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Ajani J, El Hajbi F, Cunningham D, Alsina M, Thuss-Patience P, Scagliotti GV, Van den Eynde M, Kim SB, Kato K, Shen L, Li L, Ding N, Shi J, Barnes G, Van Cutsem E. Tislelizumab versus chemotherapy as second-line treatment for European and North American patients with advanced or metastatic esophageal squamous cell carcinoma: a subgroup analysis of the randomized phase III RATIONALE-302 study. ESMO Open 2024; 9:102202. [PMID: 38118368 PMCID: PMC10837773 DOI: 10.1016/j.esmoop.2023.102202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND The phase III RATIONALE-302 study evaluated tislelizumab, an anti-programmed cell death protein 1 antibody, as second-line (2L) treatment for advanced/metastatic esophageal squamous cell carcinoma (ESCC). This prespecified exploratory analysis investigated outcomes in patients from Europe and North America (Europe/North America subgroup). PATIENTS AND METHODS Patients with tumor progression during/after first-line systemic treatment were randomized 1 : 1 to open-label tislelizumab or investigator's choice of chemotherapy (paclitaxel, docetaxel, or irinotecan). RESULTS The Europe/North America subgroup comprised 108 patients (tislelizumab: n = 55; chemotherapy: n = 53). Overall survival (OS) was prolonged with tislelizumab versus chemotherapy (median: 11.2 versus 6.3 months), with a hazard ratio (HR) of 0.55 [95% confidence interval (CI) 0.35-0.87]; HR was similar irrespective of programmed death-ligand 1 score [≥10%: 0.47 (95% CI 0.18-1.21); <10%: 0.55 (95% CI 0.30-1.01)]. Median progression-free survival was 2.3 versus 2.7 months with tislelizumab versus chemotherapy [HR: 0.97 (95% CI 0.64-1.47)]. Overall response rate was greater with tislelizumab (20.0%) versus chemotherapy (11.3%), with more durable response (median duration of response: 5.1 versus 2.1 months). Tislelizumab had a favorable safety profile versus chemotherapy, with fewer patients experiencing ≥grade 3 treatment-related adverse events (13.0% versus 51.0%). Those on tislelizumab experienced less deterioration in health-related quality of life, physical functioning, and/or disease- and treatment-related symptoms (i.e. fatigue, pain, and eating problems) as compared to those on chemotherapy, per the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) and QLQ-OES18 scores. CONCLUSIONS As a 2L therapy for advanced/metastatic ESCC, tislelizumab improved OS and had a favorable safety profile as compared to chemotherapy in European/North American ESCC patients in the randomized phase III RATIONALE-302 study.
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Affiliation(s)
- J Ajani
- Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - F El Hajbi
- Department of Gastro-intestinal Oncology, Oscar Lambert Center, Lille, France
| | - D Cunningham
- Department of Oncology, Royal Marsden NHS Foundation Trust, London, UK
| | - M Alsina
- Department of Medical Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - P Thuss-Patience
- Department of Hematology, Oncology and Tumor Immunology, Campus Virchow-Klinikum, Charité-University Medicine Berlin, Berlin, Germany
| | - G V Scagliotti
- Department of Oncology, University of Torino, Orbassano, Torino, Italy
| | - M Van den Eynde
- Department of Medical Oncology and Hepato-gastroenterology, Institut Roi Albert II, Cliniques Universitaires Saint-Luc/Université Catholique De Louvain (Uclouvain), Brussels, Belgium
| | - S-B Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - K Kato
- Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - L Shen
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - L Li
- BeiGene, Ltd., Zhongguancun Life Science Park, Beijing, China
| | - N Ding
- BeiGene, Ltd., Zhongguancun Life Science Park, Beijing, China
| | - J Shi
- BeiGene, Ltd., Zhongguancun Life Science Park, Beijing, China
| | | | - E Van Cutsem
- Digestive Oncology, University Hospitals Gasthuisberg Leuven and KULeuven, Leuven, Belgium.
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Thapa R, Garikipati A, Ciobanu M, Singh NP, Browning E, DeCurzio J, Barnes G, Dinenno FA, Mao Q, Das R. Machine Learning Differentiation of Autism Spectrum Sub-Classifications. J Autism Dev Disord 2023:10.1007/s10803-023-06121-4. [PMID: 37751097 DOI: 10.1007/s10803-023-06121-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE Disorders on the autism spectrum have characteristics that can manifest as difficulties with communication, executive functioning, daily living, and more. These challenges can be mitigated with early identification. However, diagnostic criteria has changed from DSM-IV to DSM-5, which can make diagnosing a disorder on the autism spectrum complex. We evaluated machine learning to classify individuals as having one of three disorders of the autism spectrum under DSM-IV, or as non-spectrum. METHODS We employed machine learning to analyze retrospective data from 38,560 individuals. Inputs encompassed clinical, demographic, and assessment data. RESULTS The algorithm achieved AUROCs ranging from 0.863 to 0.980. The model correctly classified 80.5% individuals; 12.6% of individuals from this dataset were misclassified with another disorder on the autism spectrum. CONCLUSION Machine learning can classify individuals as having a disorder on the autism spectrum or as non-spectrum using minimal data inputs.
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Affiliation(s)
- R Thapa
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - A Garikipati
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - M Ciobanu
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - N P Singh
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - E Browning
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - J DeCurzio
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - G Barnes
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - F A Dinenno
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
| | - Q Mao
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA.
| | - R Das
- Montera, Inc dba Forta, 548 Market St, PMB 89605, San Francisco, CA, USA
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Yee WX, Barnes G, Lavender H, Tang CM. Meningococcal factor H-binding protein: implications for disease susceptibility, virulence, and vaccines. Trends Microbiol 2023; 31:805-815. [PMID: 36941192 PMCID: PMC10914675 DOI: 10.1016/j.tim.2023.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 03/23/2023]
Abstract
Neisseria meningitidis is a human-adapted pathogen that causes meningitis and sepsis worldwide. N. meningitidis factor H-binding protein (fHbp) provides a mechanism for immune evasion by binding human complement factor H (CFH) to protect it from complement-mediated killing. Here, we discuss features of fHbp which enable it to engage human CFH (hCFH), and the regulation of fHbp expression. Studies of host susceptibility and bacterial genome-wide association studies (GWAS) highlight the importance of the interaction between fHbp and CFH and other complement factors, such as CFHR3, on the development of invasive meningococcal disease (IMD). Understanding the basis of fHbp:CFH interactions has also informed the design of next-generation vaccines as fHbp is a protective antigen. Structure-informed refinement of fHbp vaccines will help to combat the threat posed by the meningococcus, and accelerate the elimination of IMD.
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Affiliation(s)
- Wearn-Xin Yee
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, UK
| | - Grace Barnes
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, UK
| | - Hayley Lavender
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, UK.
| | - Christoph M Tang
- Sir William Dunn School of Pathology, University of Oxford, South Parks Road, Oxford OX1 3RE, UK.
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Dooley KE, Hendricks B, Gupte N, Barnes G, Narunsky K, Whitelaw C, Smit T, Ignatius EH, Friedman A, Dorman SE, Dawson R. Assessing Pretomanid for Tuberculosis (APT), a Randomized Phase 2 Trial of Pretomanid-Containing Regimens for Drug-Sensitive Tuberculosis: 12-Week Results. Am J Respir Crit Care Med 2023; 207:929-935. [PMID: 36455068 DOI: 10.1164/rccm.202208-1475oc] [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: 08/04/2022] [Accepted: 11/30/2022] [Indexed: 12/02/2022] Open
Abstract
Rationale: Pretomanid is a new nitroimidazole with proven treatment-shortening efficacy in drug-resistant tuberculosis. Pretomanid-rifamycin-pyrazinamide combinations are potent in mice but have not been tested clinically. Rifampicin, but not rifabutin, reduces pretomanid exposures. Objectives: To evaluate the safety and efficacy of regimens containing pretomanid-rifamycin-pyrazinamide among participants with drug-sensitive pulmonary tuberculosis. Methods: A phase 2, 12-week, open-label randomized trial was conducted of isoniazid and pyrazinamide plus 1) pretomanid and rifampicin (arm 1), 2) pretomanid and rifabutin (arm 2), or 3) rifampicin and ethambutol (standard of care; arm 3). Laboratory values of safety and sputum cultures were collected at Weeks 1, 2, 3, 4, 6, 8, 10, and 12. Time to culture conversion on liquid medium was the primary outcome. Measurements and Main Results: Among 157 participants, 125 (80%) had cavitary disease. Median time to liquid culture negativity in the modified intention-to-treat population (n = 150) was 42 (arm 1), 28 (arm 2), and 56 (arm 3) days (P = 0.01) (adjusted hazard ratio for arm 1 vs. arm 3, 1.41 [95% confidence interval (CI), 0.93-2.12; P = 0.10]; adjusted hazard ratio for arm 2 vs. arm 3, 1.89 [95% CI, 1.24-2.87; P = 0.003]). Eight-week liquid culture conversion was 79%, 89%, and 69%, respectively. Grade ≥3 adverse events occurred in 3 of 56 (5%), 5 of 53 (9%), and 2 of 56 (4%) participants. Six participants were withdrawn because of elevated transaminase concentrations (five in arm 2, one in arm 1). There were three serious adverse events (arm 2) and no deaths. Conclusions: Pretomanid enhanced the microbiologic activity of regimens containing a rifamycin and pyrazinamide. Efficacy and hepatic adverse events appeared highest with the pretomanid and rifabutin-containing regimen. Whether this is due to higher pretomanid concentrations merits exploration. Clinical trial registered with www.clinicaltrials.gov (NCT02256696).
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Affiliation(s)
- Kelly E Dooley
- Vanderbilt University Medical Center, Nashville, Tennessee
| | - Bronwyn Hendricks
- Division of Pulmonology, Department of Medicine and University of Cape Town Lung Institute, University of Cape Town, Cape Town, South Africa
| | - Nikhil Gupte
- Johns Hopkins India Private Limited, Pune, India
| | - Grace Barnes
- School of Medicine, Johns Hopkins University, Baltimore, Maryland; and
| | - Kim Narunsky
- Division of Pulmonology, Department of Medicine and University of Cape Town Lung Institute, University of Cape Town, Cape Town, South Africa
| | - Colleen Whitelaw
- Division of Pulmonology, Department of Medicine and University of Cape Town Lung Institute, University of Cape Town, Cape Town, South Africa
| | - Tanya Smit
- Division of Pulmonology, Department of Medicine and University of Cape Town Lung Institute, University of Cape Town, Cape Town, South Africa
| | - Elisa H Ignatius
- School of Medicine, Johns Hopkins University, Baltimore, Maryland; and
| | - Adine Friedman
- Division of Pulmonology, Department of Medicine and University of Cape Town Lung Institute, University of Cape Town, Cape Town, South Africa
| | - Susan E Dorman
- Medical University of South Carolina, Charleston, South Carolina
| | - Rodney Dawson
- Division of Pulmonology, Department of Medicine and University of Cape Town Lung Institute, University of Cape Town, Cape Town, South Africa
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Kim SB, Van Cutsem E, Ajani J, Shen L, Barnes G, Ding N, Tao A, Xia T, Zhan L, Kato K. 80P RATIONALE-302: Tislelizumab vs chemotherapy as second-line treatment for patients with advanced or metastatic esophageal squamous cell carcinoma (ESCC): Impact on health-related quality of life (HRQoL) in Asian patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.116] [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: 12/07/2022] Open
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6
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Vivekananda U, Mellor S, Tierney T, Aristovich K, Barnes G, Walker M. Future approaches to seizure source localisation using optically pumped magnetoencephalography and electrical impedance tomography. J Neurol Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn2.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A third of patients with epilepsy are drug resistant, and epilepsy surgery (i.e. removal of the brain epilepsy focus) may present a powerful alternative in achieving seizure freedom. Magnetoencephalography (MEG) has been increasingly used in identifying the epilepsy focus due to its inherent properties of high spatial resolution and relative immunity to muscle artefact. However current MEG systems are cumbersome and restrictive for the patient, meaning that recording sessions are usually brief (1-2 hours). Here we demon- strate the first use of Optically Pumped Magnetoencephalography (OP-MEG) worldwide in three epilepsy patients with unrestricted head movement. We use a different type of sensor, which operates at room temperature and can be placed directly on the patient’s scalp, permitting free head movement. We show that OP-MEG could reliably identify abnormal epileptiform activity, even in cases where EEG could not, and localise this activity to the abnormal brain region.In patients who undergo intracranial EEG i.e. electrodes surgically placed within the brain, we have also demonstrated the first use of Electrical Impedance Tomography (EIT), a method for producing images of the internal electrical impedance of a subject due to nerve cell swelling. This method can produce images of seizure propagation similar to fMRI, but can be recorded continuously at any time during presurgical video-telemetry. Both methods have the potential to revolutionise how functional imaging is performed in epilepsy.
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7
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Van Cutsem E, Kato K, Ajani J, Shen L, Xia T, Ding N, Zhan L, Barnes G, Kim SB. Tislelizumab versus chemotherapy as second-line treatment of advanced or metastatic esophageal squamous cell carcinoma (RATIONALE 302): impact on health-related quality of life. ESMO Open 2022; 7:100517. [PMID: 35785595 PMCID: PMC9434166 DOI: 10.1016/j.esmoop.2022.100517] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 12/05/2022] Open
Abstract
Background RATIONALE 302 (NCT03430843) an open-label, phase III study of second-line treatment of advanced/metastatic esophageal squamous cell carcinoma (ESCC), reported that tislelizumab, relative to investigator-chosen chemotherapy (ICC), was associated with improvements in overall survival and a favorable safety profile. This study assessed the health-related quality of life (HRQoL) and ESCC-related symptoms of patients in RATIONALE 302. Methods Adults with advanced/metastatic ESCC whose disease progressed following prior systemic therapy were randomized 1 : 1 to receive either tislelizumab or ICC (paclitaxel, docetaxel, or irinotecan). HRQoL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 items (EORTC QLQ-C30), the EORTC Quality of Life Questionnaire Oesophageal Cancer Module 18 items (QLQ-OES18), and the EuroQoL Five-Dimensions Five-Levels (EQ-5D-5L) visual analogue scale. Mixed effect modeling for repeated measurements examined changes from baseline to weeks 12 and 18. The Kaplan–Meier method was used to examine time to deterioration. Results Overall, 512 patients were randomized to tislelizumab (n = 256) or ICC (n = 256). The tislelizumab arm maintained QLQ-C30 global health status/quality whereas the ICC arm worsened at week 12 {difference in least square (LS) mean change: 5.8 [95% confidence interval (CI): 2.0-9.5], P = 0.0028} and week 18 [difference in LS mean change: 8.1 (95% CI: 3.4-12.8), P = 0.0008]. Physical functioning (week 18) and fatigue (weeks 12 and 18) worsened less in the tislelizumab compared with the ICC arm. The tislelizumab arm improved in reflux symptoms, whereas the ICC worsened at week 12 [difference in LS mean change: −4.1 (95% CI: −7.6 to −0.6), P = 0.0229]. The visual analogue scale remained consistent in the tislelizumab arm whereas it worsened in the ICC arm. The hazard of time to deterioration was lower in tislelizumab patients compared with ICC for physical functioning and reflux. Conclusions HRQoL, including fatigue symptoms and physical functioning, was maintained in patients with advanced or metastatic ESCC receiving tislelizumab compared with ICC-treated patients. These results provide additional support for the benefits of tislelizumab in this patient population. Global health status and HRQoL remained consistent in the tislelizumab arm whereas the ICC arm experienced worsening. Fatigue and physical functioning worsened in both arms; however, the worsening was greater in the ICC arm. The tislelizumab arm was at lower risk of reaching the threshold for worsening in physical functioning and reflux.
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Affiliation(s)
- E Van Cutsem
- University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium.
| | - K Kato
- National Cancer Center Hospital, Tokyo, Japan
| | - J Ajani
- University of Texas MD Anderson Cancer Center, Houston, USA
| | - L Shen
- Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China
| | - T Xia
- BeiGene, Ltd., Cambridge, USA
| | - N Ding
- BeiGene (Shanghai) Co., Ltd., Shanghai, China
| | - L Zhan
- BeiGene, Ltd., Emeryville, USA
| | | | - S-B Kim
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Wang J, Yu X, Barnes G, Leaw S, Bao Y, Tang B. The effects of tislelizumab plus chemotherapy as first-line treatment on health-related quality of life of patients with advanced squamous non-small cell lung cancer: Results from a phase 3 randomized clinical trial. Cancer Treat Res Commun 2021; 30:100501. [PMID: 34952253 DOI: 10.1016/j.ctarc.2021.100501] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study assessed the effects of adding tislelizumab to first-line standard-of- care chemotherapy on the health-related quality of life (HRQoL) of patients with advanced squamous non-small cell lung cancer (sq-NSCLC). PATIENTS AND METHODS Patients in this open-label, multicenter, phase 3 RATIONALE 307 trial were randomized to one of the three arms: tislelizumab plus carboplatin and paclitaxel (Arm A), tislelizumab plus carboplatin and nab-paclitaxel (Arm B), or paclitaxel plus carboplatin (Arm C). HRQoL was measured using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the EORTC Quality of Life Questionnaire Lung Cancer 13-item module (QLQ-LC13). Mean score change from baseline at Weeks 6 and 12 in the QLQ-C30's global health status/quality of life (GHS/QoL), fatigue, and physical functioning scores and QLQ-LC13 lung cancer specific subscales were examined. Time to deterioration was estimated for the GHS/QoL score. RESULTS A total of 355 sq-NSCLC patients received at least one dose of study drug and completed at least one HRQoL assessment. The GHS/QoL scores improved in Arms A and B relative to Arm C at Weeks 6 and 12. Arms A and B also experienced a reduction in most lung cancer-specific symptoms relative to Arm C. Time to deterioration of GHS/QoL was not reached by any of the three arms. CONCLUSIONS The addition of tislelizumab to platinum-based chemotherapy is associated with improvements in sq-NSCLC patients' HRQoL, especially in GHS/QoL and most importantly in lung cancer-specific symptoms including coughing, dyspnea, and hemoptysis.
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Affiliation(s)
- J Wang
- Department of Parenteral and Enteral Nutrition, State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - X Yu
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - G Barnes
- Health Economics and Outcomes Research, BeiGene, Ltd., Emeryville, CA, USA
| | - S Leaw
- Clinical Development, BeiGene (Shanghai) Co., Ltd., Shanghai, China
| | - Y Bao
- Clinical Development, BeiGene (Shanghai) Co., Ltd., Shanghai, China
| | - B Tang
- Health Economics and Outcomes Research, BeiGene, Ltd., Emeryville, CA, USA
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9
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Neumann JT, Sorenson NA, McCarthy CP, Magaret CA, Rhyne RF, Peters CC, Barnes G, Defilippi CR, Westermann D, Januzzi JL. A pooled multi-national validation study of a machine learning, high-sensitivity troponin-based multi-proteomic model to predict the presence of obstructive coronary artery disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Undetected obstructive coronary artery disease (oCAD) is a global health problem associated with significant morbidity and mortality. A need exists for an accurate and easily accessible diagnostic test for oCAD. Using machine learning, a multi-biomarker blood diagnostic test for oCAD based on high-sensitivity cardiac troponin-I (hs-cTnI) has been developed.
Purpose
To validate the performance of a previously developed, algorithmically weighted, multiple protein diagnostic panel to diagnose oCAD in a pooled multi-national cohort and to compare the diagnostic panel's performance to predict oCAD to hs-cTnI alone.
Methods
Three clinical factors (sex, age, and previous coronary percutaneous intervention) and three biomarkers (hs-cTnI, Adiponectin, and Kidney Injury Molecule-1) were combined. hs-cTnI blood samples were assayed on the Siemens Atellica and Abbott Diagnostics ARCHITECT immunoassay platforms. Adiponectin and Kidney Injury Molecule-1 were measured with a multiplex assay on blood samples via the Luminex 100/200 xMAP platform. Individual data from a total of 924 patients with a mixture of acute and lesser acute presentations from three centers were pooled (Table 1). oCAD was defined as >50% coronary obstruction in at least one coronary artery (for the University Hospital Hamburg-Eppendorf cohort) or >70% coronary obstruction in at least one coronary artery (for the other two cohorts). The multiple biomarker diagnostic panel's performance to predict oCAD was also compared to hs-cTnI alone.
Results
The multiple protein panel had an area under the receiver-operating characteristic curve of 0.80 (95% CI, 0.77, 0.83, p<0.001) for the presence of oCAD (Figure 1). At optimal cutoff, the score had 74% sensitivity, 72% specificity, and a positive predictive value of 81% for oCAD. The multiple biomarker panel had a diagnostic odds ratio of 7.48 (95% CI 5.55, 10.09, p<0.001). In comparison, in patients without an acute MI, hs-cTnI alone had an area under the receiver-operating characteristic curve of 0.63 (95% CI, 0.60, 0.67, p<0.001)) for oCAD (Figure 1).
Conclusions
In this multinational pooled cohort, a previously described novel machine learning, multiple biomarker panel provided high accuracy to diagnose patients for oCAD.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Prevencio, Inc. Table 1. Pooled Variable DataFigure 1. ROC for HART CADhs and hs-cTnI
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Affiliation(s)
- J T Neumann
- University Heart & Vascular Center Hamburg, Cardiology, Hamburg, Germany, Germany
| | - N A Sorenson
- University Heart & Vascular Center Hamburg, Cardiology, Hamburg, Germany, Germany
| | - C P McCarthy
- Massachusetts General Hospital, Medicine, Division of Cardiology, Boston, United States of America
| | - C A Magaret
- Prevencio, Inc., Kirkland, United States of America
| | - R F Rhyne
- Prevencio, Inc., Kirkland, United States of America
| | - C C Peters
- Prevencio, Inc., Kirkland, United States of America
| | - G Barnes
- Prevencio, Inc., Kirkland, United States of America
| | - C R Defilippi
- Inova Heart and Vascular Institute, Falls Church, VA, United States of America
| | - D Westermann
- University Heart & Vascular Center Hamburg, Cardiology, Hamburg, Germany, Germany
| | - J L Januzzi
- Massachusetts General Hospital, Medicine, Division of Cardiology, Boston, United States of America
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O'Hare C, Grace K, Schaeffer W, Cranford J, Kocher K, Barnes G, Greineder C. 268 Impact of Concerning Computed Tomagraphy Imaging Findings on the Management and Outcomes of Acute Emergency Department Pulmonary Embolism With Low-Risk Stratification Scores. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Van den Bruel A, Verbakel J, Wang K, Fleming S, Holtman G, Glogowska M, Morris E, Edwards G, Abakar Ismail F, Curtis K, Goetz J, Barnes G, Slivkova R, Nesbitt C, Aslam S, Swift E, Williams H, Hayward G. Non-contact infrared thermometers compared with current approaches in primary care for children aged 5 years and under: a method comparison study. Health Technol Assess 2021; 24:1-28. [PMID: 33111663 DOI: 10.3310/hta24530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Current options for temperature measurement in children presenting to primary care include either electronic axillary or infrared tympanic thermometers. Non-contact infrared thermometers could reduce both the distress of the child and the risk of cross-infection. OBJECTIVES The objective of this study was to compare the use of non-contact thermometers with the use of electronic axillary and infrared tympanic thermometers in children presenting to primary care. DESIGN Method comparison study with a nested qualitative study. SETTING Primary care in Oxfordshire. PARTICIPANTS Children aged ≤ 5 years attending with an acute illness. INTERVENTIONS Two types of non-contact infrared thermometers [i.e. Thermofocus (Tecnimed, Varese, Italy) and Firhealth (Firhealth, Shenzhen, China)] were compared with an electronic axillary thermometer and an infrared tympanic thermometer. MAIN OUTCOME MEASURES The primary outcome was agreement between the Thermofocus non-contact infrared thermometer and the axillary thermometer. Secondary outcomes included agreement between all other sets of thermometers, diagnostic accuracy for detecting fever, parental and child ratings of acceptability and discomfort, and themes arising from our qualitative interviews with parents. RESULTS A total of 401 children (203 boys) were recruited, with a median age of 1.6 years (interquartile range 0.79-3.38 years). The readings of the Thermofocus non-contact infrared thermometer differed from those of the axillary thermometer by -0.14 °C (95% confidence interval -0.21 to -0.06 °C) on average with the lower limit of agreement being -1.57 °C (95% confidence interval -1.69 to -1.44 °C) and the upper limit being 1.29 °C (95% confidence interval 1.16 to 1.42 °C). The readings of the Firhealth non-contact infrared thermometer differed from those of the axillary thermometer by -0.16 °C (95% confidence interval -0.23 to -0.09 °C) on average, with the lower limit of agreement being -1.54 °C (95% confidence interval -1.66 to -1.41 °C) and the upper limit being 1.22 °C (95% confidence interval 1.10 to 1.34 °C). The difference between the first and second readings of the Thermofocus was -0.04 °C (95% confidence interval -0.07 to -0.01 °C); the lower limit was -0.56 °C (95% confidence interval -0.60 to -0.51 °C) and the upper limit was 0.47 °C (95% confidence interval 0.43 to 0.52 °C). The difference between the first and second readings of the Firhealth thermometer was 0.01 °C (95% confidence interval -0.02 to 0.04 °C); the lower limit was -0.60 °C (95% confidence interval -0.65 to -0.54 °C) and the upper limit was 0.61 °C (95% confidence interval 0.56 to 0.67 °C). Sensitivity and specificity for the Thermofocus non-contact infrared thermometer were 66.7% (95% confidence interval 38.4% to 88.2%) and 98.0% (95% confidence interval 96.0% to 99.2%), respectively. For the Firhealth non-contact infrared thermometer, sensitivity was 12.5% (95% confidence interval 1.6% to 38.3%) and specificity was 99.4% (95% confidence interval 98.0% to 99.9%). The majority of parents found all methods to be acceptable, although discomfort ratings were highest for the axillary thermometer. The non-contact thermometers required fewer readings than the comparator thermometers. LIMITATIONS A method comparison study does not compare new methods against a reference standard, which in this case would be central thermometry requiring the placement of a central line, which is not feasible or acceptable in primary care. Electronic axillary and infrared tympanic thermometers have been found to have moderate agreement themselves with central temperature measurements. CONCLUSIONS The 95% limits of agreement are > 1 °C for both non-contact infrared thermometers compared with electronic axillary and infrared tympanic thermometers, which could affect clinical decision-making. Sensitivity for fever was low to moderate for both non-contact thermometers. FUTURE WORK Better methods for peripheral temperature measurement that agree well with central thermometry are needed. TRIAL REGISTRATION Current Controlled Trials ISRCTN15413321. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 53. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ann Van den Bruel
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,Academic Centre for Primary Care, University of Leuven, Leuven, Belgium
| | - Jan Verbakel
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,Academic Centre for Primary Care, University of Leuven, Leuven, Belgium
| | - Kay Wang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Susannah Fleming
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Gea Holtman
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Margaret Glogowska
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Elizabeth Morris
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - George Edwards
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Fatene Abakar Ismail
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Kathryn Curtis
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - James Goetz
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Grace Barnes
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ralitsa Slivkova
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Charlotte Nesbitt
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Suhail Aslam
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ealish Swift
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Harriet Williams
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Gail Hayward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Ren Z, Assenat E, Rimassa L, Fang W, Tang B, Chica Duque S, Li V, Wu J, Wang Y, Barnes G. 936P Effects of tislelizumab (TIS) monotherapy on health-related quality of life in patients with previously treated unresectable hepatocellular carcinoma (HCC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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13
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Lu S, Yu Y, Barnes G, Qiu X, Bao Y, Li J, Tang B. MO01.43 Examining the Impact of Tislelizumab Added to Platinum Doublet Chemotherapy on Health-Related Quality of Life in Patients with Non-Squamous NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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14
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Wang J, Yu X, Barnes G, Li J, Leaw S, Lin X, Tang B. MO01.50 Tislelizumab Plus Standard Chemotherapy for Treatment of Advanced Squamous Non-Small Cell Lung Cancer: Patients’ Health Related Quality of Life. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Fredericksen RJ, Harding BN, Ruderman SA, McReynolds J, Barnes G, Lober WB, Fitzsimmons E, Nance RM, Whitney BM, Delaney JAC, Mathews WC, Willig J, Crane PK, Crane HM. Patient acceptability and usability of a self-administered electronic patient-reported outcome assessment in HIV care: relationship with health behaviors and outcomes. AIDS Care 2020; 33:1167-1177. [PMID: 33190523 DOI: 10.1080/09540121.2020.1845288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We assessed acceptability/usability of tablet-based patient-reported outcome (PRO) assessments among patients in HIV care, and relationships with health outcomes using a modified Acceptability E-Scale (AES) within a self-administered PRO assessment. Using multivariable linear regression, we measured associations between patient characteristics and continuous combined AES score. Among 786 patients (median age=48; 91% male; 49% white; 17% Spanish-speaking) overall mean score was 26/30 points (SD: 4.4). Mean scores per dimension (max 5, 1=lowest acceptability, 5=highest): ease of use 4.7, understandability 4.7, time burden 4.3, overall satisfaction 4.3, helpfulness describing symptoms/behaviors 4.2, and enjoyability 3.8. Higher overall score was associated with race/ethnicity (+1.3 points/African-American patients (95%CI:0.3-2.3); +1.6 points/Latino patients (95%CI:0.9-2.3) compared to white patients). Patients completing PROs in Spanish scored +2.4 points on average (95%CI:1.6-3.3). Higher acceptability was associated with better quality of life (0.3 points (95%CI:0.2-0.5)) and adherence (0.4 points (95%CI:0.2-0.6)). Lower acceptability was associated with: higher depression symptoms (-0.9 points (95%CI:-1.4 to -0.4)); recent illicit opioid use (-2.0 points (95%CI:-3.9 to -0.2)); multiple recent sex partners (-0.8 points (95%CI:-1.5 to -0.1)). While patients endorsing depression symptoms, recent opioid use, condomless sex, or multiple sex partners found PROs less acceptable, overall, patients found the assessments highly acceptable and easy to use.
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Affiliation(s)
| | | | | | | | - G Barnes
- University of Washington, Seattle, WA, USA
| | - W B Lober
- University of Washington, Seattle, WA, USA
| | | | - R M Nance
- University of Washington, Seattle, WA, USA
| | | | | | - W C Mathews
- University of California at San Diego, San Diego, CA, USA
| | - J Willig
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - P K Crane
- University of Washington, Seattle, WA, USA
| | - H M Crane
- University of Washington, Seattle, WA, USA
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16
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Rajakulasingam R, Nielles-Vallespin S, Ferreira P, Scott A, Khalique Z, Rogers P, Barnes G, Tindale A, Prendergast C, Cantor E, Wage R, Dalby M, Firmin D, Pennell D, De Silva R. Diffusion tensor cardiovascular magnetic resonance detects altered myocardial microstructure in patients with acute st-elevation myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Diffusion Tensor Cardiovascular Magnetic Resonance (DT-CMR) can quantify metrics of tissue integrity (mean diffusivity [MD] and fractional anisotropy [FA]) and changes in laminar microstructures (sheetlets), which reorientate from more wall-parallel in diastole (DIA) towards wall-perpendicular in systole (SYS) as the myocardium thickens, quantified by E2 angle [E2A]. Microstructural changes after STEMI may provide new insights into adverse LV remodelling and risk stratification.
Methods
In vivo DT-CMR was performed 3–5 days after PPCI for first presentation STEMI (N=19, mean age 57±9, 79% male). DT-CMR was acquired in 2 short-axes (SYS & DIA) using a STEAM-EPI sequence. 12 segment analysis of MD, FA, E2A and E2A mobility (ΔE2A = E2ASYS − E2ADIA) was performed. Infarct (INF) segments were defined as >25% LGE, adjacent (ADJ, located contiguous to INF) and remote (REM, all other segments). Wilcoxon signed rank tests were used with threshold P<0.017 (Bonferroni corrected).
Results
See Table.
MD in both SYS and DIA was significantly higher in INF and ADJ regions compared to REM. FA in both SYS and DIA was lower in the INF and ADJ compared to REM. E2ADIA was higher in INF, indicating a more wall-perpendicular orientation of sheetlets, compared to ADJ and REM zones. E2ASYS in INF was significantly reduced, indicating a more wall-parallel orientation of sheetlets, compared to ADJ and REM regions, resulting in significantly reduced sheetlet mobility (ΔE2A).
Conclusions
Microstructural changes can be detected after acute STEMI by in vivo DT-CMR. Zonal changes in MD and FA may suggest loss of barriers to water diffusion and altered cardiomyocyte organisation, respectively. We provide the first report of reduced sheetlet mobility after acute STEMI in INF. Ongoing work is evaluating the mechanisms and prognostic importance of altered sheetlet mobility after STEMI.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): British Heart Foundation Clinical Research Training Fellowship
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Affiliation(s)
- R Rajakulasingam
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - S Nielles-Vallespin
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | | | - A.D Scott
- Royal Brompton Hospital, London, United Kingdom
| | - Z Khalique
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - P Rogers
- Harefield Hospital, Cardiology, London, United Kingdom
| | - G Barnes
- Harefield Hospital, Cardiology, London, United Kingdom
| | - A Tindale
- Harefield Hospital, Cardiology, London, United Kingdom
| | - C Prendergast
- Harefield Hospital, Cardiology, London, United Kingdom
| | - E Cantor
- Royal Brompton Hospital, London, United Kingdom
| | - R Wage
- Royal Brompton Hospital, London, United Kingdom
| | - M Dalby
- Harefield Hospital, Cardiology, London, United Kingdom
| | - D.N Firmin
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - D.J Pennell
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - R De Silva
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
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Schultz J, Giordano N, Zheng H, Parry B, Barnes G, Kabrhel C. 377 A Multidisciplinary Pulmonary Embolism Response Team: Experience From the National Pulmonary Embolism Response Team Consortium Multicenter Registry. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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18
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McCarthy C, Shrestha S, Ibrahim NE, Van Kimmenade R, Gaggin HK, Mukai R, Magaret CA, Barnes G, Rhyne R, Garasic JM, Januzzi JL. P732Performance of a clinical/proteomic panel to predict obstructive peripheral artery disease in patients with and without diabetes mellitus. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C McCarthy
- Massachusetts General Hospital, Medicine, Boston, United States of America
| | - S Shrestha
- Massachusetts General Hospital, Medicine, Boston, United States of America
| | - N E Ibrahim
- Massachusetts General Hospital, Medicine, Boston, United States of America
| | - R Van Kimmenade
- Maastricht University Medical Centre (MUMC), Maastricht, Netherlands
| | - H K Gaggin
- Massachusetts General Hospital, Medicine, Boston, United States of America
| | - R Mukai
- Massachusetts General Hospital, Medicine, Boston, United States of America
| | - C A Magaret
- Prevencio, Inc, Kirkland, United States of America
| | - G Barnes
- Prevencio, Inc, Kirkland, United States of America
| | - R Rhyne
- Prevencio, Inc, Kirkland, United States of America
| | - J M Garasic
- Massachusetts General Hospital, Medicine, Boston, United States of America
| | - J L Januzzi
- Massachusetts General Hospital, Medicine, Boston, United States of America
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19
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Eisenberger M, Hardy-Bessard AC, Kim C, Géczi L, Ford D, Mourey L, Carles J, Parente P, Font A, Kacsó G, Barnes G, Wang H, Zhang W, Ozatilgan A, de Bono J. Assessment of health-related quality of life (HRQL) in PROSELICA: A Phase 3 trial assessing cabazitaxel 20 mg/m2 (C20) vs 25 mg/m2 (C25) in post-docetaxel (D) patients (pts) with metastatic castration-resistant prostate cancer (mCRPC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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20
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Pichler A, Barnes G, Katolicka J, Korunkova H, Tomova A, Ghosn M, El Karak F, Koroleva I, Makdessi J, Ozatilgan A, Hitier S, Carles J. Health-related quality of life (HRQL) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) treated with cabazitaxel (CBZ) in a prospective observational study (CAPRISTANA). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx370.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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21
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Gilchrist SA, Braun DC, Barnes G. A Fixed-point Scheme for the Numerical Construction of Magnetohydrostatic Atmospheres in Three Dimensions. Sol Phys 2016; 291:3583-3603. [PMID: 29670304 PMCID: PMC5902051 DOI: 10.1007/s11207-016-0992-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 09/03/2016] [Indexed: 06/08/2023]
Abstract
Magnetohydrostatic models of the solar atmosphere are often based on idealized analytic solutions because the underlying equations are too difficult to solve in full generality. Numerical approaches, too, are often limited in scope and have tended to focus on the two-dimensional problem. In this article we develop a numerical method for solving the nonlinear magnetohydrostatic equations in three dimensions. Our method is a fixed-point iteration scheme that extends the method of Grad and Rubin (Proc. 2nd Int. Conf. on Peaceful Uses of Atomic Energy31, 190, 1958) to include a finite gravity force. We apply the method to a test case to demonstrate the method in general and our implementation in code in particular.
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Affiliation(s)
- S A Gilchrist
- NorthWest Research Associates (NWRA), 3380 Mitchell Ln., Boulder, CO 80301, USA
| | - D C Braun
- NorthWest Research Associates (NWRA), 3380 Mitchell Ln., Boulder, CO 80301, USA
| | - G Barnes
- NorthWest Research Associates (NWRA), 3380 Mitchell Ln., Boulder, CO 80301, USA
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22
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Packham B, Barnes G, Dos Santos GS, Aristovich K, Gilad O, Ghosh A, Oh T, Holder D. Empirical validation of statistical parametric mapping for group imaging of fast neural activity using electrical impedance tomography. Physiol Meas 2016; 37:951-67. [PMID: 27203477 PMCID: PMC5717540 DOI: 10.1088/0967-3334/37/6/951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Electrical impedance tomography (EIT) allows for the reconstruction of internal conductivity from surface measurements. A change in conductivity occurs as ion channels open during neural activity, making EIT a potential tool for functional brain imaging. EIT images can have >10 000 voxels, which means statistical analysis of such images presents a substantial multiple testing problem. One way to optimally correct for these issues and still maintain the flexibility of complicated experimental designs is to use random field theory. This parametric method estimates the distribution of peaks one would expect by chance in a smooth random field of a given size. Random field theory has been used in several other neuroimaging techniques but never validated for EIT images of fast neural activity, such validation can be achieved using non-parametric techniques. Both parametric and non-parametric techniques were used to analyze a set of 22 images collected from 8 rats. Significant group activations were detected using both techniques (corrected p < 0.05). Both parametric and non-parametric analyses yielded similar results, although the latter was less conservative. These results demonstrate the first statistical analysis of such an image set and indicate that such an analysis is an approach for EIT images of neural activity.
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Affiliation(s)
- B Packham
- Department of Medical Physics & Bioengineering, University College London, UK
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23
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DeRosa ML, Wheatland MS, Leka KD, Barnes G, Amari T, Canou A, Gilchrist SA, Thalmann JK, Valori G, Wiegelmann T, Schrijver CJ, Malanushenko A, Sun X, Régnier S. THE INFLUENCE OF SPATIAL RESOLUTION ON NONLINEAR FORCE-FREE MODELING. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/0004-637x/811/2/107] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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24
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Kruse MM, Wildner R, Barnes G, Martin M, Mueller U, Lo Coco F, Leyman S, Pathak A. Cost of Treating Acute Promyelocytic Leukemia (APL) Patients in Italy. Value Health 2014; 17:A624. [PMID: 27202202 DOI: 10.1016/j.jval.2014.08.2218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | | | - G Barnes
- Teva Pharmaceutical, 19355, PA, USA
| | - M Martin
- OptumInsight, Uxbridge, Middlesex, UK
| | - U Mueller
- Teva Pharmaceutical, Ehrenkirchen, Germany
| | - F Lo Coco
- University Tor Vergata, Rome, PA, USA
| | - S Leyman
- TEVA Pharmaceuticals Europe, Amsterdam, The Netherlands
| | - A Pathak
- Teva Pharmaceutical, 19355, PA, USA
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25
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Ito N, Tamaki N, Masuno A, Ikeno K, Onishi S, Kobayashi N, Takei H, Olley P, Chiba S, Inoue K, Barnes G, Fukushima K, Warabi T. Comparison of smooth pursuit eye movement (SPEM) in patients with idiopathic Parkinson'/INS;s disease (PD) and progressive supranuclear palsy (PSP). J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Brennan M, Fitzpatrick J, McNulty S, Campo T, Welbeck J, Barnes G. Paediatric resuscitation for nurses working in Ghana: an educational intervention. Int Nurs Rev 2012; 60:136-43. [DOI: 10.1111/j.1466-7657.2012.01033.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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Pinotsis DA, Schwarzkopf DS, Litvak V, Rees G, Barnes G, Friston KJ. Dynamic causal modelling of lateral interactions in the visual cortex. Neuroimage 2012; 66:563-76. [PMID: 23128079 PMCID: PMC3547173 DOI: 10.1016/j.neuroimage.2012.10.078] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 10/24/2012] [Accepted: 10/25/2012] [Indexed: 11/25/2022] Open
Abstract
This paper presents a dynamic causal model based upon neural field models of the Amari type. We consider the application of these models to non-invasive data, with a special focus on the mapping from source activity on the cortical surface to a single channel. We introduce a neural field model based upon the canonical microcircuit (CMC), in which neuronal populations are assigned to different cortical layers. We show that DCM can disambiguate between alternative (neural mass and field) models of cortical activity. However, unlike neural mass models, DCM with neural fields can address questions about neuronal microcircuitry and lateral interactions. This is because they are equipped with interlaminar connections and horizontal intra-laminar connections that are patchy in nature. These horizontal or lateral connections can be regarded as connecting macrocolumns with similar feature selectivity. Crucially, the spatial parameters governing horizontal connectivity determine the separation (width) of cortical macrocolumns. Thus we can estimate the width of macro columns, using non-invasive electromagnetic signals. We illustrate this estimation using dynamic causal models of steady-state or ongoing spectral activity measured using magnetoencephalography (MEG) in human visual cortex. Specifically, we revisit the hypothesis that the size of a macrocolumn is a key determinant of neuronal dynamics, particularly the peak gamma frequency. We are able to show a correlation, over subjects, between columnar size and peak gamma frequency — that fits comfortably with established correlations between peak gamma frequency and the size of visual cortex defined retinotopically. We also considered cortical excitability and assessed its relative influence on observed gamma activity. This example highlights the potential utility of dynamic causal modelling and neural fields in providing quantitative characterisations of spatially extended dynamics on the cortical surface — that are parameterised in terms of horizontal connections, implicit in the cortical micro-architecture and its synaptic parameters.
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Affiliation(s)
- D A Pinotsis
- The Wellcome Trust Centre for Neuroimaging, University College London, Queen Square, London WC1N 3BG, UK.
| | - D S Schwarzkopf
- The Wellcome Trust Centre for Neuroimaging, University College London, Queen Square, London WC1N 3BG, UK
| | - V Litvak
- The Wellcome Trust Centre for Neuroimaging, University College London, Queen Square, London WC1N 3BG, UK
| | - G Rees
- The Wellcome Trust Centre for Neuroimaging, University College London, Queen Square, London WC1N 3BG, UK
| | - G Barnes
- The Wellcome Trust Centre for Neuroimaging, University College London, Queen Square, London WC1N 3BG, UK
| | - K J Friston
- The Wellcome Trust Centre for Neuroimaging, University College London, Queen Square, London WC1N 3BG, UK
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Johnson L, Yester M, Barnes G. SU-E-I-53: Optimal KVp for Image Quality and Noise in Iodine Contrast in Head CTA. Med Phys 2012; 39:3637. [PMID: 28519494 DOI: 10.1118/1.4734769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE For brain CT perfusion it is well established that 80 kVp is optimal. Although neuro-CT angiography is somewhat similar, emphasis is on the detection of aneurysms and related vascular pathologies throughout the brain. Thus it is necessary to visualize small and large blood vessels with contrast material, as well as form multi-planar views and 3D images, so image quality and noise in addition to contrast are important for thin slices. A study was initiated to determine the optimal kVp for neuro-CTA. METHODS A customized version of a commercial head phantom (CIRS 007TE-27 medium adult head CT dose phantom) was purchased to facilitate quantitative measurements with iodinated contrast material, contrast for white and gray matter, and to maintain the ability to perform dosimetry. The customization consisted of adding four 25 mm holes, 35 mm from the center arranged at 45 degree angles from the center, with solid rods equivalent with brain, white, and gray matter, as well as four fillable vials were included for study of contrast agents. Dosimetry measurements were carried out with standard pencil chamber and with 0.6 cc ionization chamber. For study of the optimal kVp for a head CTA, the vials were filled with four different concentrations of contrast, approximating low to medium concentrations that would be expected in such a study. The standard CTA protocol was followed, 64 × 0.625, pitch 0.53, rotation speed 0.5 second, and CTDIvol was kept constant for each kVp. RESULTS The best contrast was observed at 80 kVp; however, in order to achieve noise in CTA low enough to be clinically useful there may be issues with tube current capability for a clinical technique. Clinical investigation is underway. CONCLUSIONS The best balance of contrast and noise currently possible will be achieved at 100 kVp in a clinical scan.
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Affiliation(s)
- L Johnson
- University of Alabama, Birmingham, Birmingham, AL.,X-Ray Imaging Innovations, Birmingham, AL
| | - M Yester
- University of Alabama, Birmingham, Birmingham, AL.,X-Ray Imaging Innovations, Birmingham, AL
| | - G Barnes
- University of Alabama, Birmingham, Birmingham, AL.,X-Ray Imaging Innovations, Birmingham, AL
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MacGillivray T, Richards J, Joshi N, Lang N, Barnes G, Semple S, Henriksen P, Mckillop G, Mirsadraee S, Fox K, Newby DE, Alam SR. 084 In vivo assessment of cellular inflammation following acute myocardial infarction. Heart 2012. [DOI: 10.1136/heartjnl-2012-301877b.84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sandberg K, Bahrami B, Kanai R, Barnes G, Overgaard M, Rees G. Predicting the conscious experience of other people. J Vis 2011. [DOI: 10.1167/11.11.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Pedersen CM, Schmidt MR, Barnes G, Botker HE, Kharbanda RK, Newby DE, Cruden NL. Bradykinin does not mediate remote ischaemic preconditioning or ischaemia-reperfusion injury in vivo in man. Heart 2011; 97:1857-61. [DOI: 10.1136/heartjnl-2011-300323] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gauntt D, Barnes G. SU-C-220-02: A High Efficiency Grid System for Abdominal Radiography. Med Phys 2011. [DOI: 10.1118/1.3611508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Kenney D, Radwan R, Zhu L, Burkhart B, Glover C, Vasko A, Young J, Acon B, Polkowski J, Raju S, Falcone K, Li Z, Dickson D, Simamora R, Kettlety T, Barnes G. Abstract 4653: Role of serum HE4 in studying ovarian cancer progression and response to therapy with ARCHITECT HE4 assay. Cancer Res 2010. [DOI: 10.1158/1538-7445.am10-4653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Human epididymis protein 4 (HE4) is a whey acidic four-disulfide core protein. Serum HE4 has been shown to be a promising biomarker for epithelial ovarian cancer (EOC) with manual HE4 EIA assays. The ARCHITECT system is one of the major automated formats for cancer immunodiagnostics. This abstract describes the clinical performance of an investigational ARCHITECT HE4 assay in the measurement of serum HE4 from longitudinal samples of subjects with EOC and single-point samples from healthy subjects, and subjects with malignancy, benign diseases, EOC or other malignant diseases.
PROCEDURES: The ARCHITECT HE4 Assay is a paramagnetic microparticle chemiluminescent assay adopting the sensitive CHEMIFLEX® technology. Single-point and longitudinal serum samples were tested with an investigational ARCHITECT HE4 Assay reagent lot on the ARCHITECT i2000SR. Single-point sera were collected from healthy subjects (N = 400), subjects with pregnancy (N = 50) and benign disease (N = 612), and subjects which were diagnosed with EOC (N = 314) and other cancers (N = 250) including endometrial, breast, gastrointestinal, lung, and bladder cancer. Longitudinal sera (N = 506), including initial time point and follow-up visits (average = 5.7 per subject), were collected from subjects (N = 76) which were diagnosed with EOC. All of the single-point and longitudinal samples were handled in accordance with IRB-approved and GCP-compliant protocols.
RESULTS: Using an ARCHITECT HE4 cut-off value of >140 pmol/L, the percent distributions of ARCHITECT HE4 by cohort are: 3% of healthy subjects, 0% with pregnancy, 7.2% of subjects with benign diseases, 53.5% with EOC and 28.4% with other cancers. Using the upper 95% point of the distribution of the HE4 ratio at 14% to categorize the successive HE4 readings into those that were and were not significantly elevated for the longitudinal samples, the sensitivity, specificity and positive predictive value of HE4 elevation versus disease progression were 53.4% (95% CI: 44.1%-62.5%), 78.8% (95% CI: 74.7% - 82.4%) and 43.2% (95% CI: 32.9% - 54.1%) respectively. The total concordance between HE4 elevation and disease progression was 73%. Receiver Operator Characteristic analysis showed an area under the curve of 0.685 (SE = 0.033) for the diagnosis of progression from the ratio of successive HE4 readings. When comparing the change of the HE4 ratio with the diagnostic response to therapy, a decrease in HE4 reflected response to therapy with a sensitivity of 82% and a specificity of 53%.
CONCLUSIONS: The study with single-point samples has shown the utility of ARCHITECT HE4 values as a serum biomarker for EOC. The longitudinal increase of ARCHITECT HE4 values in sera seemed to be effective in recognizing the progression of EOC. The longitudinal decrease of ARCHITECT HE4 values in sera seemed to correlate with the response of EOC subjects to therapy.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4653.
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Affiliation(s)
- D. Kenney
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | - R. Radwan
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | - L. Zhu
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | | | - C. Glover
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | - A. Vasko
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | - J. Young
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | - B. Acon
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | | | - S. Raju
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | - K. Falcone
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | - Z. Li
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | - D. Dickson
- 1Fujirebio Diagnostics, Inc., Malvern, PA
| | | | | | - G. Barnes
- 1Fujirebio Diagnostics, Inc., Malvern, PA
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Japp AG, Cruden NL, Barnes G, van Gemeren N, Mathews J, Adamson J, Johnston NR, Denvir MA, Megson IL, Flapan AD, Newby DE. Acute cardiovascular effects of apelin in humans: potential role in patients with chronic heart failure. Circulation 2010; 121:1818-27. [PMID: 20385929 DOI: 10.1161/circulationaha.109.911339] [Citation(s) in RCA: 249] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Apelin, the endogenous ligand for the novel G protein-coupled receptor APJ, has major cardiovascular effects in preclinical models. The study objectives were to establish the effects of acute apelin administration on peripheral, cardiac, and systemic hemodynamic variables in healthy volunteers and patients with heart failure. METHODS AND RESULTS Eighteen patients with New York Heart Association class II to III chronic heart failure, 6 patients undergoing diagnostic coronary angiography, and 26 healthy volunteers participated in a series of randomized, double-blind, placebo-controlled studies. Measurements of forearm blood flow, coronary blood flow, left ventricular pressure, and cardiac output were made by venous occlusion plethysmography, Doppler flow wire and quantitative coronary angiography, pressure wire, and thoracic bioimpedance, respectively. Intrabrachial infusions of (Pyr(1))apelin-13, acetylcholine, and sodium nitroprusside caused forearm vasodilatation in patients and control subjects (all P<0.0001). Vasodilatation to acetylcholine (P=0.01) but not apelin (P=0.3) or sodium nitroprusside (P=0.9) was attenuated in patients with heart failure. Intracoronary bolus of apelin-36 increased coronary blood flow and the maximum rate of rise in left ventricular pressure and reduced peak and end-diastolic left ventricular pressures (all P<0.05). Systemic infusions of (Pyr(1))apelin-13 (30 to 300 nmol/min) increased cardiac index and lowered mean arterial pressure and peripheral vascular resistance in patients and healthy control subjects (all P<0.01) but increased heart rate only in control subjects (P<0.01). CONCLUSIONS Acute apelin administration in humans causes peripheral and coronary vasodilatation and increases cardiac output. APJ agonism represents a novel potential therapeutic target for patients with heart failure.
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Affiliation(s)
- A G Japp
- Department of Cardiology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, UK.
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Burke M, Barnes G. Differences in active versus passive short-term memory acquisition for smooth pursuit eye movements revealed by event-related fMRI. J Vis 2010. [DOI: 10.1167/9.8.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Scott A, Barnes G, Yester M. WE-C-304A-02: Testing for Optimal Grid Choice in Automated Bedside Imaging. Med Phys 2009. [DOI: 10.1118/1.3182489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Barnes G. TU-E-211A-03: Medical Imaging Physics: Career Opportunities and Considerations. Med Phys 2009. [DOI: 10.1118/1.3182405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Barnes G. TU-E-350-02: Medical Imaging Physics: Career Opportunities and Considerations. Med Phys 2008. [DOI: 10.1118/1.2962630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Barnes G. TU-E-BRB-06: Meet the Expert - Medical Imaging Physics: Career Opportunities and Considerations. Med Phys 2007. [DOI: 10.1118/1.2761433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Wilson D, Johnston F, Holt D, Moreton M, Engelmayer J, Gaulier JM, Luthe H, Marquet P, Moscato D, Oellerich M, Mosso R, Streit F, Brunet M, Fillee C, Schmid R, Wallemacq P, Barnes G. WITHDRAWN: Multi-center evaluation of analytical performance of the microparticle enzyme immunoassay for sirolimus. Clin Biochem 2006:S0009-9120(06)00312-2. [PMID: 18375204 DOI: 10.1016/j.clinbiochem.2006.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2005] [Revised: 01/09/2006] [Accepted: 10/10/2006] [Indexed: 11/28/2022]
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published in Clin. Biochem. 39 (2006) 378-386, doi:10.1016/j.clinbiochem.2006.01.017. The duplicate article has therefore been withdrawn. This article has been withdrawn consistent with Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The Publisher apologizes for any inconvenience this may cause.
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Affiliation(s)
- D Wilson
- Abbott Laboratories, Abbott Park, IL, USA
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Barnes G. S1.1 The potential of magnetoencephalographic (MEG) brain imaging. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.07.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Furlong P, Barnes G. BS6 Magnetoencephalography and source localisation techniques. Clin Neurophysiol 2006. [DOI: 10.1016/j.clinph.2006.07.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wilson D, Johnston F, Holt D, Moreton M, Engelmayer J, Gaulier JM, Luthe H, Marquet P, Moscato D, Oellerich M, Mosso R, Streit F, Brunet M, Fillee C, Schmid R, Wallemacq P, Barnes G. Multi-center evaluation of analytical performance of the microparticle enzyme immunoassay for sirolimus. Clin Biochem 2006; 39:378-86. [PMID: 16545357 DOI: 10.1016/j.clinbiochem.2006.01.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [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: 03/15/2005] [Revised: 01/09/2006] [Accepted: 01/11/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVES This study evaluated the analytical characteristics of the new Abbott microparticle enzyme immunoassay (MEIA) for sirolimus. DESIGN AND METHODS The protocol consisted of nine sections: evaluation of antibody specificity, linearity, detection limit, quantification limit, endogenous interferents, exogenous interferents, precision, proficiency testing panel, and method comparison. RESULTS The mean analytical detection limit was 0.68 microg/L. The sirolimus concentration corresponding to a total CV of 20% was 1.5 microg/L. Linearity of response was demonstrated across the dynamic range of the assay. Total precision (CVs) at QC control levels from 5 to 22 microg/L ranged from 5.7 to 12.6%. Assay standardization was found to be in good agreement with LC/MS/MS as compared with target values for spiked sirolimus proficiency samples from an international sirolimus proficiency testing program. Good correlations (R values) of the immunoassay were observed in comparisons to LC/MS/MS. R values tended to be lower in comparisons with LC/UV methods. Across both LC-based methods and all study sites, there was approximately 25% overall positive slope bias due to cross reactivity of the MEIA antibody to metabolites of sirolimus. The assay cross-reactivity to metabolites of sirolimus parent drug ranged from 6 to 63%. Assay interferences were minimal with the exception of hematocrit, which presented a negative relationship to measured sirolimus concentration. CONCLUSIONS The MEIA demonstrated acceptable analytical characteristics for use for routine monitoring of sirolimus immunosuppressive therapy, and is a viable alternative to HPLC-based methods for sirolimus monitoring.
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Affiliation(s)
- D Wilson
- Abbott Laboratories, Abbott Park, IL 60064, USA.
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Barnes G, Bulusu VR, Hardwick RH, Carroll N, Hatcher H, Earl HM, Save VE, Balan K, Jamieson NV. A review of the surgical management of metastatic gastrointestinal stromal tumours (GISTs) on imatinib mesylate (Glivec™). Int J Surg 2005; 3:206-12. [PMID: 17462285 DOI: 10.1016/j.ijsu.2005.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Gastrointestinal stromal tumours (GISTs) are defined as a group of C-KIT positive mesenchymal tumours of the gastrointestinal tract. Although they may arise throughout the gut, the commonest sites are stomach and small intestine. Over 80% of metastases are to the liver and omentum. Targeted therapy (imatinib) can inhibit C-KIT and thereby aberrant tumoural proliferation. Imatinib may induce shrinkage of lesions and cystic change. Such physical changes often correspond with reduced metabolic activity demonstrated by (18-FDG)PET scans. These changes may enable metastatectomy reducing tumour pain and the risk of haemorrhage and rupture in the short term. In the long term, resection may lessen the risk of recurrence by removing potentially resistant clones. The precise role of palliative resection for GIST metastases on imatinib remains unclear. Imatinib has changed the natural history of metastatic GISTs, with increased survival times. Surgery remains an important management strategy in the metastatic setting because complete pathological responses are rare with imatinib. Surgery is likely to provide the best palliation, greatest reduction in tumour burden and eliminate resistant clones. A multidisciplinary team approach with expertise concentrated in a few centres specialising in the management of these rare tumours is vital to the successful outcome. Future issues regarding the management of differential response of the metastases to imatinib are highlighted. With the emergence of techniques enabling identification of the precise mutational status of the C-KIT oncogene, the imatinib/surgery sequence could be tailored to the type of C-KIT mutation.
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Affiliation(s)
- G Barnes
- Directorate of Surgery, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK
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Welte J, Barnes G, Hoffman J, Wieczorek W, Zhang L. Substance Involvement and the Trajectory of Criminal Offending in Young Males. The Am J of Drug & Alcohol Abuse 2005. [DOI: 10.1081/ada-200047934] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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York JL, Welte J, Hirsch J, Hoffman JH, Barnes G. Association of age at first drink with current alcohol drinking variables in a national general population sample. Alcohol Clin Exp Res 2004; 28:1379-87. [PMID: 15365309 DOI: 10.1097/01.alc.0000139812.98173.a4] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Age at first drink has been found to be associated with alcohol problems in adulthood, but little is known regarding the relationship of age at first drink and current alcohol intake variables. This study was designed to determine the relationship of age at first drink to traditional drinking variables as well as novel current drinking variables assessed for the first time in a national general population sample. METHOD Data on age of first drink, pathological drinking (DSM-IV alcohol abuse or dependence) and alcohol intake on typical drinking occasions were collected on a national general population sample of 2631 subjects by means of computerized telephone interviewing. Variables assessed for the first time in a national survey included the duration of the typical drinking episode and the predicted peak blood alcohol levels achieved during those episodes. RESULTS Data from 2276 subjects who reported an age at first drink were used in this study. Men and lifetime pathological drinkers reported an earlier age at first drink than did, respectively, women or lifetime nonpathological drinkers. There were significant regression coefficients between age at first drink and several current drinking measures. The largest coefficients were usually found within younger age groups. CONCLUSIONS Age at first drink may be a useful predictive variable for some current drinking measures, including predicted peak blood alcohol levels as well as lifetime alcohol pathology. Further support was provided for the "convergence" hypothesis that the drinking habits of women have become more like those of men.
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Affiliation(s)
- James L York
- State University of New York at Buffalo, Research Institute on Addictions, Buffalo, New York 14203, USA.
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Duly EB, Grimason S, Grimason P, Barnes G, Trinick TR. Measurement of serum albumin by capillary zone electrophoresis, bromocresol green, bromocresol purple, and immunoassay methods. J Clin Pathol 2003; 56:780-1. [PMID: 14514785 PMCID: PMC1770085 DOI: 10.1136/jcp.56.10.780] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [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: 11/03/2022]
Abstract
BACKGROUND/AIMS The introduction of capillary zone electrophoresis (CZE) to this laboratory has highlighted discrepancies in albumin measured on an Abbott Aeroset by bromocresol green (BCG) and that calculated by CZE on the basis of total protein measured by Biuret. METHODS This study examined differences in albumin estimation by CZE, Abbott Aeroset BCG, and Aeroset bromocresol purple (BCP), and compared these with albumin estimated by Beckman Array immunoassay. RESULTS Altman and Bland analysis of results showed a positive bias of BCG with CZE (4.51 g/litre; 95% limits of agreement, 3.77 to 5.26; n = 72) and BCP (3.85 g/litre; 95% limits of agreement, -1.42 to 9.12; n = 72). CZE and BCP agreed closely (0.67 g/litre; 95% limits of agreement, -4.39 to 3.06; n = 72). Analysis of 57 of those samples in which BCG and CZE differed > or = 5 g/litre showed a positive bias of BCG with immunoassay (8.35 g/litre; 95% limits of agreement, 1.54 to 15.16; n =57), with good agreement between CZE and immunoassay (-0.44 g/litre; 95% limits of agreement, -2.82 to 1.94; n = 57). CONCLUSIONS BCP is superior to BCG for the assay of albumin and has replaced BCG as the routine test for albumin in this laboratory.
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Affiliation(s)
- E B Duly
- Department of Clinical Chemistry, Ulster Hospital, Dundonald, BT16 1RH, Northern Ireland.
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