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Wilson K, Rich C, Hakimi Z, Horneff R, Fishman J, Mellor J, Earl L, Taylor Y, Simons A, Conyers J, Mulherin B, Majerus E, Röth A. Pegcetacoplan in paroxysmal nocturnal haemoglobinuria: Its use, its clinical effectiveness, and its influence on health-related quality of life and productivity. Eur J Haematol 2024; 112:516-529. [PMID: 37994576 DOI: 10.1111/ejh.14139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVES To describe real-world use/effectiveness of pegcetacoplan (PEG) in paroxysmal nocturnal haemoglobinuria (PNH). METHODS Data were drawn from the Adelphi PNH Disease Specific Programme™, a cross-sectional survey conducted in France, Italy, Germany, Spain and the United States from January to November 2022. Patients had a confirmed PNH diagnosis and received PEG for ≥1 month. Physicians reported patient characteristics, treatment use/satisfaction and their perception of patients' fatigue and health-related quality of life (HRQoL). Patients reported treatment satisfaction and completed questionnaires assessing fatigue, HRQoL and productivity. Descriptive statistics were reported. RESULTS Overall, 14 physicians provided data for 61 patients who had received 1080 mg/dose PEG for 1.3-14.8 months. At data collection compared to PEG initiation: haemoglobin was 2.5 g/dL higher on average; proportion of patients with lactate dehydrogenase (LDH) ≥1.5 × upper limit of normal was reduced by 27.4%; physician-perceived fatigue was lower and HRQoL better. Physician- and patient-reported treatment satisfaction was high for >90% of patients. Physicians and patients were more satisfied with PEG than previously prescribed C5 complement inhibitors. Mean work impairment and activity impairment in the 7 days prior to data collection were 32.9% and 22.4%, respectively. CONCLUSIONS These real-world data support the effectiveness of PEG through positive effects on haemoglobin, LDH, fatigue and HRQoL.
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Affiliation(s)
| | | | | | | | - Jesse Fishman
- Apellis Pharmaceuticals, Waltham, Massachusetts, USA
| | | | | | | | | | | | - Brian Mulherin
- Hematology Oncology of Indiana, Indianapolis, Indiana, USA
| | - Elaine Majerus
- Department of Medicine, Washington University, St. Louis, Missouri, USA
| | - Alexander Röth
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, West German Cancer Center, University of Duisburg-Essen, Essen, Germany
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Rich C, Wilson K, Olsen J, Pedersen M, Frederiksen H. The disease burden of paroxysmal nocturnal hemoglobinuria in Denmark: Epidemiology, survival, healthcare resource utilization, costs, treatment gaps, and labor market attachment. Eur J Haematol 2024; 112:412-423. [PMID: 38009907 DOI: 10.1111/ejh.14128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES To establish epidemiology, healthcare costs, and labor market attachment in patients with paroxysmal nocturnal hemoglobinuria (Pt-PNH) in Denmark. METHODS Data were from Statistics Denmark and the Danish Health Data Authority national population registers (2005-2021). Descriptive baseline statistics characterized the Pt-PNH analytic population; ordinary least squares and adjusted Cox proportional hazards regressions measured outcomes in the Pt-PNH versus Danish general population matched comparators. RESULTS Overall PNH incidence in Denmark was n = 11 during 2007-2009, n = 25 during 2016-2018 and n = 7 during 2019-2020; prevalence increased from n = 13 in 2006 to n = 62 in 2021. Of the overall n = 85 Pt-PNH; n = 24 were treated with complement-5 inhibitors (Pt-C5i) and n = 61 not treated with C5i (Pt-nC5i). Versus respective comparators, all patients had significantly greater annual per-patient costs (from inpatient hospital admissions, outpatient contacts, PNH treatments; indirect costs from lost earnings + transfer payments; post-diagnosis for Pt-PNH and Pt-nC5i, post-treatment initiation for Pt-C5i). The Pt-C5i incurred the greatest healthcare and indirect cost differences (€709 119; €152 832, respectively) followed by the Pt-PNH (€189 323; €29 159, respectively) and Pt-nC5i (€95 548; €4713, respectively). The Pt-PNH versus comparators also had an increased hazard of death (2.71 [95% CI, 1.63 - 4.51]). CONCLUSION Although a rare disease, PNH is associated with significant patient, healthcare system, and societal burdens in Denmark.
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Affiliation(s)
- Carly Rich
- Swedish Orphan Biovitrum AB, Stockholm, Sweden
| | - Koo Wilson
- Swedish Orphan Biovitrum AB, Stockholm, Sweden
| | | | | | - Henrik Frederiksen
- Department and Research Unit of Haematology, Odense University Hospital and Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Ke M, Soothill G, Wilson K, Swietlik S, Leckie A, Sutherland R. Descriptive study of COVID-19 vaccinations and infections within an NHS workforce. Occup Med (Lond) 2024; 74:120-127. [PMID: 38029429 DOI: 10.1093/occmed/kqad126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Healthcare workers were a priority group for coronavirus disease 2019 (COVID-19) vaccination during the pandemic. Occupational exposure may account for some of the increased risk faced. AIMS Describe COVID-19 vaccine uptake and infection rates in staff across a large NHS board in Scotland to better understand occupational risk during the pandemic. METHODS Descriptive cross-sectional study. Demographic data were extracted on 5 August 2021 from 26 058 members of staff. COVID-19 vaccination status and positive polymerase chain reaction (PCR) results were extracted on two separate dates to describe the timeline of staff infections between March 2020 and January 2022. RESULTS There was high uptake of all three vaccine doses across all demographic groups in hospital staff. PCR positivity decreased with increasing age and Scottish Index of Multiple Deprivation score. Staff and nosocomial COVID-19 infections followed peaks in community infection rates. CONCLUSIONS NHS Lothian is a typical NHS workforce with good vaccine uptake. Beyond very early cases, there seems to be minimal evidence of occupational acquisition of COVID-19. The large number of nosocomial infections at the start of the pandemic may, in fact, reflect lack of community testing at this time. Despite protection from high vaccine coverage, job type and good Infection Prevention and Control practices, it seems that staff remain at high risk of catching the highly transmissible omicron variant from the community rather than work.
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Affiliation(s)
- M Ke
- Clinical Infection Research Group, Edinburgh, EH4 2JP, UK
| | - G Soothill
- Regional Infectious Diseases Unit, Edinburgh, EH4 2JP, UK
| | - K Wilson
- Lothian Occupational Health and Safety Service, Edinburgh, EH9 2HL, UK
| | - S Swietlik
- Lothian NHS Board, Edinburgh, EH1 3EG, UK
| | - A Leckie
- Lothian Occupational Health and Safety Service, Edinburgh, EH9 2HL, UK
| | - R Sutherland
- Clinical Infection Research Group, Edinburgh, EH4 2JP, UK
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Adams DQ, Alduino C, Alfonso K, Avignone FT, Azzolini O, Bari G, Bellini F, Benato G, Biassoni M, Branca A, Brofferio C, Bucci C, Camilleri J, Caminata A, Campani A, Canonica L, Cao XG, Capelli S, Cappelli L, Cardani L, Carniti P, Casali N, Chiesa D, Clemenza M, Copello S, Cosmelli C, Cremonesi O, Creswick RJ, D'Addabbo A, Dafinei I, Davis CJ, Dell'Oro S, Di Domizio S, Dompè V, Fang DQ, Fantini G, Faverzani M, Ferri E, Ferroni F, Fiorini E, Franceschi MA, Freedman SJ, Fu SH, Fujikawa BK, Giachero A, Gironi L, Giuliani A, Gorla P, Gotti C, Gutierrez TD, Han K, Heeger KM, Huang RG, Huang HZ, Johnston J, Keppel G, Kolomensky YG, Ligi C, Ma L, Ma YG, Marini L, Maruyama RH, Mayer D, Mei Y, Moggi N, Morganti S, Napolitano T, Nastasi M, Nikkel J, Nones C, Norman EB, Nucciotti A, Nutini I, O'Donnell T, Ouellet JL, Pagan S, Pagliarone CE, Pagnanini L, Pallavicini M, Pattavina L, Pavan M, Pessina G, Pettinacci V, Pira C, Pirro S, Pozzi S, Previtali E, Puiu A, Rosenfeld C, Rusconi C, Sakai M, Sangiorgio S, Schmidt B, Scielzo ND, Sharma V, Singh V, Sisti M, Speller D, Surukuchi PT, Taffarello L, Terranova F, Tomei C, Vetter KJ, Vignati M, Wagaarachchi SL, Wang BS, Welliver B, Wilson J, Wilson K, Winslow LA, Zimmermann S, Zucchelli S. Erratum: Measurement of the 2νββ Decay Half-Life of ^{130}Te with CUORE [Phys. Rev. Lett. 126, 171801 (2021)]. Phys Rev Lett 2023; 131:249902. [PMID: 38181163 DOI: 10.1103/physrevlett.131.249902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Indexed: 01/07/2024]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.126.171801.
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Lucchesi A, Lovrencic B, McDonald V, Newland A, Morgan M, Eriksson D, Wilson K, Giordano G, Carli G, Geldman E, Daykin-Pont O, Prince S, Napolitano M. Treatment preferences towards thrombopoietin-receptor agonists for immune thrombocytopenia and experience of disease (TRAPeze): Italy cohort. Hematology 2023; 28:2253069. [PMID: 37680028 DOI: 10.1080/16078454.2023.2253069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVE Identify patient preference towards thrombopoietin-receptor agonists (TPO-RAs) and determine the clinical and social impact of immune thrombocytopenia (ITP) in Italy. METHODS The Thrombopoietin-Receptor Agonist Patient experience (TRAPeze) survey collected responses from Italian residents from 17th January to 28th February 2022. TRAPeze utilized a discrete choice experiment (DCE) to elicit patient preferences towards TPO-RA attributes and a patient burden survey (PBS) to determine ITP disease characteristics and social impact. RESULTS Seventy-six respondents completed the DCE, of which 69 completed both the DCE and PBS (mean [range] age 45 [18.0-73.0] years, 80% female). TPO-RA attributes with the greatest influence over respondent choice were method of administration (odds ratio [OR] 2.96; 95% confidence interval [CI] 2.16-4.06), drug-food interactions (OR 1.48; 95% CI 1.17-1.86) and frequency of dosing (OR 1.32; 95% CI 1.15-1.52). Respondents were more likely to prefer therapies administered orally over subcutaneous injection (OR 3.76; 95% CI 2.51-5.63), once weekly over once daily (OR 1.83; 95% CI 1.26-2.65), and therapies without food restrictions over with restrictions (OR 1.58; 95% CI 1.17-2.14).The most frequently reported symptoms were bruising (82%), petechiae (65%) and fatigue (64%). Most respondents (84%) felt ITP impacted familial relationships and 71% of employed respondents reported fatigue influencing their ability to work, with 31% reducing working hours. CONCLUSION Although responses indicated a moderate perception of general health, ITP clearly impacted respondent work and social life. Our findings demonstrate respondents preferred TPO-RAs delivered orally, with less frequent dosing and without food restrictions.
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Affiliation(s)
- Alessandro Lucchesi
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Barbara Lovrencic
- Associazione Italiana Porpora Immune Trombocitopenica (AIPIT), Caprino Veronese, Italy
| | - Vickie McDonald
- Department of Clinical Haematology, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Adrian Newland
- Academic Haematology Unit, Blizard Institute, Barts & The London School of Medicine & Dentistry, Queen Mary Institute of London, London, UK
| | - Mervyn Morgan
- ITP Support Association, Bolnhurst, Bedfordshire, UK
| | | | - Koo Wilson
- Swedish Orphan Biovitrum AB, Stockholm, Sweden
| | - Giulio Giordano
- Division of Internal Medicine, Hematology Service, Regional Hospital "A. Cardarelli", Campobasso, Italy
| | - Giuseppe Carli
- Department of Hematology, S. Bortolo Hospital, Vicenza, Italy
| | | | | | | | - Mariasanta Napolitano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
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Wong R, Fishman J, Wilson K, Yeh M, Al-Adhami M, Zion A, Yee CW, Huynh L, Duh MS. Correction to: Comparative Effectiveness of Pegcetacoplan Versus Ravulizumab and Eculizumab in Complement Inhibitor-Naïve Patients with Paroxysmal Nocturnal Hemoglobinuria: A Matching-Adjusted Indirect Comparison. Adv Ther 2023; 40:5591-5595. [PMID: 37789229 PMCID: PMC10611589 DOI: 10.1007/s12325-023-02640-9] [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] [Accepted: 08/07/2023] [Indexed: 10/05/2023]
Affiliation(s)
- Raymond Wong
- Sir Y.K. Pao Centre for Cancer and Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong
| | - Jesse Fishman
- Apellis Pharmaceuticals, Inc., 100 5th Avenue, Waltham, MA, 02451, USA
| | - Koo Wilson
- Swedish Orphan Biovitrum AB, Tomtebodavägen 23a, Solna, 171 65, Stockholm, Sweden
| | - Michael Yeh
- Apellis Pharmaceuticals, Inc., 100 5th Avenue, Waltham, MA, 02451, USA
| | | | - Abigail Zion
- Analysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA
| | - Christopher W Yee
- Analysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA
| | - Lynn Huynh
- Analysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA.
| | - Mei Sheng Duh
- Analysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA
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Gerard Jansen AJ, McDonald V, Newland A, Morgan M, Bastiaanse M, Wilson K, Eriksson D, Geldman E, Daykin-Pont O, Prince S, Zwaginga JJ. Patient preferences and experiences regarding thrombopoietin-receptor agonists for immune thrombocytopenia in The Netherlands (TRAPeze Netherlands study). Hematology 2023; 28:2267942. [PMID: 37818773 DOI: 10.1080/16078454.2023.2267942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE Identify patient experience and preference towards thrombopoietin-receptor agonists (TPO-RAs) in treatment of immune thrombocytopenia (ITP) in the Netherlands. METHODS The Thrombopoietin-Receptor Agonist Patient experience (TRAPeze) survey used a discrete choice experiment (DCE) to elicit patient preferences and a patient burden survey (PBS) to evaluate the clinical and social impact of ITP. TRAPeze collected responses from 6th October to 19th November 2021. RESULTS Seventy-six respondents completed the DCE: treatment preference appeared to be driven by method of administration (odds ratio [OR] 4.33; 95% confidence interval [CI] 2.88-6.52), frequency of dosing (OR 2.33; 95% CI 1.86-2.92) and drug-food interactions (OR 1.91; 95% CI 1.54-2.37). Respondents preferred therapies delivered orally over subcutaneous injection (OR 4.22; 95% CI 2.76-6.46), dosed once weekly over once daily (OR 2.37; 95% CI 1.58-3.54) and without food restrictions over with restrictions (OR 1.90; 95% CI 1.52-2.38). Sixty-nine respondents completed the DCE and PBS (mean [range] age 53 [19-83] years, 65% female). Seven incomplete PBS responses were excluded from analysis. Respondents were currently, or most recently, receiving eltrombopag (n = 43) or romiplostim (n = 26), of which 30% (n = 21/69) had previously received another TPO-RA. Loss (29%, n = 6/21) and lack (29%, n = 6/21) of response were the most common reasons for switching TPO-RA. Only 28% (n = 18/65) of respondents felt their TPO-RA increased energy levels. CONCLUSION Patients preferred therapies delivered orally, dosed less frequently and without food restrictions. QoL of ITP patients on TPO-RAs can be improved; the burden analyses presented can inform future efforts towards this.
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Affiliation(s)
- A J Gerard Jansen
- Department of Haematology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Vickie McDonald
- Department of Clinical Haematology, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Adrian Newland
- Academic Haematology Unit, Blizzard Institute, Barts & The London School of Medicine & Dentistry, Queen Mary Institute of London, London, UK
| | | | | | | | | | | | | | | | - Jaap Jan Zwaginga
- Department of Haematology, Leiden University Medical Centre, Leiden, Netherlands
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Tanner J, Brierley Jones L, Rochon M, Westwood N, Wloch C, Vaja R, Rogers L, Dearling J, Wilson K, Magboo R, Aujla H, Page S, Whiting P, Murphy G, Brown C, Lamagni T, Harrington P. Barriers and facilitators for surgical site infection surveillance for adult cardiac surgery in a high-income setting: an in-depth exploration. J Hosp Infect 2023; 141:112-118. [PMID: 37734675 DOI: 10.1016/j.jhin.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Surgical site infection (SSI) surveillance aims to facilitate a reduction in SSIs through identifying infection rates, benchmarking, triggering clinical review and instituting infection control measures. Participation in surveillance is, however, variable suggesting opportunities to improve wider adoption. AIM To gain an in-depth understanding of the barriers and facilitators for SSI surveillance in a high-income European setting. METHODS Key informant interviews with 16 surveillance staff, infection prevention staff, nurses and surgeons from nine cardiac hospitals in England. Data were analysed thematically. FINDINGS SSI surveillance was reported to be resource intensive. Barriers to surveillance included challenges associated with data collection: data being located in numerous places, multiple SSI data reporting schemes, difficulty in finding denominator data, lack of interface between computerized systems, 'labour intensive' or 'antiquated' methods to collect data (e.g., using postal systems for patient questionnaires). Additional reported concerns included: relevance of definitions, perceived variability in data reporting, lack of surgeon engagement, unsupportive managers, low priority of SSIs among staff, and a 'blame culture' around high SSI rates. Facilitators were increased resources, better use of digital technologies (e.g., remote digital wound monitoring), integrating surveillance within routine clinical work, having champions, mandating surveillance, ensuring a closer relationship between surveillance and improved patient outcomes, increasing the focus on post-discharge surveillance, and integration with primary care data. CONCLUSION Using novel interviews with 'front-line' staff, identified opportunities for improving participation in SSI surveillance. Translating these findings into action will increase surveillance activity and bring patient safety benefits to a larger pool of surgical patients.
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Affiliation(s)
- J Tanner
- School of Health Sciences, University of Nottingham, Nottingham, UK.
| | - L Brierley Jones
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - M Rochon
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - C Wloch
- HCAI Fungal AMR AMU & Sepsis Division, UKHSA, London, UK
| | - R Vaja
- Department of Cardiothoracic Surgery, Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - L Rogers
- Department of Cardiothoracic Surgery, University Hospitals of Bristol and Weston NHS Foundation Trust
| | | | - K Wilson
- Patient and Public Representative, UK
| | - R Magboo
- Critical Care, Barts Health NHS Trust, London, UK
| | - H Aujla
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - S Page
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - P Whiting
- Bristol Medical School, University of Bristol, Bristol, UK
| | - G Murphy
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - C Brown
- HCAI Fungal AMR AMU & Sepsis Division, UKHSA, London, UK
| | - T Lamagni
- HCAI Fungal AMR AMU & Sepsis Division, UKHSA, London, UK
| | - P Harrington
- HCAI Fungal AMR AMU & Sepsis Division, UKHSA, London, UK
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Fishman J, Wilson K, Drzewiecka A, Pochopień M, Dingli D. The cost-effectiveness of pegcetacoplan in complement treatment-naïve adults with paroxysmal nocturnal hemoglobinuria in the USA. J Comp Eff Res 2023; 12:e230055. [PMID: 37655691 PMCID: PMC10690430 DOI: 10.57264/cer-2023-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/09/2023] [Indexed: 09/02/2023] Open
Abstract
Aim: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare blood disorder characterized by hemolytic anemia, bone marrow failure and thrombosis, and is associated with high healthcare burden. We evaluated the cost-effectiveness of pegcetacoplan, a proximal complement-3 inhibitor (C3i), compared with the C5i, eculizumab and ravulizumab, in complement treatment-naive adults with PNH, from the US healthcare payer perspective. Materials & methods: A de novo cost-effectiveness model based on a Markov cohort structure evaluated lifetime (55-year) PNH costs and outcomes. The 6-month cycles of the model reflected the follow-up period of PRINCE (NCT04085601), an open-label trial of pegcetacoplan compared with eculizumab in C5i-naive patients. Data from PRINCE informed the clinical, safety and health-related quality of life outcomes in the model. Results: Pegcetacoplan was associated with lifetime cost savings of USD1,176,808 and USD213,062 relative to eculizumab and ravulizumab, respectively (largely attributed to reduced drug costs and blood transfusions), and additional quality-adjusted life years (QALYs) of 0.25 and 0.24. Conclusion: In patients with PNH who are treatment-naive, the base-case cost-effectiveness analysis, scenario analysis and sensitivity analysis showed both lifetime cost savings and increased QALYs associated with pegcetacoplan compared with eculizumab or ravulizumab in the USA.
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Affiliation(s)
| | - Koo Wilson
- Swedish Orphan Biovitrum AB, Stockholm, Sweden
| | - Aleksandra Drzewiecka
- Putnam PHMR, Krakow, Poland (previously Creativ-Ceutical, Krakow, Poland during conduct of study)
| | - Michał Pochopień
- Assignity, Krakow, Poland (previously of Creativ-Ceutical, Krakow, Poland during conduct of study)
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Wojciechowski P, Wdowiak M, Hakimi Z, Wilson K, Fishman J, Nazir J, Toumi M. Mapping the EORTC QLQ-C30 onto the EQ-5D-5L index for patients with paroxysmal nocturnal hemoglobinuria in France. J Comp Eff Res 2023; 12:e220178. [PMID: 37052120 PMCID: PMC10402747 DOI: 10.57264/cer-2022-0178] [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: 10/07/2022] [Accepted: 01/20/2023] [Indexed: 04/14/2023] Open
Abstract
Aim: To map patient-level data collected on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) QLQ-C30 to EQ-5D-5L data for estimating health-state utilities in patients with paroxysmal nocturnal hemoglobinuria (PNH). Materials & methods: European cross-sectional PNH patient survey data populated regression models mapping EORTC QLQ-C30 domains (covariates: sex and baseline age) to utilities calculated with the EQ-5D-5L French value set. A genetic algorithm allowed selection of the best-fitting between a set of models with and without interaction terms. We validated the selected algorithm using EQ-5D-5L utilities converted from EORTC QLQ-C30 data collected in the PEGASUS phase III, randomized controlled trial of pegcetacoplan versus eculizumab in adults with PNH. Results: Selected through the genetic algorithm, the ordinary least squares model without interactions provided highly stable results across study visits (mean [±SD] utilities 0.58 [±0.42] to 0.89 [±0.10]), and showed the best predictive validity. Conclusion: The new PNH EQ-5D-5L direct mapping developed using a genetic algorithm enabled calculation of reliable health-state utility data required for cost-utility analysis in health technology assessments supporting treatments of PNH.
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Affiliation(s)
| | - Marlena Wdowiak
- Putnam Associates (formerly Creativ Ceutical), 30-701 Krakow, Poland
| | | | - Koo Wilson
- Swedish Orphan Biovitrum AB, 171 65 Solna, Sweden
| | - Jesse Fishman
- University Aix-Marseille, 13284 Marseille Cedex 07, France
| | - Jameel Nazir
- Swedish Orphan Biovitrum AB, 171 65 Solna, Sweden
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Wong R, Fishman J, Wilson K, Yeh M, Al-Adhami M, Zion A, Yee CW, Huynh L, Duh MS. Comparative Effectiveness of Pegcetacoplan Versus Ravulizumab and Eculizumab in Complement Inhibitor-Naïve Patients with Paroxysmal Nocturnal Hemoglobinuria: A Matching-Adjusted Indirect Comparison. Adv Ther 2023; 40:1571-1589. [PMID: 36750531 PMCID: PMC10070304 DOI: 10.1007/s12325-023-02438-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 11/28/2022] [Accepted: 01/17/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION In the absence of head-to-head trials, this study compared treatment outcomes with the C3 complement inhibitor pegcetacoplan versus the C5 complement inhibitor eculizumab or ravulizumab in complement inhibitor-naïve patients with paroxysmal nocturnal hemoglobinuria (PNH). METHODS A matching-adjusted indirect comparison was conducted using individual patient data from the pegcetacoplan arm of the PRINCE trial (NCT04085601; n = 34) and aggregate data from the ravulizumab (n = 125) and eculizumab (n = 121) arms of the ALXN1210-PNH-301 trial (NCT03056040). Clinical and quality of life endpoints were evaluated after matching patients in the two trials on baseline characteristics. The weighted Wald test with 95% confidence interval was used to compare categorical and continuous variables (i.e., weighted chi-squared and z tests, respectively). Bias factor analysis was performed to quantify the extent of residual bias from unmeasured confounders. RESULTS After weighting, treatment with pegcetacoplan was associated with statistically significant improvements in most clinical endpoints compared with ravulizumab or eculizumab treatment. These included: greater absolute and percent reductions in lactate dehydrogenase (LDH) level and increase in hemoglobin level from baseline; shorter time to first occurrence of LDH normalization; larger proportions of patients achieving hemoglobin stabilization and avoiding transfusion, with fewer packed red blood cell units transfused; and a smaller proportion of patients experiencing breakthrough hemolysis (all p < 0.05). Patients receiving pegcetacoplan also had a greater increase in general health status score from baseline compared with those receiving C5 complement inhibitors. CONCLUSION Pegcetacoplan provides clinical benefits as first-line treatment for complement inhibitor-naïve patients with PNH. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT04085601.
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Affiliation(s)
- Raymond Wong
- Sir Y.K. Pao Centre for Cancer and Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong
| | - Jesse Fishman
- Apellis Pharmaceuticals, Inc., 100 5th Avenue, Waltham, MA, 02451, USA
| | - Koo Wilson
- Swedish Orphan Biovitrum AB, Tomtebodavägen 23a, Solna, 171 65, Stockholm, Sweden
| | - Michael Yeh
- Apellis Pharmaceuticals, Inc., 100 5th Avenue, Waltham, MA, 02451, USA
| | | | - Abigail Zion
- Analysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA
| | - Christopher W Yee
- Analysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA
| | - Lynn Huynh
- Analysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA.
| | - Mei Sheng Duh
- Analysis Group, Inc., 111 Huntington Avenue, 14th Floor, Boston, MA, 02199, USA
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Yaranov D, Kittipibul V, Snodgrass B, Mahmoud O, Edwards T, Shirwany A, Acheson K, Wilson K, Campbell S, Bruckner B, Fudim M, Mullinax W. The Utilities of Family Frailty Score as a Novel Social Support Assessment Tool for Patients Undergoing Advanced Heart Failure Therapies. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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13
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Panse J, Wilson K, Fishman J, Wojciechowski P, Wdowiak M, Horneff R, Patriquin CJ, Oliver M, Hakimi Z. Fatigue and health-related quality of life in paroxysmal nocturnal haemoglobinuria: a post-hoc analysis of the pegcetacoplan PEGASUS trial data. Eur J Haematol 2023. [PMID: 36965105 DOI: 10.1111/ejh.13969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVES Paroxysmal nocturnal haemoglobinuria (PNH) is a rare, non-malignant haematological disorder associated with disabling fatigue and reduced health-related quality of life. Post-hoc analysis of PEGASUS phase 3 trial (NCT03500549) characterised improvements in patient-reported fatigue measured by Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) instrument item-level ratings for pegcetacoplan and eculizumab for the treatment of PNH. METHODS Item-level responder analysis was conducted on a ≥2-level change from baseline (CFB) clinically important response (CIR) for the FACIT-fatigue 13 individual items rated on a 5-level Likert scale. We evaluated ≥2-level change against the minimal clinically important difference (MCID) of the FACIT-fatigue total score (≥5 points) and clinical parameters, haemoglobin (Hb; ≥1 g/dL) and normalised absolute reticulocyte count (ARC; 30-100 pg/cells). Logistic regressions estimated baseline-to-Week-16 FACIT-fatigue item-level transitional probabilities; Kaplan-Meier analysis estimated time to FACIT-fatigue item CIR. RESULTS Pegcetacoplan versus eculizumab was associated with significantly greater odds of Week 16 CIR across 8/13 items and on total score MCID (OR=11.19 [3.73:33.57]) and faster times to responses. The item-level CIR threshold also showed clinical relevance on Hb level and ARC normalization. CONCLUSIONS Compared with eculizumab, pegcetacoplan was associated with clinically meaningful greater improvements on a majority of FACIT-fatigue items. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jens Panse
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Aachen, Germany
- Center for Integrated Oncology Aachen, Bonn, Cologne, Duesseldorf (CIO ABCD), Aachen, Germany
| | - Koo Wilson
- Swedish Orphan Biovitrum AB, Stockholm, Sweden
| | | | - Piotr Wojciechowski
- Affiliated with Creativ-Ceutical, Krakow, Poland, during conduct of study; presently with Assignity Sp. z O.O., Krakow, Poland
| | | | | | | | - Monika Oliver
- Division of Hematology, University of Alberta, Alberta, Canada
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14
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Sicre de Fontbrune F, Burmester P, Piggin M, Matos JE, Costantino H, Wilson K, Hakimi Z, Nazir J, Desgraz R, Fishman J, Persson E, Panse J. The burden of illness of patients with paroxysmal nocturnal haemoglobinuria receiving C5 inhibitors: clinical outcomes and medical encounters from the patient perspective. Hematology 2022; 27:1140-1151. [PMID: 36165770 DOI: 10.1080/16078454.2022.2127630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES To assess the clinical and healthcare resource burden among C5 inhibitor (C5i)-treated patients with paroxysmal nocturnal haemoglobinuria (PNH), using patient-reported data. METHODS This web-based, cross-sectional survey (01FEB2021-31MAR2021) of adults with PNH treated with eculizumab (France, Germany, UK) or ravulizumab (Germany) included: patient characteristics; treatment patterns/dosage; haematological outcomes (haemoglobin [Hb] levels, transfusions, thrombotic events, breakthrough haemolysis); and medical encounters. Treatment and Hb-level subgroup differences were assessed with statistical significance tests. RESULTS Among 71 patients, 98.6% were C5i-treated for ≥3 months. The majority (with reported Hb levels) had levels ≤12.0 g/dL (85.7%; n = 54/63). The mean Hb level was 10.2 g/dL (standard deviation [SD]: 2.0; median 10.0 g/dL). Treatment with above label-recommended doses was reported by 30.4% (eculizumab) and 5.3% (ravulizumab) of patients. Within the past 12 months among patients treated with C5i for ≥1 year: 24.1% had ≥1 transfusion; 3.2% had ≥1 thrombosis; and 28.6% had ≥1 breakthrough haemolysis. Among all patients, 26.8% and 31.0% reported emergency department/room [ER] and inpatient visits, respectively. Mean annual, per-patient all-cause medical encounters were: 0.5 (ER); 1.9 (inpatient); and overall outpatient visits ranged by setting from 2.0 to 6.4. Most encounters were PNH-related, with means of 0.4 (ER); 1.8 (inpatient); and 1.6-5.4 (outpatient). Primary haematological and medical encounter outcomes were similar between treatment as well as Hb-level subgroups, with almost no statistically significant differences. CONCLUSIONS Despite at least 3 months of C5i treatment, high proportions of patients with PNH reported low haemoglobin levels and required transfusions and hospitalizations, which suggests remaining unmet needs.
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Affiliation(s)
- Flore Sicre de Fontbrune
- Hematology transplant Unit - French Reference Center for Aplastic Anemia, Hôpital Saint-Louis, Paris, France
| | | | | | - Joana E Matos
- Employee of Kantar Health, New York, NY, USA at the time of the study
| | | | - Koo Wilson
- Swedish Orphan Biovitrum AB, Stockholm, Sweden
| | | | | | | | | | | | - Jens Panse
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Aachen, Germany
- Center for Integrated Oncology (CIO) Aachen, Bonn, Cologne, Duesseldorf
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15
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Adams DQ, Alduino C, Alfonso K, Avignone FT, Azzolini O, Bari G, Bellini F, Benato G, Beretta M, Biassoni M, Branca A, Brofferio C, Bucci C, Camilleri J, Caminata A, Campani A, Canonica L, Cao XG, Capelli S, Capelli C, Cappelli L, Cardani L, Carniti P, Casali N, Celi E, Chiesa D, Clemenza M, Copello S, Cremonesi O, Creswick RJ, D'Addabbo A, Dafinei I, Del Corso F, Dell'Oro S, Di Domizio S, Di Lorenzo S, Dompè V, Fang DQ, Fantini G, Faverzani M, Ferri E, Ferroni F, Fiorini E, Franceschi MA, Freedman SJ, Fu SH, Fujikawa BK, Ghislandi S, Giachero A, Gianvecchio A, Gironi L, Giuliani A, Gorla P, Gotti C, Gutierrez TD, Han K, Hansen EV, Heeger KM, Huang RG, Huang HZ, Johnston J, Keppel G, Kolomensky YG, Kowalski R, Liu R, Ma L, Ma YG, Marini L, Maruyama RH, Mayer D, Mei Y, Morganti S, Napolitano T, Nastasi M, Nikkel J, Nones C, Norman EB, Nucciotti A, Nutini I, O'Donnell T, Olmi M, Ouellet JL, Pagan S, Pagliarone CE, Pagnanini L, Pallavicini M, Pattavina L, Pavan M, Pessina G, Pettinacci V, Pira C, Pirro S, Pozzi S, Previtali E, Puiu A, Quitadamo S, Ressa A, Rosenfeld C, Sangiorgio S, Schmidt B, Scielzo ND, Sharma V, Singh V, Sisti M, Speller D, Surukuchi PT, Taffarello L, Terranova F, Tomei C, Vetter KJ, Vignati M, Wagaarachchi SL, Wang BS, Welliver B, Wilson J, Wilson K, Winslow LA, Zimmermann S, Zucchelli S. New Direct Limit on Neutrinoless Double Beta Decay Half-Life of ^{128}Te with CUORE. Phys Rev Lett 2022; 129:222501. [PMID: 36493444 DOI: 10.1103/physrevlett.129.222501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/22/2022] [Accepted: 10/03/2022] [Indexed: 06/17/2023]
Abstract
The Cryogenic Underground Observatory for Rare Events (CUORE) at Laboratori Nazionali del Gran Sasso of INFN in Italy is an experiment searching for neutrinoless double beta (0νββ) decay. Its main goal is to investigate this decay in ^{130}Te, but its ton-scale mass and low background make CUORE sensitive to other rare processes as well. In this Letter, we present our first results on the search for 0νββ decay of ^{128}Te, the Te isotope with the second highest natural isotopic abundance. We find no evidence for this decay, and using a Bayesian analysis we set a lower limit on the ^{128}Te 0νββ decay half-life of T_{1/2}>3.6×10^{24} yr (90% CI). This represents the most stringent limit on the half-life of this isotope, improving by over a factor of 30 the previous direct search results, and exceeding those from geochemical experiments for the first time.
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Affiliation(s)
- D Q Adams
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - C Alduino
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - K Alfonso
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - F T Avignone
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - O Azzolini
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - G Bari
- INFN-Sezione di Bologna, Bologna I-40127, Italy
| | - F Bellini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - G Benato
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Beretta
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - M Biassoni
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - A Branca
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Brofferio
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Bucci
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - J Camilleri
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - A Caminata
- INFN-Sezione di Genova, Genova I-16146, Italy
| | - A Campani
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - L Canonica
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - X G Cao
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - S Capelli
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Capelli
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L Cappelli
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - L Cardani
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - P Carniti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - N Casali
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - E Celi
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - D Chiesa
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Clemenza
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - S Copello
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - O Cremonesi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - R J Creswick
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - A D'Addabbo
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - I Dafinei
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - F Del Corso
- INFN-Sezione di Bologna, Bologna I-40127, Italy
| | - S Dell'Oro
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - S Di Domizio
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - S Di Lorenzo
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - V Dompè
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - D Q Fang
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - G Fantini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - M Faverzani
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - E Ferri
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - F Ferroni
- INFN-Sezione di Roma, Roma I-00185, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - E Fiorini
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M A Franceschi
- INFN-Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - S J Freedman
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S H Fu
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - B K Fujikawa
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Ghislandi
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - A Giachero
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Gianvecchio
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - L Gironi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Giuliani
- Universit Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - P Gorla
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - C Gotti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - T D Gutierrez
- Physics Department, California Polytechnic State University, San Luis Obispo, California 93407, USA
| | - K Han
- INPAC and School of Physics and Astronomy, Shanghai Jiao Tong University; Shanghai Laboratory for Particle Physics and Cosmology, Shanghai 200240, China
| | - E V Hansen
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - K M Heeger
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R G Huang
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - H Z Huang
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - J Johnston
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - G Keppel
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - Yu G Kolomensky
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - R Kowalski
- Department of Physics and Astronomy, The Johns Hopkins University, 3400 North Charles Street Baltimore, Maryland 21211, USA
| | - R Liu
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - L Ma
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - Y G Ma
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - L Marini
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - R H Maruyama
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D Mayer
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Y Mei
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Morganti
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - T Napolitano
- INFN-Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - M Nastasi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - J Nikkel
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - C Nones
- IRFU, CEA, Universit Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E B Norman
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - A Nucciotti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - I Nutini
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - T O'Donnell
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - M Olmi
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - J L Ouellet
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S Pagan
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - C E Pagliarone
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Ingegneria Civile e Meccanica, Università degli Studi di Cassino e del Lazio Meridionale, Cassino I-03043, Italy
| | - L Pagnanini
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Pallavicini
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - L Pattavina
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Pavan
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - G Pessina
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | | | - C Pira
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - S Pirro
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - S Pozzi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - E Previtali
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Puiu
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - S Quitadamo
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - A Ressa
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - C Rosenfeld
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - S Sangiorgio
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Schmidt
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - N D Scielzo
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - V Sharma
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - V Singh
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - M Sisti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - D Speller
- Department of Physics and Astronomy, The Johns Hopkins University, 3400 North Charles Street Baltimore, Maryland 21211, USA
| | - P T Surukuchi
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | | | - F Terranova
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Tomei
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - K J Vetter
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - M Vignati
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - S L Wagaarachchi
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B S Wang
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - B Welliver
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - K Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - L A Winslow
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S Zimmermann
- Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Zucchelli
- INFN-Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum-Università di Bologna, Bologna I-40127, Italy
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16
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Wilson K, Dusek R, Gammon G. 374P NX-019, a brain penetrant, mutation selective EGFR inhibitor with broad mutant EGFR activity. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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17
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Ridgeon E, Wilson K, Wilkinson D, Douglass P, Elrefaey A. Defining complexity in anaesthesia: description and validation of the Oxford Anaesthetic Complexity (OxAnCo) score. Anaesthesia 2022; 77:1251-1258. [PMID: 35974666 DOI: 10.1111/anae.15840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 01/07/2023]
Abstract
Increasing demand for surgery and anaesthesia has created an imperative to manage anaesthetic workforce and caseload. This may include changes to distribution of cases amongst anaesthetists of different grades, including non-physician anaesthetists. To achieve this safely, an assessment of case complexity is essential. We present a novel system for scoring complexity of cases in anaesthesia, the Oxford Anaesthetic Complexity score. This integrates patient, anaesthetic, surgical and systems factors, and is different from assessments of risk. We adopted an end-user development approach to the design of the score, and validated it using a dataset of anaesthetic cases. Across 688 cases, the median (IQR [range]) complexity score was 19 (17-22 [15-33]). Cases requiring a consultant anaesthetist had a significantly higher median (IQR [range]) score than those requiring a senior trainee at 22 (20-25 [15-33]) vs. 19(17-21 [15-28]), p < 0.001. Cases undertaken in a tertiary acute hospital had a significantly higher score than those in a district general hospital, the median (IQR [range]) scores being 20 (17-22 [15-33]) vs. 17 (16-19 [17-28]), p < 0.001. Receiver-operating characteristic analysis showed good prediction of complexity sufficient to require a consultant anaesthetist, with area under the curve of 0.84. Any rise in complexity above baseline (score > 15) was strongly predictive of a case too complex for a junior trainee (positive predictive value 0.93). The Oxford Anaesthetic Complexity score can be used to match cases to different grades of anaesthetist, and can help in defining cases appropriate for the expanding non-physician anaesthetist workforce.
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Affiliation(s)
- E Ridgeon
- Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Trust, Oxford, UK
| | - K Wilson
- Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Trust, Oxford, UK
| | - D Wilkinson
- Department of Anaesthesia, Royal Berkshire Hospital, Reading, UK
| | - P Douglass
- Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Trust, Oxford, UK
| | - A Elrefaey
- Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Trust, Oxford, UK
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18
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Hall A, Blind F, Wilson K. 18b Comparative Safety and Efficacy of a Hybrid Intravenous and Oral Diltiazem Protocol for Acute Rate Control in the Emergency Department. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.041] [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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19
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Hakimi Z, Wilson K, McAughey E, Pochopien M, Wojciechowski P, Toumi M, Knight C, Sarda SP, Patel N, Wiseman C, de Castro NP, Nazir J, Kelly RJ. The cost-effectiveness, of pegcetacoplan compared with ravulizumab for the treatment of paroxysmal nocturnal hemoglobinuria, in a UK setting. J Comp Eff Res 2022; 11:969-985. [PMID: 35796199 DOI: 10.2217/cer-2022-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare blood disorder characterized by hemolytic anemia, bone marrow failure and thrombosis. We evaluated, the cost-effectiveness of pegcetacoplan, a novel proximal C3 inhibitor, versus ravulizumab in patients with PNH and hemoglobin levels <10.5 g/dl despite eculizumab treatment in the UK healthcare and social services setting. Materials & methods: A Markov cohort framework model, based on the data from the pivotal trial of pegcetacoplan (PEGASUS/NCT03500549), evaluated lifetime costs and outcomes. Patients transitioned through 3 PNH hemoglobin level/red blood cell transfusion health states. Results: Pegcetacoplan provides lower lifetime costs/greater quality-adjusted life years (£6,409,166/14.694QALYs, respectively) versus ravulizumab (£6,660,676/12.942QALYs). Conclusion: Pegcetacoplan is associated with enhanced anemia control, greater QALYs and reduced healthcare costs versus ravulizumab in the UK healthcare and social services setting.
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Affiliation(s)
- Zalmai Hakimi
- Swedish Orphan Biovitrum AB, Stockholm, SE-112 76, Sweden
| | - Koo Wilson
- Swedish Orphan Biovitrum AB, Stockholm, SE-112 76, Sweden
| | | | | | | | | | | | | | | | | | | | - Jameel Nazir
- Swedish Orphan Biovitrum AB, Stockholm, SE-112 76, Sweden
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20
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Panse J, Sicre de Fontbrune F, Burmester P, Piggin M, Matos JE, Costantino H, Wilson K, Hakimi Z, Nazir J, Desgraz R, Fishman J, Persson E, Kulasekararaj A. The Burden of Illness of Patients With Paroxysmal Nocturnal Haemoglobinuria Receiving C5 Inhibitors in France, Germany and the United Kingdom: Patient-reported Insights on Symptoms and Quality of Life. Eur J Haematol Suppl 2022; 109:351-363. [PMID: 35746830 PMCID: PMC9545353 DOI: 10.1111/ejh.13816] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To assess the clinical, humanistic, and economic burden of paroxysmal nocturnal haemoglobinuria (PNH) among C5 inhibitor (C5i)-treated patients with PNH METHODS: This was a web-based, cross-sectional survey (01FEB2021-31MAR2021) of adults with PNH treated with eculizumab (France, Germany, UK) or ravulizumab (Germany). Self-reported outcomes included: patient characteristics; patient-reported symptoms; and standardized patient-reported outcomes (e.g., Functional Assessment of Chronic Illness Therapy [FACIT]-Fatigue, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 [EORTC QLQ-C30]). RESULTS Among 71 included patients, 98.6% were C5i-treated for ≥3 months (88.7% ≥12 months); among those with self-reported haemoglobin (Hb) levels (n=63), most (85.7%) were anaemic (defined as ≤12.0 g/dL). Fatigue was the most common symptom at both diagnosis (73.2%) and survey time (63.4%); there were no statistically significant differences in symptom prevalence between treatment subgroups (eculizumab versus ravulizumab). Total FACIT-Fatigue and EORTC QLQ-C30 scores were substantially lower than European general population references, but there were no statistically significant differences between treatment subgroups. Hb level subgroups (<10.5 g/dL versus ≥10.5 g/dL) followed similar trends for all measures, with few significant subgroup differences. CONCLUSIONS Results suggest that there remains a considerable burden and unmet need among C5i-treated patients with PNH that requires improved therapies.
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Affiliation(s)
- Jens Panse
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Germany.,Center for Integrated Oncology (CIO) Aachen, Bonn, Cologne, Duesseldorf
| | - Flore Sicre de Fontbrune
- Hematology transplant Unit-French Reference Center for Aplastic Anemia, Hôpital Saint-Louis, Paris, France
| | | | | | | | | | - Koo Wilson
- Swedish Orphan Biovitrum AB, Stockholm, Sweden
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21
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Mercieca-Bebber R, Barnes EH, Wilson K, Samoon Z, Walpole E, Mai T, Ackland S, Burge M, Dickie G, Watson D, Leung J, Wang T, Bohmer R, Cameron D, Simes J, Gebski V, Smithers M, Thomas J, Zalcberg J, Barbour AP. Patient-reported outcome (PRO) results from the AGITG DOCTOR trial: a randomised phase 2 trial of tailored neoadjuvant therapy for resectable oesophageal adenocarcinoma. BMC Cancer 2022; 22:276. [PMID: 35291965 PMCID: PMC8922838 DOI: 10.1186/s12885-022-09270-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/07/2022] [Indexed: 11/12/2022] Open
Abstract
Background AGITG DOCTOR was a randomised phase 2 trial of pre-operative cisplatin, 5 fluorouracil (CF) followed by docetaxel (D) with or without radiotherapy (RT) based on poor early response to CF, detected via PET, for resectable oesophageal adenocarcinoma. This study describes PROs over 2 years. Methods Participants (N = 116) completed the EORTC QLQ-C30 and oesophageal module (QLQ-OES18) before chemotherapy (baseline), before surgery, six and 12 weeks post-surgery and three-monthly until 2 years. We plotted PROs over time and calculated the percentage of participants per treatment group whose post-surgery score was within 10 points (threshold for clinically relevant change) of their baseline score, for each PRO scale. We examined the relationship between Grade 3+ adverse events (AEs) and PROs. This analysis included four groups: CF responders, non-responders randomised to DCF, non-responders randomised to DCF + RT, and “others” who were not randomised. Results Global QOL was clinically similar between groups from 6 weeks post-surgery. All groups had poorer functional and higher symptom scores during active treatment and shortly after surgery, particularly the DCF and DCF + RT groups. DCF + RT reported a clinically significant difference (−13points) in mean overall health/QOL between baseline and pre-surgery. Similar proportions of patients across groups scored +/− 10 points of baseline scores within 2 years for most PRO domains. Instance of grade 3+ AEs were not related to PROs at baseline or 2 years. Conclusions By 2 years, similar proportions of patients scored within 10 points of baseline for most PRO domains, with the exception of pain and insomnia for the DCF + RT group. Non-responders randomised to DCF or DCF + RT experienced additional short-term burden compared to CF responders, reflecting the longer duration of neoadjuvant treatment and additional toxicity. This should be weighed against clinical benefits reported in AGITG DOCTOR. This data will inform communication of the trajectory of treatment options for early CF non-responders. Trial registration Australia New Zealand Clinical Trials Registry (ANZCTR), ACTRN12609000665235. Registered 31 July 2009. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09270-4.
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Affiliation(s)
- R Mercieca-Bebber
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - E H Barnes
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - K Wilson
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Z Samoon
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - E Walpole
- Division of Cancer Services, Princess Alexandra Hospital, Woolloongabba, Qld, Australia.,School of Clinical Medicine, University of Queensland, Brisbane, Qld, Australia
| | - T Mai
- Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - S Ackland
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - M Burge
- Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.,Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | - G Dickie
- Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | - D Watson
- Discipline of Surgery, College of Medicine and Public Health, Flinders University, Adelaide, South Australia
| | - J Leung
- GenesisCare St Andrew's Hospital, 352 South Terrace, Adelaide, SA, Australia
| | - T Wang
- Crown Princess Mary Cancer Center, Westmead hospital; Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - R Bohmer
- Hobart Private Hospital, Ground Floor- Suite 6 Corner Argyle & Collins Streets, Hobart, Tasmania, Australia
| | - D Cameron
- Townsville University Hospital, Townsville, Qld, Australia
| | - J Simes
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - V Gebski
- National Health and Medical Research Council (NHMRC) Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - M Smithers
- Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.,Divisions of Surgery and Cancer Services, Princess Alexandra Hospital, Woolloongabba, Australia
| | - J Thomas
- GIAST Clinic Mater Medical Centre South Brisbane, Brisbane, Australia
| | - J Zalcberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - A P Barbour
- Division of Cancer Services, Princess Alexandra Hospital, Woolloongabba, Qld, Australia. .,Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.
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22
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Lopes LR, Losi MA, Sheikh N, Laroche C, Charron P, Gimeno J, Kaski JP, Maggioni AP, Tavazzi L, Arbustini E, Brito D, Celutkiene J, Hagege A, Linhart A, Mogensen J, Garcia-Pinilla JM, Ripoll-Vera T, Seggewiss H, Villacorta E, Caforio A, Elliott PM, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Erlinge D, Emberson J, Glikson M, Gray A, Kayikcioglu M, Maggioni A, Nagy KV, Nedoshivin A, Petronio AS, Hesselink JR, Wallentin L, Zeymer U, Caforio A, Blanes JRG, Charron P, Elliott P, Kaski JP, Maggioni AP, Tavazzi L, Tendera M, Komissarova S, Chakova N, Niyazova S, Linhart A, Kuchynka P, Palecek T, Podzimkova J, Fikrle M, Nemecek E, Bundgaard H, Tfelt-Hansen J, Theilade J, Thune JJ, Axelsson A, Mogensen J, Henriksen F, Hey T, Nielsen SK, Videbaek L, Andreasen S, Arnsted H, Saad A, Ali M, Lommi J, Helio T, Nieminen MS, Dubourg O, Mansencal N, Arslan M, Tsieu VS, Damy T, Guellich A, Guendouz S, Tissot CM, Lamine A, Rappeneau S, Hagege A, Desnos M, Bachet A, Hamzaoui M, Charron P, Isnard R, Legrand L, Maupain C, Gandjbakhch E, Kerneis M, Pruny JF, Bauer A, Pfeiffer B, Felix SB, Dorr M, Kaczmarek S, Lehnert K, Pedersen AL, Beug D, Bruder M, Böhm M, Kindermann I, Linicus Y, Werner C, Neurath B, Schild-Ungerbuehler M, Seggewiss H, Pfeiffer B, Neugebauer A, McKeown P, Muir A, McOsker J, Jardine T, Divine G, Elliott P, Lorenzini M, Watkinson O, Wicks E, Iqbal H, Mohiddin S, O'Mahony C, Sekri N, Carr-White G, Bueser T, Rajani R, Clack L, Damm J, Jones S, Sanchez-Vidal R, Smith M, Walters T, Wilson K, Rosmini S, Anastasakis A, Ritsatos K, Vlagkouli V, Forster T, Sepp R, Borbas J, Nagy V, Tringer A, Kakonyi K, Szabo LA, Maleki M, Bezanjani FN, Amin A, Naderi N, Parsaee M, Taghavi S, Ghadrdoost B, Jafari S, Khoshavi M, Rapezzi C, Biagini E, Corsini A, Gagliardi C, Graziosi M, Longhi S, Milandri A, Ragni L, Palmieri S, Olivotto I, Arretini A, Castelli G, Cecchi F, Fornaro A, Tomberli B, Spirito P, Devoto E, Bella PD, Maccabelli G, Sala S, Guarracini F, Peretto G, Russo MG, Calabro R, Pacileo G, Limongelli G, Masarone D, Pazzanese V, Rea A, Rubino M, Tramonte S, Valente F, Caiazza M, Cirillo A, Del Giorno G, Esposito A, Gravino R, Marrazzo T, Trimarco B, Losi MA, Di Nardo C, Giamundo A, Musella F, Pacelli F, Scatteia A, Canciello G, Caforio A, Iliceto S, Calore C, Leoni L, Marra MP, Rigato I, Tarantini G, Schiavo A, Testolina M, Arbustini E, Di Toro A, Giuliani LP, Serio A, Fedele F, Frustaci A, Alfarano M, Chimenti C, Drago F, Baban A, Calò L, Lanzillo C, Martino A, Uguccioni M, Zachara E, Halasz G, Re F, Sinagra G, Carriere C, Merlo M, Ramani F, Kavoliuniene A, Krivickiene A, Tamuleviciute-Prasciene E, Viezelis M, Celutkiene J, Balkeviciene L, Laukyte M, Paleviciute E, Pinto Y, Wilde A, Asselbergs FW, Sammani A, Van Der Heijden J, Van Laake L, De Jonge N, Hassink R, Kirkels JH, Ajuluchukwu J, Olusegun-Joseph A, Ekure E, Mizia-Stec K, Tendera M, Czekaj A, Sikora-Puz A, Skoczynska A, Wybraniec M, Rubis P, Dziewiecka E, Wisniowska-Smialek S, Bilinska Z, Chmielewski P, Foss-Nieradko B, Michalak E, Stepien-Wojno M, Mazek B, Lopes LR, Almeida AR, Cruz I, Gomes AC, Pereira AR, Brito D, Madeira H, Francisco AR, Menezes M, Moldovan O, Guimaraes TO, Silva D, Ginghina C, Jurcut R, Mursa A, Popescu BA, Apetrei E, Militaru S, Coman IM, Frigy A, Fogarasi Z, Kocsis I, Szabo IA, Fehervari L, Nikitin I, Resnik E, Komissarova M, Lazarev V, Shebzukhova M, Ustyuzhanin D, Blagova O, Alieva I, Kulikova V, Lutokhina Y, Pavlenko E, Varionchik N, Ristic AD, Seferovic PM, Veljic I, Zivkovic I, Milinkovic I, Pavlovic A, Radovanovic G, Simeunovic D, Zdravkovic M, Aleksic M, Djokic J, Hinic S, Klasnja S, Mircetic K, Monserrat L, Fernandez X, Garcia-Giustiniani D, Larrañaga JM, Ortiz-Genga M, Barriales-Villa R, Martinez-Veira C, Veira E, Cequier A, Salazar-Mendiguchia J, Manito N, Gonzalez J, Fernández-Avilés F, Medrano C, Yotti R, Cuenca S, Espinosa MA, Mendez I, Zatarain E, Alvarez R, Pavia PG, Briceno A, Cobo-Marcos M, Dominguez F, Galvan EDT, Pinilla JMG, Abdeselam-Mohamed N, Lopez-Garrido MA, Hidalgo LM, Ortega-Jimenez MV, Mezcua AR, Guijarro-Contreras A, Gomez-Garcia D, Robles-Mezcua M, Blanes JRG, Castro FJ, Esparza CM, Molina MS, García MS, Cuenca DL, de Mallorca P, Ripoll-Vera T, Alvarez J, Nunez J, Gomez Y, Fernandez PLS, Villacorta E, Avila C, Bravo L, Diaz-Pelaez E, Gallego-Delgado M, Garcia-Cuenllas L, Plata B, Lopez-Haldon JE, Pena Pena ML, Perez EMC, Zorio E, Arnau MA, Sanz J, Marques-Sule E. Association between common cardiovascular risk factors and clinical phenotype in patients with hypertrophic cardiomyopathy from the European Society of Cardiology (ESC) EurObservational Research Programme (EORP) Cardiomyopathy/Myocarditis registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:42-53. [PMID: 35138368 PMCID: PMC9745665 DOI: 10.1093/ehjqcco/qcac006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 12/15/2022]
Abstract
AIMS The interaction between common cardiovascular risk factors (CVRF) and hypertrophic cardiomyopathy (HCM) is poorly studied. We sought to explore the relation between CVRF and the clinical characteristics of patients with HCM enrolled in the EURObservational Research Programme (EORP) Cardiomyopathy registry. METHODS AND RESULTS 1739 patients with HCM were studied. The relation between hypertension (HT), diabetes (DM), body mass index (BMI), and clinical traits was analysed. Analyses were stratified according to the presence or absence of a pathogenic variant in a sarcomere gene. The prevalence of HT, DM, and obesity (Ob) was 37, 10, and 21%, respectively. HT, DM, and Ob were associated with older age (P<0.001), less family history of HCM (HT and DM P<0.001), higher New York Heart Association (NYHA) class (P<0.001), atrial fibrillation (HT and DM P<0.001; Ob p = 0.03) and LV (left ventricular) diastolic dysfunction (HT and Ob P<0.001; DM P = 0.003). Stroke was more frequent in HT (P<0.001) and mutation-positive patients with DM (P = 0.02). HT and Ob were associated with higher provocable LV outflow tract gradients (HT P<0.001, Ob P = 0.036). LV hypertrophy was more severe in Ob (P = 0.018). HT and Ob were independently associated with NYHA class (OR 1.419, P = 0.017 and OR 1.584, P = 0.004, respectively). Other associations, including a higher proportion of females in HT and of systolic dysfunction in HT and Ob, were observed only in mutation-positive patients. CONCLUSION Common CVRF are associated with a more severe HCM phenotype, suggesting a proactive management of CVRF should be promoted. An interaction between genotype and CVRF was observed for some traits.
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Affiliation(s)
- Luis R Lopes
- Corresponding author. Tel: +447765109343, , Twitter handle: @LuisRLopesDr
| | - Maria-Angela Losi
- Department of Advanced Biomedical Sciences, University Federico II, Corso Umberto I, 40, Naples 80138, Italy
| | - Nabeel Sheikh
- Department of Cardiology and Division of Cardiovascular Sciences, Guy's and St. Thomas’ Hospitals and King's College London, Strand, London WC2R 2LS, UK
| | - Cécile Laroche
- EORP, European Society of Cardiology, Sophia-Antipolis, France
| | | | | | - Juan P Kaski
- Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Aldo P Maggioni
- EORP, European Society of Cardiology, Sophia-Antipolis, France,Maria Cecilia Hospital, GVM Care&Research, Via Corriera, 1, Cotignola 48033 RA, Italy
| | - Luigi Tavazzi
- Maria Cecilia Hospital, GVM Care&Research, Via Corriera, 1, Cotignola 48033 RA, Italy
| | | | - Dulce Brito
- Serviço de Cardiologia, Centro Hospitalar Universitário Lisboa Norte, Lisbon 1169-050, Portugal,CCUL, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz MB, Lisbon 1649-028, Portugal
| | - Jelena Celutkiene
- Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Universiteto g. 3, Vilnius 01513, Lithuania,State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
| | | | - Ales Linhart
- 2nd Department of Internal Cardiovascular Medicine, General University Hospital and First Medical Faculty, Charles University, Opletalova 38, Prague 110 00, Czech Republic
| | - Jens Mogensen
- Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, Odense 5000, Denmark
| | - José Manuel Garcia-Pinilla
- Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares. Servicio de Cardiología. Hospital Universitario Virgen de la Victoria. IBIMA. Málaga and Ciber-Cardiovascular. Instituto de Salud Carlos III. Madrid, Spain
| | - Tomas Ripoll-Vera
- Inherited Cardiovascular Disease Unit Son Llatzer University Hospital & IdISBa, Palma de Mallorca, Spain
| | - Hubert Seggewiss
- Universitätsklinikum Würzburg, Deutsches Zentrum für Herzinsuffizienz (DZHI), Comprehensive Heart Failure Center (CHFC), Am Schwarzenberg 15, Haus 15A, 97078 Wurzburg, Germany
| | - Eduardo Villacorta
- Member of National Centers of expertise for familial cardiopathies (CSUR), Cardiology Department, University Hospital of Salamanca. Institute of Biomedical Research of Salamanca (IBSAL), CIBERCV, Salamanca, Spain
| | | | - Perry M Elliott
- Institute of Cardiovascular Science, University College London, Gower St, London WC1E 6BT, UK,St. Bartholomew's Hospital, Barts Heart Centre, Barts Health NHS Trust, Whitechapel Rd, London E1 1BB, UK
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Wilson K, Fourtounas M, Anamourlis C. A comparison of the warming capabilities of two Baragwanath rewarming appliances with the Hotline fluid warming device. South Afr J Crit Care 2022; 38:10.7196/SAJCC.2022.v38i3.549. [PMID: 36936729 PMCID: PMC10016232 DOI: 10.7196/sajcc.2022.v38i3.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background Accidental intraoperative hypothermia is a common and avoidable adverse event of the perioperative period and is associated with detrimental effects on multiple organ systems and postoperative patient outcomes. In a resource-limited environment, prevention of intraoperative hypothermia is often challenging. Resourceful clinicians overcome these challenges through creative devices and frugal innovations. Objectives To investigate the thermal performance of two Baragwanath Rewarming Appliances (BaRA) against that of the Hotline device to describe an optimal setup for these devices. Methods This was a quasi-experimental laboratory study that measured the thermal performance of two BaRA devices and the Hotline device under a number of scenarios. Independent variables including fluid type, flow rate, warming temperature and warming transit distance were sequentially altered and temperatures measured along the fluid stream. Change in temperature (ΔT) was calculated as the difference between entry and exit temperature for each combination of variables for each warming device. Results A total of 219 experiments were performed. At a temperature of 43.0°C and a transit distance of 200 cm, the BaRA A configuration either matched or exceeded the ΔT of the Hotline over all fluid type and flowrate combinations. The BaRA B configuration does not provide comparable thermal performance to the Hotline. Measured flowrates were noticeably slower than manufacturer-quoted values for all intravenous (IV) cannulae used. Conclusion A warm-water bath at 43.0°C with 200 cm of submerged IV tubing provides thermal performance comparable to the Hotline device, with all fluid type and flowrate combinations. Contributions of the study The present study provides an evidence-based method for warming intravenous fluid in resource-limited scenarios.
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Affiliation(s)
- K Wilson
- Department of Anaesthesiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - M Fourtounas
- Department of Anaesthesiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - C Anamourlis
- Department of Anaesthesiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Pogna EA, Middleton S, Nazir J, Ralph L, Wilson K, Jurczak W. Characterization and treatment of immune thrombocytopenia in Europe: a qualitative observational study. ACTA ACUST UNITED AC 2021; 26:860-869. [PMID: 34719349 DOI: 10.1080/16078454.2021.1992945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Immune thrombocytopenia (ITP) is a rare disease, characterized by increased platelet destruction/suboptimal platelet production, leading to thrombocytopenia and risk of severe bleeding events. METHODS Interviews with 23 physicians and 12 payors, a survey with 113 physicians and validation using published data were used to define the current treatment paradigm and healthcare resource utilization and to determine the costs associated with managing acute bleeds in six European countries (Germany, Spain, France, Italy, Netherlands, UK). The study estimated a prevalence of 9 to 10 per 100,000 adults in 2020 across all six countries (disease severity split: 34% mild, 32% moderate, 33% severe (due to rounding up some values might not sum up to 100%). RESULTS Physician feedback showed that most patients with ITP (60%) received first-line treatment or were monitored by their physician; ∼75% of patients relapsed within 3-4 months. Thrombopoietin-receptor agonists (TPO-RAs) and rituximab were used to achieve disease stabilization in patients who relapse; patients could switch to an alternative TPO-RA to control symptoms, manage side-effects or improve adherence. The costs of rescue therapies and hospital services (e.g. surgery and admissions) accounted for the majority of healthcare resources to manage bleeding events. CONCLUSION Physicians would welcome earlier use of TPO-RAs to help maintain long-term control of ITP bleeds and potentially reduce both hospitalization and therapy costs.
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Affiliation(s)
| | | | - Jameel Nazir
- Swedish Orphan Biovitrum (Sobi™), Stockholm, Sweden
| | | | - Koo Wilson
- Swedish Orphan Biovitrum (Sobi™), Stockholm, Sweden
| | - Wojciech Jurczak
- Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
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25
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McDonald V, Newland A, Morgan M, Wilson K, Nazir J, Maguire P, Geldman E, Wynne T. Patient preferences and experiences regarding thrombopoietin-receptor agonists for immune thrombocytopenia in the United Kingdom and Ireland (TRAPeze UK & IE study). Hematology 2021; 26:799-808. [PMID: 34605362 DOI: 10.1080/16078454.2021.1978689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To establish the experiences with and preferences towards existing thrombopoietin-receptor agonist (TPO-RA) treatments of individuals with immune thrombocytopenia (ITP) in the UK and Ireland, based on treatment attributes. METHODS Responses from UK and Ireland individuals with ITP were collected in a pan-European online survey (TRAPeze, [Thrombopoietin-Receptor Agonist Patient experience survey]) from 18 September 2020 to 18 February 2021. TRAPeze was a survey of treatment preference regarding TPO-RAs (using a discrete choice experiment design), participant demographics, disease characteristics, treatment history, overall satisfaction with therapy, direct healthcare resource utilization and wider social impact. RESULTS The survey was completed by 32 UK respondents. Characteristics with the greatest influence on preference towards TPO-RA treatments were method of administration (odds ratio (OR) 5.6, 95% confidence interval (CI) 3.2-10.1) and drug-food interactions (OR 3.2, 95% CI 1.8-5.7). Particularly, participants were more likely to select an oral tablet over a subcutaneous injection (OR 7.4, 95% CI 3.6-15.1) and a treatment without food restrictions rather than with food restrictions (OR 3.6, 95% CI 1.8-6.8). CONCLUSION This is the first study to quantify the preference of individuals with ITP towards TPO-RA treatment attributes and demonstrates preference for orally administered treatments, without drug-food interactions.
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Affiliation(s)
- Vickie McDonald
- Department of Haematology, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Adrian Newland
- Academic Haematology Unit, Blizard Institute, Barts, London, UK.,The London School of Medicine & Dentistry, Queen Mary Institute of London, London, UK
| | | | - Koo Wilson
- Swedish Orphan Biovitrum AB, Stockholm, Sweden
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26
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Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
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Bell LM, Smith R, van de Venter EC, Shuttleworth C, Wilson K, Lycett D. COVID-19 stressors, wellbeing and health behaviours: a cross-sectional study. J Public Health (Oxf) 2021; 43:e453-e461. [PMID: 34195830 DOI: 10.1093/pubmed/fdab241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/08/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Following the implementation of pandemic response measures, concerns arose regarding the impact for population health and wellbeing. METHODS This study reports findings from a survey (N = 2510) conducted in Warwickshire (UK) during August and September 2020, and for the first time investigates behaviours which may worsen or mitigate the association between COVID-19-related stressors and wellbeing. RESULTS Increased stressors were associated with lower mental wellbeing and higher loneliness. Participants with a mental health condition reported lower wellbeing, as did younger groups, women and participants not in employment. To cope with restrictions, more participants engaged in healthier behaviours over unhealthy behaviours, and relaxing reduced the association between stressors and poor wellbeing. Some participants reported increasing alcohol and unhealthy dietary behaviours to cope with restrictions, however, these behaviours did not mitigate the impact of COVID-19 stressors and were instead negatively associated with wellbeing. Around half of participants helped neighbours during the pandemic, a behaviour positively associated with wellbeing particularly among older adults. CONCLUSION These findings contribute understanding about how various positive and negative health behaviours may mitigate or worsen the impact of COVID-19 on wellbeing, and how public health interventions may effectively target behaviours and groups in similar populations.
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Affiliation(s)
- L M Bell
- Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
| | - R Smith
- Business Intelligence Team, Warwickshire County Council, Warwick CV34 4RL, UK
| | - E C van de Venter
- Public Health Team, Warwickshire County Council, Warwick, CV34 4RL and NHS Coventry & Warwickshire CCG, Warwick CV34 4DE, UK
| | - C Shuttleworth
- Public Health Team, Warwickshire County Council, Warwick, CV34 4RL, UK
| | - K Wilson
- Public Health Team, Warwickshire County Council, Warwick, CV34 4RL, UK
| | - D Lycett
- Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK
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Wojciechowski P, Wilson K, Nazir J, Pustułka I, Tytuła A, Smela B, Pochopien M, Vredenburg M, McCrae KR, Jurczak W. Efficacy and Safety of Avatrombopag in Patients with Chronic Immune Thrombocytopenia: A Systematic Literature Review and Network Meta-Analysis. Adv Ther 2021; 38:3113-3128. [PMID: 33934279 PMCID: PMC8189936 DOI: 10.1007/s12325-021-01752-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/18/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION A network meta-analysis (NMA) was performed to assess the efficacy and safety of avatrombopag, relative to eltrombopag, romiplostim, and fostamatinib, for patients with chronic immune thrombocytopenia (ITP) not responding adequately to corticosteroids. METHODS A systematic search of publication and clinical trial databases was conducted to identify relevant randomized controlled trials (RCTs) and observational studies. Data from eligible studies were extracted and analyzed in a Bayesian framework using relative effect sizes vs placebo. Outcomes included durable platelet response; need for rescue therapy; reduction in use of concomitant ITP medication; incidence of any or World Health Organization (WHO) grade 2-4 bleeding events, and any adverse events. Results were reported as odds ratios or incidence rate ratios (IRR) with 95% credible intervals (CrIs). RESULTS The NMA included seven phase 3 RCTs. Compared with placebo, avatrombopag was associated with statistically significant improvements in durable platelet response, reduction in use of concomitant ITP medication, and incidence of any bleeding events. Statistically significant differences vs placebo were also observed for durable platelet response and need for rescue therapy (eltrombopag, romiplostim, and fostamatinib); reduction in use of concomitant ITP medication (eltrombopag and romiplostim); incidence of any bleeding events (fostamatinib); and incidence of WHO grade 2-4 bleeding events (romiplostim and fostamatinib). No statistically significant differences were observed for any adverse events. Avatrombopag was associated with a statistically significant lower incidence of any bleeding events vs eltrombopag (IRR 0.38 [95% CrI 0.19, 0.75]) and romiplostim (IRR 0.38 [95% Crl 0.17, 0.86]); no other between-treatment differences were observed. CONCLUSION In this NMA, avatrombopag significantly increased the chance of achieving durable platelet response and reducing the use of concomitant ITP medication vs placebo, and significantly reduced the incidence of any bleeding events compared with placebo, eltrombopag, and romiplostim. The study aims to help guide clinicians managing patients with chronic ITP and insufficient response to previous treatment.
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Affiliation(s)
- Piotr Wojciechowski
- Creativ-Ceutical, Creativ-Ceutical Poland Sp. z o.o., Ul. Przemysłowa 12, 30-701, Krakow, Poland.
| | - Koo Wilson
- Swedish Orphan Biovitrum AB, Stockholm, Sweden
| | | | - Iwona Pustułka
- Creativ-Ceutical, Creativ-Ceutical Poland Sp. z o.o., Ul. Przemysłowa 12, 30-701, Krakow, Poland
| | - Anna Tytuła
- Creativ-Ceutical, Creativ-Ceutical Poland Sp. z o.o., Ul. Przemysłowa 12, 30-701, Krakow, Poland
| | - Beata Smela
- Creativ-Ceutical, Creativ-Ceutical Poland Sp. z o.o., Ul. Przemysłowa 12, 30-701, Krakow, Poland
| | - Michał Pochopien
- Creativ-Ceutical, Creativ-Ceutical Poland Sp. z o.o., Ul. Przemysłowa 12, 30-701, Krakow, Poland
| | | | - Keith R McCrae
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
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Adams DQ, Alduino C, Alfonso K, Avignone FT, Azzolini O, Bari G, Bellini F, Benato G, Biassoni M, Branca A, Brofferio C, Bucci C, Camilleri J, Caminata A, Campani A, Canonica L, Cao XG, Capelli S, Cappelli L, Cardani L, Carniti P, Casali N, Chiesa D, Clemenza M, Copello S, Cosmelli C, Cremonesi O, Creswick RJ, D'Addabbo A, Dafinei I, Davis CJ, Dell'Oro S, Di Domizio S, Dompè V, Fang DQ, Fantini G, Faverzani M, Ferri E, Ferroni F, Fiorini E, Franceschi MA, Freedman SJ, Fu SH, Fujikawa BK, Giachero A, Gironi L, Giuliani A, Gorla P, Gotti C, Gutierrez TD, Han K, Heeger KM, Huang RG, Huang HZ, Johnston J, Keppel G, Kolomensky YG, Ligi C, Ma L, Ma YG, Marini L, Maruyama RH, Mayer D, Mei Y, Moggi N, Morganti S, Napolitano T, Nastasi M, Nikkel J, Nones C, Norman EB, Nucciotti A, Nutini I, O'Donnell T, Ouellet JL, Pagan S, Pagliarone CE, Pagnanini L, Pallavicini M, Pattavina L, Pavan M, Pessina G, Pettinacci V, Pira C, Pirro S, Pozzi S, Previtali E, Puiu A, Rosenfeld C, Rusconi C, Sakai M, Sangiorgio S, Schmidt B, Scielzo ND, Sharma V, Singh V, Sisti M, Speller D, Surukuchi PT, Taffarello L, Terranova F, Tomei C, Vetter KJ, Vignati M, Wagaarachchi SL, Wang BS, Welliver B, Wilson J, Wilson K, Winslow LA, Zimmermann S, Zucchelli S. Measurement of the 2νββ Decay Half-Life of ^{130}Te with CUORE. Phys Rev Lett 2021; 126:171801. [PMID: 33988435 DOI: 10.1103/physrevlett.126.171801] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
We measured two-neutrino double beta decay of ^{130}Te using an exposure of 300.7 kg yr accumulated with the CUORE detector. Using a Bayesian analysis to fit simulated spectra to experimental data, it was possible to disentangle all the major background sources and precisely measure the two-neutrino contribution. The half-life is in agreement with past measurements with a strongly reduced uncertainty: T_{1/2}^{2ν}=7.71_{-0.06}^{+0.08}(stat)_{-0.15}^{+0.12}(syst)×10^{20} yr. This measurement is the most precise determination of the ^{130}Te 2νββ decay half-life to date.
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Affiliation(s)
- D Q Adams
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - C Alduino
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - K Alfonso
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - F T Avignone
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - O Azzolini
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - G Bari
- INFN-Sezione di Bologna, Bologna I-40127, Italy
| | - F Bellini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - G Benato
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Biassoni
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - A Branca
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Brofferio
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Bucci
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - J Camilleri
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - A Caminata
- INFN-Sezione di Genova, Genova I-16146, Italy
| | - A Campani
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - L Canonica
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - X G Cao
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - S Capelli
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - L Cappelli
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L Cardani
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - P Carniti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - N Casali
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - D Chiesa
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Clemenza
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - S Copello
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - C Cosmelli
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - O Cremonesi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - R J Creswick
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - A D'Addabbo
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - I Dafinei
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - C J Davis
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - S Dell'Oro
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - S Di Domizio
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - V Dompè
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - D Q Fang
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - G Fantini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - M Faverzani
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - E Ferri
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - F Ferroni
- INFN-Sezione di Roma, Roma I-00185, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - E Fiorini
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M A Franceschi
- INFN-Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - S J Freedman
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S H Fu
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - B K Fujikawa
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Giachero
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - L Gironi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Giuliani
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - P Gorla
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - C Gotti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - T D Gutierrez
- Physics Department, California Polytechnic State University, San Luis Obispo, California 93407, USA
| | - K Han
- INPAC and School of Physics and Astronomy, Shanghai Jiao Tong University; Shanghai Laboratory for Particle Physics and Cosmology, Shanghai 200240, China
| | - K M Heeger
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R G Huang
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - H Z Huang
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - J Johnston
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - G Keppel
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - Yu G Kolomensky
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - C Ligi
- INFN-Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - L Ma
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - Y G Ma
- Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - L Marini
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - R H Maruyama
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - D Mayer
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Y Mei
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - N Moggi
- INFN-Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum-Università di Bologna, Bologna I-40127, Italy
| | - S Morganti
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - T Napolitano
- INFN-Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - M Nastasi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - J Nikkel
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - C Nones
- IRFU, CEA, Université Paris-Saclay, F-91191 Gif-sur-Yvette, France
| | - E B Norman
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - A Nucciotti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - I Nutini
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - T O'Donnell
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - J L Ouellet
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S Pagan
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - C E Pagliarone
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Ingegneria Civile e Meccanica, Università degli Studi di Cassino e del Lazio Meridionale, Cassino I-03043, Italy
| | - L Pagnanini
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - M Pallavicini
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - L Pattavina
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Pavan
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - G Pessina
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | | | - C Pira
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - S Pirro
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - S Pozzi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - E Previtali
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Puiu
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - C Rosenfeld
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - C Rusconi
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Sakai
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - S Sangiorgio
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Schmidt
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - N D Scielzo
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - V Sharma
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - V Singh
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - M Sisti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - D Speller
- Department of Physics and Astronomy, The Johns Hopkins University, 3400 North Charles Street Baltimore, Maryland 21211, USA
| | - P T Surukuchi
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | | | - F Terranova
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Tomei
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - K J Vetter
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - M Vignati
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - S L Wagaarachchi
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B S Wang
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - B Welliver
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - K Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - L A Winslow
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S Zimmermann
- Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Zucchelli
- INFN-Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum-Università di Bologna, Bologna I-40127, Italy
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Wilson K, Flood M, Narasimhan V, Pham T, Warrier S, Ramsay R, Michael M, Heriot A. Complete pathological response in rectal cancer utilising novel treatment strategies for neo-adjuvant therapy: A systematic review. Eur J Surg Oncol 2021; 47:1862-1874. [PMID: 33814240 DOI: 10.1016/j.ejso.2021.03.245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/07/2021] [Accepted: 03/17/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Locally advanced rectal cancer is routinely treated with neo-adjuvant long course chemoradiotherapy or short course radiotherapy, followed by total mesorectal excision. Not all patients respond to this treatment and there has been an emergence of novel treatment strategies designed to improve outcomes for these patients. This systematic review aims to assess the current novel neo-adjuvant treatment strategies being utilised in the treatment of patients with rectal cancer and how these impact pathological complete response (pCR) rates. METHODS A systematic review of the literature was performed to evaluate pathological response in patients with rectal cancer receiving novel neo-adjuvant therapy. EMBASE and Medline electronic databases were searched for relevant articles. Articles published between January 2008 and February 2019 were retrieved. Included studies underwent critical appraisal and complete pathological response rates were recorded. RESULTS Of the initial 1074 articles identified, 217 articles fulfilled the inclusion criteria, of these 60 articles (4359 patients) were included. Neo-adjuvant therapy delivered included novel long course chemoradiation therapy, neoadjuvant chemotherapy alone, addition of a biological agent, total neo-adjuvant therapy, novel short course radiation therapy and studies utilising biomarkers to select patients for therapy. Complete pathological response rates ranged from 0 to 60%. CONCLUSION A validated novel neo-adjuvant therapy that significantly increases pCR rates in patients with rectal cancer has not been identified.
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Affiliation(s)
- K Wilson
- Peter MacCallum Cancer Centre, Department of Surgical Oncology, Australia; Differentiation and Transcription Laboratory, Sir Peter MacCallum Cancer Centre, Australia; Sir Peter MacCallum Dept. of Oncology, University of Melbourne, Australia.
| | - M Flood
- Peter MacCallum Cancer Centre, Department of Surgical Oncology, Australia; Differentiation and Transcription Laboratory, Sir Peter MacCallum Cancer Centre, Australia; Sir Peter MacCallum Dept. of Oncology, University of Melbourne, Australia
| | - V Narasimhan
- Peter MacCallum Cancer Centre, Department of Surgical Oncology, Australia; Differentiation and Transcription Laboratory, Sir Peter MacCallum Cancer Centre, Australia; Sir Peter MacCallum Dept. of Oncology, University of Melbourne, Australia
| | - T Pham
- Peter MacCallum Cancer Centre, Department of Surgical Oncology, Australia; Differentiation and Transcription Laboratory, Sir Peter MacCallum Cancer Centre, Australia; Sir Peter MacCallum Dept. of Oncology, University of Melbourne, Australia
| | - S Warrier
- Peter MacCallum Cancer Centre, Department of Surgical Oncology, Australia
| | - R Ramsay
- Peter MacCallum Cancer Centre, Department of Surgical Oncology, Australia; Differentiation and Transcription Laboratory, Sir Peter MacCallum Cancer Centre, Australia
| | - M Michael
- Peter MacCallum Cancer Centre, Department of Medical Oncology, Australia; Sir Peter MacCallum Dept. of Oncology, University of Melbourne, Australia
| | - A Heriot
- Peter MacCallum Cancer Centre, Department of Surgical Oncology, Australia; Sir Peter MacCallum Dept. of Oncology, University of Melbourne, Australia
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Figueiredo FC, Glanville JM, Arber M, Carr E, Rydevik G, Hogg J, Okonkwo A, Figueiredo G, Lako M, Whiter F, Wilson K. A systematic review of cellular therapies for the treatment of limbal stem cell deficiency affecting one or both eyes. Ocul Surf 2021; 20:48-61. [PMID: 33412337 DOI: 10.1016/j.jtos.2020.12.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 12/15/2020] [Accepted: 12/28/2020] [Indexed: 01/18/2023]
Abstract
PURPOSE This systematic review (SR) assessed the efficacy, safety and cost-effectiveness of cell-based therapy to manage limbal stem cell deficiency (LSCD), a sight-threatening orphan condition most frequently associated with severe chemical or thermal burns. LSCD has historically been treated by transplanting limbal tissue. In 1997, a new treatment, cultured limbal epithelial autografts, was described for unilateral LSCD. In cases of bilateral disease cultured autologous oral mucosa stem cells have been used. The relative efficacy of different cultured tissue procedures is unknown. METHODS A protocol was registered with PROSPERO (CRD42017081117). Searches were conducted in 14 databases and 6 conference websites. Two reviewers independently selected studies, conducted data extraction and assessed risk of bias. One reviewer extracted individual patient data (IPD); a second checked extracted data. Data were assessed to determine the feasibility of statistical analysis, with Bayesian synthesis used to estimate improvement achieved by different treatments. RESULTS Fifty-two studies were eligible for inclusion (1113 eyes); 41 studies (716 eyes) reported IPD. No evidence was identified on cost-effectiveness. This SR was unable to confirm that any of the types of ex vivo cultured stem cell transplants identified for LSCD treatment were statistically superior when assessed against the outcomes of interest. CONCLUSIONS We believe this SR is the first to include IPD analysis of LSCD data. There is no evidence for the superiority of any method of limbal stem cell transplant. Confirmation of the safety and efficacy of this treatment modality is challenging due to heterogeneity within and between the studies identified. Therefore, recommendations for future research are proposed.
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Affiliation(s)
- F C Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary and University of Newcastle, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK.
| | - J M Glanville
- York Health Economics Consortium, Enterprise House, Innovation Way, University of York, York, YO10 5NQ, UK
| | - M Arber
- York Health Economics Consortium, Enterprise House, Innovation Way, University of York, York, YO10 5NQ, UK
| | - E Carr
- York Health Economics Consortium, Enterprise House, Innovation Way, University of York, York, YO10 5NQ, UK
| | - G Rydevik
- Quantics Biostatistics, West End House, 28 Drumsheugh Gardens, Edinburgh, EH3 7RN, UK
| | - J Hogg
- Department of Ophthalmology, Royal Victoria Infirmary and University of Newcastle, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK
| | - A Okonkwo
- Department of Ophthalmology, Royal Victoria Infirmary and University of Newcastle, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK
| | - G Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary and University of Newcastle, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK
| | - M Lako
- Biosciences Institute, Newcastle University, International Centre for Life, Newcastle, NE1 3BZ, UK
| | - F Whiter
- York Health Economics Consortium, Enterprise House, Innovation Way, University of York, York, YO10 5NQ, UK
| | - K Wilson
- York Health Economics Consortium, Enterprise House, Innovation Way, University of York, York, YO10 5NQ, UK
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Gerona-Navarro G, Zhang G, Barragan F, Elie B, Wilson K, Herskovits A, Rodriguez Y, Cornejo M. An allosteric modulator of PRC2 methyltransferase activity inhibits renal cancer cell proliferation. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31127-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lang M, Sourbier C, Schmidt L, Wei D, Gibbs B, Ricketts C, Vocke C, Wilson K, Thomas C, Linehan W. High-throughput small molecule screens reveal therapeutic opportunities against TFE3-fusion renal cell carcinoma. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)31109-6] [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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Mercieca-Bebber R, Barnes E, Wilson K, Samoon Z, Walpole E, Mai T, Ackland S, Burge M, Dickie G, Watson D, Leung J, Wang T, Bohmer R, Cameron D, Simes R, Gebski V, Smithers M, Thomas J, Zalcberg J, Barbour A. 1430P Patient-reported outcome (PRO) results from AGITG DOCTOR: A randomised phase II trial of tailored neoadjuvant therapy for resectable oesophageal adenocarcinoma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1936] [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] Open
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Adams DQ, Alduino C, Alfonso K, Avignone FT, Azzolini O, Bari G, Bellini F, Benato G, Biassoni M, Branca A, Brofferio C, Bucci C, Caminata A, Campani A, Canonica L, Cao XG, Capelli S, Cappelli L, Cardani L, Carniti P, Casali N, Chiesa D, Chott N, Clemenza M, Copello S, Cosmelli C, Cremonesi O, Creswick RJ, D'Addabbo A, D'Aguanno D, Dafinei I, Davis CJ, Dell'Oro S, Di Domizio S, Dompè V, Fang DQ, Fantini G, Faverzani M, Ferri E, Ferroni F, Fiorini E, Franceschi MA, Freedman SJ, Fujikawa BK, Giachero A, Gironi L, Giuliani A, Gorla P, Gotti C, Gutierrez TD, Han K, Heeger KM, Huang RG, Huang HZ, Johnston J, Keppel G, Kolomensky YG, Ligi C, Ma YG, Ma L, Marini L, Maruyama RH, Mei Y, Moggi N, Morganti S, Napolitano T, Nastasi M, Nikkel J, Nones C, Norman EB, Novati V, Nucciotti A, Nutini I, O'Donnell T, Ouellet JL, Pagliarone CE, Pagnanini L, Pallavicini M, Pattavina L, Pavan M, Pessina G, Pettinacci V, Pira C, Pirro S, Pozzi S, Previtali E, Puiu A, Rosenfeld C, Rusconi C, Sakai M, Sangiorgio S, Schmidt B, Scielzo ND, Sharma V, Singh V, Sisti M, Speller D, Surukuchi PT, Taffarello L, Terranova F, Tomei C, Vignati M, Wagaarachchi SL, Wang BS, Welliver B, Wilson J, Wilson K, Winslow LA, Zanotti L, Zimmermann S, Zucchelli S. Improved Limit on Neutrinoless Double-Beta Decay in ^{130} Te with CUORE. Phys Rev Lett 2020; 124:122501. [PMID: 32281829 DOI: 10.1103/physrevlett.124.122501] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/11/2020] [Accepted: 02/27/2020] [Indexed: 06/11/2023]
Abstract
We report new results from the search for neutrinoless double-beta decay in ^{130} Te with the CUORE detector. This search benefits from a fourfold increase in exposure, lower trigger thresholds, and analysis improvements relative to our previous results. We observe a background of (1.38±0.07)×10^{-2} counts/(keV kg yr)) in the 0νββ decay region of interest and, with a total exposure of 372.5 kg yr, we attain a median exclusion sensitivity of 1.7×10^{25} yr. We find no evidence for 0νββ decay and set a 90% credibility interval Bayesian lower limit of 3.2×10^{25} yr on the ^{130} Te half-life for this process. In the hypothesis that 0νββ decay is mediated by light Majorana neutrinos, this results in an upper limit on the effective Majorana mass of 75-350 meV, depending on the nuclear matrix elements used.
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Affiliation(s)
- D Q Adams
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - C Alduino
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - K Alfonso
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - F T Avignone
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - O Azzolini
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - G Bari
- INFN-Sezione di Bologna, Bologna I-40127, Italy
| | - F Bellini
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - G Benato
- Department of Physics, University of California, Berkeley, California 94720, USA
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Biassoni
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - A Branca
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Brofferio
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Bucci
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - A Caminata
- INFN-Sezione di Genova, Genova I-16146, Italy
| | - A Campani
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - L Canonica
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - X G Cao
- Key Laboratory of Nuclear Physics and Ion-Beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - S Capelli
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - L Cappelli
- Department of Physics, University of California, Berkeley, California 94720, USA
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - L Cardani
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - P Carniti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - N Casali
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - D Chiesa
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - N Chott
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - M Clemenza
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - S Copello
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - C Cosmelli
- Dipartimento di Fisica, Sapienza Università di Roma, Roma I-00185, Italy
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - O Cremonesi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | - R J Creswick
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - A D'Addabbo
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - D D'Aguanno
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Ingegneria Civile e Meccanica, Università degli Studi di Cassino e del Lazio Meridionale, Cassino I-03043, Italy
| | - I Dafinei
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - C J Davis
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - S Dell'Oro
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - S Di Domizio
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - V Dompè
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - D Q Fang
- Key Laboratory of Nuclear Physics and Ion-Beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - G Fantini
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - M Faverzani
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - E Ferri
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - F Ferroni
- INFN-Sezione di Roma, Roma I-00185, Italy
- Gran Sasso Science Institute, L'Aquila I-67100, Italy
| | - E Fiorini
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M A Franceschi
- INFN-Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - S J Freedman
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B K Fujikawa
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Giachero
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - L Gironi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Giuliani
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay, France
| | - P Gorla
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - C Gotti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - T D Gutierrez
- Physics Department, California Polytechnic State University, San Luis Obispo, California 93407, USA
| | - K Han
- INPAC and School of Physics and Astronomy, Shanghai Jiao Tong University; Shanghai Laboratory for Particle Physics and Cosmology, Shanghai 200240, China
| | - K M Heeger
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - R G Huang
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - H Z Huang
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - J Johnston
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - G Keppel
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - Yu G Kolomensky
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - C Ligi
- INFN-Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - Y G Ma
- Key Laboratory of Nuclear Physics and Ion-Beam Application (MOE), Institute of Modern Physics, Fudan University, Shanghai 200433, China
| | - L Ma
- Department of Physics and Astronomy, University of California, Los Angeles, California 90095, USA
| | - L Marini
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - R H Maruyama
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - Y Mei
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - N Moggi
- INFN-Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum-Università di Bologna, Bologna I-40127, Italy
| | - S Morganti
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - T Napolitano
- INFN-Laboratori Nazionali di Frascati, Frascati (Roma) I-00044, Italy
| | - M Nastasi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - J Nikkel
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - C Nones
- Service de Physique des Particules, CEA/Saclay, 91191 Gif-sur-Yvette, France
| | - E B Norman
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - V Novati
- CSNSM, Univ. Paris-Sud, CNRS/IN2P3, Universit Paris-Saclay, 91405 Orsay, France
| | - A Nucciotti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - I Nutini
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - T O'Donnell
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - J L Ouellet
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - C E Pagliarone
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
- Dipartimento di Ingegneria Civile e Meccanica, Università degli Studi di Cassino e del Lazio Meridionale, Cassino I-03043, Italy
| | - L Pagnanini
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - M Pallavicini
- INFN-Sezione di Genova, Genova I-16146, Italy
- Dipartimento di Fisica, Università di Genova, Genova I-16146, Italy
| | - L Pattavina
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Pavan
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - G Pessina
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
| | | | - C Pira
- INFN-Laboratori Nazionali di Legnaro, Legnaro (Padova) I-35020, Italy
| | - S Pirro
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - S Pozzi
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - E Previtali
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - A Puiu
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Rosenfeld
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - C Rusconi
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
- INFN-Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila) I-67100, Italy
| | - M Sakai
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - S Sangiorgio
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - B Schmidt
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - N D Scielzo
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - V Sharma
- Center for Neutrino Physics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - V Singh
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - M Sisti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - D Speller
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - P T Surukuchi
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | | | - F Terranova
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - C Tomei
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - M Vignati
- INFN-Sezione di Roma, Roma I-00185, Italy
| | - S L Wagaarachchi
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B S Wang
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
- Department of Nuclear Engineering, University of California, Berkeley, California 94720, USA
| | - B Welliver
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - J Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - K Wilson
- Department of Physics and Astronomy, University of South Carolina, Columbia, South Carolina 29208, USA
| | - L A Winslow
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - L Zanotti
- INFN-Sezione di Milano Bicocca, Milano I-20126, Italy
- Dipartimento di Fisica, Università di Milano-Bicocca, Milano I-20126, Italy
| | - S Zimmermann
- Engineering Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S Zucchelli
- INFN-Sezione di Bologna, Bologna I-40127, Italy
- Dipartimento di Fisica e Astronomia, Alma Mater Studiorum-Università di Bologna, Bologna I-40127, Italy
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Bullement A, McMordie ST, Hatswell AJ, Li N, Wilson K. Cost-Effectiveness Analysis of Recombinant Factor VIII Fc-Fusion Protein (rFVIIIFc) for the Treatment of Severe Hemophilia A in Italy Incorporating Real-World Dosing and Joint Health Data. Pharmacoecon Open 2020; 4:133-142. [PMID: 31280415 PMCID: PMC7018914 DOI: 10.1007/s41669-019-0158-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Patients with severe hemophilia A (SHA) in Italy are routinely treated with standard half-life recombinant factor VIII (rFVIII) products. rFVIII Fc-fusion protein (rFVIIIFc) is an extended half-life rFVIII product that enables less frequent administration than rFVIII, which may support improved adherence. Available data indicate low breakthrough bleed rates and potentially improved long-term joint health for patients treated with rFVIIIFc prophylaxis. OBJECTIVE This study assessed the cost effectiveness of rFVIIIFc versus rFVIII from an Italian healthcare perspective. METHODS A Semi-Markov model was constructed to assess the lifetime costs and benefits of rFVIII and rFVIIIFc prophylaxis. rFVIII product acquisition costs from a published Italian database were included for both prophylaxis and the resolution of breakthrough bleeding. Clinical outcomes within the model were determined based on published annualized bleeding rates and literature regarding the development of target joints (TJs) as the incidence of bleeds and TJs is associated with impaired health-related quality of life. Cost effectiveness was assessed using cost per quality-adjusted life-year (QALY) gained. RESULTS Compared with rFVIII, rFVIIIFc was associated with a per-patient cost saving of approximately €1.3 million and QALY gains of 0.39 over a lifetime horizon. Sensitivity analyses considering alternative efficacy, dosing, and structural assumptions each showed that rFVIIIFc dominated rFVIII (i.e., provided more QALYs at a reduced cost). CONCLUSIONS This cost-effectiveness analysis demonstrated that rFVIIIFc may offer a cost-effective treatment option for patients with SHA in Italy.
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Affiliation(s)
| | | | | | - Nanxin Li
- Bioverativ, a Sanofi Company, Waltham, MA, USA
| | - Koo Wilson
- Swedish Orphan Biovitrum AB (publ), 112 76, Stockholm, Sweden.
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Barbour A, Walpole E, Mai G, Barnes E, Watson D, Ackland S, Martin J, Burge M, Finch R, Karapetis C, Shannon J, Nott L, Varma S, Marx G, Falk G, Gebski V, Oostendorp M, Wilson K, Thomas J, Lampe G, Zalcberg J, Simes J, Smithers B, Barbour A, Simes J, Walpole E, Mai T, Watson D, Karapetis C, Gebski V, Barnes L, Oostendorp M, Wilson K. Preoperative cisplatin, fluorouracil, and docetaxel with or without radiotherapy after poor early response to cisplatin and fluorouracil for resectable oesophageal adenocarcinoma (AGITG DOCTOR): results from a multicentre, randomised controlled phase II trial. Ann Oncol 2020; 31:236-245. [DOI: 10.1016/j.annonc.2019.10.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 11/24/2022] Open
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Gifford RM, O'Leary TJ, Double RL, Wardle SL, Wilson K, Boyle LD, Homer NZM, Kirschbaum C, Greeves JP, Woods DR, Reynolds RM. Positive adaptation of HPA axis function in women during 44 weeks of infantry-based military training. Psychoneuroendocrinology 2019; 110:104432. [PMID: 31536944 DOI: 10.1016/j.psyneuen.2019.104432] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Basic military training (BMT) is a useful model of prolonged exposure to multiple stressors. 8-12 week BMT is associated with perturbations in the hypothalamic-pituitary-adrenal (HPA) axis which could predispose recruits to injury and psychological strain. However, characterisations of HPA axis adaptations during BMT have not been comprehensive and most studies included few if any women. METHODS We studied women undertaking an arduous, 44-week BMT programme in the UK. Anxiety, depression and resilience questionnaires, average hair cortisol concentration (HCC), morning and evening saliva cortisol and morning plasma cortisol were assessed at regular intervals throughout. A 1-h dynamic cortisol response to 1 μg adrenocorticotrophic hormone-1-24 was performed during weeks 1 and 29. RESULTS Fifty-three women (aged 24 ± 2.5 years) completed the study. Questionnaires demonstrated increased depression and reduced resilience during training (F 6.93 and F 7.24, respectively, both p < 0.001). HCC increased from 3 months before training to the final 3 months of training (median (IQR) 9.63 (5.38, 16.26) versus 11.56 (6.2, 22.45) pg/mg, p = 0.003). Morning saliva cortisol increased during the first 7 weeks of training (0.44 ± 0.23 versus 0.59 ± 0.24 μg/dl p < 0.001) and decreased thereafter, with no difference between the first and final weeks (0.44 ± 0.23 versus 0.38 ± 0.21 μg/dl, p = 0.2). Evening saliva cortisol did not change. Fasting cortisol decreased during training (beginning, mid and end-training concentrations: 701 ± 134, 671 ± 158 and 561 ± 177 nmol/l, respectively, p < 0.001). Afternoon basal cortisol increased during training while there was a trend towards increased peak stimulated cortisol (177 ± 92 versus 259 ± 13 nmol/l, p = 0.003, and 589 ± 164 versus 656 ± 135, p = 0.058, respectively). DISCUSSION These results suggest a normal stress response in early training was followed quickly by habituation, despite psychological and physical stress evidenced by questionnaire scores and HCC, respectively. There was no evidence of HPA axis maladaptation. These observations are reassuring for women undertaking arduous employment.
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Affiliation(s)
- R M Gifford
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK; Research & Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
| | - T J O'Leary
- Department of Army Health and Physical Performance Research, Andover, Hampshire, UK
| | - R L Double
- Department of Army Health and Physical Performance Research, Andover, Hampshire, UK
| | - S L Wardle
- Department of Army Health and Physical Performance Research, Andover, Hampshire, UK
| | - K Wilson
- Medical Research Council Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, EH16 4TJ, UK
| | - L D Boyle
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - N Z M Homer
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK; Mass Spectrometry Core, Edinburgh Clinical Research Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | | | - J P Greeves
- Department of Army Health and Physical Performance Research, Andover, Hampshire, UK; Norwich Medical School, University of East Anglia, Norwich, UK
| | - D R Woods
- Research & Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK; Research Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK; Northumbria and Newcastle NHS Trusts, Wansbeck General and Royal Victoria Infirmary, Newcastle, UK
| | - R M Reynolds
- University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
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Silbernagel K, Jechorek R, Barbour WM, Mrozinski P, Alejo W, Aleo V, Andaloro B, Beacorn F, Benzinger J, Bogar S, Brayman C, Broom J, Carson M, Carver C, Cheng C, Centrella B, Clayborn J, Collins C, Deibel C, Divine M, Eliasberg S, Farmer D, Frye S, Gatesy T, Goodstein E, Halker C, Hall G, Hanson P, Hartman G, Heddaeus K, Hembree J, Hutchins J, Istafanos P, Jechorek R, Jenkins J, Kerdahi K, Kremer S, Lal A, Leighton S, Lester D, Lewis J, Lin J, Martin J, Maselli M, McCarthy P, McGovern B, Mills M, Mohnke F, Moon B, Moss D, Plaza M, Robeson S, Romero H, Rubalcaba D, Schultz A, Seehusen J, Shaw C, Siem K, Sloan E, Stanerson J, Stepanova N, Van K, Van Enkenvoort K, Vialpando M, Warren W, Watts K, Wilson K, Woodruff T. Evaluation of the BAX® System for Detection of Listeria monocytogenes in Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/87.2.395] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A multilaboratory study was conducted to compare the automated BAX® system and the standard cultural methods for detection of Listeria monocytogenes in foods. Six food types (frankfurters, soft cheese, smoked salmon, raw, ground beef, fresh radishes, and frozen peas) were analyzed by each method. For each food type, 3 inoculation levels were tested: high (average of 2 CFU/g), low (average of 0.2 CFU/g) and uninoculated controls. A total of 25 laboratories representing government and industry participated. Of the 2335 samples analyzed, 1109 were positive by the BAX system and 1115 were positive by the standard method. A Chi square analysis of each of the 6 food types, at the 3 inoculation levels tested, was performed. For all foods, except radishes, the BAX system performed as well as or better than the standard reference methods based on the Chi square results.
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Affiliation(s)
| | | | - W Mark Barbour
- DuPont Qualicon, 3531 Silverside Rd, Bedford Bldg, Wilmington, DE 19810
| | - Peter Mrozinski
- DuPont Qualicon, 3531 Silverside Rd, Bedford Bldg, Wilmington, DE 19810
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Silbernagel K, Jechorek R, Carver C, Barbour WM, Mrozinski P, Albert A, Andaloro B, Anderson G, Beacorn F, Brooks R, Carson M, Crossfield D, Eliasberg S, Farmer D, Frantzeskakis C, Gasses T, Gatesy T, Hall G, Hanson P, Heddaeus K, Hermann K, Hutchins J, Jenkins J, Johnson F, Johnson J, Kawalek M, Kelly L, Koschmann C, Lannon P, Lester D, Manner K, Martin J, Maselli M, McGovern B, Mohnke F, Moon B, Murray L, Pace R, Richards J, Robeson S, Rodgers D, Rosario G, Saunders C, Shaw C, Dana Shell J, Sloan E, Thompson S, Vialpando M, Voermans R, Watts K, Wieczorek K, Wilson K, Yeh H, Zamora D. Evaluation of the BAX® System for Detection of Salmonella in Selected Foods: Collaborative Study. J AOAC Int 2019. [DOI: 10.1093/jaoac/86.6.1149] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A multilaboratory study was conducted to compare the automated BAX® System to the standard cultural methods for detection of Salmonella in selected foods. Five food types—frankfurters, raw ground beef, mozzarella cheese, raw frozen tilapia fish, and orange juice—at 3 inoculation levels, were analyzed by each method. A sixth food type, raw ground chicken, was tested using 3 naturally contaminated lots. A total of 16 laboratories representing government and industry participated. In this study, 1386 samples were analyzed, of which 1188 were paired samples and 198 were unpaired samples. Of the 1188 paired samples, 461 were positive by both methods and 404 were negative by both methods. Thirty-seven samples were positive by the BAX System but negative by the standard reference method, and 11 samples were positive by standard cultural method and negative by the BAX System. Of the 198 unpaired samples, 106 were positive by the BAX System and 60 were positive by the standard cultural method. A Chi square analysis of each of the 6 food types, at the 3 inoculation levels tested, was performed. For all foods, the BAX System demonstrated results comparable to those of the standard reference methods based on the Chi square results.
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Affiliation(s)
| | | | - Charles Carver
- rtech laboratories, PO Box 64101, St. Paul, MN 55164-0101
| | - W Mark Barbour
- DuPont Qualicon, 3531 Silverside Rd, Bedford Building, Wilmington, DE 19810
| | - Peter Mrozinski
- DuPont Qualicon, 3531 Silverside Rd, Bedford Building, Wilmington, DE 19810
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Schaffer P, Benard F, Vuckovic M, Zeisler S, Anazodo U, Romsa J, Cross M, Foster S, Gleeson F, Hayashi K, Hook B, Kumlin J, Buckley K, Schlosser J, Wilson K, Dodd M, Hanemaayer V, Kovacs M, Mcdiarmid S, Prato F, Ruth TH, Valliant J. Cyclotron-based production of Tc-99m and other metals. Nucl Med Biol 2019. [DOI: 10.1016/s0969-8051(19)30209-4] [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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MANNON E, Wilson K, O'Connor P. SAT-328 DIETARY NA+ LOADING WITH NACL OR NAHCO3 PRODUCES SIMILAR CHANGES IN CIRCULATING TH17 AND REGULATORY T-CELLS. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.373] [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: 10/26/2022] Open
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Frank P, Ball S, Thibodeau L, Perry R, Ditullio K, Wilson K, Trivedi A, Villeneuve A. Evaluation of the next generation I-STAT® point-of-care prothrombin time test (I-STAT PTPLUS) against other commercially available prothrombin time tests. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1361] [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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Pontefract SK, Wilson K. Using electronic patient records: defining learning outcomes for undergraduate education. BMC Med Educ 2019; 19:30. [PMID: 30670000 PMCID: PMC6341543 DOI: 10.1186/s12909-019-1466-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/10/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Healthcare professionals are required to access, interpret and generate patient data in the digital environment, and use this information to deliver and optimise patient care. Healthcare students are rarely exposed to the technology, or given the opportunity to use this during their training, which can impact on the digital competence of the graduating workforce. In this study we set out to develop and define domains of competence and associated learning outcomes needed by healthcare graduates to commence working in a digital healthcare environment. METHOD A National Working Group was established in the UK to integrate Electronic Patient Records (EPRs) into undergraduate education for healthcare students studying medicine, pharmacy, nursing and midwifery. The working group, comprising 12 academic institutions and representatives from NHS England, NHS Digital and EPR system providers, met to discuss and document key learning outcomes required for using EPRs in the healthcare environment. Outcomes were grouped into six key domains and refined by the group prior to external review by experts working in medical education or with EPRs. RESULTS Six key domains of competence and associated learning outcomes were identified and defined. External expert review provided iterative refinement and amendment. The agreed domains were: 1) Digital Health: work as a practitioner in the digital healthcare environment; 2) Accessing Data: access and interpret patient data to inform clinical decision-making; 3) Communication: communicate effectively with healthcare professionals and patients in the digital environment; 4) Generating data: generate data for and about patients within the EPR; 5) Multidisciplinary working: work with healthcare professionals with and alongside EPRs; and 6) Monitoring and audit: monitor and improve the quality and safety of healthcare. CONCLUSION The six domains of competence and associated learning outcomes can be used by academics to guide the integration of EPRs into undergraduate healthcare programmes. This is key to ensuring that the future healthcare workforce can work with and alongside EPRs.
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Affiliation(s)
- S K Pontefract
- School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Institute of Clinical Sciences, Birmingham, B15 2TT, UK
- University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, B15 2SP, UK
| | - K Wilson
- Manchester Medical School, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, M13 9PL, UK.
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Turner RBS, Hepworth G, Wilson K, Tyrrell D, Dunshea FR, Mansfield CS. Abdominal volume computed tomography assessment of body composition in dogs. BMC Vet Res 2019; 15:21. [PMID: 30621710 PMCID: PMC6325834 DOI: 10.1186/s12917-018-1768-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Accepted: 12/27/2018] [Indexed: 02/02/2023] Open
Abstract
Background Computed tomography (CT) has been used to estimate body composition and determine tissue distribution in dogs, despite limited validation. This may introduce error into estimates of body composition studies and its effect on health in dogs. Further, the modality has not been validated against dual-energy X-ray absorptiometry (DXA) or over a wide range of dog breeds, ages and sexes. The objective of this study was to validate the use of semi-automated, abdominal volume CT for estimating total body composition of dogs relative to DXA. Twenty-two staff-owned dogs (weighing between 5.1-60 kg) were sedated and underwent full body DXA scan and abdominal CT. Abdominal tissue composition was estimated by CT using semi-automated volume segmentation, over predetermined tissue Hounsfield threshold values. Abdominal tissue composition determined by the various CT threshold ranges was compared to total body composition determined by DXA. Results Abdominal tissue composition estimated by CT strongly correlated with the estimates derived from DXA with a small Bland-Altman mean percentage differences in values: total body mass (− 250/2000HU: r2 = 0.985; − 1.10%); total fat mass (− 250/-25HU: r2 = 0.981; − 1.90%); total lean tissue mass (− 25/150HU: r2 = 0.972; 3.47%); and total bone mineral content (150/2000HU: r2 = 0.900; − 0.87%). Although averaged CT values compared well to DXA analysis, there was moderate variation in the individual predicted values. There was near perfect inter- and intra-observer agreement in segmentation volumes for abdominal fat. Conclusions Abdominal volume computed tomography (CT) accurately and reliably estimates total body composition in dogs, but greater variations may be observed in dogs weighing less than 10 kg.
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Affiliation(s)
- R B S Turner
- U-Vet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia.
| | - G Hepworth
- Statistical Consulting Centre, University of Melbourne, 139 Barry Street, Carlton, Melbourne, Victoria, 3053, Australia
| | - K Wilson
- U-Vet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia
| | - D Tyrrell
- U-Vet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia
| | - F R Dunshea
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Victoria, 3052, Australia
| | - C S Mansfield
- U-Vet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, 250 Princes Highway, Werribee, Victoria, 3030, Australia
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Wilson K, Stinchcombe A, Kortes-Miller K. BRINGING DIVERSE STORIES OF AGING INTO THE CLASSROOM: A FOCUS ON LGBTQ+ AGING. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3157] [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: 11/12/2022] Open
Affiliation(s)
- K Wilson
- Department of Family Relations & Applied Nutrition, University of Guelph
| | - A Stinchcombe
- Faculty of Human Sciences, Saint Paul University (Ottawa)
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Stinchcombe A, Wilson K. THE MENTAL HEALTH OF AGING SEXUAL MINORITIES IN CANADA: FINDINGS FROM THE CANADIAN LONGITUDINAL STUDY ON AGING (CLSA). Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2476] [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: 11/14/2022] Open
Affiliation(s)
| | - K Wilson
- Department of Family Relations & Applied Nutrition, University of Guelph
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Barbour A, Walpole E, Mai G, Barnes L, Watson D, Ackland S, Wills V, Martin J, Burge M, Karapetis C, Shannon J, Nott L, Gebski V, Oostendorp M, Wilson K, Thomas J, Lampe G, Zalcberg J, Simes J, Smithers M. Progression-free survival and recurrence results for AGITG DOCTOR: Pre-op cisplatin, 5FU & DOCetaxel +/-radiotherapy after poor early response to cisplatin & 5FU for resectable oesophageal adenocarcinoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.003] [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: 11/14/2022] Open
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Tita AT, Jablonski KA, Bailit JL, Grobman WA, Wapner RJ, Reddy UM, Varner MW, Thorp JM, Leveno KJ, Caritis SN, Iams JD, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Wallace M, Northen A, Grant J, Colquitt C, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Shubert P, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Neonatal outcomes of elective early-term births after demonstrated fetal lung maturity. Am J Obstet Gynecol 2018; 219:296.e1-296.e8. [PMID: 29800541 DOI: 10.1016/j.ajog.2018.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 11/09/2016] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Studies of early-term birth after demonstrated fetal lung maturity show that respiratory and other outcomes are worse with early-term birth (370-386 weeks) even after demonstrated fetal lung maturity when compared with full-term birth (390-406 weeks). However, these studies included medically indicated births and are therefore potentially limited by confounding by the indication for delivery. Thus, the increase in adverse outcomes might be due to the indication for early-term birth rather than the early-term birth itself. OBJECTIVE We examined the prevalence and risks of adverse neonatal outcomes associated with early-term birth after confirmed fetal lung maturity as compared with full-term birth in the absence of indications for early delivery. STUDY DESIGN This is a secondary analysis of an observational study of births to 115,502 women in 25 hospitals in the United States from 2008 through 2011. Singleton nonanomalous births at 37-40 weeks with no identifiable indication for delivery were included; early-term births after positive fetal lung maturity testing were compared with full-term births. The primary outcome was a composite of death, ventilator for ≥2 days, continuous positive airway pressure, proven sepsis, pneumonia or meningitis, treated hypoglycemia, hyperbilirubinemia (phototherapy), and 5-minute Apgar <7. Logistic regression and propensity score matching (both 1:1 and 1:2) were used. RESULTS In all, 48,137 births met inclusion criteria; the prevalence of fetal lung maturity testing in the absence of medical or obstetric indications for early delivery was 0.52% (n = 249). There were 180 (0.37%) early-term births after confirmed pulmonary maturity and 47,957 full-term births. Women in the former group were more likely to be non-Hispanic white, smoke, have received antenatal steroids, have induction, and have a cesarean. Risks of the composite (16.1% vs 5.4%; adjusted odds ratio, 3.2; 95% confidence interval, 2.1-4.8 from logistic regression) were more frequent with elective early-term birth. Propensity scores matching confirmed the increased primary composite in elective early-term births: adjusted odds ratios, 4.3 (95% confidence interval, 1.8-10.5) for 1:1 and 3.5 (95% confidence interval, 1.8-6.5) for 1:2 matching. Among components of the primary outcome, CPAP use and hyperbilirubinemia requiring phototherapy were significantly increased. Transient tachypnea of the newborn, neonatal intensive care unit admission, and prolonged neonatal intensive care unit stay (>2 days) were also increased with early-term birth. CONCLUSION Even with confirmed pulmonary maturity, early-term birth in the absence of medical or obstetric indications is associated with worse neonatal respiratory and hepatic outcomes compared with full-term birth, suggesting relative immaturity of these organ systems in early-term births.
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Mosing M, Waldmann AD, Raisis A, Böhm SH, Drynan E, Wilson K. Monitoring of tidal ventilation by electrical impedance tomography in anaesthetised horses. Equine Vet J 2018; 51:222-226. [PMID: 30035329 DOI: 10.1111/evj.12998] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 07/13/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Electrical impedance tomography (EIT) is a method to measure regional impedance changes within the thorax. The total tidal impedance variation has been used to measure changes in tidal volumes in pigs, dogs and men. OBJECTIVES To assess the ability of EIT to quantify changes in tidal volume in anaesthetised mechanically ventilated horses. STUDY DESIGN In vivo experimental study. METHODS Six horses (mean ± s.d.: age 11.5 ± 7.5 years and body weight 491 ± 40 kg) were anaesthetised using isoflurane in oxygen. The lungs were mechanically ventilated using a volume-controlled mode. With an end-tidal carbon dioxide tension in the physiological range, and a set tidal volume (VTvent ) of 11-16 mL/kg (baseline volume), EIT data and VT measured by conventional spirometry were collected over 1 min. Thereafter, VTvent was changed in 1 L steps until reaching 10 L. After, VTvent was reduced to 1 L below the baseline volume and then further reduced in 1 L steps until 4 L. On each VT step data were recorded for 1 min after allowing 1 min of stabilisation. Impedance changes within the predefined two lung regions of interest (EITROI ) and the whole image (EITthorax ) were calculated. Linear regression analysis was used to assess the relationship between spirometry data and EITROI and EITthorax for individual horses and pooled data. RESULTS Both EITROI and EITthorax significantly predicted spirometry data for individual horses with R2 ranging from 0.937 to 0.999 and from 0.954 to 0.997 respectively. This was similar for pooled data from all six horses with EITROI (R2 = 0.799; P<0.001) and EITthorax (R2 = 0.841; P<0.001). MAIN LIMITATIONS The method was only tested in healthy mechanically ventilated horses. CONCLUSIONS The EIT can be used to quantify changes in tidal volume.
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Affiliation(s)
- M Mosing
- College of Veterinary Medicine, Murdoch University, Perth, Australia
| | - A D Waldmann
- Swisstom, Landquart, Switzerland.,Department of Pneumology and Critical Care Medicine, Witten/Herdecke University Hospital, Cologne, Germany
| | - A Raisis
- College of Veterinary Medicine, Murdoch University, Perth, Australia
| | - S H Böhm
- Department of Anesthesiology and Intensive Care Medicine, Rostock University Medical Center, Rostock, Germany
| | - E Drynan
- College of Veterinary Medicine, Murdoch University, Perth, Australia
| | - K Wilson
- College of Veterinary Medicine, Murdoch University, Perth, Australia
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