, Ireland
| | | | | | - Stefano Masneri
- Computer Languages and Systems Department, University of the Basque Country UPV/EHU, San Sebastian, 20011, Spain
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28
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Routledge M, Lyon J, Vincent C, Gordon Clarke A, Shawcross K, Turpin C, Cormack H, Robson SC, Beckett A, Glaysher S, Cook K, Fearn C, Goudarzi S, Hutley EJ, Ross D. Management of a large outbreak of COVID-19 at a British Army training centre: lessons for the future. BMJ Mil Health 2023; 169:488-492. [PMID: 34772689 PMCID: PMC8594976 DOI: 10.1136/bmjmilitary-2021-001976] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/07/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The COVID-19 pandemic has posed major challenges for infection control within training centres, both civilian and military. Here we present a narrative review of an outbreak that occurred at the Royal Military Academy Sandhurst (RMAS) in January-March 2021, in the context of the circulating, highly transmissible SARS-CoV-2 variant B.1.1.7. METHODS Testing for SARS-CoV-2 was performed using a combination of reverse transcriptase PCR and Lateral Flow Devices (LFDs). Testing and isolation procedures were conducted in line with a pre-established symptom stratification system. Genomic sequencing was performed on 10 sample isolates. RESULTS By the end of the outbreak, 185 cases (153 Officer Cadets, 32 permanent staff) had contracted confirmed COVID-19. This represented 15% of the total RMAS population. This resulted in 0 deaths and 0 hospitalisations, but due to necessary isolation procedures did represent an estimated 12 959 person-days of lost training. 9 of 10 (90%) of sequenced isolates had a reportable lineage. All of those reported were found to be the Alpha lineage B.1.1.7. CONCLUSIONS We discuss the key lessons learnt from the after-action review by the Incident Management Team. These include the importance of multidisciplinary working, the utility of sync matrices to monitor outbreaks in real time, issues around Officer Cadets reporting symptoms, timing of high-risk training activities, infrastructure and use of LFDs. COVID-19 represents a vital learning opportunity to minimise the impact of potential future pandemics, which may produce considerably higher morbidity and mortality in military populations.
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Affiliation(s)
- Matthew Routledge
- Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK
- Medical Officer, 254 Medical Regiment, Cambridge, UK
| | - J Lyon
- Senior Medical Officer, Royal Military Academy Sandhurst, Camberley, UK
| | - C Vincent
- Medical Planner, HQ Army Recruiting and Initial Training Command, Pewsey, UK
| | - A Gordon Clarke
- XO, HQ Army Recruiting and Initial Training Command, Pewsey, UK
| | - K Shawcross
- Environmental Health, Medical Branch, Head Quarters Regional Command, Aldershot, UK
| | - C Turpin
- ACOS, Royal Military Academy Sandhurst, Camberley, UK
| | - H Cormack
- Chief of Staff, HQ Army Recruiting and Initial Training Command, Pewsey, UK
| | - S C Robson
- School of Pharmacy & Biomedical Science, University of Portsmouth, Portsmouth, UK
- Centre for Enzyme Innovation, University of Portsmouth, Portsmouth, UK
- School of Biological Sciences, University of Portsmouth, Portsmouth, UK
| | - A Beckett
- Centre for Enzyme Innovation, University of Portsmouth, Portsmouth, UK
| | - S Glaysher
- Research & Innovation, Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - K Cook
- School of Pharmacy & Biomedical Science, University of Portsmouth, Portsmouth, UK
| | - C Fearn
- School of Pharmacy & Biomedical Science, University of Portsmouth, Portsmouth, UK
| | - S Goudarzi
- School of Pharmacy & Biomedical Science, University of Portsmouth, Portsmouth, UK
| | - E J Hutley
- Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK
| | - D Ross
- Parkes Professor, Army Medical Services, Camberley, UK
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29
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Haroon J, Aboody K, Flores L, McDonald M, Mahdavi K, Zielinski M, Jordan K, Rindner E, Surya J, Venkatraman V, Go-Stevens V, Ngai G, Lara J, Hyde C, Schafer S, Schafer M, Bystritsky A, Nardi I, Kuhn T, Ross D, Jordan S. Use of transcranial low-intensity focused ultrasound for targeted delivery of stem cell-derived exosomes to the brain. Sci Rep 2023; 13:17707. [PMID: 37853206 PMCID: PMC10584845 DOI: 10.1038/s41598-023-44785-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/12/2023] [Indexed: 10/20/2023] Open
Abstract
The blood-brain barrier (BBB) presents a significant challenge for targeted drug delivery. A proposed method to improve drug delivery across the BBB is focused ultrasound (fUS), which delivers ultrasound waves to a targeted location in the brain and is hypothesized to open the BBB. Furthermore, stem cell-derived exosomes have been suggested as a possible anti-inflammatory molecule that may have neural benefits, if able to pass the BBB. In the present study, transcranial low-intensity focused ultrasound (LIFU), without the use of intravenous microbubbles, was assessed for both (1) its ability to influence the BBB, as well as (2) its ability to increase the localization of intravenously administered small molecules to a specific region in the brain. In vivo rat studies were conducted with a rodent-customized 2 MHz LIFU probe (peak pressure = 1.5 MPa), and injection of labeled stem cell-derived exosomes. The results suggested that LIFU (without microbubbles) did not appear to open the BBB after exposure times of 20, 40, or 60 min; instead, there appeared to be an increase in transcytosis of the dextran tracer. Furthermore, the imaging results of the exosome study showed an increase in exosome localization in the right hippocampus following 60 min of targeted LIFU.
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Affiliation(s)
- J Haroon
- The Regenesis Project, Santa Monica, CA, USA.
| | - K Aboody
- Department of Stem Cell Biology & Regenerative Medicine, and Beckman Research Institute, City of Hope, Duarte, CA, USA.
| | - L Flores
- Department of Stem Cell Biology & Regenerative Medicine, and Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - M McDonald
- Department of Stem Cell Biology & Regenerative Medicine, and Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - K Mahdavi
- The Regenesis Project, Santa Monica, CA, USA
| | - M Zielinski
- The Regenesis Project, Santa Monica, CA, USA
| | - K Jordan
- The Regenesis Project, Santa Monica, CA, USA
| | - E Rindner
- The Regenesis Project, Santa Monica, CA, USA
| | - J Surya
- The Regenesis Project, Santa Monica, CA, USA
| | | | - V Go-Stevens
- Department of Stem Cell Biology & Regenerative Medicine, and Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - G Ngai
- Department of Stem Cell Biology & Regenerative Medicine, and Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - J Lara
- Department of Stem Cell Biology & Regenerative Medicine, and Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - C Hyde
- Department of Stem Cell Biology & Regenerative Medicine, and Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - S Schafer
- School of Biomedical Engineering, Science, and Health Systems, Drexel University, Philadelphia, USA
| | - M Schafer
- School of Biomedical Engineering, Science, and Health Systems, Drexel University, Philadelphia, USA
| | - A Bystritsky
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA
| | - I Nardi
- Kimera Labs Inc., Miramar, USA
| | - T Kuhn
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA
| | - D Ross
- Kimera Labs Inc., Miramar, USA
| | - S Jordan
- The Regenesis Project, Santa Monica, CA, USA
- Department of Neurology, University of California Los Angeles, Los Angeles, USA
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Alperovich N, Scott BM, Ross D. Automation protocol for high-efficiency and high-quality genomic DNA extraction from Saccharomyces cerevisiae. PLoS One 2023; 18:e0292401. [PMID: 37847718 PMCID: PMC10581484 DOI: 10.1371/journal.pone.0292401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/19/2023] [Indexed: 10/19/2023] Open
Abstract
Although many protocols have been previously developed for genomic DNA (gDNA) extraction from S. cerevisiae, to take advantage of recent advances in laboratory automation and DNA-barcode sequencing, there is a need for automated methods that can provide high-quality gDNA at high efficiency. Here, we describe and demonstrate a fully automated protocol that includes five basic steps: cell wall and RNA digestion, cell lysis, DNA binding to magnetic beads, washing with ethanol, and elution. Our protocol avoids the use of hazardous reagents (e.g., phenol, chloroform), glass beads for mechanical cell disruption, or incubation of samples at 100°C (i.e., boiling). We show that our protocol can extract gDNA with high efficiency both from cells grown in liquid culture and from colonies grown on agar plates. We also show results from gel electrophoresis that demonstrate that the resulting gDNA is of high quality.
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Affiliation(s)
- Nina Alperovich
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
| | - Benjamin M. Scott
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
- Department of Chemistry and Biochemistry, University of Maryland, College Park, MD, United States of America
| | - David Ross
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
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Ross D, Venkatesulu B, Yoo R, Block AM, Welsh JS, Baldea K, Farooq A, Gupta G, Showalter TN, Garant A, Harkenrider MM, Solanki AA. The Importance of Multi-Parametric MRI, PET/CT, and Biopsy for Identifying and Delineating the Extent of Locally Radiorecurrent Prostate Cancer: A Multi-institutional Analysis of the F-SHARP Clinical Trial. Int J Radiat Oncol Biol Phys 2023; 117:e432. [PMID: 37785409 DOI: 10.1016/j.ijrobp.2023.06.1598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Up to 50% of clinical recurrences after curative-intent radiation are intraprostatic local radiorecurrences (LRR), with improved detection through the recent incorporation of multi-parametric MRI and PET/CT in workup. Salvage local therapy (SLT) is increasingly being offered, particularly focal SLT to try to reduce toxicity due to prior radiation. Limited data exist on the incremental value of each imaging modality and biopsy in defining LRR. The objective of this study is to compare the findings of MRI, PET/CT and biopsy in patients with LRR prostate cancer, and the impact each modality has on identifying recurrence and defining the extent of prostate involvement. MATERIALS/METHODS This is a secondary analysis of 58 patients enrolled on the ongoing F-SHARP phase I/II clinical trial of salvage HDR brachytherapy from 3 institutions who underwent PSMA or fluciclovine PET/CT, MRI, and biopsy prior to enrollment. Recurrent tumor was delineated on each imaging modality and by inclusion of involved regions on biopsy. Descriptive statistics were used to compare the imaging-defined tumor with biopsy findings to assess the congruence between the imaging modalities and generate the percentage of patients with disease involvement on biopsy outside of the image-defined targets. RESULTS Initial therapy was conventional/moderately hypofractionated photons in 35 patients, LDR in 13, proton therapy in 7, SBRT in 2, and neutrons in 1. Recurrence Gleason grade groups included 1 (n = 3), 2 (17), 3 (12), 4 (8), 5 (9), and uninterpretable (9). MRI/TRUS sextant + fusion biopsy was performed in 40 patients, TRUS saturation biopsy in 4, and TRUS systematic biopsy in 14. The median number of cores involved and obtained were 6 and 14. The median number of discrete lesions on biopsy in different quadrants of the prostate was 3 (1-6). The median number of discrete lesions seen on MRI was 1 (0-4). MRI did not identity a discrete lesion in 4 patients. The sensitivity of MRI for detection of the LRR was 92.8%. The false negative rate for not detecting the focus of LRR on MRI was 7.2%. 68.4% of patients had biopsy-proven cancer outside of the MRI-defined target. Fluciclovine PET/CT was used in 45 patients, and 13 had PSMA PET/CT. The median number of lesions on PET/CT was 1 (0-2). PET/CT did not identify a discrete lesion in 8 patients. The pooled sensitivity of PET/CT in detecting the focus of LRR was 86.2% (Fluciclovine: 82.2%, PSMA: 100%). PET/CT false negative rate of PET/CT for not detecting the focus of LRR was 13.8% (Fluciclovine: 17.8%, PSMA 0%). 72.41% of patients had biopsy-proven cancer outside of the PET/CT-defined target (Fluciclovine: 77.8%, PSMA: 53.8%). CONCLUSION Although mpMRI and PET/CT are valuable tools for identifying LRR and delineating the extent of prostate/SV involvement, a thorough biopsy is mandatory if pursuing focal SLT. Such treatment should optimally be performed on a clinical trial with robust integration of all imaging and histopathologic data.
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Affiliation(s)
- D Ross
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - B Venkatesulu
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL; Loyola University Medical Center, Maywood, IL
| | - R Yoo
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - A M Block
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL; Loyola University Medical Center, Maywood, IL
| | - J S Welsh
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL; Loyola University Medical Center, Maywood, IL
| | - K Baldea
- Loyola University Medical Center, Maywood, IL; Department of Urology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL
| | - A Farooq
- Loyola University Medical Center, Maywood, IL; Department of Urology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL
| | - G Gupta
- Loyola University Medical Center, Maywood, IL; Department of Urology, Stritch School of Medicine, Loyola University Chicago, Maywood, IL
| | | | - A Garant
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - M M Harkenrider
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL; Loyola University Medical Center, Maywood, IL
| | - A A Solanki
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL; Loyola University Medical Center, Maywood, IL
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Saripalli A, Ross D, Murphy E, Gomez K, Thilges S, Harkenrider MM. Prevalence of Trauma History and Symptoms in Patients Who Have Received Vaginal Brachytherapy as Part of their Endometrial Cancer Treatment. Int J Radiat Oncol Biol Phys 2023; 117:e542. [PMID: 37785674 DOI: 10.1016/j.ijrobp.2023.06.1837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Vaginal brachytherapy (VBT) is an essential component of curative intent treatment for many patients with endometrial cancer. The prevalence of trauma history in this population is unknown and is important to understand considering VBT requires patients to have an instrument vaginally inserted while in the vulnerable lithotomy position. We aim to retrospectively identify patients treated with VBT for early-stage endometrial cancer and collect survey data to assess the prevalence of trauma history, whether VBT re-induced trauma symptoms, and whether VBT was considered an independent traumatic event by patients. MATERIALS/METHODS We retrospectively identified patients with endometrial cancer treated with VBT at our institution from January 2017 to August 2022. Patients were mailed a cover letter and unique-identifier coded survey that included the Brief Trauma Questionnaire (BTQ) and Primary Care Post Traumatic Stress Disorder Screen for DSM-V (PC-PTSD-5), both validated instruments. Patients were instructed to fill out the surveys as it relates to their trauma history prior to VBT and again considering any trauma symptomatology related to VBT. BTQ was interpreted as positive if the patient responded yes to any question. PC-PTSD-5 was interpreted positive if the patient responded yes to at least 3 questions. Electronic medical record review was performed to identify clinical and pathologic features. Descriptive statistics and qualitative analysis were used to assess survey responses. RESULTS A total of 51 of 206 patients returned the survey at the time of interim analysis. 43 patients (84%) screened positive on the BTQ for having trauma history. Of those patients, 7 (16%) screened positive on the PC-PTSD-5 for a probable PTSD diagnosis. Additionally, 22 (51%)/18 (42%) patients answered yes to at least one/two symptoms on the PC-PTSD-5 respectively. Of the patients who answered yes to at least one question on the PC-PTSD-5, 18% (4 patients) responded that VBT triggered flashbacks of their past trauma. Regarding PC-PTSD-5 considering trauma symptomatology related to VBT, 20 patients (39%) answered yes to any question, though only 2 patients (4%) met the threshold to screen positive for probable PTSD. 20 patients (39%) indicated they would have accepted a referral to psychology before or during VBT. Suggested improvements made via free text responses included minimizing the time the cylinder was inserted and eliminating the need to transfer via hallway from the simulation room to the treatment room. CONCLUSION This study provides a baseline for understanding the prevalence of trauma history and trauma related to VBT in patients with endometrial cancer. This data can be used to guide patient centered discussions of endometrial cancer care, importantly including to counsel patients that a possible toxicity of VBT is trauma symptomatology, particularly for those with a history of trauma.
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Affiliation(s)
- A Saripalli
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - D Ross
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - E Murphy
- Department of Psychiatry and Behavioral Neurosciences, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - K Gomez
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - S Thilges
- Department of Psychiatry and Behavioral Neurosciences, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - M M Harkenrider
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
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Harkenrider MM, Stang K, Ross D, Carpenter DJ, Corteville J, Merfeld E, Bradley KA, Chino JP, Erickson BA, Solanki AA, Small W. A Multi-Institutional Analysis of MRI-Based Brachytherapy for Medically Inoperable Endometrial Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e515-e516. [PMID: 37785609 DOI: 10.1016/j.ijrobp.2023.06.1777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients with medically inoperable endometrial cancer (MIEC) are curable with brachytherapy (BT)-based treatment yet have competing comorbidities making definitive treatment challenging. MRI demonstrates superior soft tissue anatomy and target volume delineation but with limited data in MIEC patients. We aim to report disease and toxicity outcomes with MRI-based BT and identify dose-volume relationships for toxicities in the treatment of MIEC patients treated with MRI-based BT. MATERIALS/METHODS We conducted a retrospective multi-institutional analysis of MIEC patients undergoing definitive MRI-based BT (+/- EBRT). MRI-based BT was delivered with the applicator in situ or coregistered to a planning CT. We identified patient, tumor, and dosimetric factors associated with disease and toxicity outcomes. Kaplan-Meier method was used for survival estimates. Log rank test and Cox proportional hazards were used for univariate and multivariate analyses, respectively. T-test was used for dose-volume toxicity analysis. RESULTS A total of 120 patients were included with a median follow up of 28.0 months. Median age was 68.5 years. ECOG PS was 0-1 in 70%. Clinical stage I was 83.3% and II-IV, 16.7%. Most patients (91.7%) were node negative. Endometrioid and high risk histologies comprised 83.3%, and 16.7%, respectively. EBRT + BT was delivered in 97 patients (80.8%) and BT alone in 23 patients (19.2%). Chemotherapy or hormonal therapy was delivered during treatment in 10 (8.3%) and 11 (9.2%) patients, respectively. Estimated 3-year freedom from local, nodal, and distant recurrence were 88.0%, 96.0%, and 89.1% respectively. Estimated 3-year PFS and OS were 60.9% and 62.9%, respectively. On UVA, older age, PS ≥2, high risk histology, higher grade, and larger GTV at BT were significant (p<0.1). On MVA, older age, higher grade, and larger GTV at BT (p<0.05) predicted for inferior PFS. Fifteen late grade ≥3 toxicities were experienced in 14 (11.6%) patients, 13 of whom received EBRT and BT and 1 who received BT alone. Grade ≥3 toxicities were rectal (2, 1.7%), sigmoid (8, 6.7%), bowel (1, 0.8%), bladder (3, 2.5%), and osseous (1, 0.8%). EBRT was delivered in 7 of 8 sigmoid toxicities. Median sigmoid doses (EQD2a/b = 3Gy) for patients with and without late grade ≥3 sigmoid toxicity were 69.6 Gy and 64.3 Gy, respectively (p = 0.009). CONCLUSION MRI-based BT for MIEC patients results in high rates of local control and favorable rates of late grade ≥3 morbidity. Older age, higher grade, and larger GTV at BT predicted for poorer PFS. Sigmoid colon was the predominant organ at risk for grade ≥3 toxicity with a dose -volume relationship observed. Attention to the location of the sigmoid throughout the treatment course may add insight into its predilection for risk. Future work will include additional institutions and dose-volume relationships of target volumes and normal tissues for further disease control and toxicity analysis.
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Affiliation(s)
- M M Harkenrider
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL; Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL
| | - K Stang
- Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL
| | - D Ross
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - D J Carpenter
- Department of Radiation Oncology, Duke University Cancer Center, Durham, NC
| | - J Corteville
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - E Merfeld
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - K A Bradley
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - J P Chino
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC
| | - B A Erickson
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI
| | - A A Solanki
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL; Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL
| | - W Small
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL; Department of Radiation Oncology, Loyola University Medical Center, Maywood, IL
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Ross D, Deamer D. Template-Directed Replication and Chiral Resolution during Wet-Dry Cycling in Hydrothermal Pools. Life (Basel) 2023; 13:1749. [PMID: 37629605 PMCID: PMC10456050 DOI: 10.3390/life13081749] [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: 07/18/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
The commonly supposed template-based format for RNA self-replication requires both duplex assembly and disassembly. This requisite binary provision presents a challenge to the development of a serviceable self-replication model since chemical reactions are thermochemically unidirectional. We submit that a solution to this problem lies in volcanic landmasses that engage in continuous cycles of wetting and drying and thus uniquely provide the twofold state required for self-replication. Moreover, they offer conditions that initiate chain branching, and thus furnish a path to autocatalytic self-replication. The foundations of this dual thermochemical landscape arise from the broad differences in the properties of the bulk water phase on the one hand, and the air/water interfacial regions that emerge in the evaporative stages on the other. With this reaction system as a basis and employing recognized thermochemical and kinetic parameters, we present simulations displaying the spontaneous and autocatalyzed conversion of racemic and unactivated RNA monomers to necessarily homochiral duplex structures over characteristic periods of years.
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Affiliation(s)
- David Ross
- SRI International, Menlo Park, CA 94025, USA
| | - David Deamer
- Department of Biomolecular Engineering, University of California, Santa Cruz, CA 95064, USA
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Sharplin K, Proudman W, Chhetri R, Tran ENH, Choong J, Kutyna M, Selby P, Sapio A, Friel O, Khanna S, Singhal D, Damin M, Ross D, Yeung D, Thomas D, Kok CH, Hiwase D. A Personalized Risk Model for Azacitidine Outcome in Myelodysplastic Syndrome and Other Myeloid Neoplasms Identified by Machine Learning Model Utilizing Real-World Data. Cancers (Basel) 2023; 15:4019. [PMID: 37627047 PMCID: PMC10452100 DOI: 10.3390/cancers15164019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023] Open
Abstract
Azacitidine is an approved therapy for higher-risk myelodysplastic syndrome (MDS). However, only 30-40% patients respond to azacitidine, and the responses may take up to six cycles to become evident. Delayed responses and the myelosuppressive effects of azacitidine make it challenging to predict which patients will benefit. This is further compounded by a lack of uniform prognostic tools to identify patients at risk of early treatment failure. Hence, we performed a retrospective analysis of 273 consecutive azacytidine-treated patients. The median overall survival was 16.25 months with only 9% alive at 5 years. By using pre-treatment variables incorporated into a random forest machine learning model, we successfully identified those patients unlikely to benefit from azacytidine upfront (7.99 vs. 22.8 months, p < 0.0001). This model also identified those who required significantly more hospitalizations and transfusion support. Notably, it accurately predicted survival outcomes, outperforming the existing prognostic scoring system. By integrating somatic mutations, we further refined the model and identified three distinct risk groups with significant differences in survival (5.6 vs. 10.5 vs. 43.5 months, p < 0.0001). These real-world findings emphasize the urgent need for personalized prediction tools tailored to hypomethylating agents, reducing unnecessary complications and resource utilization in MDS treatment.
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Affiliation(s)
- Kirsty Sharplin
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
| | - William Proudman
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
| | - Rakchha Chhetri
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Elizabeth Ngoc Hoa Tran
- Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Jamie Choong
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
| | - Monika Kutyna
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Philip Selby
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Aidan Sapio
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
| | - Oisin Friel
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
- Beaumont Hospital, D09 V2N0 Dublin, Ireland
| | - Shreyas Khanna
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Deepak Singhal
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Michelle Damin
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
| | - David Ross
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, SA 5000, Australia
- Genetic and Molecular Pathology, SA Pathology, Adelaide, SA 5000, Australia
| | - David Yeung
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, SA 5000, Australia
| | - Daniel Thomas
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, SA 5000, Australia
| | - Chung H. Kok
- Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, SA 5000, Australia
| | - Devendra Hiwase
- Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA 5000, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA 5000, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, SA 5000, Australia
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Montarello N, Leslie A, Chhetri R, Friel O, Singhal D, Ross D, Yeung D, Kok CH, Psaltis PJ, Hiwase DK. Personalized risk model for predicting risk of acute coronary syndrome in patients with myelodysplastic syndromes. Blood Adv 2023; 7:3032-3035. [PMID: 36884290 PMCID: PMC10331405 DOI: 10.1182/bloodadvances.2022009173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Affiliation(s)
- Natalie Montarello
- Department of Cardiology, Central Adelaide Local Health Network, Adelaide, SA, Australia
| | - Alasdair Leslie
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Rakchha Chhetri
- Department of Haematology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Oisin Friel
- Department of Medicine, Beaumont Hospital, Dublin, Ireland
| | - Deepak Singhal
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Department of Haematology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - David Ross
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Department of Haematology, Royal Adelaide Hospital, Adelaide, SA, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - David Yeung
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Department of Haematology, Royal Adelaide Hospital, Adelaide, SA, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Chung H. Kok
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Peter J. Psaltis
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Department of Cardiology, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia
- Vascular Research Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Devendra K. Hiwase
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Department of Haematology, Royal Adelaide Hospital, Adelaide, SA, Australia
- Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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Villamagna AH, Beste LA, Borgerding J, Lowy E, Hauser RG, Ross D, Maier MM. Testing and Case Rates of Gonorrhea, Chlamydia, Syphilis, and HIV among People with Substance Use Disorders in the Veterans Health Administration. J Addict Med 2023; 17:387-393. [PMID: 37579093 DOI: 10.1097/adm.0000000000001134] [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: 02/03/2023]
Abstract
BACKGROUND Little is known about national patterns of sexually transmitted infection (STI) testing and infections among people with substance use disorders (SUDs). METHODS This study used a national retrospective analysis of people with SUDs receiving healthcare in the Veterans Health Administration in 2019 (N = 485,869). We describe testing rates, test positivity, and case rates for gonorrhea, chlamydia, syphilis, and HIV among individuals with alcohol, opioid, cocaine, and noncocaine stimulant use disorders in a national cohort of Veterans Health Administration patients. RESULTS Test and case rates for all STIs were highest among people with noncocaine stimulant use. People with alcohol use disorder had the lowest testing rates but intermediate incidence for all STIs. People with multiple SUDs had higher incidence of all STIs than those with single SUDs. Mental health diagnoses and houselessness were common. The HIV test positivity was 0.14% to 0.36% across SUD groups. CONCLUSIONS Sexually transmitted infection testing rates between SUD groups were discordant with their respective case rates. High STI rates in people with SUDs suggest a need for more comprehensive testing, particularly for those with noncocaine stimulant use and those with comorbid houselessness or mental health diagnoses.
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Affiliation(s)
- Angela Holly Villamagna
- From the Division of Infectious Diseases, Department of Medicine, Oregon Health and Science University, Portland, OR (AHV, MMM); Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA (LAB); General Medicine Service, VA Puget Sound Health Care System, Seattle, WA (LAB, JB, EL); Pathology and Laboratory Medicine Department, VA Connecticut Health Care System, New Haven, CT (RGH); Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT (RGH); Infectious Diseases Section, VA Portland Health Care System, Portland, OR (MMM); Department of Health Services, University of Washington School of Public Health, Seattle, WA (EL); Office of Specialty Care Services, Veterans Health Administration, Washington, DC (DR)
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Williams LG, Ross D. Impact of poor air quality while deployed on respiratory health: a systematic review. BMJ Mil Health 2023:e002381. [PMID: 37336578 DOI: 10.1136/military-2023-002381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/25/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION British military personnel deploy internationally to areas with high levels of ambient air pollution. Air pollution can cause acute respiratory symptoms which lead to concern about potential long-lasting health effects. There is a requirement for evidence-based policy on chronic respiratory disease associated with military deployments to areas with poor air quality (AQ). This literature review examines the published evidence relating to the development of chronic respiratory disease in military personnel after exposure to poor AQ while deployed. METHODS A literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Embase, MEDLINE and Global health databases were searched for English language studies published since 2014 examining the respiratory health of military personnel deployed to Southwest Asia since 2001. A quality appraisal of selected articles was conducted using the Critical Appraisals Skills Programme checklist and a descriptive review completed. RESULTS Eleven studies were found, eight of which had objective outcome measures. Two prospective cohort studies were included; the remainder of the data were retrospective. CONCLUSION High rates of respiratory symptoms are reported by personnel who deploy to areas of poor AQ, giving rise to high levels of concern. Spirometry testing has found mild deficits, mostly of an obstructive nature, in a third of those with ongoing symptoms post deployment. These have not been consistently linked with deployment length. An increased risk of asthma appears to be multi-factorial in aetiology and there is no evidence for an increased risk of chronic obstructive pulmonary disease or histological pathology post deployment. At present, there is no definitive evidence of chronic respiratory disease due to exposure to poor AQ while deployed. Further objective longitudinal studies are required to continue to investigate the association, diagnosis and management of those with ongoing symptoms.
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Affiliation(s)
| | - D Ross
- AMS Support Unit, Army Medical Services, Camberley, UK
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Mason A, Findlay-Cooper K, Holden G, Nevin W, Ross D, Lamb L. Facilitating future research and policy in PVL-associated Staphylococcus aureus in military cohorts. BMJ Mil Health 2023; 169:105-107. [PMID: 34266973 DOI: 10.1136/bmjmilitary-2020-001737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Aaron Mason
- AMS Support Unit, Army Medical Service, Camberley, UK
| | | | - G Holden
- HQ Surgeon General, Whittington Barracks, Defence Medical Services, Lichfield, UK
| | - W Nevin
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - D Ross
- AMS Support Unit, Army Medical Service, Camberley, UK
| | - L Lamb
- Academic Department of Military, Royal Centre for Defence Medicine, Birmingham, UK
- Department of Infectious Diseases, Imperial College London Faculty of Medicine, London, UK
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Sultan S, Ross D, Ioannou N, Betensley A, De Oliveira N. Total Cell-Free Dna May Reflect Non-Rejection Causes of Lung Allograft Injury. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1420] [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: 04/05/2023] Open
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Keller M, Ross D, Bhorade S, Agbor-Enoh S. Study Design for a Randomized Control Trial of Lung Allograft Monitoring with Blood Donor-Derived Cell-Free DNA Assessments (LAMBDA 001). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1398] [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: 04/05/2023] Open
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Zhang H, Sucato DJ, Ross D. A novel Hinge-Link correction system for vertebral column resection: a pilot study in a porcine model. Spine Deform 2023; 11:269-279. [PMID: 36422835 DOI: 10.1007/s43390-022-00617-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/12/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To introduce a novel Hinge-Link (HL) correction system for vertebral column resection (VCR) in the most severe scoliosis and surgically assess the device in a porcine scoliosis model. METHODS The HL was introduced and described how it works on a reproduced three-dimensional spine model of severe scoliosis. A right thoracic scoliosis was surgically created in five 4-month-old pigs. Two weeks later, the VCR was performed to correct the deformity using the HL to test its feasibility and neurological safety in the pig scoliosis model. RESULTS The surgically created right thoracic scoliosis averaged 32° ± 9.3 prior to the VCR. All animals tolerated the VCR procedure awakening neurologically intact and ambulated for 24 h. The HL takes advantage of the ability to provide three-dimensional correction of the deformity and excellent control of the spine segments to prevent damage to the spinal cord in the VCR procedure. The mean correction of the scoliosis was 94% correcting to 1.8° ± 0.8. At sacrifice, the pathological anatomy of the neural axis demonstrated no vertebral subluxation and no dural impingement in any animal. CONCLUSION The HL was feasible and neurologically safe for the VCR procedure in the pig scoliosis model. It can provide significant correction of the spinal deformity with appropriate mild shortening at the resected levels and overall lengthening without neurologic deficits. The rigid control of the spine segments provided by this device should allow for improved correction with decreased neurologic deficits and potentially shorter surgical time.
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Affiliation(s)
- Hong Zhang
- Scottish Rite for Children, 2222 Welborn St., Dallas, TX, 75219, USA.
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA.
| | - Daniel J Sucato
- Scottish Rite for Children, 2222 Welborn St., Dallas, TX, 75219, USA
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390, USA
| | - David Ross
- Scottish Rite for Children, 2222 Welborn St., Dallas, TX, 75219, USA
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Affiliation(s)
| | - S Banu Ozkan
- Department of Physics, Arizona State University, Phoenix, AZ, USA
| | - Liskin Swint-Kruse
- Department of Biochemistry and Molecular Biology, University of Kansas Medical Center, Kansas City, KS, USA
| | - David Ross
- National Institute of Standards and Technology, Gaithersburg, MD, USA
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Soares C, Kwok M, Boucher KA, Haji M, Echouffo-Tcheugui JB, Longenecker CT, Bloomfield GS, Ross D, Jutkowtiz E, Sullivan JL, Rudolph JL, Wu WC, Erqou S. Performance of Cardiovascular Risk Prediction Models Among People Living With HIV: A Systematic Review and Meta-analysis. JAMA Cardiol 2023; 8:139-149. [PMID: 36576812 PMCID: PMC9857084 DOI: 10.1001/jamacardio.2022.4873] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/20/2022] [Indexed: 12/29/2022]
Abstract
Importance Extant data on the performance of cardiovascular disease (CVD) risk score models in people living with HIV have not been synthesized. Objective To synthesize available data on the performance of the various CVD risk scores in people living with HIV. Data Sources PubMed and Embase were searched from inception through January 31, 2021. Study Selection Selected studies (1) were chosen based on cohort design, (2) included adults with a diagnosis of HIV, (3) assessed CVD outcomes, and (4) had available data on a minimum of 1 CVD risk score. Data Extraction and Synthesis Relevant data related to study characteristics, CVD outcome, and risk prediction models were extracted in duplicate. Measures of calibration and discrimination are presented in tables and qualitatively summarized. Additionally, where possible, estimates of discrimination and calibration measures were combined and stratified by type of risk model. Main Outcomes and Measures Measures of calibration and discrimination. Results Nine unique observational studies involving 75 304 people (weighted average age, 42 years; 59 490 male individuals [79%]) living with HIV were included. In the studies reporting these data, 86% were receiving antiretroviral therapy and had a weighted average CD4+ count of 449 cells/μL. Included in the study were current smokers (50%), patients with diabetes (5%), and patients with hypertension (25%). Ten risk prediction scores (6 in the general population and 4 in the HIV-specific population) were analyzed. Most risk scores had a moderate performance in discrimination (C statistic: 0.7-0.8), without a significant difference in performance between the risk scores of the general and HIV-specific populations. One of the HIV-specific risk models (Data Collection on Adverse Effects of Anti-HIV Drugs Cohort 2016) and 2 of the general population risk models (Framingham Risk Score [FRS] and Pooled Cohort Equation [PCE] 10 year) had the highest performance in discrimination. In general, models tended to underpredict CVD risk, except for FRS and PCE 10-year scores, which were better calibrated. There was substantial heterogeneity across the studies, with only a few studies contributing data for each risk score. Conclusions and Relevance Results of this systematic review and meta-analysis suggest that general population and HIV-specific CVD risk models had comparable, moderate discrimination ability in people living with HIV, with a general tendency to underpredict risk. These results reinforce the current recommendations provided by the American College of Cardiology/American Heart Association guidelines to consider HIV as a risk-enhancing factor when estimating CVD risk.
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Affiliation(s)
- Cullen Soares
- Department of Medicine, University of Maryland School of Medicine, Baltimore
| | - Michael Kwok
- Department of Medicine, Brown University, Providence, Rhode Island
| | - Kent-Andrew Boucher
- 27th Special Operations Medical Group, US Air Force, US Department of Defense, Cannon Air Force Base, Clovis, New Mexico
| | - Mohammed Haji
- Department of Medicine, Brown University, Providence, Rhode Island
| | - Justin B. Echouffo-Tcheugui
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Gerald S. Bloomfield
- Department of Medicine, Duke Clinical Research Institute, Duke Global Health Institute, Duke University, Durham, North Carolina
| | - David Ross
- Office of Specialty Care Service, US Department of Veterans Affairs, Washington, DC
- Infectious Disease Section, Washington DC Department of Veterans Affairs Medical Center, Washington, DC
| | - Eric Jutkowtiz
- Center of Innovation in Long Term Services & Supports, Providence VA Medical Center, Providence, Rhode Island
- Evidence Synthesis Program Center, Providence VA Health Care System, Providence, Rhode Island
- Brown University School of Public Health, Brown University, Providence, Rhode Island
| | - Jennifer L. Sullivan
- Center of Innovation in Long Term Services & Supports, Providence VA Medical Center, Providence, Rhode Island
- Brown University School of Public Health, Brown University, Providence, Rhode Island
| | - James L. Rudolph
- Department of Medicine, Brown University, Providence, Rhode Island
- Center of Innovation in Long Term Services & Supports, Providence VA Medical Center, Providence, Rhode Island
- Evidence Synthesis Program Center, Providence VA Health Care System, Providence, Rhode Island
- Brown University School of Public Health, Brown University, Providence, Rhode Island
- Department of Medicine, Providence VA Medical Center, Providence, Rhode Island
| | - Wen-Chih Wu
- Department of Medicine, Brown University, Providence, Rhode Island
- Center of Innovation in Long Term Services & Supports, Providence VA Medical Center, Providence, Rhode Island
- Brown University School of Public Health, Brown University, Providence, Rhode Island
- Department of Medicine, Providence VA Medical Center, Providence, Rhode Island
| | - Sebhat Erqou
- Department of Medicine, Brown University, Providence, Rhode Island
- Center of Innovation in Long Term Services & Supports, Providence VA Medical Center, Providence, Rhode Island
- Evidence Synthesis Program Center, Providence VA Health Care System, Providence, Rhode Island
- Department of Medicine, Providence VA Medical Center, Providence, Rhode Island
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Tack DS, Tonner PD, Pressman A, Olson ND, Levy SF, Romantseva EF, Alperovich N, Vasilyeva O, Ross D. Precision engineering of biological function with large-scale measurements and machine learning. PLoS One 2023; 18:e0283548. [PMID: 36989327 PMCID: PMC10057847 DOI: 10.1371/journal.pone.0283548] [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] [Received: 11/14/2022] [Accepted: 03/11/2023] [Indexed: 03/30/2023] Open
Abstract
As synthetic biology expands and accelerates into real-world applications, methods for quantitatively and precisely engineering biological function become increasingly relevant. This is particularly true for applications that require programmed sensing to dynamically regulate gene expression in response to stimuli. However, few methods have been described that can engineer biological sensing with any level of quantitative precision. Here, we present two complementary methods for precision engineering of genetic sensors: in silico selection and machine-learning-enabled forward engineering. Both methods use a large-scale genotype-phenotype dataset to identify DNA sequences that encode sensors with quantitatively specified dose response. First, we show that in silico selection can be used to engineer sensors with a wide range of dose-response curves. To demonstrate in silico selection for precise, multi-objective engineering, we simultaneously tune a genetic sensor's sensitivity (EC50) and saturating output to meet quantitative specifications. In addition, we engineer sensors with inverted dose-response and specified EC50. Second, we demonstrate a machine-learning-enabled approach to predictively engineer genetic sensors with mutation combinations that are not present in the large-scale dataset. We show that the interpretable machine learning results can be combined with a biophysical model to engineer sensors with improved inverted dose-response curves.
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Affiliation(s)
- Drew S Tack
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
| | - Peter D Tonner
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
| | - Abe Pressman
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
| | - Nathan D Olson
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
| | - Sasha F Levy
- SLAC National Accelerator Laboratory, Menlo Park, CA, United States of America
- Joint Initiative for Metrology in Biology, Stanford, CA, United States of America
| | - Eugenia F Romantseva
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
| | - Nina Alperovich
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
| | - Olga Vasilyeva
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
| | - David Ross
- National Institute of Standards and Technology, Gaithersburg, MD, United States of America
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Fonseca GA, Maier M, Keddem S, Borgerding J, Lowy E, McFarland L, Comstock E, Van Epps P, Ohl M, Hauser R, Ross D, Beste L. 2214. National Testing Assessment of Select Bacterial STIs During the COVID-19 Pandemic. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.1833] [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: 12/23/2022] Open
Abstract
Abstract
Background
Chlamydia, gonorrhea, and syphilis infections rose in the US for 6 consecutive years before the COVID-19 pandemic. Patterns of sexually transmitted infection (STI) testing during the COVID-19 pandemic have yet to be fully assessed.
Methods
We performed a retrospective study of STI testing in the Veteran’s Health Administration (VHA) healthcare system during each calendar year 2019-2021 using electronic health record data. We determined the number of chlamydia (CT) and gonorrhea (GC), and syphilis tests performed overall and in demographic groups defined by age, birth sex, self-reported race, region, and HIV status.
Results
VHA performed 202,503 CT tests, 201,314 GC tests and 250,790 syphilis tests in 2019, followed by a 23% and 25% decrease in 2020 for CT/GC and syphilis testing, respectively. We observed decreases among all subgroups defined by age, sex, race, and geography. Race groups with the biggest decreases in 2020 include Asian Americans (-28%) and Hawaiian and Pacific Islanders (-27%). By 2021, overall testing rates demonstrated a partial recovery to 89.8% of their 2019 levels. Testing rates in 2021 in rural/ highly rural residents remained 17% below baseline, compared with 10% for urban dwellers. Veterans living in the Northeast, South, or Midwest had the least recovery among geographic regions (16%, 11% and 11% below baseline, respectively). People with HIV experienced a decline in CT/GC testing of 15% but by the end of 2021 this had recovered to 1.9% below baseline. Women experienced both a steeper drop and a smaller recovery in CT and GC testing relative to men (Figure 1), except for women under age 25 (Figure 2). Figure 1STI testing rates by CY and sexFigure 2Percent change in STI testing rates versus 2019
Conclusion
After dramatic reductions in STI testing during the COVID-19 pandemic, rates returned to near-baseline levels nationally by 2021. Testing rates have lagged in some patient groups, most notably rural and highly rural populations, women, and Black and Asian American Veterans, placing them at risk for disparities in STI diagnosis, and therefore treatment. Testing rates in Veterans under age 25 years have reached or exceeded pre-pandemic levels.
Disclosures
All Authors: No reported disclosures.
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Affiliation(s)
| | - Marissa Maier
- Oregon Health and Sciences University , VA Portland Health Care System, Portland, Oregon
| | - Shimrit Keddem
- Michael J. Crescenz VA Medical Center , Philadelphia, Pennsylvania
| | | | | | - Lorenzo McFarland
- Office of Specialty Care Services, Veterans Health Administration , Washington D.C., District of Columbia
| | - Emily Comstock
- National HIV Testing and Care Quality Improvement Lead at HIV, Hepatitis , and Related Conditions (HHRC) Programs at VHA, Baltimore City, Maryland
| | - Puja Van Epps
- eterans Affairs Northeast Ohio Healthcare System, Case Western Reserve University School of Medicine , Cleveland, Ohio
| | - Michael Ohl
- Center for Access and Delivery Research and Evaluation (CADRE), Department of Medicine, University of Iowa Carver College of Medicine , Iowa City, Iowa
| | - Ronald Hauser
- Pathology and Laboratory Medicine Department, Veterans Affairs Connecticut Healthcare, Department of Laboratory Medicine, Yale University School of Medicine , New Haven, Connecticut
| | - David Ross
- Office of Specialty Care Services, Veterans Health Administration , Washington D.C., District of Columbia
| | - Lauren Beste
- VA Puget Sound Health Care System , Seattle, Washington
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Beste LA, Keddem S, Borgerding J, Lowy E, Gardella C, McFarland L, Comstock E, Fonseca GA, Van Epps P, Ohl M, Hauser RG, Ross D, Maier MM. Sexually Transmitted Infection Testing in the National Veterans Health Administration Patient Cohort During the Coronavirus Disease 2019 Pandemic. Open Forum Infect Dis 2022; 9:ofac433. [PMID: 36514443 PMCID: PMC9452156 DOI: 10.1093/ofid/ofac433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/21/2022] [Indexed: 12/15/2022] Open
Abstract
Background We performed a retrospective study of chlamydia, gonorrhea, syphilis, and human immunodeficiency virus (HIV) testing in the Veterans Health Administration (VHA) during 2019-2021. Methods We determined the annual number of chlamydia, gonorrhea, syphilis, and HIV tests from 2019 through 2021 using electronic health record data. We calculated rates by age, birth sex, race, census region, rurality, HIV status, and use of preexposure prophylaxis. Results The VHA system experienced a 24% drop in chlamydia/gonorrhea testing, a 25% drop in syphilis testing, and a 29% drop in HIV testing in 2020 versus 2019. By the conclusion of 2021, testing rates had recovered to 90% of baseline for chlamydia/gonorrhea, 91% for syphilis, and 88% for HIV. Declines and subsequent improvements in sexually transmitted infection (STI) testing occurred unequally across age, sex, race, and geographic groups. Testing for all 4 STIs in 2021 remained below baseline in rural Veterans. Excluding those aged <25 years, women experienced a steeper decline and slower recovery in chlamydia/gonorrhea testing relative to men, but quicker recovery in HIV testing. Asian Americans and Hawaiian/Pacific Islanders had a steeper decline and a slower recovery in testing for chlamydia/gonorrhea. Black and White Veterans had slower recovery in HIV testing compared with other race groups. People living with HIV experienced a smaller drop in testing for syphilis compared with people without HIV, followed by a near-total recovery of testing by 2021. Conclusions After dramatic reductions from 2019 to 2020, STI testing rates returned to near-baseline in 2021. Testing recovery lagged in rural, female, Asian American, Hawaiian/Pacific Islander, and Black Veterans.
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Affiliation(s)
- Lauren A Beste
- Correspondence: Lauren A. Beste, MD, MSc, VA Puget Sound Health Care System,1660 S Columbian Way, Seattle, WA 98108 ()
| | - Shimrit Keddem
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Veterans Affairs Center for Health Equity Research and Promotion, Philadelphia, Pennsylvania, USA
- Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Joleen Borgerding
- Health Services Research and Development, Veterans Affairs Puget Sound Healthcare System, Seattle, Washington, USA
| | - Elliott Lowy
- Health Services Research and Development, Veterans Affairs Puget Sound Healthcare System, Seattle, Washington, USA
- University of Washington School of Public Health, Seattle, Washington, USA
| | - Carolyn Gardella
- Gynecology Service, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Lorenzo McFarland
- Office of Specialty Care Services, Veterans Health Administration, Washington, District of Columbia, USA
| | - Emily Comstock
- Department of Infectious Diseases, Baltimore Veterans Affairs Medical Center, Baltimore, Maryland, USA
| | - Giuseppe Allan Fonseca
- Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Puja Van Epps
- Division of Infectious Diseases, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Veterans Affairs Northeast Ohio Healthcare System,Cleveland, Ohio, USA
| | - Michael Ohl
- Center for Access and Delivery Research and Evaluation, Iowa City Veterans Affairs, Iowa City, Iowa, USA
- Department of Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Ronald G Hauser
- Pathology and Laboratory Medicine Department, Veterans Affairs Connecticut Healthcare, New Haven, Connecticut, USA
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - David Ross
- Office of Specialty Care Services, Veterans Health Administration, Washington, District of Columbia, USA
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Ross D. Foreword to the Humanitarian and Disaster Relief Operations special issue of BMJ Military Health. BMJ Mil Health 2022; 168:405. [PMID: 37778872 DOI: 10.1136/military-2022-002254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 01/23/2023]
Affiliation(s)
- David Ross
- Health Unit, RAMC, Aldershot, Surrey, UK
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Falconer Hall T, Horne S, Ross D. Comparison between Defence Healthcare Engagement and humanitarian assistance. BMJ Mil Health 2022; 168:417-419. [PMID: 32217687 PMCID: PMC9685730 DOI: 10.1136/bmjmilitary-2020-001437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 11/03/2022]
Abstract
Humanitarian assistance and Defence Healthcare Engagement have traditionally both been taught on the Medical Humanitarian Stabilisation Operations Course. However, the two activities are distinct. This paper outlines the critical differences between them, focusing on their specific purposes, scope, timescales and ethics. Humanitarian assistance will remain a distinct activity with a focus on the relief of suffering, guided by international norms, while Defence Healthcare Engagement will encompass a broader range of activities, less constrained by internationally agreed principles. This presents an opportunity for the Defence Medical Services to directly contribute to projecting UK influence, preventing conflict and building stability. However, it requires the Defence Medical Services to take responsibility for the ethical issues that Defence Healthcare Engagement raises. This paper recommends the development of an ethical framework that reconciles the strategic aims of Defence Healthcare Engagement with maximising patient welfare at the tactical level. This is a paper commissioned as a part of the Humanitarian and Disaster Relief Operations special issue of BMJ Military Health.
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Affiliation(s)
| | - S Horne
- Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK
| | - D Ross
- Robertson House, Camberley, Surrey, UK
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Makin S, Ross D. Priorities of primary care in disaster medicine. BMJ Mil Health 2022; 168:444-448. [PMID: 35534017 DOI: 10.1136/bmjmilitary-2022-002115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 03/31/2022] [Indexed: 11/04/2022]
Abstract
The role of primary care in a disaster has too often been poorly defined and poorly understood. Due to its relative low-cost adaptability and closeness to the community, primary care can treat across multiple medical domains. By interacting with stakeholders from international data collection, state health bodies and secondary care to community groups, primary care can generate effect. Minimal standards are defined by Sphere guidelines to work within international, national and local frameworks. Evolution of the understanding of primary care in disaster medicine has resulted in a greater emphasis on maintaining outputs. In a disaster, effect is maximised by using strong local and wider resiliency frameworks to enable adaptation to new inputs and outputs while continuing continuity of care while moving through the disaster cycle. This is a paper commissioned as a part of the Humanitarian and Disaster Relief Operations special issue of BMJ Military Health.
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Affiliation(s)
- Seth Makin
- Academic Department of Military General Practice, Royal Centre for Defence Medicine, Birmingham, UK
| | - D Ross
- Army Health Unit, Royal Army Medical Corps, Camberley, UK
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