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Lee D, Yang S, Berry M, Stinchcombe T, Cohen HJ, Wang X. genRCT: a statistical analysis framework for generalizing RCT findings to real-world population. J Biopharm Stat 2024:1-20. [PMID: 38590156 DOI: 10.1080/10543406.2024.2333136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/10/2024]
Abstract
When evaluating the real-world treatment effect, the analysis based on randomized clinical trials (RCTs) often introduces generalizability bias due to the difference in risk factors between the trial participants and the real-world patient population. This problem of lack of generalizability associated with the RCT-only analysis can be addressed by leveraging observational studies with large sample sizes that are representative of the real-world population. A set of novel statistical methods, termed "genRCT", for improving the generalizability of the trial has been developed using calibration weighting, which enforces the covariates balance between the RCT and observational study. This paper aims to review statistical methods for generalizing the RCT findings by harnessing information from large observational studies that represent real-world patients. Specifically, we discuss the choices of data sources and variables to meet key theoretical assumptions and principles. We introduce and compare estimation methods for continuous, binary, and survival endpoints. We showcase the use of the R package genRCT through a case study that estimates the average treatment effect of adjuvant chemotherapy for the stage 1B non-small cell lung patients represented by a large cancer registry.
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Affiliation(s)
- Dasom Lee
- Department of Statistics, North Carolina State University, Elk Grove, USA
| | - Shu Yang
- Department of Statistics, North Carolina State University, Elk Grove, USA
| | - Mark Berry
- Department of Cardiothoracic Surgery, Stanford University, Stanford, USA
| | | | | | - Xiaofei Wang
- Department of Biostatistics & Bioinformatics, Duke University, Durham, USA
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Mozaffari E, Chandak A, Gottlieb RL, Chima-Melton C, Kalil AC, Sarda V, Der-Torossian C, Oppelt T, Berry M, Amin AN. Treatment of patients hospitalized for COVID-19 with remdesivir is associated with lower likelihood of 30-day readmission: a retrospective observational study. J Comp Eff Res 2024; 13:e230131. [PMID: 38420658 PMCID: PMC11044956 DOI: 10.57264/cer-2023-0131] [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: 08/07/2023] [Accepted: 02/14/2024] [Indexed: 03/02/2024] Open
Abstract
Aim: This observational study investigated the association between remdesivir treatment during hospitalization for COVID-19 and 30-day COVID-19-related and all-cause readmission across different variants time periods. Patients & methods: Hospitalization records for adult patients discharged from a COVID-19 hospitalization between 1 May 2020 to 30 April 2022 were extracted from the US PINC AI Healthcare Database. Likelihood of 30-day readmission was compared among remdesivir-treated and nonremdesivir-treated patients using multivariable logistic regression models adjusted for age, corticosteroid treatment, Charlson comorbidity index and intensive care unit stay during the COVID-19 hospitalization. Analyses were stratified by maximum supplemental oxygen requirement and variant time period (pre-Delta, Delta and Omicron). Results: Of the 440,601 patients discharged alive after a COVID-19 hospitalization, 248,785 (56.5%) patients received remdesivir. Overall, remdesivir patients had a 30-day COVID-19-related readmission rate of 3.0% and all-cause readmission rate of 6.3% compared with 5.4% and 9.1%, respectively, for patients who did not receive remdesivir during their COVID-19 hospitalization. After adjusting for demographics and clinical characteristics, remdesivir treatment was associated with significantly lower odds of 30-day COVID-19-related readmission (odds ratio 0.60 [95% confidence interval: 0.58-0.62]), and all-cause readmission (0.73 [0.72-0.75]). Significantly lower odds of 30-day readmission in remdesivir-treated patients was observed across all variant time periods. Conclusion: Treating patients hospitalized for COVID-19 with remdesivir is associated with a statistically significant reduction in 30-day COVID-19-related and all-cause readmission across variant time periods. These findings indicate that the clinical benefit of remdesivir may extend beyond the COVID-19 hospitalization.
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Affiliation(s)
| | | | - Robert L Gottlieb
- Baylor University Medical Center, Dallas, TX 75246, USA
- Baylor Scott & White Heart & Vascular Hospital, Dallas, TX USA, 75226
- Baylor Scott & White The Heart Hospital, Plano, TX 75093, USA
- Baylor Scott & White Research Institute, Dallas, TX 75204, USA
| | | | - Andre C Kalil
- University of Nebraska Medical Center, Omaha, NE 68198, USA
| | | | | | | | - Mark Berry
- Gilead Sciences, Foster City, CA, 94404, USA
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Mozaffari E, Chandak A, Amin AN, Gottlieb RL, Kalil AC, Sarda V, Berry M, Brown G, Okulicz JF, Chima-Melton C. Racial and Ethnic Disparities in COVID-19 Treatments in the United States. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01942-0. [PMID: 38409487 DOI: 10.1007/s40615-024-01942-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Racial and ethnic disparities in patient outcomes following COVID-19 exist, in part, due to factors involving healthcare delivery. The aim of the study was to characterize disparities in the administration of evidence-based COVID-19 treatments among patients hospitalized for COVID-19. METHODS Using a large, US hospital database, initiation of COVID-19 treatments was compared among patients hospitalized for COVID-19 between May 2020 and April 2022 according to patient race and ethnicity. Multivariate logistic regression models were used to examine the effect of race and ethnicity on the likelihood of receiving COVID-19 treatments, stratified by baseline supplemental oxygen requirement. RESULTS The identified population comprised 317,918 White, 76,715 Black, 9297 Asian, and 50,821 patients of other or unknown race. There were 329,940 non-Hispanic, 74,199 Hispanic, and 50,622 patients of unknown ethnicity. White patients were more likely to receive COVID-19 treatments, and specifically corticosteroids, compared to Black, Asian, and other patients (COVID-19 treatment: 87% vs. 81% vs. 85% vs. 84%, corticosteroids: 85% vs. 79% vs. 82% vs. 82%). After covariate adjustment, White patients were significantly more likely to receive COVID-19 treatments than Black patients across all levels of supplemental oxygen requirement. No clear trend in COVID-19 treatments according to ethnicity (Hispanic vs. non-Hispanic) was observed. CONCLUSION There were important racial disparities in inpatient COVID-19 treatment initiation, including the undertreatment of Black patients and overtreatment of White patients. Our new findings reveal the actual magnitude of this issue in routine clinical practice to clinicians, policymakers, and guideline developers. This is crucial to ensuring equitable and appropriate access to evidence-based therapies.
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Affiliation(s)
| | | | | | - Robert L Gottlieb
- Baylor University Medical Center, Dallas, TX, USA
- Baylor Scott & White Heart and Vascular Hospital, Dallas, TX, USA
- Baylor Scott & White The Heart Hospital, Plano, TX, USA
- Baylor Scott & White Research Institute, Dallas, TX, USA
| | - Andre C Kalil
- University of Nebraska Medical Center, Omaha, NE, USA
| | | | | | | | | | - Chidinma Chima-Melton
- Department of Medicine, Division of Pulmonary & Critical Care Medicine, UCLA Health System, David Geffen School of Medicine at University of California, Los Angeles, CA, USA.
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R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Mozaffari E, Chandak A, Gottlieb RL, Chima-Melton C, Read SH, Jiang H, Chiang M, Lee E, Gupta R, Berry M, Kalil AC. Remdesivir Reduced Mortality in Immunocompromised Patients Hospitalized for COVID-19 Across Variant Waves: Findings From Routine Clinical Practice. Clin Infect Dis 2023; 77:1626-1634. [PMID: 37556727 PMCID: PMC10724457 DOI: 10.1093/cid/ciad460] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Immunocompromised patients are at high risk of severe coronavirus disease 2019 (COVID-19) and death, yet treatment strategies for immunocompromised patients hospitalized for COVID-19 reflect variations in clinical practice. In this comparative effectiveness study, we investigated the effect of remdesivir treatment on inpatient mortality among immunocompromised patients hospitalized for COVID-19 across all variants of concern (VOC) periods. METHODS Data for immunocompromised patients hospitalized for COVID-19 between December 2020 and April 2022 were extracted from the US PINC AITM Healthcare Database. Patients who received remdesivir within 2 days of hospitalization were matched 1:1 using propensity score matching to patients who did not receive remdesivir. Additional matching criteria included admission month, age group, and hospital. Cox proportional hazards models were used to examine the effect of remdesivir on risk of 14- and 28-day mortality during VOC periods. RESULTS A total of 19 184 remdesivir patients were matched to 11 213 non-remdesivir patients. Overall, 11.1% and 17.7% of remdesivir patients died within 14 and 28 days, respectively, compared with 15.4% and 22.4% of non-remdesivir patients. Remdesivir was associated with a reduction in mortality at 14 (hazard ratio [HR], 0.70; 95% confidence interval, .62-.78) and 28 days (HR, 0.75; 95% CI, .68-.83). The survival benefit remained significant during the pre-Delta, Delta, and Omicron periods. CONCLUSIONS Prompt initiation of remdesivir in immunocompromised patients hospitalized for COVID-19 is associated with significant survival benefit across all variant waves. These findings provide much-needed evidence relating to the effectiveness of a foundational treatment for hospitalized COVID-19 patients among a high-risk population.
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Affiliation(s)
| | | | - Robert L Gottlieb
- Baylor University Medical Center, Dallas, Texas, USA
- Baylor Scott & White Heart and Vascular Hospital, Dallas, Texas, USA
- Baylor Scott & White The Heart Hospital, Plano, Texas, USA
- Baylor Scott & White Research Institute, Dallas, Texas, USA
| | | | | | | | - Mel Chiang
- Gilead Sciences, Foster City, California, USA
| | | | | | - Mark Berry
- Gilead Sciences, Foster City, California, USA
| | - Andre C Kalil
- University of Nebraska Medical Center, Omaha, Nebraska, USA
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Mozaffari E, Chandak A, Gottlieb RL, Chima-Melton C, Read SH, Lee E, Der-Torossian C, Gupta R, Berry M, Hollemeersch S, Kalil AC. Remdesivir Is Associated With Reduced Mortality in COVID-19 Patients Requiring Supplemental Oxygen Including Invasive Mechanical Ventilation Across SARS-CoV-2 Variants. Open Forum Infect Dis 2023; 10:ofad482. [PMID: 37869410 PMCID: PMC10588622 DOI: 10.1093/ofid/ofad482] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
Background This comparative effectiveness study investigated the effect of remdesivir on in-hospital mortality among patients hospitalized for coronavirus disease 2019 (COVID-19) requiring supplemental oxygen including low-flow oxygen (LFO), high-flow oxygen/noninvasive ventilation (HFO/NIV), or invasive mechanical ventilation/extracorporeal membrane oxygenation (IMV/ECMO) across variant of concern (VOC) periods. Methods Patients hospitalized for COVID-19 between December 2020 and April 2022 and administered remdesivir upon admission were 1:1 propensity score matched to patients not administered remdesivir during their COVID-19 hospitalization. Analyses were stratified by supplemental oxygen requirement upon admission and VOC period. Cox proportional hazards models were used to derive adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for 14- and 28-day mortality. Results Patients treated with remdesivir (67 582 LFO, 34 857 HFO/NIV, and 4164 IMV/ECMO) were matched to non-remdesivir patients. Unadjusted mortality rates were significantly lower for remdesivir-treated patients at 14 days (LFO: 6.4% vs. 8.8%; HFO/NIV: 16.8% vs. 19.4%; IMV/ECMO: 27.8% vs. 35.3%) and 28 days (LFO: 9.8% vs. 12.3%; HFO/NIV: 25.8% vs. 28.3%; IMV/ECMO: 41.4% vs. 50.6%). After adjustment, remdesivir treatment was associated with a statistically significant reduction in in-hospital mortality at 14 days (LFO: aHR, 0.72; 95% CI, 0.66-0.79; HFO/NIV: aHR, 0.83; 95% CI, 0.77-0.89; IMV/ECMO: aHR, 0.73; 95% CI, 0.65-0.82) and 28 days (LFO: aHR, 0.79; 95% CI, 0.73-0.85; HFO/NIV: aHR, 0.88; 95% CI, 0.82-0.93; IMV/ECMO: aHR, 0.74; 95% CI, 0.67-0.82) compared with non-remdesivir treatment. Lower risk of mortality among remdesivir-treated patients was observed across VOC periods. Conclusions Remdesivir treatment is associated with significantly reduced mortality among patients hospitalized for COVID-19 requiring supplemental oxygen upon admission, including those requiring HFO/NIV or IMV/ECMO with severe or critical disease, across VOC periods.
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Affiliation(s)
| | | | - Robert L Gottlieb
- Department of Internal Medicine, Baylor University Medical Center, Dallas, Texas, USA
- Baylor Scott & White Research Institute, Dallas, Texas, USA
- Department of Internal Medicine, Burnett School of Medicineat TCU, Fort Worth, Texas, USA
- Department of Interal Medicine, Texas A&M Health Science Center, Dallas, Texas, USA
| | - Chidinma Chima-Melton
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, UCLA Health, Torrance, California, USA
| | | | | | | | | | - Mark Berry
- Gilead Sciences, Foster City, California, USA
| | | | - Andre C Kalil
- Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Eugene N, Kuryba A, Martin P, Oliver CM, Berry M, Moppett IK, Johnston C, Hare S, Lockwood S, Murray D, Walker K, Cromwell DA. Development and validation of a prognostic model for death 30 days after adult emergency laparotomy. Anaesthesia 2023; 78:1262-1271. [PMID: 37450350 DOI: 10.1111/anae.16096] [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] [Accepted: 06/25/2023] [Indexed: 07/18/2023]
Abstract
The probability of death after emergency laparotomy varies greatly between patients. Accurate pre-operative risk prediction is fundamental to planning care and improving outcomes. We aimed to develop a model limited to a few pre-operative factors that performed well irrespective of surgical indication: obstruction; sepsis; ischaemia; bleeding; and other. We derived a model with data from the National Emergency Laparotomy Audit for patients who had emergency laparotomy between December 2016 and November 2018. We tested the model on patients who underwent emergency laparotomy between December 2018 and November 2019. There were 4077/40,816 (10%) deaths 30 days after surgery in the derivation cohort. The final model had 13 pre-operative variables: surgical indication; age; blood pressure; heart rate; respiratory history; urgency; biochemical markers; anticipated malignancy; anticipated peritoneal soiling; and ASA physical status. The predicted mortality probability deciles ranged from 0.1% to 47%. There were 1888/11,187 deaths in the test cohort. The scaled Brier score, integrated calibration index and concordance for the model were 20%, 0.006 and 0.86, respectively. Model metrics were similar for the five surgical indications. In conclusion, we think that this prognostic model is suitable to support decision-making before emergency laparotomy as well as for risk adjustment for comparing organisations.
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Affiliation(s)
- N Eugene
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK
| | - A Kuryba
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK
| | - P Martin
- Department of Applied Health Research, University College London, London, UK
| | - C M Oliver
- UCL Division of Surgery and Interventional Science, University College London Hospitals NHS Foundation Trust, London, UK
| | - M Berry
- Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - I K Moppett
- Anaesthesia and Critical Care Section, Academic Unit of Injury, Inflammation and Repair, University of Nottingham, Nottingham, UK
| | - C Johnston
- Department of Anaesthesia, St George's Hospital, London, UK
| | - S Hare
- Department of Anaesthesia, Medway Maritime Hospital, Gillingham, Kent, UK
| | - S Lockwood
- Colorectal Surgery Department, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - D Murray
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - K Walker
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - D A Cromwell
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Kelly JD, Curteis T, Rawal A, Murton M, Clark LJ, Jafry Z, Shah-Gupta R, Berry M, Espinueva A, Chen L, Abdelghany M, Sweeney DA, Quint JK. SARS-CoV-2 post-acute sequelae in previously hospitalised patients: systematic literature review and meta-analysis. Eur Respir Rev 2023; 32:220254. [PMID: 37437914 PMCID: PMC10336551 DOI: 10.1183/16000617.0254-2022] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/03/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND Many individuals hospitalised with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection experience post-acute sequelae of SARS-CoV-2 infection (PASC), sometimes referred to as "long COVID". Our objective was to conduct a systematic literature review and meta-analysis to identify PASC-associated symptoms in previously hospitalised patients and determine the frequency and temporal nature of PASC. METHODS Searches of MEDLINE, Embase, Cochrane Library (2019-2021), World Health Organization International Clinical Trials Registry Platform and reference lists were performed from November to December 2021. Articles were assessed by two reviewers against eligibility criteria and a risk of bias tool. Symptom data were synthesised by random effects meta-analyses. RESULTS Of 6942 records, 52 studies with at least 100 patients were analysed; ∼70% were Europe-based studies. Most data were from the first wave of the pandemic. PASC symptoms were analysed from 28 days after hospital discharge. At 1-4 months post-acute SARS-CoV-2 infection, the most frequent individual symptoms were fatigue (29.3% (95% CI 20.1-40.6%)) and dyspnoea (19.6% (95% CI 12.8-28.7%)). Many patients experienced at least one symptom at 4-8 months (73.1% (95% CI 44.2-90.3%)) and 8-12 months (75.0% (95% CI 56.4-87.4%)). CONCLUSIONS A wide spectrum of persistent PASC-associated symptoms were reported over the 1-year follow-up period in a significant proportion of participants. Further research is needed to better define PASC duration and determine whether factors such as disease severity, vaccination and treatments have an impact on PASC.
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Affiliation(s)
- J Daniel Kelly
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | | | | | | | | | - Zarena Jafry
- Costello Medical Consulting, Inc., Boston, MA, USA
| | | | - Mark Berry
- Gilead Sciences Europe Ltd, Uxbridge, UK
| | | | - Linda Chen
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | - Daniel A Sweeney
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California, San Diego, CA, USA
| | - Jennifer K Quint
- School of Public Health and National Heart and Lung Institute, Imperial College London, London, UK
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Diehl PU, Singer Y, Zilly H, Schönfeld U, Meyer-Rachner P, Berry M, Sprekeler H, Sprengel E, Pudszuhn A, Hofmann VM. Restoring speech intelligibility for hearing aid users with deep learning. Sci Rep 2023; 13:2719. [PMID: 36792797 PMCID: PMC9932078 DOI: 10.1038/s41598-023-29871-8] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/11/2023] [Indexed: 02/17/2023] Open
Abstract
Almost half a billion people world-wide suffer from disabling hearing loss. While hearing aids can partially compensate for this, a large proportion of users struggle to understand speech in situations with background noise. Here, we present a deep learning-based algorithm that selectively suppresses noise while maintaining speech signals. The algorithm restores speech intelligibility for hearing aid users to the level of control subjects with normal hearing. It consists of a deep network that is trained on a large custom database of noisy speech signals and is further optimized by a neural architecture search, using a novel deep learning-based metric for speech intelligibility. The network achieves state-of-the-art denoising on a range of human-graded assessments, generalizes across different noise categories and-in contrast to classic beamforming approaches-operates on a single microphone. The system runs in real time on a laptop, suggesting that large-scale deployment on hearing aid chips could be achieved within a few years. Deep learning-based denoising therefore holds the potential to improve the quality of life of millions of hearing impaired people soon.
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Affiliation(s)
- Peter Udo Diehl
- Audatic, Berlin, Friedrichstr. 210, 10117, Berlin, Germany. .,Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
| | - Yosef Singer
- Audatic, Berlin, Friedrichstr. 210, 10117 Berlin, Germany
| | - Hannes Zilly
- Audatic, Berlin, Friedrichstr. 210, 10117 Berlin, Germany
| | - Uwe Schönfeld
- grid.6363.00000 0001 2218 4662Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | | | - Mark Berry
- Audatic, Berlin, Friedrichstr. 210, 10117 Berlin, Germany
| | - Henning Sprekeler
- grid.6734.60000 0001 2292 8254Department for Electrical Engineering and Computer Science, Technische Universität Berlin, Berlin, Germany ,grid.455089.50000 0004 0456 0961Bernstein Center for Computational Neuroscience Berlin, Philippstr. 13, 10115 Berlin, Germany ,grid.6734.60000 0001 2292 8254Exzellenzcluster Science of Intelligence, Technische Universität Berlin, Marchstr. 23, 10587 Berlin, Germany
| | - Elias Sprengel
- Audatic, Berlin, Friedrichstr. 210, 10117 Berlin, Germany
| | - Annett Pudszuhn
- grid.6363.00000 0001 2218 4662Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Veit M. Hofmann
- grid.6363.00000 0001 2218 4662Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
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Fukui N, Conaghan PG, Togo K, Ebata N, Abraham L, Jackson J, Berry M, Cappelleri JC, Pandit H. Physician and patient perceptions of surgical procedures for osteoarthritis of the knee in the United States, Europe, and Japan: results of a real-world study. BMC Musculoskelet Disord 2022; 23:1065. [PMID: 36471384 PMCID: PMC9720939 DOI: 10.1186/s12891-022-05954-x] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is the most common form of arthritis, with the knee being the joint most frequently affected, and symptomatic knee OA affecting around one quarter of the general population. For patients who do not respond to non-pharmacologic or pharmacologic treatment, surgery is a recommended option. The objectives of this study were to compare the willingness of patients with knee OA to undergo surgery, together with reasons for delaying surgery, and factors affecting successful outcomes. METHODS A point-in-time survey was conducted in 729 primary care physicians, rheumatologists, orthopedic surgeons, and 2,316 patients with knee OA across three geographical regions: Japan, the United States (US), and Europe (EUR: France, Spain, Italy, Germany, and the United Kingdom), in order to garner their perceptions of knee surgery. Regression models were used to identify factors that might affect patients' and physicians' perceptions of surgery, including severity of OA (mild/moderate/severe), number of affected joints, surgery status, and willingness to undergo or delay surgery. RESULTS Baseline demographics were similar between US and EUR, although patients in Japan were more likely to be female, older, and only 7% in fulltime employment. We found that few patients with end-stage knee OA, across all regions, but particularly Japan, were willing to undergo surgery (Japan 17%, US 32%, EUR 38%), either through fear, or the lack of awareness of the risk/benefits. Moreover, surgeons are prepared to delay surgery in elderly or unwilling patients, due to their dissatisfaction with the outcome, and may defer surgery in younger patients due to the need for future revision. We also identified a disconnect between physicians, of whom over 80% consider improved functioning to be the most important outcome of surgery, and patients, who seek pain relief (Japan 60%, US 35%, EUR 14%). Since physicians across all regions considered pain reduction to be an indication of surgery success (Japan 27%, US 47%, EUR 43%), this may indicate a need for improved communication to patients on the potential benefits of surgery. CONCLUSION Managing the expectations of patients undergoing surgery remains an important goal in the treatment of knee OA and may help guide physician choice.
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Affiliation(s)
- N Fukui
- grid.26999.3d0000 0001 2151 536XUniversity of Tokyo, Tokyo, Japan
| | - PG Conaghan
- grid.454370.10000 0004 0439 7412Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds & NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - K Togo
- grid.418567.90000 0004 1761 4439Pfizer Japan Inc, Tokyo, Japan
| | - N Ebata
- grid.418567.90000 0004 1761 4439Pfizer Japan Inc, Tokyo, Japan
| | - L Abraham
- grid.418566.80000 0000 9348 0090Pfizer Ltd, Surrey, UK
| | | | - M Berry
- Adelphi Real World, Bollington, UK
| | - JC Cappelleri
- grid.410513.20000 0000 8800 7493Pfizer Inc, New York, USA
| | - H Pandit
- grid.9909.90000 0004 1936 8403University of Leeds, Leeds, UK
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Erwin PA, Lee AC, Ahmad U, Antonoff M, Arndt A, Backhus L, Berry M, Birdas T, Cassivi SD, Chang AC, Cooke DT, Crabtree T, DeCamp M, Donington J, Fernandez F, Force S, Gaissert H, Hofstetter W, Huang J, Kent M, Kim AW, Lin J, Martin LW, Meyerson S, Mitchell JD, Molena D, Odell D, Onaitis M, Puri V, Putnam JB, Reddy R, Schipper P, Seder CW, Shrager J, Tong B, Veeramachaneni N, Watson T, Whyte R, Ferguson MK. Consensus for Thoracoscopic Lower Lobectomy: Essential Components and Targets for Simulation. Ann Thorac Surg 2022; 114:1895-1901. [PMID: 34688617 DOI: 10.1016/j.athoracsur.2021.09.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/20/2021] [Accepted: 09/15/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Despite demonstration of its clear benefits relative to open approaches, a video-assisted thoracic surgery technique for pulmonary lobectomy has not been universally adopted. This study aims to overcome potential barriers by establishing the essential components of the operation and determining which steps are most useful for simulation training. METHODS After randomly selecting experienced thoracic surgeons to participate, an initial list of components to a lower lobectomy was distributed. Feedback was provided by the participants, and modifications were made based on anonymous responses in a Delphi process. Components were declared essential once at least 80% of participants came to an agreement. The steps were then rated based on cognitive and technical difficulty followed by listing the components most appropriate for simulation. RESULTS After 3 rounds of voting 18 components were identified as essential to performance of a video-assisted thoracic surgery for lower lobectomy. The components deemed the most difficult were isolation and division of the basilar and superior segmental branches of the pulmonary artery, isolation and division of the lower lobe bronchus, and dissection of lymphovascular tissue to expose the target bronchus. The steps determined to be most amenable for simulation were isolation and division of the branches of the pulmonary artery, the lower lobe bronchus, and the inferior pulmonary vein. CONCLUSIONS Using a Delphi process a list of essential components for a video-assisted thoracic surgery for lower lobectomy was established. Furthermore 3 components were identified as most appropriate for simulation-based training, providing insights for future simulation development.
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Affiliation(s)
- Philip A Erwin
- Department of Surgery, University of Chicago, Chicago, Illinois
| | - Andy C Lee
- Department of Surgery, University of Chicago, Chicago, Illinois
| | - Usman Ahmad
- Department of Thoracic and Cardiovascular Surgery Cleveland Clinic, Cleveland, Ohio
| | - Mara Antonoff
- Department of Thoracic and Cardiovascular Surgery MD Anderson Cancer Center Houston, Texas
| | - Andrew Arndt
- Department of Surgery Northwestern University, Chicago, Illinois
| | - Leah Backhus
- Department of Cardiothoracic Surgery Stanford University, Stanford, California
| | - Mark Berry
- Department of Cardiothoracic Surgery Stanford University, Stanford, California
| | - Thomas Birdas
- Department of Surgery, Indiana University, Indianapolis, Indiana
| | | | - Andrew C Chang
- Department of Surgery, University of Michigan Ann Arbor, Michigan
| | - David T Cooke
- Department of Surgery, University of California, Davis Health, Sacramento, California
| | - Traves Crabtree
- Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Malcolm DeCamp
- Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | | | | | - Seth Force
- Department of Surgery, Emory University, Atlanta, Georgia
| | - Henning Gaissert
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Wayne Hofstetter
- Department of Thoracic and Cardiovascular Surgery MD Anderson Cancer Center Houston, Texas
| | - James Huang
- Department of Surgery, Memorial Sloan Kettering, New York, New York
| | - Michael Kent
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Anthony W Kim
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jules Lin
- Department of Surgery, University of Michigan Ann Arbor, Michigan
| | - Linda W Martin
- Department of Surgery, University of Virginia, Charlottesville, Virginia
| | - Shari Meyerson
- Department of Surgery, University of Kentucky, Lexington, Kentucky
| | - John D Mitchell
- Department of Surgery, University of Colorado Aurora, Colorado
| | - Daniela Molena
- Department of Surgery, Memorial Sloan Kettering, New York, New York
| | - David Odell
- Department of Surgery Northwestern University, Chicago, Illinois
| | - Mark Onaitis
- Department of Surgery, University of California-San Diego, La Jolla, California
| | - Varun Puri
- Department of Surgery, Washington University, St. Louis, Missouri
| | - Joe B Putnam
- Department of Surgery, Baptist MD Anderson Cancer Center, Jacksonville, Florida
| | - Rishindra Reddy
- Department of Surgery, University of Michigan Ann Arbor, Michigan
| | - Paul Schipper
- Department of Surgery, Oregon Health and Sciences University, Portland, Oregon
| | | | - Joseph Shrager
- Department of Cardiothoracic Surgery Stanford University, Stanford, California
| | - Betty Tong
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | | | - Thomas Watson
- Department of Surgery, Beaumont Health-Detroit, Royal Oak, Michigan
| | - Richard Whyte
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Mark K Ferguson
- Department of Surgery, University of Chicago, Chicago, Illinois.
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Berry M, Limberg D, Lee-Trimble ME, Hayward R, Santangelo CD. Controlling the configuration space topology of mechanical structures. Phys Rev E 2022; 106:055002. [PMID: 36559440 DOI: 10.1103/physreve.106.055002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/15/2022] [Indexed: 06/17/2023]
Abstract
Linkages are mechanical devices constructed from rigid bars and freely rotating joints studied both for their utility in engineering and as mathematical idealizations in a number of physical systems. Recently, there has been a resurgence of interest in designing linkages in the physics community due to the concurrent developments of mechanical metamaterials, topological mechanics, and the discovery of anomalous rigidity in fiber networks and vertex models. These developments raise a natural question: to what extent can the motion of a linkage or mechanical structure be designed? Here, we describe a method to design the topology of the configuration space of a linkage by first identifying the manifold of critical points, then perturbing around such critical configurations. Unlike other methods, our methods are tractable and provide a simple visual toolkit for mechanism design. We demonstrate our procedure by designing a mechanism to gate the propagation of a soliton in a Kane-Lubensky chain of interconnected rotors.
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Affiliation(s)
- M Berry
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - David Limberg
- Department of Polymer Science and Engineering, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - M E Lee-Trimble
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - Ryan Hayward
- Department of Chemical and Biological Engineering, University of Colorado, Boulder, Colorado 80309, USA
| | - C D Santangelo
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
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Lutrick K, Fowlkes A, Rivers P, Herder K, Santibanez TA, LeClair L, Groover K, Lamberte JM, Grant L, Odame-Bamfo L, Ferraris MV, Phillips AL, Sokol B, Lowe AA, Mathenge C, Pubillones FA, Cottam B, McLeland-Wieser H, Jovel KS, Ochoa JS, Mckell J, Berry M, Khan S, Solle NS, Rai RP, Nakayima FM, Newes-Adeyi G, Porter C, Baccam Z, Ellingson KD, Burgess JL, Gaglani M, Gwynn L, Caban-Martinez A, Yoon S. Parental Intentions and Perceptions Toward COVID-19 Vaccination Among Children Aged 4 Months to 4 Years — PROTECT Cohort, Four States, July 2021–May 2022. MMWR Morb Mortal Wkly Rep 2022; 71:1109-1114. [PMID: 36048723 PMCID: PMC9472774 DOI: 10.15585/mmwr.mm7135a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Abstract
Blurb: This cohort study assesses the number of women who were eligible for and underwent lung cancer screening among those who received mammograms at a single academic medical center.
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Affiliation(s)
- Ashley L. Titan
- Department of Surgery, Stanford University Hospital, Stanford, California
| | - Ioana Baiu
- Department of Surgery, Stanford University Hospital, Stanford, California
- Department of Cardiothoracic Surgery, Stanford University Hospital, Stanford, California
| | - Doug Liou
- Department of Cardiothoracic Surgery, Stanford University Hospital, Stanford, California
| | - Natalie S. Lui
- Department of Cardiothoracic Surgery, Stanford University Hospital, Stanford, California
| | - Mark Berry
- Department of Cardiothoracic Surgery, Stanford University Hospital, Stanford, California
| | - Joseph Shrager
- Department of Cardiothoracic Surgery, Stanford University Hospital, Stanford, California
| | - Leah Backhus
- Stanford School of Medicine, Stanford, California
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La Puente M, Berry M, Milloy N, Montgomery R, Bleasdale C, Kluth C, Kirker M, Kearney M, Costa N, Chang J. CN71 Evaluating real-world caregiver involvement from a survey of patients (pts) with metastatic urothelial cancer (mUC) receiving systemic anticancer treatment in France, Germany, Italy, Spain, and the UK (Eu5). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.394] [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: 11/16/2022] Open
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17
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Nair VS, Hui ABY, Chabon JJ, Esfahani MS, Stehr H, Nabet BY, Zhou L, Chaudhuri AA, Benson J, Ayers K, Bedi H, Ramsey M, Van Wert R, Antic S, Lui N, Backhus L, Berry M, Sung AW, Massion PP, Shrager JB, Alizadeh AA, Diehn M. Genomic Profiling of Bronchoalveolar Lavage Fluid in Lung Cancer. Cancer Res 2022; 82:2838-2847. [PMID: 35748739 PMCID: PMC9379362 DOI: 10.1158/0008-5472.can-22-0554] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/24/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022]
Abstract
Genomic profiling of bronchoalveolar lavage (BAL) samples may be useful for tumor profiling and diagnosis in the clinic. Here, we compared tumor-derived mutations detected in BAL samples from subjects with non-small cell lung cancer (NSCLC) to those detected in matched plasma samples. Cancer Personalized Profiling by Deep Sequencing (CAPP-Seq) was used to genotype DNA purified from BAL, plasma, and tumor samples from patients with NSCLC. The characteristics of cell-free DNA (cfDNA) isolated from BAL fluid were first characterized to optimize the technical approach. Somatic mutations identified in tumor were then compared with those identified in BAL and plasma, and the potential of BAL cfDNA analysis to distinguish lung cancer patients from risk-matched controls was explored. In total, 200 biofluid and tumor samples from 38 cases and 21 controls undergoing BAL for lung cancer evaluation were profiled. More tumor variants were identified in BAL cfDNA than plasma cfDNA in all stages (P < 0.001) and in stage I to II disease only. Four of 21 controls harbored low levels of cancer-associated driver mutations in BAL cfDNA [mean variant allele frequency (VAF) = 0.5%], suggesting the presence of somatic mutations in nonmalignant airway cells. Finally, using a Random Forest model with leave-one-out cross-validation, an exploratory BAL genomic classifier identified lung cancer with 69% sensitivity and 100% specificity in this cohort and detected more cancers than BAL cytology. Detecting tumor-derived mutations by targeted sequencing of BAL cfDNA is technically feasible and appears to be more sensitive than plasma profiling. Further studies are required to define optimal diagnostic applications and clinical utility. SIGNIFICANCE Hybrid-capture, targeted deep sequencing of lung cancer mutational burden in cell-free BAL fluid identifies more tumor-derived mutations with increased allele frequencies compared with plasma cell-free DNA. See related commentary by Rolfo et al., p. 2826.
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Affiliation(s)
- Viswam S. Nair
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Division of Pulmonary, Critical Care & Sleep Medicine, University of Washington School of Medicine, Seattle, Washington
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Angela Bik-Yu Hui
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Jacob J. Chabon
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Mohammad S. Esfahani
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Henning Stehr
- Department of Pathology, Stanford University School of Medicine, Stanford, California
| | - Barzin Y. Nabet
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Li Zhou
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Aadel A. Chaudhuri
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Jalen Benson
- Division of Thoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Kelsey Ayers
- Division of Thoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Harmeet Bedi
- Division of Pulmonary, Allergy & Critical Care Medicine, Stanford University School of Medicine, Stanford, California
| | - Meghan Ramsey
- Division of Pulmonary, Allergy & Critical Care Medicine, Stanford University School of Medicine, Stanford, California
| | - Ryan Van Wert
- Division of Pulmonary, Allergy & Critical Care Medicine, Stanford University School of Medicine, Stanford, California
| | - Sanja Antic
- Division of Allergy, Pulmonary & Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Natalie Lui
- Division of Thoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Leah Backhus
- Division of Thoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Mark Berry
- Division of Thoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Arthur W. Sung
- Division of Pulmonary, Allergy & Critical Care Medicine, Stanford University School of Medicine, Stanford, California
| | - Pierre P. Massion
- Division of Allergy, Pulmonary & Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Joseph B. Shrager
- Division of Thoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Ash A. Alizadeh
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California
| | - Maximilian Diehn
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, California
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Conaghan PG, Abraham L, Viktrup L, Cappelleri JC, Beck C, Bushmakin AG, Berry M, Jackson J. Impact of osteoarthritis disease severity on treatment patterns and healthcare resource use: analysis of real-world data. Scand J Rheumatol 2022:1-11. [PMID: 35587006 DOI: 10.1080/03009742.2022.2058168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To understand treatment patterns and healthcare resource utilization (HCRU) related to osteoarthritis (OA) disease severity in patients in five European countries. METHOD Data were drawn from the Adelphi OA Disease Specific Programme™ (2017-18). Physicians classified their patients as having mild, moderate, or severe OA, and provided details on their current prescribed therapy and HCRU, including healthcare professional (HCP) consultations, diagnostics and testing, and hospitalizations. Comparisons between disease severity groups were made using analysis of variance and chi-squared tests. RESULTS The study included 489 physicians (primary care physicians, rheumatologists, orthopaedic surgeons) reporting on 3596 OA patients: 24% mild, 53% moderate, and 23% severe disease. Both physicians and patients reported decreasing satisfaction with treatment with greater disease severity, despite the number of classes of prescribed drugs and increased use of opioids, which were used in almost half of patients with severe OA. For patients whose treatment was not effective, physicians prescribed the same therapeutic options, which were cycled in subsequent treatment lines, with multiple treatment regimens being commonly used. Patients with greater symptom severity also had more physician consultations, while the numbers of tests/imaging, predominantly X-rays, conducted to diagnose or monitor OA increased significantly with disease severity. The type of HCP involvement in patient management also varied by OA severity. CONCLUSIONS Across five European countries, the use of both non-pharmacological and pharmacological treatments increases with greater disease severity. Those with more severe disease place a greater demand on healthcare resources, with HCP consultations, tests, and hospital visits increasing with severity.
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Affiliation(s)
| | | | - L Viktrup
- Eli Lilly and Co., Indianapolis, IN, USA
| | | | | | | | - M Berry
- Adelphi Real World, Bollington, UK
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Fowlkes AL, Yoon SK, Lutrick K, Gwynn L, Burns J, Grant L, Phillips AL, Ellingson K, Ferraris MV, LeClair LB, Mathenge C, Yoo YM, Thiese MS, Gerald LB, Solle NS, Jeddy Z, Odame-Bamfo L, Mak J, Hegmann KT, Gerald JK, Ochoa JS, Berry M, Rose S, Lamberte JM, Madhivanan P, Pubillones FA, Rai RP, Dunnigan K, Jones JT, Krupp K, Edwards LJ, Bedrick EJ, Sokol BE, Lowe A, McLeland-Wieser H, Jovel KS, Fleary DE, Khan SM, Poe B, Hollister J, Lopez J, Rivers P, Beitel S, Tyner HL, Naleway AL, Olsho LE, Caban-Martinez AJ, Burgess JL, Thompson MG, Gaglani M. Effectiveness of 2-Dose BNT162b2 (Pfizer BioNTech) mRNA Vaccine in Preventing SARS-CoV-2 Infection Among Children Aged 5-11 Years and Adolescents Aged 12-15 Years - PROTECT Cohort, July 2021-February 2022. MMWR Morb Mortal Wkly Rep 2022; 71:422-428. [PMID: 35298453 PMCID: PMC8942308 DOI: 10.15585/mmwr.mm7111e1] [Citation(s) in RCA: 99] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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20
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Baussant T, Arnberg M, Lyng E, Ramanand S, Bamber S, Berry M, Myrnes Hansen I, Van Oevelen D, Van Breugel P. Identification of tolerance levels on the cold-water coral Desmophyllum pertusum (Lophelia pertusa) from realistic exposure conditions to suspended bentonite, barite and drill cutting particles. PLoS One 2022; 17:e0263061. [PMID: 35192627 PMCID: PMC8863230 DOI: 10.1371/journal.pone.0263061] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 01/11/2022] [Indexed: 11/22/2022] Open
Abstract
Cold-water coral (CWC) reefs are numerous and widespread along the Norwegian continental shelf where oil and gas industry operate. Uncertainties exist regarding their impacts from operational discharges to drilling. Effect thresholds obtained from near-realistic exposure of suspended particle concentrations for use in coral risk modeling are particularly needed. Here, nubbins of Desmophyllum pertusum (Lophelia pertusa) were exposed shortly (5 days, 4h repeated pulses) to suspended particles (bentonite BE; barite BA, and drill cuttings DC) in the range of ~ 4 to ~ 60 mg.l-1 (actual concentration). Physiological responses (respiration rate, growth rate, mucus-related particulate organic carbon OC and particulate organic nitrogen ON) and polyp mortality were then measured 2 and 6 weeks post-exposure to assess long-term effects. Respiration and growth rates were not significantly different in any of the treatments tested compared to control. OC production was not affected in any treatment, but a significant increase of OC:ON in mucus produced by BE-exposed (23 and 48 mg.l-1) corals was revealed 2 weeks after exposure. Polyp mortality increased significantly at the two highest DC doses (19 and 49 mg.l-1) 2 and 6 weeks post-exposure but no significant difference was observed in any of the other treatments compared to the control. These findings are adding new knowledge on coral resilience to short realistic exposure of suspended drill particles and indicate overall a risk for long-term effects at a threshold of ~20 mg.l-1.
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Affiliation(s)
| | - Maj Arnberg
- NORCE Norwegian Research Centre AS, Randaberg, Norway
| | - Emily Lyng
- NORCE Norwegian Research Centre AS, Randaberg, Norway
| | | | - Shaw Bamber
- NORCE Norwegian Research Centre AS, Randaberg, Norway
| | - Mark Berry
- NORCE Norwegian Research Centre AS, Randaberg, Norway
| | - Ingrid Myrnes Hansen
- Ecotone AS, Trondheim, Norway
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Dick Van Oevelen
- Department of Estuarine and Delta Systems, NIOZ – Royal Netherlands Institute for Sea Research, Yerseke, the Netherlands
| | - Peter Van Breugel
- Department of Estuarine and Delta Systems, NIOZ – Royal Netherlands Institute for Sea Research, Yerseke, the Netherlands
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Fontes S, Marín-Jiménez A, Berry M, Sánchez-García J, Reyes G, Krygier G, Cuello M. P-177 Early onset colorectal cancer outcomes in a public Uruguayan cancer centre. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Fukui N, Conaghan PG, Togo K, Ebata N, Abraham L, Jackson J, Jackson J, Berry M, Pandit H. POS0128 PHYSICIAN AND PATIENT PERCEPTIONS OF SURGICAL PROCEDURES FOR KNEE OA ACROSS JAPAN, THE US AND 5 EU COUNTRIES: RESULTS OF A REAL-WORLD STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Patients with knee osteoarthritis (OA) who do not achieve adequate pain relief and functional improvement with a combination of non-pharmacologic and pharmacologic therapies are recommended an arthroplasty as an effective option to relieve severe pain and functional limitations. However, some patients are reluctant to undergo surgical interventions, and clinicians may choose to avoid or delay surgery due to safety risks and/or the financial cost. It is of interest to understand if the use and perception of surgery differs between countries, however, few published data exist.Objectives:To demonstrate how surgery and the use of surgical procedures differs across Japan, United States of America (US) and 5 major European countries (EU5) and to evaluate patient perception towards surgery.Methods:Data were drawn from the Adelphi OA Disease Specific Programme (2017-18), a point-in-time survey of primary care physicians (PCP), rheumatologists (rheums), orthopaedic surgeons (orthos) and their OA patients. Patients with physician-diagnosed knee OA were included and segmented into two categories: had previous surgery (PS) and never had surgery (NS). A Fisher’s exact test was performed on the two groups. Physicians reported on patient demographics; whether patients had undergone surgery; type of surgery; success of surgery; how success was defined; and reasons for wanting to delay surgery. Patients reported their willingness to undergo surgery; reasons for not wanting surgery; how successful their surgery was; and how they defined this success.Results:Physician/patient reported data were available for 302,230 (Japan), 527,283 (US) and 1487,726 (EU5) patients with diagnosed knee OA. Patients were categorised by their physicians as mild (40% Japan; 34% US; 24% EU5), moderate (49% Japan; 49% US; 56% EU5) or severe (9% Japan; 17% US; 19% EU5). Patients in Japan were more likely to be female (78% vs 54% US; 58% EU5), older (73 vs 65 US; 66 EU5) and have a lower BMI than patients in the US and EU5. Obesity and diabetes were much less prevalent among patients in Japan. One in ten patients in Japan had undergone a surgery (10%), far fewer than in the US (22%) or EU5 (17%). When surgery was performed, this was more likely to be a total joint replacement (TJR) in Japan, whereas in the EU and US, arthroscopic washout was more commonly performed.For over half of Japanese patients (56%), successful surgery was more likely to be defined as having no more pain (vs. 35% US; 14% EU5). Improved mobility and a reduction in pain were also commonly reported reasons. Physicians (in each region) were more likely to suggest pain reduction, rather than no pain, and improved mobility as markers of success. Patients in Japan were much more likely to say they would not agree to surgery if recommended by their doctor, or were unsure (84% vs. 68% US; 62% EU5). The main reason for patient reluctance in Japan was fear of surgery, whereas in the US and EU5 the main reason given was that surgery was not needed. This finding was also evident among physicians in Japan, who frequently reported that patient reluctance was a key reason for delaying surgery. Physicians in Japan, do however, report that patient request was one of their main triggers for recommending surgery (45% vs 20% US; 16% EU5).Conclusion:Although surgery can be an effective option for those with OA who have exhausted other treatment options, some patients are reluctant to undergo surgery out of fear, especially in Japan, possibly due to the higher patient age. Physicians aiming to delay surgery were driven by patient reluctance in Japan, whereas cost to patient was a bigger factor in the US and EU5. The higher level of TJR vs. other surgery options among patients in Japan may suggest physicians are looking for higher levels of efficacy.Disclosure of Interests:Naoshi Fukui Speakers bureau: Pfizer, Consultant of: Pfizer, Philip G Conaghan Speakers bureau: Abbvie, Novartis, Consultant of: AstraZeneca, BMS, Eli Lilly, EMD Serono, Flexion Therapeutics, Galapagos, Gilead, Novartis, Pfizer, Kanae Togo Shareholder of: Pfizer, Employee of: Pfizer, Nozomi Ebata Shareholder of: Pfizer, Employee of: Pfizer, Lucy Abraham Shareholder of: Pfizer, Employee of: Pfizer, James Jackson: None declared, Jessica Jackson: None declared, Mia Berry: None declared, Hemant Pandit Paid instructor for: Bristol Myers Squibb, Consultant of: Johnson and Johnson, Grant/research support from: GSK
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Benson J, Bhandari P, Lui N, Berry M, Liou DZ, Shrager J, Ayers K, Backhus LM. Use of a Personalized Multimedia Education Platform Improves Preoperative Teaching for Lung Cancer Patients. Semin Thorac Cardiovasc Surg 2021; 34:363-372. [PMID: 33711462 DOI: 10.1053/j.semtcvs.2021.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/04/2021] [Accepted: 03/04/2021] [Indexed: 11/11/2022]
Abstract
We sought to develop and evaluate a personalized multimedia education (ME) tool for preoperative patient education to improve patient health knowledge, quality of life and satisfaction with care in thoracic surgery. The ME tool was developed and deployed in outpatient clinic during preoperative teaching for patients undergoing surgical resection for lung cancer for quality improvement. Patients were given an electronic survey prior to preoperative teaching and at initial postoperative visit to assess teaching effectiveness and care satisfaction. Sequential patients received either standard preoperative teaching or teaching using the ME tool. Pre- and postoperative survey responses were compared using independent sample paired t test and multivariable linear regression modeling for adjustment. The final ME tool was an iPad application that incorporated real-time annotations of 3-dimensional, interactive anatomic diagrams. The tool featured video tours of operations, and radiology image import for annotation by the surgeon. Forty-eight patients were included in this pilot study (standard education n = 26; ME, n = 22). ME patients had significantly higher satisfaction scores compared to SE patients with respect to length of education materials, clarity of content, supportiveness of content and willingness to recommend materials to others. There was no difference in length of clinic visit between groups. Both patient and provider input can be used to create an innovative electronic preoperative educational tool that prepares and empowers patients in shared decision-making before surgery. Improvements in health literacy and self-efficacy may be more difficult to achieve but remain important as multimedia teaching tools are further developed.
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Affiliation(s)
| | - Prasha Bhandari
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Natalie Lui
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Mark Berry
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Douglas Z Liou
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Joseph Shrager
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Kelsey Ayers
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Leah M Backhus
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University, Stanford, California.
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Abstract
Women's multiorgasmic capacity has long been mentioned in the human sexuality literature. However, due in part to the conceptual vagueness surrounding this phenomenon, few empirical studies have focused on this topic, and our scientific knowledge is currently limited. This exploratory research is mainly aimed at providing a much-needed assessment of the profiles of women reporting multiorgasmic experiences. For this study, 419 sexually diverse women ages 18 through 69 who identified as multiorgasmic completed an online survey assessing variables pertaining to sociodemographic background, context and characteristics of a recent/typical multiorgasmic experience, relationships between multiple orgasm and sexual/nonsexual aspects of life, and sexual and orgasmic history. Data reduction analyses using principal component analysis pointed out that 15 variables of interest were distributed across six components, accounting for a large proportion of the sample's variance. A k-means cluster analysis further revealed that four distinct groups of women could be parsed out. These four groups could be differentiated by three sets of variables-sexual motivation, sexual history, and multiple orgasm characteristics-suggesting that female multiple orgasm is not a unitary phenomenon. This research provides to date the most comprehensive picture of female multiple orgasm and helps refine our conceptual understanding.
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Affiliation(s)
- M Gérard
- Department of Psychology, Université du Québec à Montréal
| | - M Berry
- McGill University Health Center
| | - R A Shtarkshall
- Braun School of Public Health and Community Medicine of the Hebrew University and Hadassah
| | - R Amsel
- Department of Psychology, McGill University
| | - Y M Binik
- Department of Psychology, McGill University
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Berry M, Izquierdo P, Jeffery H, Shaw S, Nchimbi-Msolla S, Cichy K. QTL analysis of cooking time and quality traits in dry bean (Phaseolus vulgaris L.). Theor Appl Genet 2020; 133:2291-2305. [PMID: 32377883 DOI: 10.1007/s00122-020-03598-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
Three robust QTL for dry bean cooking time shortened cooking time 11-26 min and co-localized with QTL for increased cooked seed protein concentration. Cooking time is a major factor associated with consumer preference of dry beans (Phaseolus vulgaris L.). The genetic control of cooking time was investigated with a quantitative trait loci (QTL) study on a recombinant inbred line (RIL) population developed from TZ-27 (slow cooking) and TZ-37 (fast cooking). The RIL population of 146 lines was grown on research farms over 2 years in Arusha and Morogoro, Tanzania. Arusha is an important mid-altitude bean-growing region, with moderate temperatures and reliable rainfall, whereas the low altitude and high temperatures in Morogoro make it unfavorable for bean production. The population exhibited large variation for cooking time with a range of 22-98 min. On average, beans grown in Arusha cooked 15 min faster than those grown in Morogoro. A linkage map developed with 1951 SNP markers was used for QTL analysis. Ten QTL were identified for cooking time, three of which were found in multiple environments. RILs with all three QTL (CT3.1, CT6.1, and CT11.2) cooked on average 11 min faster in Arusha and 26 min faster in Morogoro than RILs with none. Seed attributes were related to cooking time such that seeds with greater seed mass and less seed coat percentage cooked faster. Cooked seed protein concentration ranged from 17.8 to 30.8% across the years and locations. All three of the most robust cooking time QTL co-localized with QTL for protein concentration, and TZ-37 always contributed faster cooking time and increased protein concentration.
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Affiliation(s)
- M Berry
- Plant Soil and Microbial Sciences, Michigan State University, East Lansing, MI, USA
| | - P Izquierdo
- Plant Soil and Microbial Sciences, Michigan State University, East Lansing, MI, USA
| | - H Jeffery
- Plant Soil and Microbial Sciences, Michigan State University, East Lansing, MI, USA
| | - S Shaw
- Sugarbeet and Bean Research Unit, USDA-ARS, Michigan State University, 1066 Bogue St. A366, East Lansing, MI, 48824, USA
| | | | - K Cichy
- Plant Soil and Microbial Sciences, Michigan State University, East Lansing, MI, USA.
- Sugarbeet and Bean Research Unit, USDA-ARS, Michigan State University, 1066 Bogue St. A366, East Lansing, MI, 48824, USA.
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Sholtis C, Teymourtash M, Berry M, Backhus L, Bhandari P, He H, Benson J, Wang YY, Yevudza E, Lui N, Shrager J. Transcervical Thymectomy Is the Most Cost-Effective Surgical Approach in Myasthenia Gravis. Ann Thorac Surg 2020; 109:1705-1712. [DOI: 10.1016/j.athoracsur.2020.01.047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/10/2020] [Accepted: 01/20/2020] [Indexed: 12/01/2022]
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Cooper A, Parker J, Berry M, Wallace R, Ward J, Allan R. Wixela Inhub: Dosing Performance In Vitro and Inhaled Flow Rates in Healthy Subjects and Patients Compared with Advair Diskus. J Aerosol Med Pulm Drug Deliv 2020; 33:323-341. [PMID: 32429788 PMCID: PMC7757596 DOI: 10.1089/jamp.2019.1584] [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] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Wixela™ Inhub™ is a fluticasone propionate/salmeterol dry powder inhaler developed as a generic equivalent of Advair Diskus® for the treatment of asthma and chronic obstructive pulmonary disease (COPD). Wixela Inhub and Advair Diskus are comparable in terms of functionality, user interface, and device resistance. The primary objectives of the studies were to evaluate in vitro dose delivery with Wixela Inhub compared with Advair Diskus at relevant flow rates and to explore inhalation profiles generated by patients with asthma or COPD. Methods: In vitro studies: Emitted dose (ED) and individual dose aerodynamic particle size distribution (APSD) were measured at flow rates ranging from 30 to 90 L min-1. Patient inhalation study: Inhalation profile recording was conducted three times in each patient (40 children with asthma, 14 adults with asthma, and 14 adults with severe-to-very-severe COPD) with an empty Inhub in an open-label study. The primary endpoint was peak inhaled flow rate (PIFR). An additional endpoint was peak pressure drop. Results: In vitro studies: ED and APSD delivered from Wixela Inhub showed low flow dependency across the patient-relevant flow-rate range. Wixela Inhub gave in vitro performance comparable with Advair Diskus for all strengths and flow rates. Patient inhalation study: For Inhub, mean PIFR was lowest for children with asthma ages 4 to 7 years (50.6 L min-1) and highest for adults with asthma (74.8 L min-1). For adults with severe-to-very-severe COPD, mean PIFR was 69.5 L min-1 with Inhub. The PIFRs observed with Diskus were higher than those with Inhub, consistent with slightly higher resistance measured in vitro. The difference in resistance did not impact demonstration of bioequivalence and does not impact substitutability of the product. Peak pressure drop values were comparable between Diskus and Inhub. Conclusions: Comparable in vitro performance of Wixela Inhub to Advair Diskus confirmed that Wixela Inhub is a generic equivalent to Advair Diskus across all patient groups.
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Affiliation(s)
| | | | - Mark Berry
- Mylan Pharma UK Ltd., Sandwich, United Kingdom
| | | | - Jon Ward
- Mylan Pharma UK Ltd., Sandwich, United Kingdom
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Berry M, Lee-Trimble ME, Santangelo CD. Topological transitions in the configuration space of non-Euclidean origami. Phys Rev E 2020; 101:043003. [PMID: 32422808 DOI: 10.1103/physreve.101.043003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/16/2020] [Indexed: 06/11/2023]
Abstract
Origami structures have been proposed as a means of creating three-dimensional structures from the micro- to the macroscale and as a means of fabricating mechanical metamaterials. The design of such structures requires a deep understanding of the kinematics of origami fold patterns. Here we study the configurations of non-Euclidean origami, folding structures with Gaussian curvature concentrated on the vertices, for arbitrary origami fold patterns. The kinematics of such structures depends crucially on the sign of the Gaussian curvature. As an application of our general results, we show that the configuration space of nonintersecting, oriented vertices with positive Gaussian curvature decomposes into disconnected subspaces; there is no pathway between them without tearing the origami. In contrast, the configuration space of negative Gaussian curvature vertices remains connected. This provides a new, and only partially explored, mechanism by which the mechanics and folding of an origami structure could be controlled.
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Affiliation(s)
- M Berry
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - M E Lee-Trimble
- Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003, USA
| | - C D Santangelo
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA and Department of Physics, University of Massachusetts, Amherst, Massachusetts 01003, USA
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Young VL, Berry M, Verlander NQ, Ridgway A, McNulty CA. Using debate to educate young people in schools about antibiotic use and resistance: A before and after evaluation using a questionnaire survey. J Infect Prev 2019; 20:281-288. [PMID: 31762790 DOI: 10.1177/1757177419862039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 06/03/2019] [Indexed: 11/15/2022] Open
Abstract
Introduction The use of debating as an educational tool is increasing in popularity. Students who take part in debates can develop a range of skills such as confidence and communication as well as gaining a greater understanding of the topic discussed. Within this study we have evaluated an antibiotic-resistant debate kit, assessing the ability of the debate lesson to improve student knowledge and awareness around antibiotics. Methods The debate lesson was delivered in seven schools across South West England to 235 students aged 13-16 years. Change in student knowledge was measured using before and after knowledge questionnaires. Student and teacher feedback and suggestions for improvements for the lesson were also collected through questionnaires and interviews. Results Quantitative questionnaires found a significant improvement in knowledge for most areas covered in the debate, particularly around the use of antibiotics to treat colds and bacteria developing resistance. Teachers felt their students engaged well with the debate session and made suggestions for minor modifications that could improve the lesson. Conclusions The results suggest that the e-Bug antibiotic resistant debate kit is able to improve knowledge in young people around antibiotics and antibiotic resistance. Furthermore, the lesson was enjoyed by students and therefore this resource should be promoted more widely to teachers and schools.
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Affiliation(s)
- Vicki L Young
- Microbiology Department, Public Health England Primary Care Unit, Gloucester Royal Hospital, Gloucester, UK
| | - Mark Berry
- Department of Applied Sciences, University of the West of England, Coldharbour Lane, Bristol, UK
| | - Neville Q Verlander
- Modelling and Economics Department, Statistics, Public Health England, Colindale, London, UK
| | - Andy Ridgway
- Department of Applied Sciences, University of the West of England, Coldharbour Lane, Bristol, UK
| | - Cliodna Am McNulty
- Microbiology Department, Public Health England Primary Care Unit, Gloucester Royal Hospital, Gloucester, UK
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Titan AL, He H, Lui N, Liou D, Berry M, Shrager JB, Backhus LM. The influence of hormone replacement therapy on lung cancer incidence and mortality. J Thorac Cardiovasc Surg 2019; 159:1546-1556.e4. [PMID: 31866083 DOI: 10.1016/j.jtcvs.2019.10.070] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Data regarding the effects of hormone replacement therapy (HRT) on non-small cell lung cancer (NSCLC) are mixed. We hypothesized HRT would have a protective benefit with reduced NSCLC incidence among women in a large, prospective cohort. METHODS We used data from the multicenter randomized Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (1993-2001). Participants were women aged 50 to 74 years followed prospectively for up to 13 years for cancer screening. The influence of HRT on the primary outcome of NSCLC incidence and secondary outcomes of all-cause and disease-specific mortality were assessed with Kaplan-Meier analysis and Cox proportional hazard models adjusting for covariates. RESULTS In the overall cohort of 75,587 women, 1147 women developed NSCLC after a median follow-up of 11.5 years. HRT use was characterized as 49.4% current users, 17.0% former users, and 33.6% never users. Increased age, smoking, comorbidities, and family history were associated with increased risk of NSCLC. On multivariable analysis, current HRT use was associated with reduced risk of NSCLC compared with never users (hazard ratio, 0.80; 95% confidence interval, 0.70-0.93; P = .009). HRT or oral contraception use was not associated with significant differences in all-cause mortality or disease-specific mortality. CONCLUSIONS These data represent among the largest prospective cohorts suggesting HRT use may have a protective effect on the development of NSCLC among women; the physiological basis of this effect merits further study; however, the results may influence discussion surrounding HRT use in women.
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Affiliation(s)
- Ashley L Titan
- Division of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Hao He
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Natalie Lui
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Douglas Liou
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Mark Berry
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Joseph B Shrager
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Leah M Backhus
- Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
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Nair V, Bik-Yu Hui A, Chabon J, Esfahani M, Stehr H, Nabet B, Benson J, Chaudhuri A, Zhou L, Ayers K, Bedi H, Ramsey M, Van Wert R, Sung A, Lui N, Backhus L, Berry M, Massion P, Shrager J, Alizadeh A, Diehn M. P2.05-01 Broad Genomic Profiling of Bronchoalveolar Lavage Fluid in Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bechmann RK, Arnberg M, Gomiero A, Westerlund S, Lyng E, Berry M, Agustsson T, Jager T, Burridge LE. Gill damage and delayed mortality of Northern shrimp (Pandalus borealis) after short time exposure to anti-parasitic veterinary medicine containing hydrogen peroxide. Ecotoxicol Environ Saf 2019; 180:473-482. [PMID: 31121554 DOI: 10.1016/j.ecoenv.2019.05.045] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/10/2019] [Accepted: 05/13/2019] [Indexed: 06/09/2023]
Abstract
Hydrogen peroxide (H2O2) is used as anti-parasitic veterinary medicine in salmon farms worldwide. In the period from 2009 to 2018 a total of 135 million kg of H2O2 was used in Norway, the world's largest producer of Atlantic salmon. Since the treatment water is discharged to the sea, concerns have been raised about effects of H2O2 on the coastal ecosystem. In the present study, Northern shrimp (Pandalus borealis) have been exposed to short pulses of H2O2 in the PARAMOVE® formulation, followed by a recovery period in clean seawater. The exposure concentrations represented 100, 1000 and 10 000 times dilutions of the prescribed treatment concentration for salmon; 15 mg/L, 1.5 mg/L and 0.15 mg/L H2O2. Significantly increased mortality was observed after 2 h exposure to 15 mg/L H2O2 (50%) and after 2 h exposure to 1.5 mg/L H2O2 on 3 consecutive days (33%), but no mortality was observed after 2 h exposure to 0.15 mg/L. The mortality occurred 2-4 days after the first pulse of exposure. The patterns of acute effects (immobility and death) could be captured with a toxicokinetic-toxicodynamic model (GUTS), which allows extrapolations to LC50s for constant exposure, or thresholds for effects given untested exposure profiles. Effects of H2O2 were also detected in shrimp that survived until the end of the recovery period. The feeding rate was 66% lower than in the control after 12 days of recovery for the three-pulse 1.5 mg/L exposure. Furthermore, dose dependent tissue damage was detected in the gills and evidence of lipid peroxidation in the hepatopancreas in shrimp exposed for 1 h to 1.5 mg/L and 15 mg/L and kept in recovery for 8 days. Fluorescence intensity in the hepatopancreas of treated shrimp increased 47% and 157% at 1.5 mg/L and 15 mg/L, respectively, compared to the control. Local hydrodynamic conditions will determine how fast the concentration of H2O2 will be diluted and how far it will be transported horizontally and vertically. Results from dispersion modelling (literature data) together with the current experiments indicate that treatment water with toxic concentrations of H2O2 (1.5 mg/L) could reach P. borealis living more than 1 km from a treated salmon farm.
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Affiliation(s)
| | - Maj Arnberg
- NORCE Norwegian Research Centre, Mekjarvik 12, 4072, Randaberg, Norway.
| | - Alessio Gomiero
- NORCE Norwegian Research Centre, Mekjarvik 12, 4072, Randaberg, Norway.
| | - Stig Westerlund
- NORCE Norwegian Research Centre, Mekjarvik 12, 4072, Randaberg, Norway.
| | - Emily Lyng
- NORCE Norwegian Research Centre, Mekjarvik 12, 4072, Randaberg, Norway.
| | - Mark Berry
- NORCE Norwegian Research Centre, Mekjarvik 12, 4072, Randaberg, Norway.
| | | | | | - Les E Burridge
- Burridge Consulting Inc., 61 Emmalee Dr Stratford PE, Canada, C1B 0B5, Canada.
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Auciello FR, Bulusu V, Oon C, Tait-Mulder J, Berry M, Bhattacharyya S, Tumanov S, Allen-Petersen BL, Link J, Kendsersky ND, Vringer E, Schug M, Novo D, Hwang RF, Evans RM, Nixon C, Dorrell C, Morton JP, Norman JC, Sears RC, Kamphorst JJ, Sherman MH. A Stromal Lysolipid-Autotaxin Signaling Axis Promotes Pancreatic Tumor Progression. Cancer Discov 2019; 9:617-627. [PMID: 30837243 PMCID: PMC6497553 DOI: 10.1158/2159-8290.cd-18-1212] [Citation(s) in RCA: 190] [Impact Index Per Article: 38.0] [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: 10/12/2018] [Revised: 02/03/2019] [Accepted: 02/28/2019] [Indexed: 01/04/2023]
Abstract
Pancreatic ductal adenocarcinoma (PDAC) develops a pronounced stromal response reflecting an aberrant wound-healing process. This stromal reaction features transdifferentiation of tissue-resident pancreatic stellate cells (PSC) into activated cancer-associated fibroblasts, a process induced by PDAC cells but of unclear significance for PDAC progression. Here, we show that PSCs undergo a dramatic lipid metabolic shift during differentiation in the context of pancreatic tumorigenesis, including remodeling of the intracellular lipidome and secretion of abundant lipids in the activated, fibroblastic state. Specifically, stroma-derived lysophosphatidylcholines support PDAC cell synthesis of phosphatidylcholines, key components of cell membranes, and also facilitate production of the potent wound-healing mediator lysophosphatidic acid (LPA) by the extracellular enzyme autotaxin, which is overexpressed in PDAC. The autotaxin-LPA axis promotes PDAC cell proliferation, migration, and AKT activation, and genetic or pharmacologic autotaxin inhibition suppresses PDAC growth in vivo. Our work demonstrates how PDAC cells exploit the local production of wound-healing mediators to stimulate their own growth and migration. SIGNIFICANCE: Our work highlights an unanticipated role for PSCs in producing the oncogenic LPA signaling lipid and demonstrates how PDAC tumor cells co-opt the release of wound-healing mediators by neighboring PSCs to promote their own proliferation and migration.See related commentary by Biffi and Tuveson, p. 578.This article is highlighted in the In This Issue feature, p. 565.
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Affiliation(s)
- Francesca R Auciello
- Cancer Research UK Beatson Institute, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Vinay Bulusu
- Cancer Research UK Beatson Institute, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Chet Oon
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, Oregon
| | - Jacqueline Tait-Mulder
- Cancer Research UK Beatson Institute, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Mark Berry
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, Oregon
| | - Sohinee Bhattacharyya
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, Oregon
| | - Sergey Tumanov
- Cancer Research UK Beatson Institute, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Jason Link
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, Oregon
| | - Nicholas D Kendsersky
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, Oregon
| | - Esmee Vringer
- Cancer Research UK Beatson Institute, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Michelle Schug
- Cancer Research UK Beatson Institute, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - David Novo
- Cancer Research UK Beatson Institute, Glasgow, UK
| | - Rosa F Hwang
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ronald M Evans
- The Salk Institute for Biological Studies, Gene Expression Laboratory, Howard Hughes Medical Institute, La Jolla, California
| | - Colin Nixon
- Cancer Research UK Beatson Institute, Glasgow, UK
| | - Craig Dorrell
- Oregon Health & Science University Brenden-Colson Center for Pancreatic Care, Portland, Oregon
| | | | - Jim C Norman
- Cancer Research UK Beatson Institute, Glasgow, UK
| | - Rosalie C Sears
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, Oregon
| | - Jurre J Kamphorst
- Cancer Research UK Beatson Institute, Glasgow, UK.
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Mara H Sherman
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, Oregon.
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Colwell E, Bhandari P, Benson J, He H, Lui N, Berry M, Shrager J, Backhus L. P2.15-06 Examination of Optimal Timing of Post-Surgical Surveillance for Early Stage Lung Cancer Patients and Association with Outcomes. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Yang C, Mayne N, Deng J, Commander S, D'Amico T, Berry M. MA12.03 The Impact of Malignant Pleural Mesothelioma Histology on the Use of Surgery and Survival in a Population-Based Analysis. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Raman V, Yang C, Jawitz O, Erkmen C, Tong B, D'Amico T, Berry M, Harpole D. P1.16-50 The Role of Adjuvant Therapy for Patients with Early Stage Large Cell Neuroendocrine Lung Cancer: A National Analysis. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Morgan B, Chen S, Christopher D, Långström G, Wiggenhorn C, Burmeister Getz E, Beresford H, Hoffelder T, Acerbi D, Andrews S, Berry M, Dey M, Joshi K, McKenry M, Pertile M, Strickland H, Wilcox D, Lyapustina S. Performance of the Population Bioequivalence (PBE) Statistical Test Using an IPAC-RS Database of Delivered Dose from Metered Dose Inhalers. AAPS PharmSciTech 2018; 19:1410-1425. [PMID: 29435904 DOI: 10.1208/s12249-017-0941-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022] Open
Abstract
This article reports performance characteristics of the population bioequivalence (PBE) statistical test recommended by the US Food and Drug Administration (FDA) for orally inhaled products. A PBE Working Group of the International Pharmaceutical Aerosol Consortium on Regulation and Science (IPAC-RS) assembled and considered a database comprising delivered dose measurements from 856 individual batches across 20 metered dose inhaler products submitted by industry. A review of the industry dataset identified variability between batches and a systematic lifestage effect that was not included in the FDA-prescribed model for PBE. A simulation study was designed to understand PBE performance when factors identified in the industry database were present. Neglecting between-batch variability in the PBE model inflated errors in the equivalence conclusion: (i) The probability of incorrectly concluding equivalence (type I error) often exceeded 15% for non-zero between-batch variability, and (ii) the probability of incorrectly rejecting equivalence (type II error) for identical products approached 20% when product and between-batch variabilities were high. Neglecting a systematic through-life increase in the PBE model did not substantially impact PBE performance for the magnitude of lifestage effect considered. Extreme values were present in 80% of the industry products considered, with low-dose extremes having a larger impact on equivalence conclusions. The dataset did not support the need for log-transformation prior to analysis, as requested by FDA. Log-transformation resulted in equivalence conclusions that depended on the direction of product mean differences. These results highlight a need for further refinement of in vitro equivalence methodology.
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Berry M, Galinier M, Delmas C, Fournier P, Desmoulin F, Turkieh A, Mischak H, Mullen W, Barutaut M, Eurlings L, Brunner La Rocca H, Butler J, Roncalli J, Evaristi M, Cohen-Solal A, Escamilla R, Ferrieres J, Koukoui F, Smih F, Rouet P. Discovery and validation of a new biomarker for heart failure diagnostic. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2018.02.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jameson M, Dowling J, Faustino J, Cloak K, Sidhom M, Martin J, De Leon J, Berry M, Pryor D, Holloway L. PO-0823: TRAC: Automated atlas based machine learning QA of contouring accuracy for the PROMETHEUS trial. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31133-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Elshiekh M, Mani A, Kitson R, Josephides E, Clifford A, Desai S, Gupta N, Bowen F, Berry M, Bloch S, Ross C, Counihan I, Anderson J, Nandi J, Roddie M, Copley S, Hatcher O, Denton A, Power D, Lewanski C, Newsom-Davis T, Viola P. Non-small cell lung cancers (NSCLC) and programmed death ligand 1 (PD-L1) testing: multicentric analysis of clinical, pathological and molecular features. Lung Cancer 2018. [DOI: 10.1016/s0169-5002(18)30151-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Yi JS, Ready N, Healy P, Dumbauld C, Osborne R, Berry M, Shoemaker D, Clarke J, Crawford J, Tong B, Harpole D, D'Amico TA, McSherry F, Dunphy F, McCall SJ, Christensen JD, Wang X, Weinhold KJ. Immune Activation in Early-Stage Non-Small Cell Lung Cancer Patients Receiving Neoadjuvant Chemotherapy Plus Ipilimumab. Clin Cancer Res 2017; 23:7474-7482. [PMID: 28951518 DOI: 10.1158/1078-0432.ccr-17-2005] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 08/25/2017] [Accepted: 09/22/2017] [Indexed: 02/04/2023]
Abstract
Purpose: To determine the immunologic effects of neoadjuvant chemotherapy plus ipilimumab in early-stage non-small cell lung cancer (NSCLC) patients.Experimental Design: This is a single-arm chemotherapy plus phased ipilimumab phase II study of 24 treatment-naïve patients with stage IB-IIIA NSCLC. Patients received neoadjuvant therapy consisting of 3 cycles of paclitaxel with either cisplatin or carboplatin and ipilimumab included in the last 2 cycles.Results: Chemotherapy alone had little effect on immune parameters in PBMCs. Profound CD28-dependent activation of both CD4 and CD8 cells was observed following ipilimumab. Significant increases in the frequencies of CD4+ cells expressing activation markers ICOS, HLA-DR, CTLA-4, and PD-1 were apparent. Likewise, increased frequencies of CD8+ cells expressing the same activation markers, with the exception of PD-1, were observed. We also examined 7 resected tumors and found higher frequencies of activated tumor-infiltrating lymphocytes than those observed in PBMCs. Surprisingly, we found 4 cases of preexisting tumor-associated antigens (TAA) responses against survivin, PRAME, or MAGE-A3 present in PBMC at baseline, but neither increased frequencies nor the appearance of newly detectable responses following ipilimumab therapy. Ipilimumab had little effect on the frequencies of circulating regulatory T cells and MDSCs.Conclusions: This study did not meet the primary endpoint of detecting an increase in blood-based TAA T-cell responses after ipilimumab. Collectively, these results highlight the immune activating properties of ipilimumab in early-stage NSCLC. The immune profiling data for ipilimumab alone can contribute to the interpretation of immunologic data from combined immune checkpoint blockade immunotherapies. Clin Cancer Res; 23(24); 7474-82. ©2017 AACR.
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Affiliation(s)
- John S Yi
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Neal Ready
- Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Patrick Healy
- Duke Cancer Center Biostatistics, Duke University Medical Center, Durham, North Carolina
| | - Chelsae Dumbauld
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Robyn Osborne
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Mark Berry
- Department of Cardiothoracic Surgery, Stanford University, Stanford, California
| | - Debra Shoemaker
- Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Jeffrey Clarke
- Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Jeffrey Crawford
- Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Betty Tong
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - David Harpole
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Thomas A D'Amico
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Frances McSherry
- Duke Cancer Center Biostatistics, Duke University Medical Center, Durham, North Carolina
| | - Frank Dunphy
- Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Shannon J McCall
- Department of Pathology, Duke University Medical Center, Durham, North Carolina
| | - Jared D Christensen
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Xiaofei Wang
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina
| | - Kent J Weinhold
- Department of Surgery, Duke University Medical Center, Durham, North Carolina.
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Serdarevic O, Tasindi E, Dekaris I, Berry M. Vision improvement in dry and wet Age-Related Macular Degeneration (AMD) patients after treatment with new corneal CPV procedure for light redirections onto the retina. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.01182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | - M. Berry
- Ophthalmology; OAC; Austin United States
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Bechmann RK, Lyng E, Berry M, Kringstad A, Westerlund S. Exposing Northern shrimp (Pandalus borealis) to fish feed containing the antiparasitic drug diflubenzuron caused high mortality during molting. J Toxicol Environ Health A 2017; 80:941-953. [PMID: 28876214 DOI: 10.1080/15287394.2017.1352213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Use of the chitin synthesis inhibitor diflubenzuron (DFB) as an antiparasitic drug in salmon aquaculture raises concern over its impact on marine ecosystems. Further, global drivers, such as ocean warming and acidification (OAW), may increase the toxicity of hazardous substances including DFB. The aim of the present study was to examine the combined effects of DFB-medicated salmon feed on ovigerous Northern shrimp (Pandalus borealis) under Control (pHNBS 8.0, 7.0ºC) and OAW conditions (pHNBS 7.6, 9.5ºC). DFB-exposed shrimp consumed on average 0.1-0.3 g medicated feed during the 2-week exposure period, and high mortality (61-73%) was documented at both environmental conditions. There was no significant interaction between OAW and DFB. Only 2-7% of DFB-exposed shrimp molted successfully compared to 65% in Control and 63% in OAW. The shrimp molted earlier (shorter intermolt period) and exhibited higher feeding rate at OAW compared to Control conditions. An additional experiment, where female shrimp were exposed to DFB closer to molting, noted increased mortality after only 4 d exposure, and successful molting for some shrimp after 2 to 3 weeks of depuration. High mortality of shrimp exposed to DFB-medicated feed indicates that the use of this feed in aquaculture could affect local shrimp populations.
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Affiliation(s)
| | - Emily Lyng
- a International Research Institute of Stavanger (IRIS) , Randaberg , Norway
| | - Mark Berry
- a International Research Institute of Stavanger (IRIS) , Randaberg , Norway
| | | | - Stig Westerlund
- a International Research Institute of Stavanger (IRIS) , Randaberg , Norway
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Anastasiadi M, Mohareb F, Redfern SP, Berry M, Simmonds MSJ, Terry LA. Biochemical Profile of Heritage and Modern Apple Cultivars and Application of Machine Learning Methods To Predict Usage, Age, and Harvest Season. J Agric Food Chem 2017; 65:5339-5356. [PMID: 28574705 DOI: 10.1021/acs.jafc.7b00500] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The present study represents the first major attempt to characterize the biochemical profile in different tissues of a large selection of apple cultivars sourced from the United Kingdom's National Fruit Collection comprising dessert, ornamental, cider, and culinary apples. Furthermore, advanced machine learning methods were applied with the objective to identify whether the phenolic and sugar composition of an apple cultivar could be used as a biomarker fingerprint to differentiate between heritage and mainstream commercial cultivars as well as govern the separation among primary usage groups and harvest season. A prediction accuracy of >90% was achieved with the random forest method for all three models. The results highlighted the extraordinary phytochemical potency and unique profile of some heritage, cider, and ornamental apple cultivars, especially in comparison to more mainstream apple cultivars. Therefore, these findings could guide future cultivar selection on the basis of health-promoting phytochemical content.
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Affiliation(s)
- Maria Anastasiadi
- Plant Science Laboratory, Cranfield University , Bedfordshire MK43 0AL, United Kingdom
| | - Fady Mohareb
- Plant Science Laboratory, Cranfield University , Bedfordshire MK43 0AL, United Kingdom
| | - Sally P Redfern
- Unilever R&D Colworth , Sharnbrook, Bedfordshire MK44 1LQ, United Kingdom
| | - Mark Berry
- Unilever R&D Colworth , Sharnbrook, Bedfordshire MK44 1LQ, United Kingdom
| | | | - Leon A Terry
- Plant Science Laboratory, Cranfield University , Bedfordshire MK43 0AL, United Kingdom
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Berry M, Neville K, Ruben J, Holloway L, Vinod S. EP-1211: How selected are patients in clinical trials of radiotherapy for non-small cell lung cancer? Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31646-8] [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: 11/28/2022]
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46
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Grand M, Berry M, Forstner D, Gillman S, Phan P, Wong K, Vinod S. EP-1416: A new model of care to improve clinical trial participation in radiation oncology. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31851-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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47
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Redmond KJ, Berry M, Pampanin DM, Andersen OK. Valve gape behaviour of mussels (Mytilus edulis) exposed to dispersed crude oil as an environmental monitoring endpoint. Mar Pollut Bull 2017; 117:330-339. [PMID: 28190523 DOI: 10.1016/j.marpolbul.2017.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 01/31/2017] [Accepted: 02/05/2017] [Indexed: 06/06/2023]
Abstract
Environmental monitoring requires cost-effective and efficient methods for detecting potential effects of pollution, and valve gape behaviour has been used with this purpose for a range of contaminants in freshwater and marine bivalves. The current study investigated the use of a new method for measuring valve behaviour responses in mussels (Mytilus edulis) exposed to dispersed crude oil (DCO). Results confirmed that valve gape is a sensitive parameter; at the high DCO concentration (0.25mgL-1) the mean valve gape was reduced from 49 to 31%, and mussels increased shell movement (measured as distance travelled) or spent more time closed to avoid contact with the oil. At the low DCO concentration (0.015mgL-1) the distance travelled parameter was the most sensitive endpoint. Results also demonstrated that valve gape behaviour is a valid endpoint when monitoring mussels for exposure to DCO.
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Affiliation(s)
- Kirsten J Redmond
- Department of Mathematics and Natural Sciences, University of Stavanger, 4036 Stavanger, Norway; BiotaTools AS, Prof. Olav Hanssensvei 11, N-4021 Stavanger, Norway.
| | - Mark Berry
- BiotaTools AS, Prof. Olav Hanssensvei 11, N-4021 Stavanger, Norway.
| | - Daniela M Pampanin
- Department of Mathematics and Natural Sciences, University of Stavanger, 4036 Stavanger, Norway; International Research Institute of Stavanger/IRIS-Environment, Mekjarvik 12, 4070 Randaberg, Norway.
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Affiliation(s)
- M Berry
- Imperial School of Anaesthesia, London, UK
| | - E Brink
- Cambridge County Council, Cambridge, UK
| | - J Harris
- Beyond Goodbye Project, Stroud, UK
| | - K E Sleeman
- King's College London, Department of Palliative Care Policy and Rehabilitation, Cicely Saunders Institute, London, UK
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Mirshekar-Syahkal B, Summers D, Bradbury LL, Aly M, Bardsley V, Berry M, Norris JM, Torpey N, Clatworthy MR, Bradley JA, Pettigrew GJ. Local Expansion of Donation After Circulatory Death Kidney Transplant Activity Improves Waitlisted Outcomes and Addresses Inequities of Access to Transplantation. Am J Transplant 2017; 17:390-400. [PMID: 27428662 DOI: 10.1111/ajt.13968] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 01/05/2016] [Revised: 06/24/2016] [Accepted: 07/12/2016] [Indexed: 01/25/2023]
Abstract
In the United Kingdom, donation after circulatory death (DCD) kidney transplant activity has increased rapidly, but marked regional variation persists. We report how increased DCD kidney transplant activity influenced waitlisted outcomes for a single center. Between 2002-2003 and 2011-2012, 430 (54%) DCD and 361 (46%) donation after brain death (DBD) kidney-only transplants were performed at the Cambridge Transplant Centre, with a higher proportion of DCD donors fulfilling expanded criteria status (41% DCD vs. 32% DBD; p = 0.01). Compared with U.K. outcomes, for which the proportion of DCD:DBD kidney transplants performed is lower (25%; p < 0.0001), listed patients at our center waited less time for transplantation (645 vs. 1045 days; p < 0.0001), and our center had higher transplantation rates and lower numbers of waiting list deaths. This was most apparent for older patients (aged >65 years; waiting time 730 vs. 1357 days nationally; p < 0.001), who received predominantly DCD kidneys from older donors (mean donor age 64 years), whereas younger recipients received equal proportions of living donor, DBD and DCD kidney transplants. Death-censored kidney graft survival was nevertheless comparable for younger and older recipients, although transplantation conferred a survival benefit from listing for only younger recipients. Local expansion in DCD kidney transplant activity improves survival outcomes for younger patients and addresses inequity of access to transplantation for older recipients.
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Affiliation(s)
| | - D Summers
- University Department of Surgery, Addenbrooke's Hospital, Cambridge, UK
| | | | - M Aly
- University Department of Surgery, Addenbrooke's Hospital, Cambridge, UK
| | - V Bardsley
- Department of Histopathology, Addenbrooke's Hospital, Cambridge, UK
| | - M Berry
- Department of Renal Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - J M Norris
- University Department of Surgery, Addenbrooke's Hospital, Cambridge, UK
| | - N Torpey
- Department of Renal Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - M R Clatworthy
- Department of Renal Medicine, Addenbrooke's Hospital, Cambridge, UK
| | - J A Bradley
- University Department of Surgery, Addenbrooke's Hospital, Cambridge, UK
| | - G J Pettigrew
- University Department of Surgery, Addenbrooke's Hospital, Cambridge, UK
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Wu E, Terlikbayeva A, Hunt T, Primbetova S, Gun Lee Y, Berry M. Preliminary Population Size Estimation of Men Who Have Sex with Men in Kazakhstan: Implications for HIV Testing and Surveillance. LGBT Health 2016; 4:164-167. [PMID: 28005454 DOI: 10.1089/lgbt.2015.0152] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/13/2022] Open
Abstract
PURPOSE The purpose of this study is to estimate the population size of men who have sex with men (MSM) in Kazakhstan and their HIV testing history. METHODS We conducted structured interviews with MSM in four geographically disparate cities-N = 400 (n = 100/city)-to implement four population estimation methods and ascertain HIV testing history. RESULTS Approximately 3.2% of men-corresponding to ∼154,000 individuals-in Kazakhstan aged 18-59 are MSM. The 49.9% of the sample who reported taking an HIV test far exceeds the <1% reported as MSM in surveillance data. CONCLUSION HIV testing surveillance in Kazakhstan has underestimated the number of MSM. This underscores the need to redress social and structural barriers to HIV testing and disclosure of sexual behavior experienced by MSM in Kazakhstan. Recommendations include promoting cultural sensitivity among testing staff through quality assurance and regular training, and increasing protection and public awareness through antidiscrimination policy development.
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Affiliation(s)
- Elwin Wu
- 1 Social Intervention Group, Columbia University School of Social Work , New York, New York
| | | | - Timothy Hunt
- 1 Social Intervention Group, Columbia University School of Social Work , New York, New York
| | | | - Yong Gun Lee
- 1 Social Intervention Group, Columbia University School of Social Work , New York, New York
| | - Mark Berry
- 3 Centers for Disease Control and Prevention , Atlanta, Georgia
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