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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Mehta M, Polli JE, Seo P, Bhoopathy S, Berginc K, Kristan K, Cook J, Dressman JB, Mandula H, Munshi U, Shanker R, Volpe DA, Gordon J, Veerasingham S, Welink J, Almeida S, Gonzalez P, Painter D, Tsang YC, Vaidyanathan J, Velagapudi R. Drug Permeability - Best Practices for Biopharmaceutics Classification System (BCS)-Based Biowaivers: A workshop Summary Report. J Pharm Sci 2023; 112:1749-1762. [PMID: 37142122 DOI: 10.1016/j.xphs.2023.04.016] [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: 04/13/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/06/2023]
Abstract
The workshop "Drug Permeability - Best Practices for Biopharmaceutics Classification System (BCS) Based Biowaivers" was held virtually on December 6, 2021, organized by the University of Maryland Center of Excellence in Regulatory Science and Innovation (M-CERSI), and the Food and Drug Administration (FDA). The workshop focused on the industrial, academic, and regulatory experiences in generating and evaluating permeability data, with the aim to further facilitate implementation of the BCS and efficient development of high-quality drug products globally. As the first international permeability workshop since the BCS based biowaivers was finalized as the ICH M9 guideline, the workshop included lectures, panel discussions, and breakout sessions. Lecture and panel discussion topics covered case studies at IND, NDA, and ANDA stages, typical deficiencies relating to permeability assessment supporting BCS biowaiver, types of evidence that are available to demonstrate high permeability, method suitability of a permeability assay, impact of excipients, importance of global acceptance of permeability methods, opportunities to expand the use of biowaivers (e.g. non-Caco-2 cell lines, totality-of-evidence approach to demonstrate high permeability) and future of permeability testing. Breakout sessions focused on 1) in vitro and in silico intestinal permeability methods; 2) potential excipient effects on permeability and; 3) use of label and literature data to designate permeability class.
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Affiliation(s)
- M Mehta
- US Food & Drug Administration, Silver Spring, MD, USA.
| | - J E Polli
- University of Maryland, Baltimore, MD, USA
| | - P Seo
- US Food & Drug Administration, Silver Spring, MD, USA
| | | | | | | | - J Cook
- Pfizer Inc, Groton, CT, USA
| | - J B Dressman
- Fraunhofer Institute of Translational Medicine and Pharmacology, Frankfurt, Germany
| | - H Mandula
- US Food & Drug Administration, Silver Spring, MD, USA
| | - U Munshi
- US Food & Drug Administration, Silver Spring, MD, USA
| | | | - D A Volpe
- US Food & Drug Administration, Silver Spring, MD, USA
| | - J Gordon
- World Health Organization, Geneva, Switzerland
| | | | - J Welink
- European Medicines Agency, Amsterdam, the Netherlands
| | - S Almeida
- Medicines for Europe, Brussels, Belgium
| | - P Gonzalez
- Biopharmaceutical Evaluation Center, Santiago, Chile
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Wang J, Johnson M, Barve M, Pelster M, Chen X, Li Z, Gordon J, Reiss M, Pai S, Falchook G, Tolcher A. Preliminary results from HERKULES-1: a phase 1b/2, open-label, multicenter study of ERAS-007, an oral ERK1/2 inhibitor, in patients with advanced or metastatic solid tumors. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01013-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Herzler M, Abedini J, Allen D, Api A, Germolec D, Gordon J, Ko HS, Matheson J, Strickland J, Thierse HJ, To K, Truax J, Vanselow J, Kleinstreuer N. SOC-V-06 New classification approach for Human Predictive Patch Test (HPPT) results under the UN GHS improves skin sensitisation potency sub-categorisation and weight-of-evidence assessments. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.195] [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: 10/14/2022]
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Le Magueres P, Del Campo M, Ferrara J, Meyer M, Kucharczyk D, Wisniewski A, Stec P, Gordon J. Introducing the XtaLAB Synergy Flow. Acta Cryst Sect A 2022. [DOI: 10.1107/s205327332209012x] [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: 03/19/2023]
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McLaren A, McLean K, Gordon J, Lambe N. Can genetic propensity for lambing difficulty be predicted by pelvic and body shape dimensions measured by X-ray computed tomography (CT) scanning of ram lambs? Small Rumin Res 2022. [DOI: 10.1016/j.smallrumres.2022.106790] [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: 10/31/2022]
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Aguilar-Arevalo AA, Alves DSM, Biedron S, Boissevain J, Borrego M, Chavez-Estrada M, Chavez A, Conrad JM, Cooper RL, Diaz A, Distel JR, D'Olivo JC, Dunton E, Dutta B, Elliott A, Evans D, Fields D, Greenwood J, Gold M, Gordon J, Guarincerri E, Huang EC, Kamp N, Kelsey C, Knickerbocker K, Lake R, Louis WC, Mahapatra R, Maludze S, Mirabal J, Moreno R, Neog H, deNiverville P, Pandey V, Plata-Salas J, Poulson D, Ray H, Renner E, Schaub TJ, Shaevitz MH, Smith D, Sondheim W, Szelc AM, Taylor C, Thompson WH, Thornton RT, Tripathi M, Van Berg R, Van de Water RG, Verma S, Walker K. First Leptophobic Dark Matter Search from the Coherent-CAPTAIN-Mills Liquid Argon Detector. Phys Rev Lett 2022; 129:021801. [PMID: 35867467 DOI: 10.1103/physrevlett.129.021801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 05/17/2022] [Indexed: 06/15/2023]
Abstract
We report the first results of a search for leptophobic dark matter (DM) from the Coherent-CAPTAIN-Mills (CCM) liquid argon (LAr) detector. An engineering run with 120 photomultiplier tubes (PMTs) and 17.9×10^{20} protons on target (POT) was performed in fall 2019 to study the characteristics of the CCM detector. The operation of this 10-ton detector was strictly light based with a threshold of 50 keV and used coherent elastic scattering off argon nuclei to detect DM. Despite only 1.5 months of accumulated luminosity, contaminated LAr, and nonoptimized shielding, CCM's first engineering run has already achieved sensitivity to previously unexplored parameter space of light dark matter models with a baryonic vector portal. With an expected background of 115 005 events, we observe 115 005+16.5 events which is compatible with background expectations. For a benchmark mediator-to-DM mass ratio of m_{V_{B}}/m_{χ}=2.1, DM masses within the range 9 MeV≲m_{χ}≲50 MeV are excluded at 90% C. L. in the leptophobic model after applying the Feldman-Cousins test statistic. CCM's upgraded run with 200 PMTs, filtered LAr, improved shielding, and 10 times more POT will be able to exclude the remaining thermal relic density parameter space of this model, as well as probe new parameter space of other leptophobic DM models.
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Affiliation(s)
| | - D S M Alves
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Biedron
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - J Boissevain
- Bartoszek Engineering, Aurora, Illinois 60506, USA
| | - M Borrego
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | | | - A Chavez
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J M Conrad
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - R L Cooper
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
- New Mexico State University, Las Cruces, New Mexico 88003, USA
| | - A Diaz
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J R Distel
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - J C D'Olivo
- Universidad Nacional Autónoma de México, CDMX 04510, México
| | - E Dunton
- Columbia University, New York, New York 10027, USA
| | - B Dutta
- Texas A&M University, College Station, Texas 77843, USA
| | - A Elliott
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - D Evans
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - D Fields
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - J Greenwood
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - M Gold
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - J Gordon
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - E Guarincerri
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - E C Huang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - N Kamp
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - C Kelsey
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - K Knickerbocker
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R Lake
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - W C Louis
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R Mahapatra
- Texas A&M University, College Station, Texas 77843, USA
| | - S Maludze
- Texas A&M University, College Station, Texas 77843, USA
| | - J Mirabal
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R Moreno
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - H Neog
- Texas A&M University, College Station, Texas 77843, USA
| | - P deNiverville
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - V Pandey
- University of Florida, Gainesville, Florida 32611, USA
| | - J Plata-Salas
- Universidad Nacional Autónoma de México, CDMX 04510, México
| | - D Poulson
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - H Ray
- University of Florida, Gainesville, Florida 32611, USA
| | - E Renner
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - T J Schaub
- University of New Mexico, Albuquerque, New Mexico 87131, USA
| | - M H Shaevitz
- Columbia University, New York, New York 10027, USA
| | - D Smith
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
| | - W Sondheim
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A M Szelc
- University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
| | - C Taylor
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - W H Thompson
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R T Thornton
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Tripathi
- University of Florida, Gainesville, Florida 32611, USA
| | - R Van Berg
- Bartoszek Engineering, Aurora, Illinois 60506, USA
| | - R G Van de Water
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - S Verma
- Texas A&M University, College Station, Texas 77843, USA
| | - K Walker
- Embry-Riddle Aeronautical University, Prescott, Arizona 86301, USA
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Lambe NR, McLaren A, McLean K, Gordon J, Conington J. Variation in reticulo-rumen volumes between and within sheep breeds and genetic relationships with production traits. Anim Prod Sci 2022. [DOI: 10.1071/an21423] [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: 11/23/2022]
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Seekford ZK, Dickson MJ, Davis DB, Gonçlaves L, Burato S, Holton MP, Gordon J, Pohler KG, Lamb GC, Pringle TD, Stewart RL, Ferrer MS, Bromfield JJ, Fontes PLP. 95 Bulls fed a high-gain diet produce semen that results in fewer blastocysts following in vitro fertilisation and embryo culture. Reprod Fertil Dev 2021; 34:284-285. [PMID: 35231225 DOI: 10.1071/rdv34n2ab95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Z K Seekford
- University of Florida, Department of Animal Sciences, Gainesville, FL, USA
| | - M J Dickson
- University of Florida, Department of Animal Sciences, Gainesville, FL, USA
| | - D B Davis
- The University of Georgia, Department of Animal and Dairy Science, Athens, GA, USA
| | - L Gonçlaves
- Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - S Burato
- Sao Paulo State University, Botucatu, Sao Paulo, Brazil
| | - M P Holton
- The University of Georgia, Department of Animal and Dairy Science, Athens, GA, USA
| | - J Gordon
- The University of Georgia, College of Veterinary Medicine, Athens, GA, USA
| | - K G Pohler
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - G C Lamb
- Department of Animal Science, Texas A&M University, College Station, TX, USA
| | - T D Pringle
- The University of Georgia, Department of Animal and Dairy Science, Athens, GA, USA
| | - R L Stewart
- The University of Georgia, Department of Animal and Dairy Science, Athens, GA, USA
| | - M S Ferrer
- The University of Georgia, Department of Animal and Dairy Science, Athens, GA, USA
| | - J J Bromfield
- University of Florida, Department of Animal Sciences, Gainesville, FL, USA
| | - P L P Fontes
- The University of Georgia, Department of Animal and Dairy Science, Athens, GA, USA
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Gao R, Shaw K, Kaviani M, Gordon J, Zello G, Chilibeck P. Glycemic Index of lentil- and cherry-based sport nutrition products for endurance athletes. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Spiera R, Kuwana M, Khanna D, Hummers L, Frech T, Stevens W, Gordon J, Kafaja S, Matucci-Cerinic M, Distler O, Lee EB, Levy Y, Jun JB, Constantine S, Dgetluck N, White B, Furst D, Denton C. OP0171 PHASE 3 TRIAL OF LENABASUM, A CB2 AGONIST, FOR THE TREATMENT OF DIFFUSE CUTANEOUS SYSTEMIC SCLEROSIS (DCSSC). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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
Background:Lenabasum is an oral CB2 agonist that attenuates inflammation and fibrosis in SSc animal models and showed clinical benefit with acceptable safety in a Phase 2 trial in dcSSc.Objectives:Test efficacy and safety of lenabasum in a Phase 3 trial in dcSSc.Methods:Subjects ≥18 years old with disease duration ≤ 6 years were randomized 1:1:1 to lenabasum 5 mg, 20 mg, or placebo (PBO), all BID, with stable background immunosuppressant therapy (IST) allowed. The primary efficacy endpoint was ACR CRISS score, and secondary endpoints were ΔmRSS, ΔHAQ-DI, and ΔFVC, all at Week 52 for lenabasum 20 mg vs PBO.Results:363 adults were dosed; 37 (10%) stopped study drug early, with only 1 subject (PBO cohort) stopping due to adverse event (AE). Baseline demographics were similar among groups. Disease duration was ≤ 3 years in 60% and 66%, mean mRSS score was 22.0 and 23.3, and background IST was used by 89% and 84% of lenabasum 20 mg and PBO groups, respectively.Safety results showed serious AEs and severe AEs occurred in 9.2% and 5.8% vs 14.6% and 13.0%, respectively, of lenabasum 20 mg and PBO groups.Efficacy results (Table) demonstrated:Table 1.Primary and secondary efficacy endpoints and post-hoc analyses, Week 52Group, by IST treatmentCohortNΔmRSS, mean (SD)ΔFVC% mean (SD)ΔFVC, mL mean (SD)ΔHAQ-DI mean (SD)ACR CRISS medianmITT population, MMRM primary analysis methodAllPlacebo123-8.1 (7.72)-1.0 (8.68)-51 (317)-0.13 (0.468)0.887Lenabasum 20 mg120-6.7 (6.59)-1.6 (6.91)-78 (265)-0.13 (0.436)0.888Placebo subjects, per protocol completers, LOCFNo ISTPlacebo16-2.3 (9.4)-2.8 (7.4)-97 (244)0.12 (0.34)0.417All ISTPlacebo97-8.9 (7.07)-1.0 (9.2)-43 (330)-0.17 (0.474)0.936MMF, no other ISTPlacebo29-10.7 (8.1)-0.58 (7.1)-37 (235)-0.12 (0.456)0.935MMF ≤ 2 years, no other ISTPlacebo23-11.7 (8.1)-0.3 (6.0)-41 (197)-0.13 (0.495)0.935Non-MMF ≤ 2 yearsPlacebo24-6.7 (6.2)-1.4 (7.87)-52 (281)-0.15 (0.357)0.931Post-hoc comparisons, per protocol completers, LOCFNo ISTPlacebo16-2.3 (9.4)-2.8 (7.4)-97 (244)0.12 (0.34)0.417Lenabasum 20 mg10-6.3 (6.02)-2.3 (5.58)-99 (209)-0.06 (0.498)0.811Established IST1Placebo26-6.1 (5.35)-4.6 (10.11)-170 (350)-0.17 (0.445)0.619Lenabasum 20 mg38-7.4 (5.08)-0.4 (5.70)2-21 (233)3-0.07 (0.357)0.941Established IST, subjects with ILDPlacebo22-5.9 (5.28)-3.7 (5.43)-133 (206)-0.10 (0.372)0.553Lenabasum 20 mg33-7.2 (5.70)-1.0 (10.5)-47 (365)-0.06 (0.391)0.8192 P = 0.0386 two-sample t-test; 3 P = 0.0481 two-sample t-test; other comparisons were not significant• No significant differences were seen in primary and secondary efficacy endpoints. Primary MMRM analyses with treatment-by-time-by-subgroup interactions showed that background mycophenolate (MMF) significantly influenced the outcome•oSubjects on no IST with disease duration ≤3 years were only 7% of PBO subjects and showed little improvement on PBO, in line with other dcSSc trials in which IST was restricted. Post-hoc subgroup analyses of these subjects on no IST suggested improvement in ΔmRSS and ΔHAQ-DI, for lenabasum 20 mg vs PBO•uUnexpectedly high improvement occurred in PBO subjects receiving IST, notably those on MMF started within 2 years of baseline•nPost-hoc analyses of subjects on established IST (MMF or, if no MMF, ≥ 1 non-MMF IST started > 2 years before baseline) suggested improvement in ΔFVC% (nominal P = 0.0386) and ΔFVC mL (nominal P = 0.0481) for lenabasum 20 mg vs PBO. Improvement in FVC was also seen in subjects on established IST who had ILD at baseline, lenabasum 20 mg vs PBO•mACR CRISS score demonstrated a ceiling effect and correlated most highly with ΔmRSS (r = -0.739) and moderately with MDGA (-0.432), HAQ-DI (-0.362), FVC% (0.366), and PtGA (-0.288)Conclusion:Lenabasum was safely used in this study. Unexpectedly high improvement on background IST, especially MMF, has not been previously reported at this level. The primary endpoint was not met. Post-hoc analyses showed greater improvement in lenabasum- vs PBO-treated subjects who were not on background IST and those on established IST, including subjects with ILD.Disclosure of Interests:Robert Spiera Consultant of: Abbvie, Roche-Genetech, GSK, CSL Behring, Sanofi, Janssen, Chemocentryx, Formation Biologics, Mitsubishi Tanabe, Grant/research support from: Roche-Genetech, GSK, Boehringer Ingelheim, Chemocentryx, Corbus, Formation Biologics, Sanofi, Inflarx, Astra Zeneca, Kadmon, Masataka Kuwana Speakers bureau: Boehringer-Ingelheim, Chugai, Janssen, Consultant of: Boehringer-Ingelheim, Chugai, Corbus, Grant/research support from: Boehringer-Ingelheim, Chugai, MBL, Ono Pharmaceuticals, Tanabe-Mitsubishi, Dinesh Khanna Shareholder of: Eicos Sciences, Inc (less than 5%). Leadership/Equity position – Chief Medical Officer, CiviBioPharma/Eicos Sciences, Inc, Consultant of: Acceleron, Actelion, Abbvie, Amgen, Bayer, Boehringer Ingelheim, CSL Behring, Corbus, Gilead, Galapagos, Genentech/Roche, GSK, Horizon, Merck, Mitsubishi Tanabe Pharma, Sanofi-Aventis, and United Therapeutics, Grant/research support from: NIH, Immune Tolerance Network, Bayer, BMS, Horizon, Pfizer, Laura Hummers Consultant of: CSL Behring, Boehringer Ingelheim, Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals. Corbus, Boehringer Ingelheim, Medpace, Kadmon, Cumberland, CSL Behring, Tracy Frech Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Wendy Stevens Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Jessica Gordon Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals. Research funding for EICOS Pharmaceuticals and Cumberland Pharmaceuticals., Suzanne Kafaja Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Marco Matucci-Cerinic Consultant of: Actelion, Janssen, Inventiva, Bayer, Biogen, Boehringer, CSL Behring, Corbus, Galapagos, Mitsubishi, Samsung, Regeneron, Acceleron, MSD, Chemomab, Lilly, Pfizer, Roche, Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Oliver Distler Consultant of: Consultancy relationship and/or has received research funding in the area of potential treatments for systemic sclerosis and its complications from (last three years): Abbvie, Acceleron Pharma, Amgen, AnaMar, Arxx Therapeutics, Baecon Discovery, Blade Therapeutics, Bayer, Boehringer Ingelheim, ChemomAb, Corbus Pharmaceuticals, CSL Behring, Galapagos NV, Glenmark Pharmaceuticals, GSK, Horizon (Curzion) Pharmaceuticals, Inventiva, iQvia, Italfarmaco, iQone, Kymera Therapeutics, Lilly, Medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Novartis, Pfizer, Roche, Sanofi, Serodapharm, Topadur, Target Bioscience and UCB., Eun Bong Lee Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Yair Levy Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Jae-Bum Jun Consultant of: Consultant to Boehringer Ingelheim Korea, Jeil Pharma, Dae Woong Pharma, Kwangdong Pharma, and Sama Pharma., Grant/research support from: Investigator for study sponsored by Corbus Pharmaceuticals, Scott Constantine Employee of: Employee of Corbus Pharmaceuticals, Nancy Dgetluck Employee of: Employee of Corbus Pharmaceuticals, Barbara White Employee of: Employee and stockholder of Corbus Pharmaceuticals, Daniel Furst Consultant of: Corbus, Galapagos, Pfizer, CSL Behring, Mitsubishi Tanabi, Actelion, Amgen, Novartis, Roche/Genentech, Gilead, Talaris, and Boehringer Ingelheim., Grant/research support from: grants from Corbus, Galapagos, GSK, Pfizer, Talaris, CSL Behring, Mitsubishi Tanabi, Christopher Denton Consultant of: Consultancy fees and/or honoraria from Corbus, Actelion, GlaxoSmithKline, Bayer, Sanofi, Galapagos, Inventiva, Boehringer Ingelheim, Roche, CSL Behring, Acceleron, Horizon, Arxx Therapeutics
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Han J, Moayedi Y, Henricksen E, Zhang M, Lee R, Waddell K, Luikart H, Morales D, Gordon J, Lyapin A, Duclos S, Feng K, Jimenez S, Teuteberg J, Khush K. Are Those with Primary Graft Dysfunction More Likely to Have Acute Cellular Rejection or Donor-Specific Antibodies after Heart Transplantation? J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Zhang Y, Wu W, Toll RT, Naparstek S, Maron-Katz A, Watts M, Gordon J, Jeong J, Astolfi L, Shpigel E, Longwell P, Sarhadi K, El-Said D, Li Y, Cooper C, Chin-Fatt C, Arns M, Goodkind MS, Trivedi MH, Marmar CR, Etkin A. Identification of psychiatric disorder subtypes from functional connectivity patterns in resting-state electroencephalography. Nat Biomed Eng 2021; 5:309-323. [PMID: 33077939 PMCID: PMC8053667 DOI: 10.1038/s41551-020-00614-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 08/24/2020] [Indexed: 12/21/2022]
Abstract
The understanding and treatment of psychiatric disorders, which are known to be neurobiologically and clinically heterogeneous, could benefit from the data-driven identification of disease subtypes. Here, we report the identification of two clinically relevant subtypes of post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) on the basis of robust and distinct functional connectivity patterns, prominently within the frontoparietal control network and the default mode network. We identified the disease subtypes by analysing, via unsupervised and supervised machine learning, the power-envelope-based connectivity of signals reconstructed from high-density resting-state electroencephalography in four datasets of patients with PTSD and MDD, and show that the subtypes are transferable across independent datasets recorded under different conditions. The subtype whose functional connectivity differed most from those of healthy controls was less responsive to psychotherapy treatment for PTSD and failed to respond to an antidepressant medication for MDD. By contrast, both subtypes responded equally well to two different forms of repetitive transcranial magnetic stimulation therapy for MDD. Our data-driven approach may constitute a generalizable solution for connectome-based diagnosis.
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Affiliation(s)
- Yu Zhang
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Lehigh University, Bethlehem, PA, USA
| | - Wei Wu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
- School of Automation Science and Engineering, South China University of Technology, Guangzhou, China
- Alto Neuroscience, Inc., Los Altos, CA, USA
| | - Russell T Toll
- Department of Psychiatry, Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute, UT Southwestern Medical Center, Dallas, TX, USA
| | - Sharon Naparstek
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Adi Maron-Katz
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Mallissa Watts
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Joseph Gordon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
- Alto Neuroscience, Inc., Los Altos, CA, USA
| | - Jisoo Jeong
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Laura Astolfi
- Department of Computer, Control and Management Engineering "Antonio Ruberti", University of Rome Sapienza, Rome, Italy
- IRCCF Fondazione Santa Lucia, Rome, Italy
| | - Emmanuel Shpigel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Parker Longwell
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Kamron Sarhadi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Dawlat El-Said
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Yuanqing Li
- School of Automation Science and Engineering, South China University of Technology, Guangzhou, China
- Pazhou Lab, Guangzhou, China
| | - Crystal Cooper
- Department of Psychiatry, Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute, UT Southwestern Medical Center, Dallas, TX, USA
| | - Cherise Chin-Fatt
- Department of Psychiatry, Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute, UT Southwestern Medical Center, Dallas, TX, USA
| | - Martijn Arns
- Research Institute Brainclinics, Brainclinics Foundation, Nijmegen, The Netherlands
- neuroCare Group, Munich, Germany
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Location AMC, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | - Madhukar H Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, Peter O'Donnell Jr. Brain Institute, UT Southwestern Medical Center, Dallas, TX, USA
- O'Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Charles R Marmar
- Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY, USA
- Center for Alcohol Use Disorder and PTSD, New York University Langone School of Medicine, New York, NY, USA
- Department of Psychiatry, New York University Langone School of Medicine, New York, NY, USA
| | - Amit Etkin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.
- Alto Neuroscience, Inc., Los Altos, CA, USA.
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Henricksen E, Moayedi Y, Lee R, Han J, Waddell K, Luikart H, Morales D, Gordon J, Lyapin A, Duclos S, Jimenez S, Khush K, Teuteberg J. Ace in the Hole Use of Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in the First Year after Heart Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Lee R, Henricksen E, Moayedi Y, Han J, Feng K, Waddell K, Luikart H, Morales D, Gordon J, Lyapin A, Duclos S, Jimenez S, Teuteberg J, Khush K. Don't Go Breakin’ My Heart: Lack of Association between Granulocyte Colony Stimulating Factor and Development of Acute Cellular Rejection. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.809] [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] Open
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Han J, Moayedi Y, Henricksen E, Lee R, Waddell K, Luikart H, Morales D, Gordon J, Lyapin A, Duclos S, Feng K, Jimenez S, Teuteberg J, Khush K. Donor Drug Overdose Not Associated with Primary Graft Dysfunction after Heart Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Gordon J, Mcewan P, Young R, Kirkness P, Penrod J, Yuan Y. FP10.01 Survival in Advanced SCLC: Projected Impact of Immuno-Oncology-Associated Durable Response on Population Health Gains in US. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gordon III J, Remillard N, Straight C, Nagarajan R, Damon B, Chipkin S, Miller M, Kent J, Gordon J. Age-Related Changes in Molecular and Whole Muscle Function: Role of Fat Content? Innov Aging 2020. [PMCID: PMC7740761 DOI: 10.1093/geroni/igaa057.463] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Decreases in muscle size and function are a general consequence of old age; the precise mechanisms of these changes remain unclear. Recent studies suggest that fat deposition in muscle may also contribute to dysfunction in older adults. Fat content was quantified in the quadriceps, and its effects on function in healthy young (21-45 y) and older (65-75 y) men and women (n=44) of comparable physical activity were compared. A subset of the young matched with the older group for muscle fat content were also examined. Peak fat-free whole muscle cross-sectional area (mCSA; cm2), volume (MV; cm3), fat content (fat fraction, FF; %), specific torque (Nm/mCSA) and peak contraction velocity (Nm∙s-1) were determined using fat-water magnetic resonance imaging and dynamometry (0-300□∙s-1). To examine potential molecular mechanisms of muscle weakness, vastus lateralis biopsies were obtained (n=31) and cross-bridge kinetics of type I and II fibers were determined. FF was higher in older adults than young (8.4±1.2% (SE), 7.6±1.4; p=0.03), while mCSA (48.9±10.4 vs. 64.2±17.3), MV (1536±532 vs. 2112±708), specific torque (2.6±0.4 vs. 3.2±0.4), and peak voluntary contraction velocity (422±20 vs. 441±23) were lower in older than young (p<0.01). Type II fiber myosin attachment rate was slower and attachment time longer in older muscle (p<0.017), providing a potential mechanism for the slowing of peak contraction velocity with age. Notably, differences at the whole muscle and molecular levels remained for the subset of young and older groups matched for FF, suggesting that fat deposition in muscle does not exacerbate age-related changes in function.
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Affiliation(s)
- Joseph Gordon III
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Nicholas Remillard
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Chad Straight
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | | | - Bruce Damon
- Vanderbilt University, Nashville, Tennessee, United States
| | - Stuart Chipkin
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Mark Miller
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Jane Kent
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Joseph Gordon
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
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Straight C, Gordon J, Foster A, Remillard N, Damon B, Chipkin S, Kent J, Miller M. Sex-Dependent Effects of Quadriceps Fat Content on Single Muscle Fiber Size in Older Adults. Innov Aging 2020. [PMCID: PMC7741817 DOI: 10.1093/geroni/igaa057.419] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Evidence suggests that ectopic fat deposition interferes with skeletal muscle structure and function, but few studies have examined underlying morphological and contractile properties at the single fiber level. Healthy older (65-75 y) men (n=9) and women (n=9) underwent dynamometry for assessment of knee extensor maximal torque, water-fat magnetic resonance imaging to quantify quadriceps muscle cross-sectional area (CSA) and fat fraction (FF), and vastus lateralis biopsies to determine morphology and function of type I and II muscle fibers. Despite similar body mass indices (24.4±1.3 vs. 24.6±0.5 kg∙m2, p=0.93) and daily moderate-to-vigorous physical activity (46±7 vs. 41±9 min∙d-1, p=0.67), women had greater FF (9.0±0.3 [range: 7.6-10.6] vs. 7.9±0.4 [6.0-9.7] %, p=0.04) than men, indicating increased adipose tissue deposition in skeletal muscle. Women also had smaller quadriceps CSA (39.8±1.8 vs. 57.9±1.3 cm2, p=0.01), specific torque (1.5±0.1 vs. 1.9±0.1 Nm∙cm-2, p=0.01) and type II fiber CSA (3,943±312 [2,350-5,140] vs. 5,352±384 [3,560-6,590] µm2, p=0.01) than men. Type I CSA did not differ by sex (4,918±228 [3,740-5,600] vs. 5,630±440 [3,640-7,670] µm2, p=0.19). In older women, FF was inversely associated with single fiber CSA in type I (r= -0.81, p=0.02) and II (r= -0.76, p=0.03) fibers, and tended to be associated with slower myosin-actin cross-bridge kinetics (longer myosin attachment time) in type I fibers (r=0.65, p=0.08). These relationships were not observed in men. Overall, healthy older women have greater intramuscular fat than men, which may contribute to sex-specific effects on knee extensor specific torque through differences in muscle fiber size and cross-bridge kinetics.
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Affiliation(s)
- Chad Straight
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Joseph Gordon
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Aurora Foster
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Nicholas Remillard
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Bruce Damon
- Vanderbilt University, Nashville, Tennessee, United States
| | - Stuart Chipkin
- University of Massachusetts Amherst, Amherst, United States
| | - Jane Kent
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
| | - Mark Miller
- University of Massachusetts Amherst, Amherst, Massachusetts, United States
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Ostermayr TM, Kreuzer C, Englbrecht FS, Gebhard J, Hartmann J, Huebl A, Haffa D, Hilz P, Parodi K, Wenz J, Donovan ME, Dyer G, Gaul E, Gordon J, Martinez M, Mccary E, Spinks M, Tiwari G, Hegelich BM, Schreiber J. Laser-driven x-ray and proton micro-source and application to simultaneous single-shot bi-modal radiographic imaging. Nat Commun 2020; 11:6174. [PMID: 33268784 PMCID: PMC7710721 DOI: 10.1038/s41467-020-19838-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 10/29/2020] [Indexed: 11/16/2022] Open
Abstract
Radiographic imaging with x-rays and protons is an omnipresent tool in basic research and applications in industry, material science and medical diagnostics. The information contained in both modalities can often be valuable in principle, but difficult to access simultaneously. Laser-driven solid-density plasma-sources deliver both kinds of radiation, but mostly single modalities have been explored for applications. Their potential for bi-modal radiographic imaging has never been fully realized, due to problems in generating appropriate sources and separating image modalities. Here, we report on the generation of proton and x-ray micro-sources in laser-plasma interactions of the focused Texas Petawatt laser with solid-density, micrometer-sized tungsten needles. We apply them for bi-modal radiographic imaging of biological and technological objects in a single laser shot. Thereby, advantages of laser-driven sources could be enriched beyond their small footprint by embracing their additional unique properties, including the spectral bandwidth, small source size and multi-mode emission. Here the authors show a synchronized single-shot bi-modal x-ray and proton source based on laser-generated plasma. This source can be useful for radiographic and tomographic imaging.
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Affiliation(s)
- T M Ostermayr
- Ludwig-Maximilians-Universität München, Fakultät für Physik, 85748, Garching, Germany. .,Max-Planck-Institut für Quantenoptik, 85748, Garching, Germany. .,Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA.
| | - C Kreuzer
- Ludwig-Maximilians-Universität München, Fakultät für Physik, 85748, Garching, Germany
| | - F S Englbrecht
- Ludwig-Maximilians-Universität München, Fakultät für Physik, 85748, Garching, Germany
| | - J Gebhard
- Ludwig-Maximilians-Universität München, Fakultät für Physik, 85748, Garching, Germany
| | - J Hartmann
- Ludwig-Maximilians-Universität München, Fakultät für Physik, 85748, Garching, Germany
| | - A Huebl
- Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - D Haffa
- Ludwig-Maximilians-Universität München, Fakultät für Physik, 85748, Garching, Germany
| | - P Hilz
- Ludwig-Maximilians-Universität München, Fakultät für Physik, 85748, Garching, Germany.,Helmholtz Institute Jena, 07743, Jena, Germany
| | - K Parodi
- Ludwig-Maximilians-Universität München, Fakultät für Physik, 85748, Garching, Germany
| | - J Wenz
- Ludwig-Maximilians-Universität München, Fakultät für Physik, 85748, Garching, Germany
| | - M E Donovan
- Center for High Energy Density Science, University of Texas at Austin, Austin, TX, 78712, USA
| | - G Dyer
- Center for High Energy Density Science, University of Texas at Austin, Austin, TX, 78712, USA
| | - E Gaul
- Center for High Energy Density Science, University of Texas at Austin, Austin, TX, 78712, USA
| | - J Gordon
- Center for High Energy Density Science, University of Texas at Austin, Austin, TX, 78712, USA
| | - M Martinez
- Center for High Energy Density Science, University of Texas at Austin, Austin, TX, 78712, USA
| | - E Mccary
- Center for High Energy Density Science, University of Texas at Austin, Austin, TX, 78712, USA
| | - M Spinks
- Center for High Energy Density Science, University of Texas at Austin, Austin, TX, 78712, USA
| | - G Tiwari
- Center for High Energy Density Science, University of Texas at Austin, Austin, TX, 78712, USA
| | - B M Hegelich
- Center for High Energy Density Science, University of Texas at Austin, Austin, TX, 78712, USA
| | - J Schreiber
- Ludwig-Maximilians-Universität München, Fakultät für Physik, 85748, Garching, Germany. .,Max-Planck-Institut für Quantenoptik, 85748, Garching, Germany.
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DiSilvestro J, DiSilvestro P, Pandey A, Gordon J, Ball J, Moxley K. Analysis of advanced quantitative computed tomography imaging features in predicting progression free survival of advanced epithelial ovarian cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.120] [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: 11/30/2022]
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Blackburn P, Watson C, Gordon J, Covington R, Smiley L, Reed M, Tillmanns T. Video-assisted genetic counseling in patients with ovarian, fallopian, and peritoneal carcinoma: A prospective, randomized controlled trial. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.06.018] [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: 10/23/2022]
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Varghese L, Lim C, Gordon J, Gutierrez G, Gauri M. PRS5 An Environment IMPACT Analysis of the Use of Respimat RE-Usable for the Treatment of Chronic-Obstructive Pulmonary Disorder (COPD) in South-EAST ASIA and South Korea. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.519] [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: 11/25/2022]
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Kim B, Kim M, Kim T, Gordon J, Varghese L. PDB9 Budget IMPACT Analysis of Empagliflozin in Type-2 Diabetes Patients with High Cardiovascular Risk in South Korea Based on Empa-REG OUTCOME® Trial: HIRA(HEALTH INSURANCE REVIEW & ASSESSMENT SERVICE)-NPS (NATIONAL PATIENTS SAMPLE) Database. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Henning S, Groves L, Hurst M, Sugrue D, Gordon J, Choy E. AB0295 CHANGE IN DISEASE ACTIVITY AND TREATMENT RESPONSE AFTER ABATACEPT TREATMENT FOR RHEUMATOID ARTHRITIS: REAL-WORLD EVIDENCE FROM THE UK. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Background:Patients with moderate to severe active rheumatoid arthritis (RA) may be treated with biological disease-modifying antirheumatic drugs (bDMARDs), such as abatacept, after treatment failure with conventional synthetic DMARDs (csDMARDs). Abatacept has shown equivalent efficiency with other targeted therapies for RA in clinical trials and network meta-analyses. However, there is limited real-world evidence on patient outcomes associated with abatacept treatment in UK routine clinical practice.Objectives:To describe the clinical outcomes of RA patients treated with abatacept in UK real-world clinical practice.Methods:A multi-centre, retrospective observational study was undertaken in RA patients treated with abatacept at any line of therapy (LOT). Data were extracted from medical records at four UK hospitals. Patients aged 18 years or older who received abatacept between 1 January 2013 and 31 December 2017 were included. The index date was the date of first bDMARD initiation, with follow-up from index date to latest RA clinic visit, death or 31 December 2017, whichever occurred first.Clinical outcomes (disease activity and response to treatment) were measured using the 28-joint Disease Activity Score based on erythrocyte sedimentation rate (DAS28-ESR) and European League Against Rheumatism (EULAR) response criteria1-3.Results:The study included 213 patients (mean age 55.2 years, 71.4% female, 7.0 years mean duration of RA at index date). Where ACPA and RF status were recorded, 66.1% of patients were anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF) positive at index. Mean DAS28-ESR at index was 6.2 (SD 1.0) and 80.9% of patients were categorised with high disease activity.Irrespective of LOT, changes in DAS28-ESR (where recorded) from LOT initiation among patients treated with abatacept versus other bDMARDs were -1.59 vs -1.56 (LS mean (SE): -0.04; 95% CI: -0.45,0.38; p=0.86) at 6 months and -1.98 vs -1.42 (LS mean (SE): -0.56; 95% CI: -1.04,-0.07; p=0.03) at 12 months, respectively. Table 1 shows that compared with other bDMARDs, patients treated with abatacept at any LOT experienced good response to treatment at 6 months (22.8%, n= 21/92 vs 15.9%, n= 24/151) and 12 months (27.9%, n= 17/61 vs 20.5%, n= 24/117) according to EULAR criteria.Table1.Treatment response at 6 and 12 months after initiation of any LOT*EULAR response6 months12 monthsAbatacept,n = 92Other bDMARDs,n = 151Abatacept,n = 61Other bDMARDs,n = 117Good21 (22.8%)24 (15.9%)17 (27.9%)24 (20.5%)Moderate38 (41.3%)60 (39.7%)22 (36.1%)40 (34.2%)None33 (35.9%)67 (44.4%)22 (36.1%)53 (45.3%)n = number of unique LOTs in which a patient has both a DAS28-ESR collected at initiation and 6 and/or 12 months (a patient may be included in this analysis multiple times)Patients who received abatacept remained on treatment for significantly longer than patients who received other bDMARDs at LOT1 (median 53.4 vs 17.4 months; p<0.01) (Figure 1) and at LOT2 (median 40.1 vs 17.1 months; p<0.01).Figure 1.Time on treatment from first LOT initiation, abatacept versus other bDMARDsConclusion:RA patients who received bDMARDs, including abatacept, experienced reduced disease activity. These findings are comparable with those from a European, multicentre, observational study on patients receiving abatacept4. The mechanisms associated with such clinical benefit should be elucidated in future research.References:[1]Prevoo et al. Arthritis Rheum 1995;38:44–8.[2]Fransen & van Riel. Clin Exp Rheumatol 2005;23:S93–9.[3]van Gestel et al. Arthritis Rheum 1998;41:1845–50.[4]Alten et al. Clin Rheumatol (2019) 38: 1413.Acknowledgments:Yusuf PatelSrinivasan VenkatachalamJames MaxwellUsman FarooquiKevin PollockDisclosure of Interests:Sadie Henning Shareholder of: Sadie Henning is a shareholder for Bristol-Myers Squibb Pharmaceuticals Ltd., Employee of: Sadie Henning is employed by Bristol-Myers Squibb Pharmaceuticals Ltd., Lara Groves Grant/research support from: Lara Groves is an employee of Health Economics and Outcomes Research Ltd., Cardiff, UK, who received fees from Bristol-Myers Squibb Pharmaceuticals Ltd in relation to this study., Michael Hurst Grant/research support from: Michael Hurst is an employee of Health Economics and Outcomes Research Ltd., Cardiff, UK, who received fees from Bristol-Myers Squibb Pharmaceuticals Ltd in relation to this study., Daniel Sugrue Grant/research support from: Daniel Sugrue is an employee of Health Economics and Outcomes Research Ltd., Cardiff, UK, who received fees from Bristol-Myers Squibb Pharmaceuticals Ltd in relation to this study., Jason Gordon Grant/research support from: Jason Gordon is an employee of Health Economics and Outcomes Research Ltd., Cardiff, UK, who received fees from Bristol-Myers Squibb Pharmaceuticals Ltd in relation to this study., Ernest Choy Grant/research support from: Amgen, Bio-Cancer, Chugai Pharma, Ferring Pharmaceuticals, Novimmune, Pfizer, Roche, UCB, Consultant of: AbbVie, Amgen, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Chelsea Therapeutics, Chugai Pharma, Daiichi Sankyo, Eli Lilly, Ferring Pharmaceuticals, GlaxoSmithKline, Hospita, Ionis, Janssen, Jazz Pharmaceuticals, MedImmune, Merck Sharp & Dohme, Merrimack Pharmaceutical, Napp, Novartis, Novimmune, ObsEva, Pfizer, R-Pharm, Regeneron Pharmaceuticals, Inc., Roche, SynAct Pharma, Sanofi Genzyme, Tonix, UCB, Speakers bureau: Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Chugai Pharma, Eli Lilly, Hospira, Merck Sharp & Dohme, Novartis, Pfizer, Regeneron Pharmaceuticals, Inc., Roche, Sanofi-Aventis, UCB
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West AR, Turner-Brannen E, Krueger A, Syeda S, Osagie J, Gordon J. Development and Optimization of a 3D Bioprinted Experimental Model of Skeletal Muscle. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.05578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Adrian Robert West
- University of Manitoba
- Children's Hospital Research Institute of Manitoba
| | | | - Alexander Krueger
- University of Manitoba
- Children's Hospital Research Institute of Manitoba
| | - Sanjana Syeda
- University of Manitoba
- Children's Hospital Research Institute of Manitoba
| | - Jeffery Osagie
- University of Manitoba
- Children's Hospital Research Institute of Manitoba
| | - Joseph Gordon
- University of Manitoba
- Children's Hospital Research Institute of Manitoba
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Magallanes L, Meyer S, Gianoli C, Kopp B, Voss B, Jakel O, Brons S, Gordon J, Parodi K. Upgrading an Integrating Carbon-Ion Transmission Imaging System With Active Scanning Beam Delivery Toward Low Dose Ion Imaging. IEEE Trans Radiat Plasma Med Sci 2020. [DOI: 10.1109/trpms.2019.2948584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Martens M, Field J, Chapman D, Ivanco T, Gordon J. MISOPROSTOL ATTENUATES CARDIOMYOCYTE PROLIFERATION IN THE NEONATAL HEART THROUGH A BNIP3-DELTA-EXON3/MEF2-DEPENDENT SIGNALLING PATHWAY. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.213] [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: 11/17/2022] Open
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Zhang Z, Gordon J, Sedarati K. Chronic Obstructive Pulmonary Disease: Recent Advances and Controversies in Inhaler Therapies. Am J Respir Crit Care Med 2019; 197:944-946. [PMID: 29406771 DOI: 10.1164/rccm.201704-0833rr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Zhou Zhang
- Pulmonary and Critical Care Medicine Fellowship, Cedars-Sinai Medical Center, Los Angeles, California
| | - Joseph Gordon
- Pulmonary and Critical Care Medicine Fellowship, Cedars-Sinai Medical Center, Los Angeles, California
| | - Kasra Sedarati
- Pulmonary and Critical Care Medicine Fellowship, Cedars-Sinai Medical Center, Los Angeles, California
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Reddy H, Choi J, Maynes E, Carlson L, Gordon J, Horan D, Khan J, Weber M, Morris R, Massey H, Tchantchaleishvili V. Cardiac Surgical Procedures with Concomitant vs. Staged Orthotopic Liver Transplant. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Moayedi Y, Fan C, Miller R, Tremblay-Gravel M, Kawana M, Luikart H, D'Emilio N, Gordon J, Parizo J, Oro G, Wainwright R, Hiesinger W, Manlhiot C, Ross H, Khush K, Teuteberg J. The Gift That Keeps on Giving? The Impact of Donor Coronary Atherosclerosis on the Development of Coronary Allograft Vasculopathy by IVUS. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.533] [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: 10/27/2022] Open
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Gordon J, Ammendolea C, Chari N, Armstrong R, Hall W. Abstract P5-13-10: Recommendations to improve the lived experience of early stage and metastatic breast cancer patients in Canada. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-13-10] [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
Introduction: In 2017, the Canadian Breast Cancer Network (CBCN) undertook two surveys of Canadians who have experienced a breast cancer diagnosis to better understand the lived experience of patients and what opportunities exist to improve support for patients, survivors and their families and minimize the impact of this disease. There were 278 people diagnosed with early stage breast cancer, defined as stage I, II or III for the purpose of this report, and 180 people living with metastatic breast cancer, or stage IV breast cancer, who responded to these surveys.
Results: The survey data shows that while patients feel supported and well cared for in certain aspects there are still significant opportunities for improvement. CBCN has identified five overarching factors that could greatly improve health outcomes and the quality of life of Canadians who experience a breast cancer diagnosis.
1. Improved Educational Resources: The quality and availability of patient education has increased over the past couple of decades; however, there are still some patient friendly educational resources including, specific resources for newly diagnosed metastatic breast cancer patients; decision aids that support breast cancer surgery and post-surgery decisions; navigation of financial resources; treatment timelines and recovery expectations; private insurance navigation and information on dying-well.
2. Increased Access to Treatments: This challenge was specifically identified and vocalized by people living with metastatic breast cancer. Efforts need to continue to shorten the drug approval process time, increase equitable access to new medications for all Canadians, and ensure equitable access for take home oral cancer medications.
3. Increased Access to Information: Information available to patients about their health and treatment has increased; however, there is still information that isn't always communicated to patients that would help them make informed decisions about their health. This includes information about breast density, palliative care options and information around clinical trials.
4. Integrated Systemic Supports: The health care system as a whole is responsible for many of the services and supports that patients need to achieve optimal health and manage their breast cancer; however, these supports can be challenging to navigate and are sometimes lacking. Supports that need to be addressed at a systemic level include developing survivorship care plans for early stage patients, patient navigation, communication tools to support general practitioners during the diagnosis process, access to psychosocial professionals and increased Employment Insurance Sickness Benefits.
5. Increased Awareness and Understanding of Metastatic Breast Cancer: A lack of accurate statistics and overall awareness of metastatic breast cancer makes it challenging to truly understand the impact of this disease and also leaves people living with an incurable form of breast cancer feeling isolated and disconnected. Accurate statistics and increased awareness would help further the understanding of the impact of this stage of breast cancer and better support those with it.
Citation Format: Gordon J, Ammendolea C, Chari N, Armstrong R, Hall W. Recommendations to improve the lived experience of early stage and metastatic breast cancer patients in Canada [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-13-10.
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Affiliation(s)
- J Gordon
- Canadian Breast Cancer Network, Ottawa, ON, Canada
| | - C Ammendolea
- Canadian Breast Cancer Network, Ottawa, ON, Canada
| | - N Chari
- Canadian Breast Cancer Network, Ottawa, ON, Canada
| | - R Armstrong
- Canadian Breast Cancer Network, Ottawa, ON, Canada
| | - W Hall
- Canadian Breast Cancer Network, Ottawa, ON, Canada
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Muffih T, Claudettea C, Manjuha F, DeGregoriob G, Mangaa S, Nulaha K, Kiyanga E, Bradfordb L, Sandoc Z, Welty T, Welty E, Gordon J. Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.67200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. Trained nurses provide fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment of reproductive tract infections (RTI) and refer for further tests and treatment indicated. Methods: We retrospectively reviewed and analyzed WHP medical records from women who presented for cervical cancer screening from 2007-2014. Results: In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment of RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. Conclusion: The WHP's experience using a cost-recovery model and offering multiple services in a single clinic rather than stand-alone cervical cancer screening may be a practical model to make cervical cancer screening services accessible, comprehensive and sustainable. Integrating other women's health services enabled women to address additional health care needs.
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Affiliation(s)
- T.P. Muffih
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - C. Claudettea
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - F. Manjuha
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - G. DeGregoriob
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - S. Mangaa
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - K. Nulaha
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - E. Kiyanga
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - L. Bradfordb
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Z. Sandoc
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - T. Welty
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - E. Welty
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - J. Gordon
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
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Ammendolea C, Gordon J, Hall W, Armstrong R, Chari N. Financial Resources Digital Navigation Tool for Metastatic Breast Cancer Patients. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.69400] [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: 11/20/2022] Open
Abstract
Background and context: Although Canadians enjoy a universal health care system, there continues to be costs to patients that are not covered by the system. The economic impact of breast cancer is huge and, in many cases, devastating for patients and their families. As a result there is a need for educational and navigational resources that assist patients with the financial burden of facing a metastatic breast cancer diagnosis. Aim: The aim of this project is to develop an online navigation tool that will assist Canadians living with metastatic breast cancer source financial supports and resources to help lessen the financial impact of their diagnosis. Strategy/Tactics: An advisory board of people living with metastatic breast cancer was convened to help guide this project and provide input on the lived experience and financially challenges of Canadians living with this stage of the disease. The input from the advisory board along with the responses from a survey of over 150 Canadian metastatic breast cancer patients informed the type of information that should be included in the resource. Through an environmental scan and research of various financial supports, a comprehensive list of financial resources available locally, regionally and nationally was compiled. This data were integrated into a database that will be accessed through an intuitive online interface that will be integrated with CBCN´s Web site. The advisory board reviewed the draft content and framework to ensure that identified needs and priorities have been addressed. All content was translated into French as this tool will be offered in both French and English. The anticipated launch of this resource is November 2018. Outcomes: CBCN anticipates that over 1200 people living with metastatic breast cancer will access this resource in the first year and that over 50 institutions will be informed that this tool is available for their patients. Given that this will be a unique resource, CBCN expects that patients, health care professionals and support workers will access this resource to better support people living with metastatic breast cancer. What was learned: This resource has not launched, but based on CBCN´s research and the feedback of the patient advisory board, it is understood that there is a great need for this financial resources navigation tool.
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Rizk S, Amin W, Said K, Hamza H, Burns JC, Gordon J, Daniels LB, Reeves R, Kandil H, El Said G. P2634Studies on missed Kawasaki disease in developing countries. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2634] [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: 11/13/2022] Open
Affiliation(s)
- S Rizk
- Cairo University Hospitals, Cardiology, Cairo, Egypt
| | - W Amin
- Cairo University Hospitals, Cardiology, Cairo, Egypt
| | - K Said
- Cairo University Hospitals, Cardiology, Cairo, Egypt
| | - H Hamza
- Cairo University Hospitals, Pediatrics, Cairo, Egypt
| | - J C Burns
- University of California San Diego, Pediatrics, San Diego, United States of America
| | - J Gordon
- Sharp Memorial Hospital, Cardiology, San Diego, United States of America
| | - L B Daniels
- University of California San Diego, Cardiology, San Diego, United States of America
| | - R Reeves
- University of California San Diego, Cardiology, San Diego, United States of America
| | - H Kandil
- Cairo University Hospitals, Cardiology, Cairo, Egypt
| | - G El Said
- Cairo University Hospitals, Cardiology, Cairo, Egypt
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Tang WW, McGee P, Lachin JM, Li DY, Hoogwerf B, Hazen SL, Nathan D, Zinman B, Crofford O, Genuth S, Brown‐Friday J, Crandall J, Engel H, Engel S, Martinez H, Phillips M, Reid M, Shamoon H, Sheindlin J, Gubitosi‐Klug R, Mayer L, Pendegast S, Zegarra H, Miller D, Singerman L, Smith‐Brewer S, Novak M, Quin J, Genuth S, Palmert M, Brown E, McConnell J, Pugsley P, Crawford P, Dahms W, Gregory N, Lackaye M, Kiss S, Chan R, Orlin A, Rubin M, Brillon D, Reppucci V, Lee T, Heinemann M, Chang S, Levy B, Jovanovic L, Richardson M, Bosco B, Dwoskin A, Hanna R, Barron S, Campbell R, Bhan A, Kruger D, Jones J, Edwards P, Bhan A, Carey J, Angus E, Thomas A, Galprin A, McLellan M, Whitehouse F, Bergenstal R, Johnson M, Gunyou K, Thomas L, Laechelt J, Hollander P, Spencer M, Kendall D, Cuddihy R, Callahan P, List S, Gott J, Rude N, Olson B, Franz M, Castle G, Birk R, Nelson J, Freking D, Gill L, Mestrezat W, Etzwiler D, Morgan K, Aiello L, Golden E, Arrigg P, Asuquo V, Beaser R, Bestourous L, Cavallerano J, Cavicchi R, Ganda O, Hamdy O, Kirby R, Murtha T, Schlossman D, Shah S, Sharuk G, Silva P, Silver P, Stockman M, Sun J, Weimann E, Wolpert H, Aiello L, Jacobson A, Rand L, Rosenzwieg J, Nathan D, Larkin M, Christofi M, Folino K, Godine J, Lou P, Stevens C, Anderson E, Bode H, Brink S, Cornish C, Cros D, Delahanty L, eManbey ., Haggan C, Lynch J, McKitrick C, Norman D, Moore D, Ong M, Taylor C, Zimbler D, Crowell S, Fritz S, Hansen K, Gauthier‐Kelly C, Service F, Ziegler G, Barkmeier A, Schmidt L, French B, Woodwick R, Rizza R, Schwenk W, Haymond M, Pach J, Mortenson J, Zimmerman B, Lucas A, Colligan R, Luttrell L, Lopes‐Virella M, Caulder S, Pittman C, Patel N, Lee K, Nutaitis M, Fernandes J, Hermayer K, Kwon S, Blevins A, Parker J, Colwell J, Lee D, Soule J, Lindsey P, Bracey M, Farr A, Elsing S, Thompson T, Selby J, Lyons T, Yacoub‐Wasef S, Szpiech M, Wood D, Mayfield R, Molitch M, Adelman D, Colson S, Jampol L, Lyon A, Gill M, Strugula Z, Kaminski L, Mirza R, Simjanoski E, Ryan D, Johnson C, Wallia A, Ajroud‐Driss S, Astelford P, Leloudes N, Degillio A, Schaefer B, Mudaliar S, Lorenzi G, Goldbaum M, Jones K, Prince M, Swenson M, Grant I, Reed R, Lyon R, Kolterman O, Giotta M, Clark T, Friedenberg G, Sivitz W, Vittetoe B, Kramer J, Bayless M, Zeitler R, Schrott H, Olson N, Snetselaar L, Hoffman R, MacIndoe J, Weingeist T, Fountain C, Miller R, Johnsonbaugh S, Patronas M, Carney M, Mendley S, Salemi P, Liss R, Hebdon M, Counts D, Donner T, Gordon J, Hemady R, Kowarski A, Ostrowski D, Steidl S, Jones B, Herman W, Martin C, Pop‐Busui R, Greene D, Stevens M, Burkhart N, Sandford T, Floyd J, Bantle J, Flaherty N, Terry J, Koozekanani D, Montezuma S, Wimmergren N, Rogness B, Mech M, Strand T, Olson J, McKenzie L, Kwong C, Goetz F, Warhol R, Hainsworth D, Goldstein D, Hitt S, Giangiacomo J, Schade D, Canady J, Burge M, Das A, Avery R, Ketai L, Chapin J, Schluter M, Rich J, Johannes C, Hornbeck D, Schutta M, Bourne P, Brucker A, Braunstein S, Schwartz S, Maschak‐Carey B, Baker L, Orchard T, Cimino L, Songer T, Doft B, Olson S, Becker D, Rubinstein D, Bergren R, Fruit J, Hyre R, Palmer C, Silvers N, Lobes L, Rath PP, Conrad P, Yalamanchi S, Wesche J, Bratkowksi M, Arslanian S, Rinkoff J, Warnicki J, Curtin D, Steinberg D, Vagstad G, Harris R, Steranchak L, Arch J, Kelly K, Ostrosaka P, Guiliani M, Good M, Williams T, Olsen K, Campbell A, Shipe C, Conwit R, Finegold D, Zaucha M, Drash A, Morrison A, Malone J, Bernal M, Pavan P, Grove N, Tanaka E, McMillan D, Vaccaro‐Kish J, Babbione L, Solc H, DeClue T, Dagogo‐Jack S, Wigley C, Ricks H, Kitabchi A, Chaum E, Murphy M, Moser S, Meyer D, Iannacone A, Yoser S, Bryer‐Ash M, Schussler S, Lambeth H, Raskin P, Strowig S, Basco M, Cercone S, Zinman B, Barnie A, Devenyi R, Mandelcorn M, Brent M, Rogers S, Gordon A, Bakshi N, Perkins B, Tuason L, Perdikaris F, Ehrlich R, Daneman D, Perlman K, Ferguson S, Palmer J, Fahlstrom R, de Boer I, Kinyoun J, Van Ottingham L, Catton S, Ginsberg J, McDonald C, Harth J, Driscoll M, Sheidow T, Mahon J, Canny C, Nicolle D, Colby P, Dupre J, Hramiak I, Rodger N, Jenner M, Smith T, Brown W, May M, Lipps Hagan J, Agarwal A, Adkins T, Lorenz R, Feman S, Survant L, White N, Levandoski L, Grand G, Thomas M, Joseph D, Blinder K, Shah G, Burgess D, Boniuk I, Santiago J, Tamborlane W, Gatcomb P, Stoessel K, Ramos P, Fong K, Ossorio P, Ahern J, Gubitosi‐Klug R, Meadema‐Mayer L, Beck C, Farrell K, Genuth S, Quin J, Gaston P, Palmert M, Trail R, Dahms W, Lachin J, Backlund J, Bebu I, Braffett B, Diminick L, Gao X, Hsu W, Klumpp K, Pan H, Trapani V, Cleary P, McGee P, Sun W, Villavicencio S, Anderson K, Dews L, Younes N, Rutledge B, Chan K, Rosenberg D, Petty B, Determan A, Kenny D, Williams C, Cowie C, Siebert C, Steffes M, Arends V, Bucksa J, Nowicki M, Chavers B, O'Leary D, Polak J, Harrington A, Funk L, Crow R, Gloeb B, Thomas S, O'Donnell C, Soliman E, Zhang Z, Li Y, Campbell C, Keasler L, Hensley S, Hu J, Barr M, Taylor T, Prineas R, Feldman E, Albers J, Low P, Sommer C, Nickander K, Speigelberg T, Pfiefer M, Schumer M, Moran M, Farquhar J, Ryan C, Sandstrom D, Williams T, Geckle M, Cupelli E, Thoma F, Burzuk B, Woodfill T, Danis R, Blodi B, Lawrence D, Wabers H, Gangaputra S, Neill S, Burger M, Dingledine J, Gama V, Sussman R, Davis M, Hubbard L, Budoff M, Darabian S, Rezaeian P, Wong N, Fox M, Oudiz R, Kim L, Detrano R, Cruickshanks K, Dalton D, Bainbridge K, Lima J, Bluemke D, Turkbey E, der Geest ., Liu C, Malayeri A, Jain A, Miao C, Chahal H, Jarboe R, Nathan D, Monnier V, Sell D, Strauch C, Hazen S, Pratt A, Tang W, Brunzell J, Purnell J, Natarajan R, Miao F, Zhang L, Chen Z, Paterson A, Boright A, Bull S, Sun L, Scherer S, Lopes‐Virella M, Lyons T, Jenkins A, Klein R, Virella G, Jaffa A, Carter R, Stoner J, Garvey W, Lackland D, Brabham M, McGee D, Zheng D, Mayfield R, Maynard J, Wessells H, Sarma A, Jacobson A, Dunn R, Holt S, Hotaling J, Kim C, Clemens Q, Brown J, McVary K. Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study. J Am Heart Assoc 2018. [PMCID: PMC6015340 DOI: 10.1161/jaha.117.008368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background
Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.
Methods and Results
A random subcohort of 349 participants was selected from the
DCCT
/
EDIC
(Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from
DCCT
baseline, year 1, and closeout of
DCCT
, and 1 to 2 years post‐
DCCT
(
EDIC
years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F
2α
isoprostanes, and its metabolite, 2,3 dinor‐8
iso
prostaglandin F
2α
. Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8
iso
prostaglandin F
2α
, an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase,
P
<0.003; −5.3% risk for 10% higher 2,3 dinor‐8
iso
prostaglandin F
2α
,
P
=0.0092). In contrast, the oxidative markers myeloperoxidase and F
2α
isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between
DCCT
intensive and conventional treatment groups in the change in all biomarkers across time segments.
Conclusions
Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.
Clinical Trial Registration
URL
:
https://www.clinicaltrials.gov
. Unique identifiers:
NCT
00360815 and
NCT
00360893.
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Affiliation(s)
- W.H. Wilson Tang
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
| | - Paula McGee
- The Biostatistics Center, George Washington University, Rockville, MD
| | - John M. Lachin
- The Biostatistics Center, George Washington University, Rockville, MD
| | - Daniel Y. Li
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | | | - Stanley L. Hazen
- Department of Cellular and Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH
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Mew EJ, Ritchie SD, VanderBurgh D, Beardy JL, Gordon J, Fortune M, Mamakwa S, Orkin AM. An environmental scan of emergency response systems and services in remote First Nations communities in Northern Ontario. Int J Circumpolar Health 2018; 76:1320208. [PMID: 28494638 PMCID: PMC5497541 DOI: 10.1080/22423982.2017.1320208] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Approximately 24,000 Ontarians live in remote Indigenous communities with no road access. These communities are a subset of Nishnawbe Aski Nation (NAN), a political grouping of 49 First Nations communities in Northern Ontario, Canada. Limited information is available regarding the status of emergency care in these communities. Objective: We aimed to understand emergency response systems, services, and training in remote NAN communities. Design: We used an environmental scan approach to compile information from multiple sources including community-based participatory research. This included the analysis of data collected from key informant interviews (n=10) with First Nations community health leaders and a multi-stakeholder roundtable meeting (n=33) in October 2013. Results: Qualitative analysis of the interview data revealed four issues related to emergency response systems and training: (1) inequity in response capacity and services, (2) lack of formalised dispatch systems, (3) turnover and burnout in volunteer emergency services, and (4) challenges related to first aid training. Roundtable stakeholders supported the development of a community-based emergency care system to address gaps. Conclusions: Existing first response, paramedical, and ambulance service models do not meet the unique geographical, epidemiological and cultural needs in most NAN communities. Sustainable, context-appropriate, and culturally relevant emergency care systems are needed.
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Affiliation(s)
- E J Mew
- a Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | - S D Ritchie
- b School of Human Kinetics , Sudbury , Canada.,c Centre for Rural and Northern Health Research , Laurentian University , Sudbury , Canada
| | - D VanderBurgh
- d Division of Clinical Sciences , Northern Ontario School of Medicine , Thunder Bay , Canada
| | - J L Beardy
- e Nishnawbe Aski Nation , Thunder Bay , Canada.,f Northern Ontario School of Medicine , Thunder Bay , Canada
| | - J Gordon
- g Sioux Lookout First Nations Health Authority , Sioux Lookout , Canada
| | - M Fortune
- h Michael G. DeGroote School of Medicine , McMaster University , Hamilton , Canada
| | - S Mamakwa
- e Nishnawbe Aski Nation , Thunder Bay , Canada
| | - A M Orkin
- a Dalla Lana School of Public Health , University of Toronto , Toronto , Canada.,i Schwartz/Reisman Emergency Medicine Institute , Sinai Health System , Toronto , Canada
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Pietras C, Thomasson A, Gordon J, Chen C, Chung J, McLean R, Acker M, Atluri P. Cardiac Allograft Survival Stratified by Preservation Solution: A Multi-Institutional Analysis. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Zem GC, Chimayan A, Aleksanyan V, Gordon J, Gomez F, Seyedroudbari A, Chang J, Botello T, Tan N, Arefin D, Tobar D, Khachekian A, Gama L, Durodola E, Batty J, Plascencia C, Barillas L, Roverud A, Kreuz S, Sarkisyan L, Lee F, Munoz J, Reque L, Abed V, Kinog L, Oppenheimer SB. A kinetic assay for non‐automated drug screening. FASEB J 2018. [DOI: 10.1096/fasebj.2018.32.1_supplement.531.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - A Chimayan
- California State University NorthridgeNorthridgeCA
| | - V Aleksanyan
- California State University NorthridgeNorthridgeCA
| | - J Gordon
- California State University NorthridgeNorthridgeCA
| | - F Gomez
- California State University NorthridgeNorthridgeCA
| | | | - J Chang
- California State University NorthridgeNorthridgeCA
| | - T Botello
- California State University NorthridgeNorthridgeCA
| | - N Tan
- California State University NorthridgeNorthridgeCA
| | - D Arefin
- California State University NorthridgeNorthridgeCA
| | - D Tobar
- California State University NorthridgeNorthridgeCA
| | - A Khachekian
- California State University NorthridgeNorthridgeCA
| | - L Gama
- California State University NorthridgeNorthridgeCA
| | - E Durodola
- California State University NorthridgeNorthridgeCA
| | - J Batty
- California State University NorthridgeNorthridgeCA
| | - C Plascencia
- California State University NorthridgeNorthridgeCA
| | - L Barillas
- California State University NorthridgeNorthridgeCA
| | - A Roverud
- California State University NorthridgeNorthridgeCA
| | - S Kreuz
- California State University NorthridgeNorthridgeCA
| | - L Sarkisyan
- California State University NorthridgeNorthridgeCA
| | - F Lee
- California State University NorthridgeNorthridgeCA
| | - J Munoz
- California State University NorthridgeNorthridgeCA
| | - L Reque
- California State University NorthridgeNorthridgeCA
| | - V Abed
- California State University NorthridgeNorthridgeCA
| | - L Kinog
- California State University NorthridgeNorthridgeCA
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42
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Gordon J, Henson M. A pilot study to determine if screening for the risk of dehydration, giving advice to improve hydration where indicated and the presence of a red jug in the home improved the fluid intake and hydration status of community patients receiving community nursing care. Clin Nutr ESPEN 2017. [DOI: 10.1016/j.clnesp.2017.07.044] [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: 10/18/2022]
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43
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Anyanwagu U, Mamza J, Gordon J, Donnelly R, Idris I. Premixed vs basal-bolus insulin regimen in Type 2 diabetes: comparison of clinical outcomes from randomized controlled trials and real-world data. Diabet Med 2017; 34:1728-1736. [PMID: 28945928 DOI: 10.1111/dme.13518] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2017] [Indexed: 02/04/2023]
Abstract
AIM To evaluate the concordance between data derived from randomized controlled trial (RCT) and real-world estimates of HbA1c and weight change after 24 weeks of initiation of a basal-bolus compared with a premixed insulin regimen in people with Type 2 diabetes. METHODS Data eight RCTs were pooled after a systematic review of studies examining basal-bolus (n = 1893) or premixed (n = 1517) regimens. Real-world data were extracted from the UK primary care dataset for people on basal-bolus (n = 7483) or premixed insulin regimens (n=10 744). The mean differences between HbA1c and weight from baseline were calculated using t-tests, while analysis of variance was used to compare the two treatment regimens. Linear regression analyses were used to determine the predictors of this change. RESULTS Both insulin regimens were associated with HbA1c reductions (real-world data -0.28%; RCT data, -1.4%) and weight gain (real-world data, +0.27 kg; RCT data, +2.96 kg) but there were no significant differences between basal-bolus and premixed insulin. Discordances in the pattern of treatment response were observed, however, between real-world and RCT data for both insulin regimens. For any given baseline HbA1c concentration, the change in HbA1c in the RCTs was greater than in real-world conditions and for those with baseline weight above ~60 kg, RCT data showed overall weight gain in contrast to slight weight loss in the real-world population. Lastly, for both randomized controlled trial and real-world populations, while greater baseline weight was associated with reduced response to treatment, the association was much steeper in the RCT than in the real-world population. In addition, greater baseline weight was associated with greater weight reductions in both premixed insulin and basal-bolus insulin regimens, although to a lesser extent with the latter. CONCLUSION These results highlight specific discrepancies in the HbA1c reduction and weight change in insulin regimen between real world versus RCT populations; with greater reduction in HbA1c and greater increase in weight observed in the RCT population than in the real-world population. Also, the basal-bolus regimens in both real-world and RCT populations showed greater reduction in HbA1c compared to the premix regimen (though more marked in RCTs), while the premix regimen showed greater increase in weight in real-world, as against basal-bolus in the RCT population.
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Affiliation(s)
- U Anyanwagu
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - J Mamza
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - J Gordon
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - R Donnelly
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK
| | - I Idris
- Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Nottingham, UK
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44
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Wright M, Vassar M, Gordon J, Frye L, Po W, Babb C. Evaluating Research Pipelines in Clinical Research for Minimally Invasive Gynecologic Surgery Guidelines. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.339] [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: 10/18/2022]
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45
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Rempel M, MacIntosh A, Hay J, Bouchard DR, Cornish S, Hai SM, Gordon J, McGavock J, Yardley JE. Vigorous Intensity Exercise and Hypoglycemia Risk in Untrained Individuals with Type 1 Diabetes. Can J Diabetes 2017. [DOI: 10.1016/j.jcjd.2017.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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46
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Christiansen M, Francillon L, Ikwuezunma G, Gordon J, Goedecke P, Bursac Z, Detti L. Prediction of first trimester miscarriage by ultrasound. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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47
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Daily L, Gordon J, Ulm M, ElNaggar A, Tillmanns T. Postoperative opioids: Are physicians prescribing more than what is necessary for adequate pain control? Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.385] [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: 11/25/2022]
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48
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Korenchan DE, Taglang C, von Morze C, Blecha J, Gordon J, Sriram R, Larson PEZ, Vigneron D, VanBrocklin H, Kurhanewicz J, Wilson DM, Flavell RR. Dicarboxylic acids as pH sensors for hyperpolarized 13C magnetic resonance spectroscopic imaging. Analyst 2017; 142:1429-1433. [PMID: 28322385 PMCID: PMC5462110 DOI: 10.1039/c7an00076f] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 12/18/2022]
Abstract
Imaging tumoral pH may help to characterize aggressiveness, metastasis, and therapeutic response. We report the development of hyperpolarized [2-13C,D10]diethylmalonic acid, which exhibits a large pH-dependent 13C chemical shift over the physiological range. We demonstrate that co-polarization with [1-13C,D9]tert-butanol accurately measures pH via13C NMR and magnetic resonance spectroscopic imaging in phantoms.
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Affiliation(s)
- D. E. Korenchan
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - C. Taglang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - C. von Morze
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - J. Blecha
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - J. Gordon
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - R. Sriram
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - P. E. Z. Larson
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - D. Vigneron
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - H. VanBrocklin
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - J. Kurhanewicz
- UC Berkeley-UCSF Graduate Program in Bioengineering, University of California, Berkeley and University of California, San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - D. M. Wilson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - R. R. Flavell
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
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Fernandez J, Rouzard K, Webb C, Voronkov M, Healy J, Huber K, Stock J, Stock M, Gordon J, Perez E. 641 SIG-1459 and SIG-1460: Novel anti-acne phytyl-cysteine compounds. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.663] [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: 10/19/2022]
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Fernandez J, Rouzard K, Webb C, Voronkov M, Healy J, Huber K, Stock J, Stock M, Gordon J, Perez E. 708 SIG-1451: A topical anti-inflammatory new chemical entity for atopic dermatitis (AD). J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.731] [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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