1
|
Pujol O, Vila-Castillo L, Álvaro C, Aguilar M, Joshi N, Minguell J. Time dedicated to physical activity among medical residents: are there differences based on gender or specialty type? Rev Clin Esp 2024:S2254-8874(24)00065-1. [PMID: 38679321 DOI: 10.1016/j.rceng.2024.04.014] [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: 04/16/2024] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Physical activity (PA) is associated with positive health outcomes such as prevention of chronic diseases, psychological well-being and improved work performance. Medical residents are subjected to sleep deprivation, extended work schedule and high burnout prevalence. These conditions may lead to the neglect of personal health and the restriction of time dedicated to PA. The objective of the present study was to analyze the time dedicated to PA of medical residents, comparing women vs men residents and surgical vs clinical residents. METHODS It is a cross-sectional study performed in a Spanish third-level university hospital. All medical residents from our institution were invited to voluntarily participate in the study answering a web-based questionnaire on June 2022. Data regarding demographics, residency and PA practice was recorded. RESULTS The response rate was 20.73% (114/550). The 32.5% of the residents considered themselves to be physically inactive and mean time dedicated to PA in a regular week was 3.62 ± 2.22 h. Men residents dedicated more time to PA than women residents (4.23 ± 2.42 h vs 3.14 ± 1.95 h, p = 0.012) and surgical residents dedicated more time than clinical residents (4.33 ± 2.36 h vs 3.23 ± 2.05 h, p = 0.01). CONCLUSIONS One third of the medical residents consider themself physically inactive. Women and clinical residents practice PA less time than men and surgical residents. Efforts should be made to encourage PA among residents, especially in women and non-surgeons.
Collapse
Affiliation(s)
- O Pujol
- Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - L Vila-Castillo
- Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Álvaro
- Sant Joan de Deu University Hospital, Barcelona, Spain
| | - M Aguilar
- Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - N Joshi
- Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Minguell
- Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
2
|
Dollar O, Joshi N, Pfaendtner J, Beck DAC. Efficient 3D Molecular Design with an E(3) Invariant Transformer VAE. J Phys Chem A 2023; 127:7844-7852. [PMID: 37670244 DOI: 10.1021/acs.jpca.3c04188] [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: 09/07/2023]
Abstract
This work introduces a three-dimensional (3D) invariant graph-to-string transformer variational autoencoders (VAE) (Vagrant) for generating molecules with accurate density functional theory (DFT)-level properties. Vagrant learns to model the joint probability distribution of a 3D molecular structure and its properties by encoding molecular structures into a 3D-aware latent space. Directed navigation through this latent space implicitly optimizes the 3D structure of a molecule, and the latent embedding can be used to condition a generative transformer to predict the candidate structure as a one-dimensional (1D) sequence. Additionally, we introduce two novel sampling methods that exploit the latent characteristics of a VAE to improve performance. We show that our method outperforms comparable 3D autoregressive and diffusion methods for predicting quantum chemical property values of novel molecules in terms of both sample quality and computational efficiency.
Collapse
Affiliation(s)
- Orion Dollar
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, United States
| | - Nisarg Joshi
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, United States
| | - Jim Pfaendtner
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, United States
| | - David A C Beck
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, United States
- escience Institute, University of Washington, Seattle, Washington 98195, United States
| |
Collapse
|
3
|
Miller LC, Neupane S, Shrestha M, Joshi N, Lohani M, Thorne-Lyman A. Better Social-emotional Behavior in Young Nepali Children is Associated with Household Wealth, Child Age, and Family Participation in a Community Development Intervention. Kathmandu Univ Med J (KUMJ) 2023; 21:197-206. [PMID: 38628015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Background Mental health and behavior problems are under-recognized in low- and middleincome countries, especially in young children. Early identification of these problems could encourage governments to address the shortages of child mental health professionals and promote early intervention programs to help children achieve their full developmental potential. Objective Describe the social-emotional development of young rural Nepali children; explore risk factors for poor development. Method The study was embedded in a longitudinal intervention trial comparing control households with those who received training in family nutrition+livestock management (Partial Package) or family nutrition+livestock management+community mobilization (Full Package). At midline, enumerators completed a 145-item household questionnaire, child anthropometry, and Administered the Ages and Stages Questionnaire-Social-Emotional (ASQ-SE) to all enrolled children age 33-47 months (n=310). Bivariate and regression analyses examined the relationship of child and household risk factors to administered the Ages and Stages QuestionnaireSocial-Emotional scores. Result Administered the Ages and Stages Questionnaire-Social-Emotional scores were below age cutoffs in 24% of children, suggesting worse social-emotional development. In bivariate analyses and the adjusted linear regression model, older child age, greater household wealth, and Full Package Intervention status were all associated with better social-emotional development scores. Partial Package Intervention status was associated with worse scores. Conclusion The Administered the Ages and Stages Questionnaire-Social-Emotional is a potential tool to assess child social-emotional development in the context of household and community level interventions. Further work is necessary to validate the administered the Ages and Stages Questionnaire-Social-Emotional and similar tools in Nepal, and to better understand the prevalence of challenges to optimal socialemotional development in young children in order to use this information to design and monitor needed interventions.
Collapse
Affiliation(s)
- L C Miller
- Department of Pediatrics, Tufts Medical Center and Friedman School of Nutrition, Science and Policy, Tufts University, 800 Washington St., Boston MA 02111, USA
| | - S Neupane
- Program Manager,Division of Poverty, Health, and Nutrition. International Food Policy Research Institute, Block C, NASC Complex, DPS Marg Opposite Todapur, Pusa, New Delhi 110012
| | - M Shrestha
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - N Joshi
- Senior Director of Asia Programs, Heifer International, 1 World Ave, Little Rock AR 72202, USA
| | - M Lohani
- Senior Vice President of Programs, Heifer International, 1 World Ave, Little Rock AR 72202, USA
| | - A Thorne-Lyman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Room E2545, Baltimore, MD, 21205 USA
| |
Collapse
|
4
|
Emani S, Kan A, Storms T, Bonanno S, Law J, Ray S, Joshi N. Periplasmic stress contributes to a tradeoff between protein secretion and cell growth in E. Coli Nissile. bioRxiv 2023:2023.01.09.523330. [PMID: 36711660 PMCID: PMC9882030 DOI: 10.1101/2023.01.09.523330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Maximizing protein secretion is an important target in the design of engineered living systems. In this paper, we characterize a tradeoff between cell growth and per cell protein secretion in the curli biofilm secretion system of E Coli Nissile 1917. Initial characterization using 24-hour continuous growth and protein production monitoring confirms decreased growth rates at high induction leading to a local maximum in total protein production at intermediate induction. Propidium iodide staining at the endpoint indicates that cellular death is a dominant cause of growth reduction. Assaying variants with combinatorial constructs of inner and outer membrane secretion tags, we find that diminished growth at high production is specific to secretory variants associated with accumulation of protein containing the outer membrane transport tag in the periplasmic space. RNA sequencing experiments indicate upregulation of known periplasmic stress response genes in the highly secreting variant, further implicating periplasmic stress in the growth-secretion tradeoff. Overall, these results motivate additional strategies for optimizing total protein production and longevity of secretory engineered living systems.
Collapse
|
5
|
Rauthan A, Prabhash K, Rohatgi N, Thirumalairaj R, Agarwal A, P S, Limaye S, Batra U, Raizada N, Patil P, Dattatreya Palanki S, Sirohi B, Dhar A, Mukherjee A, Joshi N, Olsen S. 267P Genomic landscape of non-small cell lung cancer (NSCLC) in India using circulating tumor DNA (ctDNA) in clinical practice. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
|
6
|
Small E, Gardner L, Maharjan R, Starrs M, Cleaver L, Leamon A, Kunwar S, Joshi N, Votta K, Marvel J. 30 Current Understanding and Relevant Trends in Altitude Illness in Nepal (CURTAIN). Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.053] [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]
|
7
|
Hornick N, Damo M, Joshi N. LB878 The NINJA mouse develops peripheral tolerance in the skin and is useful as a model for the study of lichenoid immune-related adverse events. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.893] [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]
|
8
|
Lillis A, Beverly S, Collins S, O’Driscoll M, Marsh E, Matthews J, Donovan J, Banya W, Madge S, Ukor EF, Felton I, Jones A, Belkarty B, Kapila D, Ge Y, Bowd G, Joshi N, Wahed M, Patel K, Simmonds N. P201 Bowel screening for cancer in pre-transplant people with cystic fibrosis and the accuracy of faecal immunochemical testing. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00530-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Nelson CJ, Tutino R, Joshi N, Schofield E, Mulhall JP. Acceptance and commitment therapy to increase compliance to intracavernosal injection use (ICI) following radical prostatectomy (RP): Preliminary results from a randomized control trial. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.362] [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]
|
10
|
Nelson C, Flaherty K, Joshi N, Schofield E, Mulhall J. Initial Validation of the Radical Prostatectomy Questionnaire (RPQ): A New Patient Reported Outcome (PRO) to Assess Sexual Function following Radical Prostatectomy (RP). J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.107] [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]
|
11
|
Nelson C, Tutino R, Pessin H, Joshi N, Schofield E, Mulhall J. Acceptance and Commitment Therapy to Increase Compliance to Intracavernosal Injection Use (ICI) Following Radical Prostatectomy (RP): Preliminary Results from a Randomized Control Trial. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
12
|
Joshi N, Pujol O, Prat S. Complex distal femoral fractures in the fragile elderly patient treated by distal femoral replacement: A report of three cases. Rev Esp Cir Ortop Traumatol (Engl Ed) 2022; 66:149-153. [DOI: 10.1016/j.recot.2021.07.005] [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] [Received: 02/16/2021] [Revised: 05/22/2021] [Accepted: 07/18/2021] [Indexed: 10/19/2022] Open
|
13
|
Joshi N, Pujol O, Prat S. [Artículo traducido] Fractura de fémur distal compleja en el paciente frágil y anciano tratada mediante reemplazo femoral distal: reporte de 3 casos. Rev Esp Cir Ortop Traumatol (Engl Ed) 2022; 66:T149-T153. [DOI: 10.1016/j.recot.2021.07.013] [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] [Received: 02/16/2021] [Accepted: 07/18/2021] [Indexed: 10/19/2022] Open
|
14
|
Goswami P, Gupta S, Joshi N, Sharma S, Singh S. Corrigendum to "Astrocyte activation and neurotoxicity: A study in different rat brain regions and in rat C6 astroglial cells" [Environ. Toxicol. Pharmacol. 40 (2015) 122-139]. Environ Toxicol Pharmacol 2022; 89:103758. [PMID: 34776397 DOI: 10.1016/j.etap.2021.103758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- P Goswami
- Toxicology Division, CSIR-CDRI, Lucknow 226031, India; Academy of Scientific & Innovative Research (AcSIR), India
| | - S Gupta
- Toxicology Division, CSIR-CDRI, Lucknow 226031, India; Academy of Scientific & Innovative Research (AcSIR), India
| | - N Joshi
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA, United States
| | - S Sharma
- Toxicology Division, CSIR-CDRI, Lucknow 226031, India
| | - S Singh
- Toxicology Division, CSIR-CDRI, Lucknow 226031, India; Academy of Scientific & Innovative Research (AcSIR), India.
| |
Collapse
|
15
|
Fletcher A, Tzolos E, Joshi S, Kwiecinski J, Bing R, Doris MK, Moss AJ, Van Beek EJ, Joshi N, Adamson P, Whiteley W, Wardlaw J, Slomka P, Newby DE, Dweck MR. 18F-Sodium fluoride positron emission tomography, aortic disease activity and ischaemic stroke risk. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Arterial 18F-sodium fluoride (18F-NaF) activity on positron emission tomography (PET) is a marker of active microcalcification and atherosclerosis. Coronary 18F-NaF activity (CMA) predicts coronary artery disease progression and subsequent myocardial infarction.
Objective
To investigate whether aortic 18F-NaF activity (AMA) predicts thoracic aortic atherosclerotic disease progression and subsequent ischaemic stroke or myocardial infarction in patients with established cardiovascular disease.
Methods
In a post-hoc observational cohort study, we evaluated AMA and CMA in patients with stable coronary artery disease (n=239) or aortic stenosis (n=158) who had underwent thoracic 18F-NaF PET and computed tomography (CT). We assessed the associations between AMA or CMA and progression of calcified atherosclerotic plaque in both thoracic aortic and coronary territories on follow up CT, as well as subsequent ischaemic stroke or myocardial infarction.
Results
In 141 and 231 patients with repeat aortic and coronary CT imaging respectively at 12.7±2.7 months, AMA correlated with log progression of thoracic aortic calcium scores (r=0.21, p=0.011), volume (r=0.29, p<0.01) and mass (r=0.29, P<0.01) as well as log coronary calcium score progression (r=0.21, p=0.03). CMA correlated with log coronary (r=0.42, p<0.01), but not log aortic (p>0.80) calcium score progression. In 397 patients, 16 had an ischaemic stroke and 25 had a myocardial infarction after 4.7±1.6 years. After adjusting for clinical risk factors, CMA and calcium scoring, AMA was associated with stroke (hazard ratio, 1.71 [95% confidence interval 1.00–2.90], p=0.048]). AMA was superior to clinical risk and calcium scores in identifying patients with stroke (c-statistic 0.76 versus 0.58 versus 0.63 respectively, p<0.05). Survival analysis demonstrated that AMA was associated with ischaemic stroke (p<0.001) but not myocardial infarction (p=0.45), whereas CMA was associated with myocardial infarction (p<0.001) but not stroke (p=0.39).
Conclusions
In patients with established cardiovascular disease, AMA is associated with progression of aortic atherosclerosis and future ischaemic stroke. Arterial 18F-NaF identifies localised areas of atherosclerotic disease activity that relate to regional atherothrombotic events.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): British Heart Foundation AMA, disease progression and outcomesVariables associated with stroke
Collapse
Affiliation(s)
- A Fletcher
- University of Edinburgh, Edinburgh, United Kingdom
| | - E Tzolos
- University of Edinburgh, Edinburgh, United Kingdom
| | - S Joshi
- University of Edinburgh, Edinburgh, United Kingdom
| | - J Kwiecinski
- University of Edinburgh, Edinburgh, United Kingdom
| | - R Bing
- University of Edinburgh, Edinburgh, United Kingdom
| | - M K Doris
- University of Edinburgh, Edinburgh, United Kingdom
| | - A J Moss
- University of Edinburgh, Edinburgh, United Kingdom
| | - E J Van Beek
- Queen's Medical Research Institute, Edinburgh Imaging Facility, Edinburgh, United Kingdom
| | - N Joshi
- Bristol Heart Institute, Bristol, United Kingdom
| | - P Adamson
- University of Otago Christchurch, Christchurch Heart Institute, Christchurch, New Zealand
| | - W Whiteley
- University of Edinburgh, Centre for Clinical Brain Science, Edinburgh, United Kingdom
| | - J Wardlaw
- University of Edinburgh, Centre for Clinical Brain Science, Edinburgh, United Kingdom
| | - P Slomka
- Cedars-Sinai Medical Center, Department of Imaging (Division of Nuclear Cardiology), Los Angeles, United States of America
| | - D E Newby
- University of Edinburgh, Edinburgh, United Kingdom
| | - M R Dweck
- University of Edinburgh, Edinburgh, United Kingdom
| |
Collapse
|
16
|
Williams MGL, Dastidar A, Liang K, Johnson TW, Baritussio A, Strange JW, Joshi N, Dorman S, De Garate E, Spagnoli L, Fiori E, Lawton CB, Biglino G, Plein S, Bucciarelli-Ducci C. Sex and age differences in patients with acute coronary syndrome and non-obstructive coronary arteries: presentation and outcome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aims
A substantial number of patients present with acute coronary syndrome (ACS) and non-obstructive coronary arteries. Sex and age differences in these patients are not well understood. This study aims to evaluate the impact of sex and age on clinical presentation and outcome in patients with ACS and non-obstructive coronary arteries, with either an ischaemic or non-ischaemic cause.
Methods and results
Consecutive patients with an ACS and non-obstructive coronary arteries (n=719) from a single tertiary centre underwent comprehensive cardiovascular magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE). The primary endpoint was all-cause mortality. CMR was performed at a median time of 30 days after presentation and identified a diagnosis in 74% of patients. Patients with an ischaemic or non-ischaemic aetiology (n=529) on CMR were followed prospectively. All-cause mortality was 11% over a median follow up of 4.9 years, with no significant difference between sexes (11% versus 11% p=0.732). Women were more likely to have an ischaemic aetiology on CMR (40% v 31%, p=0.037). Age group (HR 1.48, p=0.002), log peak troponin (HR 0.78, p=0.033) and LVEF (HR 0.98, p=0.032) were independent predictors of mortality. Men aged >60 years with a non-ischaemic aetiology on their CMR were at higher risk of death than women >60 years (p=0.003).
Conclusions
There is no difference in all-cause mortality between sexes in patients presenting with ACS and non-obstructive coronary arteries but increasing age is an important predictor of mortality in both sexes.
Funding Acknowledgement
Type of funding sources: None. Sex differences in CMR diagnosisSex, age and mortality
Collapse
Affiliation(s)
- M G L Williams
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - A Dastidar
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - K Liang
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - T W Johnson
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - A Baritussio
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - J W Strange
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - N Joshi
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - S Dorman
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - E De Garate
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - L Spagnoli
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - E Fiori
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - C B Lawton
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom
| | - G Biglino
- University of Bristol, Bristol, United Kingdom
| | - S Plein
- University of Leeds, Department of Biomedical Imaging Science, Leeds, United Kingdom
| | | |
Collapse
|
17
|
Gupta S, Biswas G, Babu S, Maksud TM, Lakshmaiah KC, Patel JG, Raja G, Boya RR, Patil P, Choudhury K, Bondarde SA, Neve RS, Bhat G, Mamillapalli G, Patel AA, Patel P, Joshi N, Bajaj V, Khan MA. Fixed dose combination of capecitabine and cyclophosphamide in metastatic breast cancer: Results from THE ENCLOSE phase 2/3 randomized multicenter study. Breast 2021; 60:147-154. [PMID: 34624757 PMCID: PMC8503662 DOI: 10.1016/j.breast.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 11/27/2022] Open
Abstract
Aim To evaluate pharmacokinetics, efficacy and safety of fixed-dose combination (FDC) of oral capecitabine + cyclophosphamide in metastatic breast cancer (MBC) patients progressing after anthracycline and/or taxane chemotherapy. Methods In this prospective, adaptive, phase-2/3, open-label study (CTRI/2014/12/005234), patients were randomized (1:1:1) to three FDC doses (doses/day: D1, capecitabine + cyclophosphamide 1400 mg + 60 mg; D2, 1800 mg + 80 mg; D3, 2200 mg + 100 mg) for 14 days, in 21-day cycles. In Part-I, multiple-dose pharmacokinetics and optimal dose(s) were evaluated with futility analysis. Group(s) with <3 responders based on best overall response rate (BOR, complete response [CR]+partial response [PR]), were discontinued. Efficacy (BOR, disease control rates [DCR; CR + PR + stable disease]) and safety of optimal dose(s) were evaluated in Part-II. Results Of 66 patients (n = 22/group) in Part-I, pharmacokinetics (D1 = 7/22, D2 = 9/22, D3 = 8/22) showed dose-proportionality for cyclophosphamide and greater than dose-proportionality for capecitabine. Modified intent-to-treat (mITT) analysis showed BOR of 7.14% (1/14) in D1 (discontinued), and 22.22% (4/18) each in D2 and D3, respectively. In Part-II, 50 additional patients were randomized in D2 and D3 (n = 144; total 72 [22 + 50] patients/group). mITT analysis in D2 (n = 54) and D3 (n = 58) showed BOR of 29.63% (16/54, 95%CI: 17.45–41.81%) and 22.41% (13/58, 95%CI: 11.68–33.15%), respectively. DCR in D2 and D3 were 87.04% (47/54, 95%CI: 78.08–96.00%) and 82.76% (48/58; 95%CI: 73.04–92.48%) after 3 and 57.41% (31/54; 95%CI: 52.41–79.50%) and 50.00% (29/58; 95%CI: 40.40–67.00%), after 6-cycles, respectively. Hand-foot syndrome (16.67%), vomiting (9.72%) in D2, and hand-foot syndrome (18.06%), asthenia (15.28%) in D3 were most-common adverse events. Conclusion FDC of capecitabine + cyclophosphamide (1800 + 80 mg/day) showed high disease control rates and good safety profile in MBC patients. Oral fixed dose combination (FDC) of capecitabine + cyclophosphamide developed. FDC showed high efficacy and good safety profiles. Effective in MBC patients progressing post anthracycline and/or taxane exposure. Oral FDC formulation may reduce pill burden and improve patient compliance.
Collapse
Affiliation(s)
- Sudeep Gupta
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, 400012, Maharashtra, India.
| | - Ghanashyam Biswas
- Sparsh Hospital and Critical Care Pvt. Ltd., Bhubaneshwar, 751007, Odisha, India
| | - Suresh Babu
- Life Care Hospital, Bangalore, 560029, Karnataka, India
| | - Tanveer M Maksud
- Unique Hospital - Multispeciality & Research Institute, Surat, 395002, Gujarat, India
| | | | | | - Gopal Raja
- Madras Medical College and Rajiv Gandhi Govt. General Hospital, Chennai, 600003, Tamil Nadu, India
| | - Rakesh R Boya
- Mahatma Gandhi Cancer Hospital & Research Institute, Visakhapatnam, 530017, Andhra Pradesh, India
| | - Pramod Patil
- Kailash Cancer Hospital & Research Centre, Vadodara, 391760, Gujarat, India
| | | | | | - Rakesh S Neve
- P.D.E.A's Ayurved Rugnalay & Sterling Multispeciality Hospital, Pune, 411044, Maharashtra, India
| | - Guruprasad Bhat
- Mallikatta Neuro Centre, Mangalore, 575003, Karnataka, India
| | | | - Apurva A Patel
- The Gujarat Cancer & Research Institute (M.P. Shah Cancer Hospital), Ahmedabad, 380016, Gujarat, India
| | - Piyush Patel
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, 380054, Gujarat, India
| | - Nisarg Joshi
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, 380054, Gujarat, India
| | - Vinay Bajaj
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, 380054, Gujarat, India
| | - Mujtaba A Khan
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, 380054, Gujarat, India
| |
Collapse
|
18
|
Patel SV, Joshi N, Thareja T, Jhanji V. Corneal epithelial toxicity induced by belantamab mafodotin. Clin Exp Ophthalmol 2021; 49:1113-1115. [PMID: 34472175 DOI: 10.1111/ceo.13995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Savan V Patel
- Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Nisarg Joshi
- Geisinger Eye Institute, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Tarika Thareja
- Geisinger Eye Institute, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
19
|
Hornick N, Damo M, Leventhal J, Joshi N. LB778 A quantitative scoring system for cutaneous immune-related adverse events. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.07.044] [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]
|
20
|
Zeidan A, Joshi N, Kale H, Wang WJ, Corman S, Hill K, Salimi T, Epstein R. Topic: AS03-Health Economics & Outcome Research/AS03a-Cost of care. Leuk Res 2021. [DOI: 10.1016/j.leukres.2021.106681.10] [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: 10/20/2022]
|
21
|
Williams MGL, Dastidar A, Liang K, Johnson TW, Baritussio A, Strange JW, Joshi N, Dorman S, Dr Garate E, Spagnoli L, Fiori E, Lawton CB, Biglino G, Plein S, Bucciarelli-Ducci C. Sex and age differences in patients with a working diagnosis of myocardial infarction with non-obstructive coronary arteries (MINOCA): presentation and outcome. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab090.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Rosetrees Trust James Tudor Foundation
Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) is an increasingly recognised working diagnosis. Sex and age differences in MINOCA are not well understood.
Purpose This study aims to evaluate the impact of sex and age in patients with MINOCA due to ischaemic and non-ischaemic causes on clinical presentation and outcome.
Methods and Results Consecutive patients with a working diagnosis of MINOCA (n = 719) from a single tertiary centre who underwent comprehensive cardiovascular magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) were followed prospectively. The primary endpoint was all-cause mortality. CMR was performed at a median time of 30 days after presentation and identified a diagnosis in 74% of patients. Men were more likely to have a non-ischaemic cause on CMR (55% v. 41%, p < 0.001) and less likely to have a normal/non-specific scan (21% v. 32%, p = 0.001, figure 1). All-cause mortality was 9.5% over a median follow up of 4.9 years, with no significant difference between sexes (8.7% versus 10.1% p = 0.456). Age group (HR 1.61, p < 0.001) and LVEF (HR 0.98, p = 0.020) were independent predictors of mortality. Men aged >60 years with a non-ischaemic aetiology on their CMR were at higher risk of death than women with non-ischaemic causes >60 years (p = 0.003, figure 2).
Conclusions There is no difference in all-cause mortality between sexes in MINOCA but increasing age is the most important predictor of mortality in both sexes.
Collapse
Affiliation(s)
- MGL Williams
- Bristol Heart Institute, Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - A Dastidar
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - K Liang
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - TW Johnson
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - A Baritussio
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - JW Strange
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - N Joshi
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - S Dorman
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - E Dr Garate
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - L Spagnoli
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - E Fiori
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - CB Lawton
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - G Biglino
- University of Bristol, Bristol, United Kingdom of Great Britain & Northern Ireland
| | - S Plein
- University of Leeds, Department of Biomedical Imaging Science, Leeds, United Kingdom of Great Britain & Northern Ireland
| | - C Bucciarelli-Ducci
- Bristol Heart Institute, Department of Cardiology, Bristol, United Kingdom of Great Britain & Northern Ireland
| |
Collapse
|
22
|
Subramanian S, Samar A, Joshi N, Sejpal J, Khan MA, Ahmad I. Efficacy and safety of nanosomal docetaxel lipid suspension based chemotherapy in metastatic ovarian carcinoma: A retrospective study. Mol Clin Oncol 2021; 15:162. [PMID: 34194740 DOI: 10.3892/mco.2021.2324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/21/2021] [Indexed: 12/29/2022] Open
Abstract
The aim of the current study was to assess the efficacy and safety of nanosomal docetaxel lipid suspension (NDLS) based chemotherapy in patients with metastatic epithelial ovarian carcinoma. In the present multicenter study, the medical records of patients who received NDLS (60-75 mg/m2; 3-weekly cycles) based chemotherapy for metastatic epithelial ovarian cancer in routine clinical care were retrospectively evaluated. Patients were followed-up from September 2014 until September 2018. The efficacy endpoints were the overall response rate (ORR) and disease control rate measured in accordance with the Response Evaluation Criteria in Solid Tumours 1.1. Overall survival (OS) and safety were also evaluated. Of the 13 patients evaluated, 46.2% (6/13) received NDLS-based first-line chemotherapy and 53.8% (7/13) patients received second-line chemotherapy [platinum-sensitive, 57.1% (4/7); platinum-resistant, 42.9% (3/7)]. The ORRs were 60.0% (3/5) and 57.1% (4/7) for patients receiving first- and second-line chemotherapy, respectively. The estimated median OS for patients receiving NDLS-based first-line chemotherapy was 17.4 months (follow-up duration, 4.3-49.4 months). The estimated median OS was 26.1 months (follow-up duration, 5.1-37.5 months) in patients with platinum-sensitive disease, whereas the OS was 14.8 months (follow-up duration, 3.5-14.8 months) in patients with platinum-resistant disease. No grade III/IV adverse events (AEs) were observed; ≥1 AE in grade I-II was reported in 84.6% (11/13) of patients. Overall, NDLS-based chemotherapy was efficacious and well-tolerated in the management of metastatic epithelial ovarian carcinoma.
Collapse
Affiliation(s)
- Sundaram Subramanian
- VS Hospital, Madras Cancer Institute, Advanced Cancer Care, Chennai, Tamil Nadu 600031, India
| | - Aseem Samar
- Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan 302017, India
| | - Nisarg Joshi
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Sola, Ahmedabad, Gujarat 380054, India
| | - Jaykumar Sejpal
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Sola, Ahmedabad, Gujarat 380054, India
| | - Mujtaba A Khan
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Sola, Ahmedabad, Gujarat 380054, India
| | - Imran Ahmad
- Jina Pharmaceuticals Inc., Libertyville, IL 60048, USA
| |
Collapse
|
23
|
Abstract
Chemical engineering is being rapidly transformed by the tools of data science. On the horizon, artificial intelligence (AI) applications will impact a huge swath of our work, ranging from the discovery and design of new molecules to operations and manufacturing and many areas in between. Early adoption of data science, machine learning, and early examples of AI in chemical engineering has been rich with examples of molecular data science-the application tools for molecular discovery and property optimization at the atomic scale. We summarize key advances in this nascent subfield while introducing molecular data science for a broad chemical engineering readership. We introduce the field through the concept of a molecular data science life cycle and discuss relevant aspects of five distinct phases of this process: creation of curated data sets, molecular representations, data-driven property prediction, generation of new molecules, and feasibility and synthesizability considerations.
Collapse
Affiliation(s)
- Chowdhury Ashraf
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, USA; ,
| | - Nisarg Joshi
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, USA; ,
| | - David A C Beck
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, USA; , .,eScience Institute, University of Washington, Seattle, Washington 98195, USA
| | - Jim Pfaendtner
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, USA; ,
| |
Collapse
|
24
|
Parkin C, Louie-Johnsun M, Chapman S, Shepherd A, Mccredie S, Kam J, Joshi N, Gikenye N, Grills R, Smilovic T, Manivasagam A, Weinstein S. Transrectal ultrasound guided prostate needle biopsy is still a standard of care for prostate cancer diagnosis – A multicentre Australian analysis of infection rates. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01370-1] [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: 10/20/2022]
|
25
|
Dollar O, Joshi N, Beck DAC, Pfaendtner J. Attention-based generative models for de novo molecular design. Chem Sci 2021; 12:8362-8372. [PMID: 34221317 PMCID: PMC8221056 DOI: 10.1039/d1sc01050f] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/14/2021] [Indexed: 11/21/2022] Open
Abstract
Attention mechanisms have led to many breakthroughs in sequential data modeling but have yet to be incorporated into any generative algorithms for molecular design. Here we explore the impact of adding self-attention layers to generative β-VAE models and show that those with attention are able to learn a complex "molecular grammar" while improving performance on downstream tasks such as accurately sampling from the latent space ("model memory") or exploring novel chemistries not present in the training data. There is a notable relationship between a model's architecture, the structure of its latent memory and its performance during inference. We demonstrate that there is an unavoidable tradeoff between model exploration and validity that is a function of the complexity of the latent memory. However, novel sampling schemes may be used that optimize this tradeoff. We anticipate that attention will play an important role in future molecular design algorithms that can make efficient use of the detailed molecular substructures learned by the transformer.
Collapse
Affiliation(s)
- Orion Dollar
- Department of Chemical Engineering, University of Washington Seattle 98185 WA USA
| | - Nisarg Joshi
- Department of Chemical Engineering, University of Washington Seattle 98185 WA USA
| | - David A C Beck
- Department of Chemical Engineering, University of Washington Seattle 98185 WA USA
- eScience Institute, University of Washington Seattle 98185 WA USA
| | - Jim Pfaendtner
- Department of Chemical Engineering, University of Washington Seattle 98185 WA USA
| |
Collapse
|
26
|
Abstract
INTRODUCTION Docetaxel 75 mg/m2 every 3 weeks for up to 10 cycles is an accepted standard regimen in metastatic castration-resistant prostate cancer (mCRPC). We report our experience with >20 cycles of biweekly nanosomal docetaxel lipid suspension (NDLS) treatment in patients with mCRPC. CASE REPORTS Cases with long-term treatment of NDLS treatment in mCRPC patients were identified from the medical records of Jawaharlal Nehru Cancer Hospital & Research Centre Bhopal, India. A total of three cases with >20 cycles of NDLS are presented here. MANAGEMENT AND OUTCOMES Overall, the 3 patients received biweekly NDLS at a dose of 45 mg/m2 for 22, 36, and 40 cycles, respectively, except for one patient where NDLS was initiated at 50 mg/m2 and later reduced to 45 mg/m2. All the 3 patients reported prostate-specific antigen (PSA) response (>50% decline in PSA levels from baseline). The time to treatment failure (TTF) was 14.8, 18.2, and 20.6 months in these 3 patients, respectively. PSA nadir occurred after 14, 6 and 13 cycles, respectively. The OS was 21.6, 22.2 and 25.8 months, respectively. Anemia, lymphopenia, and neutropenia were the most common adverse events. NDLS treatment was overall well-tolerated without any new safety concerns. CONCLUSIONS Biweekly NDLS for >20 cycles was effective and well-tolerated in patients with mCRPC. NDLS can potentially be used for long-term management, which may be a requirement for most patients with mCRPC.
Collapse
Affiliation(s)
- Srikant Tiwari
- Department of Medical Oncology, Jawaharlal Nehru Cancer Hospital & Research Centre, Bhopal, India
| | - Abhaya Bisaria
- Department of Medical Oncology, Jawaharlal Nehru Cancer Hospital & Research Centre, Bhopal, India
| | - Harmeet Kaur
- Department of Medical Oncology, Jawaharlal Nehru Cancer Hospital & Research Centre, Bhopal, India
| | - Nisarg Joshi
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd, Ahmedabad, India
| | - Jaykumar Sejpal
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd, Ahmedabad, India
| | - Mujtaba A Khan
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd, Ahmedabad, India
| |
Collapse
|
27
|
Kwiecinski J, Tzolos E, Cadet S, Adamson P, Joshi N, Dey D, Berman D, Newby D, Dweck M, Slomka P. 18F-sodium fluoride coronary uptake in patients with coronary artery bypass grafts. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
18F-Sodium fluoride (18F-NaF) positron emission tomography (PET) provides an assessment of active calcification (microcalcification) across a wide range of cardiovascular conditions including coronary artery disease, carotid and penile atherosclerosis, aortic and mitral valve disease, and abdominal aortic aneurysms. To date the significance of 18F-NaF uptake in patients with coronary artery bypass grafts (CABG) is unknown.
We aimed to characterize 18F-NaF activity in CABG patients.
We performed 18F-NaF PET (30-min long single bed position acquisition 1h after a 250mB injection of 18F-NaF) and coronary CT angiography in patients with multivessel coronary artery disease and followed them for fatal or non-fatal myocardial infarction over 42 [31,49] months. On motion-corrected datasets we quantified the whole-vessel coronary 18F-NaF PET uptake (the coronary microcalcification activity (CMA)) by measuring the activity of voxels above the background (right atrium activity) + 2 * standard deviations threshold. All study subjects underwent a comprehensive baseline clinical assessment including evaluation of their cardiovascular risk factor profile with the SMART [Secondary Manifestations of Arterial Disease] risk score calculated, and the coronary calcium burden assessed with calcium scoring (CCS).
Among 293 study participants (65±9 years; 84% male), 48 (16%) had a history of CABG. Although the majority 124/128 (97%) of coronary bypass grafts showed no uptake, 4 saphenous vein grafts presented with a CMA>0 (range: 2.5–11.5, Figure). While a similar proportion of patients with and without prior CABG showed increased coronary 18F-NaF uptake (CMA>0) (58.3% versus 71.4%, p=0.11) overall prior-CABG subjects had higher CMA (2.0 [0.3, 6.6] versus 0.6 [0, 2.7], p=0.001) and CCS (1135 [631, 2120] versus 225 [59, 542], p<0.001), respectively. In line with the differences in the calcification activity and the coronary calcium burden, the SMART risk scores were higher in CABG patients (23 [17, 28] versus 17 [12, 24], p=0.01), and these patients were also older (68±8 versus 64±8, p=0.01). Despite the aforementioned differences the incidence of myocardial infarction 5/48 (9%) versus 15/245 (6%) and MACE 6/48 (12%) versus 34/245 (14%) during follow-up between subjects with and without prior CABG was similar (p=0.44 and p=0.80, respectively).
CABG patients have a higher coronary microcalcification activity on 18F-NaF PET than multivessel coronary artery disease patients without prior CABG. Despite evidence of higher 18F-NaF uptake there is no difference in outcome between these two groups.
Figure 1. 18F-NaF uptake in CABG patients. (A) 63-year old male with prominent uptake in stented saphenous vein bypass grafts and native coronary arteries who experienced a non-fatal non ST elevation myocardial infarction during follow-up. (B) 70-year old male with evident uptake in native coronary arteries and only little 18F-NaF activity within coronary bypasses.
Funding Acknowledgement
Type of funding source: Other. Main funding source(s): National Heart, Lung, and Blood Institute/National Institute of Health (NHLBI/NIH), British Heart Foundation
Collapse
Affiliation(s)
| | - E Tzolos
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - S Cadet
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - P.D Adamson
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - N Joshi
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - D Dey
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - D.S Berman
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - D.E Newby
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - M.R Dweck
- University of Edinburgh, Centre for Cardiovascular Sciences, Edinburgh, United Kingdom
| | - P.J Slomka
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| |
Collapse
|
28
|
Connolly G, Mora J, Sammut E, Kashyap M, Dastidar A, Gall A, De Silva K, Joshi N, Dorman S, Strange J, Johnson T. How relevant is the ISCHEMIA trial to a rapid access chest pain clinic cohort of patients? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The ISCHEMIA trial demonstrated that optimal medical therapy (OMT) is not inferior to an early interventional approach for stable angina. This could significantly impact on clinical practice. This study aimed to check the relevance of the ISCHEMIA trial in a real-world population of patients referred to a tertiary centre with recent onset chest pain (CP).
Methods
In this registry study, electronic notes of all patients assessed in a Rapid Access Chest Pain Clinic (RACPC) within a 12-month period (2018–19) were reviewed. Patients were selected if they met key ISCHEMIA trial inclusion criteria.
Results
2416 patients were assessed, 378 (15.6%) presented with typical anginal CP, 1357 (56.2%) had atypical CP and 681 (28.2%) had non anginal CP.
Of the typical CP group, 158 patients were excluded (91 known CAD, 62 ACS, 2 eGFR <30mL/min, 3 severe LVSD). This resulted in 220 patients, representing 58.2% of the typical chest pain population and 9.1% of all patients seen in RACPC. These patients had a median age of 60 years, 96 (44%) female, 119 (54.1%) had high cholesterol, 44 (20%) had diabetes, 115 (52.3%) had hypertension, 104 (47.3%) had a family history of ischaemic heart disease, and 32 (14.5%) were current smokers.
Of these 220 patients, 48 (21.8%) had a CT coronary angiogram (CTCA) requested as their first line investigation (42 completed) with 1 (2.4%) patients result suggestive of significant left main stem (LMS) disease. 15 (6.8%) patients had stress echocardiography requested as their first line investigation (13 completed), 4 (31%) were positive for inducible ischaemia. 3 (1.4%) patients had stress CMR requested as their first line investigation (2 completed), both were negative. 143 (65%) patients had an invasive coronary angiogram (ICA) requested as their first line investigation (112 completed). 8 patients had severe LMS disease and were referred for surgical opinion. A further 11 patients were referred for surgical opinion due to multivessel disease or aberrant coronary anatomy. In total 24 (21.4%) patients were treated with PCI following ICA as their first line investigation.
All patients were started on medical therapy for presumed CAD with up-titration while awaiting investigations. The median wait time for a CTCA was 55 days compared to 165.5 days for ICA.
Two patients (0.9%) from the cohort of 220 patients died during the follow up period, compared to 2.5% of patients admitted from RACPC with an ACS diagnosis.
Conclusion
Patients present with undifferentiated chest pain, consequently the outcomes of the ISCHEMIA trial must be considered cautiously. Within our cohort of 2416 patients, only 9% of patients met key inclusion criteria of the trial. Ultimately, only 19.5% patients with typical chest pain were revascularised, unlike 80% of patients in the invasive arm of ISCHEMIA. It is unclear how the results of the ISCHEMIA trial will impact on UK practice, but it is clear that OMT plays a central role.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
| | - J Mora
- Bristol Heart Institute, Bristol, United Kingdom
| | - E Sammut
- University of Bristol, Bristol, United Kingdom
| | - M Kashyap
- Bristol Heart Institute, Bristol, United Kingdom
| | - A Dastidar
- Bristol Heart Institute, Bristol, United Kingdom
| | - A Gall
- Bristol Heart Institute, Bristol, United Kingdom
| | - K De Silva
- Bristol Heart Institute, Bristol, United Kingdom
| | - N Joshi
- Bristol Heart Institute, Bristol, United Kingdom
| | - S Dorman
- Bristol Heart Institute, Bristol, United Kingdom
| | - J Strange
- Bristol Heart Institute, Bristol, United Kingdom
| | - T Johnson
- Bristol Heart Institute, Bristol, United Kingdom
| |
Collapse
|
29
|
Kumar Das Majumdar S, Subramanian S, Biswas G, Joshi N, Khan MA, Ahmad I. Efficacy and safety of nanosomal docetaxel lipid suspension-based chemotherapy in squamous cell carcinoma of the head and neck: A multicenter retrospective study. Oncol Lett 2020; 20:344. [PMID: 33123255 PMCID: PMC7583840 DOI: 10.3892/ol.2020.12207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 09/10/2020] [Indexed: 01/10/2023] Open
Abstract
Squamous cell carcinoma of the head and neck (SCCHN) is the most common cancer in Indian men. Docetaxel alone or in combination with other chemotherapeutic agents is recommended for the management of SCCHN. The present multicenter, retrospective study was conducted to evaluate the efficacy and safety of a novel docetaxel formulation 'nanosomal docetaxel lipid suspension (NDLS)'-based chemotherapy in SCCHN. The medical records of patients with SCCHN, who were treated with NDLS-based chemotherapy and followed up between August 2014 and September 2018, were reviewed. The efficacy endpoints were overall response rate [ORR; complete response (CR) + partial response (PR)] and disease control rate (DCR; CR + PR + stable disease) for patients receiving NDLS-based induction or palliative chemotherapy. Overall survival (OS) and safety were also evaluated. Efficacy evaluation was available in 30/34 patients (induction, 20/23; palliative, 10/11). NDLS-based induction chemotherapy showed an ORR and DCR of 95% and a median OS of 43.5 months (follow-up duration, 0.6-80.3 months). For NDLS-based palliative chemotherapy, the ORR and DCR were 50% and the median OS time was 4.6 months (follow-up duration, 1.8 to 14.3 months). At least one adverse event was reported in 82.6% patients. No new safety concerns were reported. Overall, NDLS-based chemotherapy was effective and well tolerated in the treatment of SCCHN.
Collapse
Affiliation(s)
- Saroj Kumar Das Majumdar
- Department of Radiotherapy, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019, India
| | - Sundaram Subramanian
- Department of Medical Oncology, VS Hospital, Madras Cancer Institute, Advanced Cancer Care, Chennai, Tamil Nadu 600031, India
| | - Ghanashyam Biswas
- Department of Medical Oncology, Sparsh Hospital, Bhubaneswar, Odisha 751007, India
| | - Nisarg Joshi
- Department of Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat 380054, India
| | - Mujtaba A Khan
- Department of Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat 380054, India
| | - Imran Ahmad
- Jina Pharmaceuticals Inc., Libertyville, IL 60048, USA
| |
Collapse
|
30
|
Subramanian S, Majumdar SKD, Biswas G, Joshi N, Bunger D, Khan MA, Ahmad I. Efficacy and safety of nanosomal docetaxel lipid suspension based chemotherapy in gastric and gastroesophageal junction adenocarcinoma. Mol Clin Oncol 2020; 13:14. [PMID: 32754328 DOI: 10.3892/mco.2020.2084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/15/2020] [Indexed: 12/24/2022] Open
Abstract
The current retrospective multicenter study evaluated the efficacy and safety of nanosomal docetaxel lipid suspension (NDLS; DoceAqualip) based chemotherapy in patients with gastric and gastroesophageal junction (GEJ) adenocarcinoma. The medical charts of patients with gastric and GEJ adenocarcinoma, who were treated with NDLS (50-75 mg/m2; 3 weekly cycles) based chemotherapy and followed-up from April 2014 to September 2018, were analyzed. The study endpoints included overall response rate (ORR) and disease control rate (DCR) in neoadjuvant and metastatic settings. Overall survival (OS) and safety were also evaluated. Of the 43 patients with gastric (n=39) and GEJ (n=4) adenocarcinoma, efficacy evaluation was available in 35 (neoadjuvant, 17/18 patients; metastatic, 18/25 patients). In the neoadjuvant setting, an ORR of 58.82% and a DCR of 94.11% were observed, whereas in the metastatic setting, the ORR was 77.77% and the DCR was 83.33%. In the neoadjuvant setting, at a follow-up ranging from 0.7 to 41.2 months, the median OS was not reached. In the metastatic setting, the median OS was 31.9 months at a follow-up ranging from 0.2 to 50.3 months. At least one adverse event (AE) was reported in 24 patients. Anemia, lymphopenia and thrombocytopenia were the most common hematological AEs, while nausea, vomiting and weakness were the most common non-hematological AEs. NDLS based treatment was well-tolerated without any new safety concerns. Overall, NDLS-based chemotherapy was effective and well-tolerated in the management of gastric and GEJ adenocarcinoma.
Collapse
Affiliation(s)
- Sundaram Subramanian
- Department of Medical Oncology, VS Hospital, Madras Cancer Institute, Advanced Cancer Care, Chennai, Tamil Nadu 600031, India
| | - Saroj Kumar Das Majumdar
- Department of Radiotherapy, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019, India
| | - Ghanashyam Biswas
- Department of Medical Oncology, Sparsh Hospital, Bhubaneswar, Odisha 751007, India
| | - Nisarg Joshi
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Sola, Ahmedabad, Gujarat 380054, India
| | - Deepak Bunger
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Sola, Ahmedabad, Gujarat 380054, India
| | - Mujtaba Ali Khan
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Sola, Ahmedabad, Gujarat 380054, India
| | - Imran Ahmad
- Jina Pharmaceuticals Inc., Libertyville, IL 60048, USA
| |
Collapse
|
31
|
Reilly JR, Artz DR, Biddinger D, Bobiwash K, Boyle NK, Brittain C, Brokaw J, Campbell JW, Daniels J, Elle E, Ellis JD, Fleischer SJ, Gibbs J, Gillespie RL, Gundersen KB, Gut L, Hoffman G, Joshi N, Lundin O, Mason K, McGrady CM, Peterson SS, Pitts-Singer TL, Rao S, Rothwell N, Rowe L, Ward KL, Williams NM, Wilson JK, Isaacs R, Winfree R. Crop production in the USA is frequently limited by a lack of pollinators. Proc Biol Sci 2020; 287:20200922. [PMID: 33043867 PMCID: PMC7423660 DOI: 10.1098/rspb.2020.0922] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/07/2020] [Indexed: 11/12/2022] Open
Abstract
Most of the world's crops depend on pollinators, so declines in both managed and wild bees raise concerns about food security. However, the degree to which insect pollination is actually limiting current crop production is poorly understood, as is the role of wild species (as opposed to managed honeybees) in pollinating crops, particularly in intensive production areas. We established a nationwide study to assess the extent of pollinator limitation in seven crops at 131 locations situated across major crop-producing areas of the USA. We found that five out of seven crops showed evidence of pollinator limitation. Wild bees and honeybees provided comparable amounts of pollination for most crops, even in agriculturally intensive regions. We estimated the nationwide annual production value of wild pollinators to the seven crops we studied at over $1.5 billion; the value of wild bee pollination of all pollinator-dependent crops would be much greater. Our findings show that pollinator declines could translate directly into decreased yields or production for most of the crops studied, and that wild species contribute substantially to pollination of most study crops in major crop-producing regions.
Collapse
Affiliation(s)
- J. R. Reilly
- Department of Ecology, Evolution and Natural Resources, Rutgers University, New Brunswick, NJ 08901, USA
| | - D. R. Artz
- USDA-Agricultural Research Service, Pollinating Insects Research Unit, Logan, UT 84322, USA
| | - D. Biddinger
- Department of Entomology, Pennsylvania State University Fruit Research and Extension Center, Biglerville, PA 17307, USA
| | - K. Bobiwash
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, V5A1S6Canada
- Department of Entomology, University of Manitoba, Winnipeg, MB R3T 2N2Canada
| | - N. K. Boyle
- USDA-Agricultural Research Service, Pollinating Insects Research Unit, Logan, UT 84322, USA
- Department of Entomology, Pennsylvania State University, University Park, PA 16802, USA
| | - C. Brittain
- Department of Entomology and Nematology, University of California Davis, Davis, CA 95616, USA
| | - J. Brokaw
- Department of Entomology, University of Minnesota, St. Paul, MN 55113, USA
| | - J. W. Campbell
- Department of Entomology and Nematology, University of Florida, Gainesville, FL 32611, USA
- USDA Agricultural Research Service, Northern Plains Agricultural Research Laboratory, Sidney, MT 59270, USA
| | - J. Daniels
- Department of Entomology and Nematology, University of Florida, Gainesville, FL 32611, USA
- Florida Museum of Natural History, University of Florida, Gainesville, FL 32611, USA
| | - E. Elle
- Department of Biological Sciences, Simon Fraser University, Burnaby, BC, V5A1S6Canada
| | - J. D. Ellis
- Department of Entomology and Nematology, University of Florida, Gainesville, FL 32611, USA
| | - S. J. Fleischer
- Department of Entomology, Pennsylvania State University, University Park, PA 16802, USA
| | - J. Gibbs
- Department of Entomology, University of Manitoba, Winnipeg, MB R3T 2N2Canada
| | - R. L. Gillespie
- Agriculture and Natural Resource Program, Wenatchee Valley College, Wenatchee, WA 98801, USA
| | - K. B. Gundersen
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - L. Gut
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - G. Hoffman
- Department of Crop and Soil Science, Oregon State University, Corvallis, OR 97331, USA
| | - N. Joshi
- Department of Entomology and Plant Pathology, University of Arkansas, Fayetteville, AR 72701, USA
| | - O. Lundin
- Department of Ecology, Swedish University of Agricultural Sciences, SE-75007 Uppsala, Sweden
| | - K. Mason
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - C. M. McGrady
- Department of Applied Ecology, North Carolina State University, Raleigh, NC 27695, USA
| | | | - T. L. Pitts-Singer
- USDA-Agricultural Research Service, Pollinating Insects Research Unit, Logan, UT 84322, USA
| | - S. Rao
- Department of Entomology, University of Minnesota, St. Paul, MN 55113, USA
| | - N. Rothwell
- Northwest Michigan Horticultural Research Center, Michigan State University, Traverse City, MI 49684, USA
| | - L. Rowe
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - K. L. Ward
- Department of Entomology and Nematology, University of California Davis, Davis, CA 95616, USA
- National Park Service, Yosemite National Park, CA 95389, USA
| | - N. M. Williams
- Department of Entomology and Nematology, University of California Davis, Davis, CA 95616, USA
| | - J. K. Wilson
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - R. Isaacs
- Department of Entomology, Michigan State University, East Lansing, MI 48824, USA
| | - R. Winfree
- Department of Ecology, Evolution and Natural Resources, Rutgers University, New Brunswick, NJ 08901, USA
| |
Collapse
|
32
|
Holste K, Dietz P, Scharmann S, Keil K, Henning T, Zschätzsch D, Reitemeyer M, Nauschütt B, Kiefer F, Kunze F, Zorn J, Heiliger C, Joshi N, Probst U, Thüringer R, Volkmar C, Packan D, Peterschmitt S, Brinkmann KT, Zaunick HG, Thoma MH, Kretschmer M, Leiter HJ, Schippers S, Hannemann K, Klar PJ. Ion thrusters for electric propulsion: Scientific issues developing a niche technology into a game changer. Rev Sci Instrum 2020; 91:061101. [PMID: 32611046 DOI: 10.1063/5.0010134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/18/2020] [Indexed: 06/11/2023]
Abstract
The transition from old space to new space along with increasing commercialization has a major impact on space flight, in general, and on electric propulsion (EP) by ion thrusters, in particular. Ion thrusters are nowadays used as primary propulsion systems in space. This article describes how these changes related to new space affect various aspects that are important for the development of EP systems. Starting with a historical overview of the development of space flight and of the technology of EP systems, a number of important missions with EP and the underlying technologies are presented. The focus of our discussion is the technology of the radio frequency ion thruster as a prominent member of the gridded ion engine family. Based on this discussion, we give an overview of important research topics such as the search for alternative propellants, the development of reliable neutralizer concepts based on novel insert materials, as well as promising neutralizer-free propulsion concepts. In addition, aspects of thruster modeling and requirements for test facilities are discussed. Furthermore, we address aspects of space electronics with regard to the development of highly efficient electronic components as well as aspects of electromagnetic compatibility and radiation hardness. This article concludes with a presentation of the interaction of EP systems with the spacecraft.
Collapse
Affiliation(s)
- K Holste
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - P Dietz
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - S Scharmann
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - K Keil
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - T Henning
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - D Zschätzsch
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - M Reitemeyer
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - B Nauschütt
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - F Kiefer
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - F Kunze
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - J Zorn
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - C Heiliger
- Institute of Theoretical Physics, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - N Joshi
- Institute of Theoretical Physics, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - U Probst
- Department of Electrical Engineering, University of Applied Sciences, Wiesenstr. 14, 35390 Giessen, Germany
| | - R Thüringer
- Department of Electrical Engineering, University of Applied Sciences, Wiesenstr. 14, 35390 Giessen, Germany
| | - C Volkmar
- Department of Electrical Engineering, University of Applied Sciences, Wiesenstr. 14, 35390 Giessen, Germany
| | | | | | - K-T Brinkmann
- Institute of Experimental Physics II, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - H-G Zaunick
- Institute of Experimental Physics II, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - M H Thoma
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - M Kretschmer
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - H J Leiter
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - S Schippers
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - K Hannemann
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| | - P J Klar
- Institute of Experimental Physics I, Justus Liebig University, Heinrich-Buff-Ring 16, 35392 Giessen, Germany
| |
Collapse
|
33
|
Subramanian S, Prasanna R, Biswas G, Das Majumdar SK, Joshi N, Bunger D, Khan MA, Ahmad I. Nanosomal Docetaxel Lipid Suspension-Based Chemotherapy in Breast Cancer: Results from a Multicenter Retrospective Study. Breast Cancer (Dove Med Press) 2020; 12:77-85. [PMID: 32547188 PMCID: PMC7250303 DOI: 10.2147/bctt.s236108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/15/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the efficacy and safety of nanosomal docetaxel lipid suspension (NDLS, DoceAqualip)-based chemotherapy in breast cancer. METHODS Medical charts of patients with breast cancer, who were treated and followed up with NDLS (75-100 mg/m2; 3-week cycle)-based chemotherapy from August 2014 to September 2018, were analyzed in this multicenter, retrospective study. The study endpoints were overall response rate (ORR: complete response [CR]+partial response [PR]) and disease control rate (DCR: CR+PR+stable disease [SD]) in neoadjuvant and metastatic settings. Overall survival (OS) and safety were evaluated for all settings. RESULTS Of 91 patients (neoadjuvant: 12, adjuvant: 61, metastatic: 18), efficacy evaluation in 29 patients (neoadjuvant: 12/12, metastatic: 17/18) demonstrated an ORR and DCR of 100%, respectively, in the neoadjuvant setting, and an ORR of 64.7% and DCR of 70.6%, respectively, in the metastatic setting. At a median follow-up of 21.6 months (range: 2.1 to 49.9 months), median OS was not reached in neoadjuvant and adjuvant settings, and it was 30.4 months in metastatic settings. At least one adverse event (AE) was reported in 59.3% of patients. Anemia, thrombocytopenia, lymphopenia, and neutropenia were the most common hematological AEs reported while hyperglycemia and alteration in liver function tests were the most common non-hematological AEs. NDLS-based treatment was well tolerated without any new safety concerns. CONCLUSION Nanosomal docetaxel lipid suspension-based chemotherapy was efficacious and well tolerated in the treatment of breast cancer. Further, NDLS is being evaluated prospectively in patients with triple-negative breast cancer (ClinicalTrials.gov: NCT03671044).
Collapse
Affiliation(s)
- Sundaram Subramanian
- VS Hospital, Madras Cancer Institute, Advanced Cancer Care, Chennai, Tamil Nadu600031, India
| | - Rammohan Prasanna
- Department of Medical Oncology, CBCC-GVN Cancer Center, Tiruchirappalli, Tamil Nadu620005, India
| | - Ghanashyam Biswas
- Department of Medical Oncology, Sparsh Hospital, Bhubaneswar, Odisha751007, India
| | - Saroj Kumar Das Majumdar
- Department of Radiotherapy, All India Institute of Medical Sciences, Bhubaneswar, Odisha751019, India
| | - Nisarg Joshi
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat380054, India
| | - Deepak Bunger
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat380054, India
| | - Mujtaba A Khan
- Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat380054, India
| | - Imran Ahmad
- Jina Pharmaceuticals Inc., Libertyville, Illinois, USA
| |
Collapse
|
34
|
Connolly K, Fitzgerald B, Nader M, Joshi N. A31 A Reservoir of Tumor-Specific CD8 T Cells in Lung Cancer Resides in the Draining Lymph Node. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
35
|
Reni M, Braverman J, Hendifar A, Li CP, Macarulla Mercade T, Oh DY, Riess H, Tempero M, Lu B, Marcus J, Joshi N, Botterman M, Dueck A. Evaluation of minimal important difference (MID) for the European organisation for research and treatment of cancer (EORTC) pancreatic cancer module (PAN26) in patients with surgically resected pancreatic adenocarcinoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
36
|
Riess H, Braverman J, Reni M, Dueck A, Hendifar A, Oh DY, Li CP, Mercade TM, Shah A, Joshi N, Botterman M, Mantovani E, Lu B, Tempero M. Impact of adjuvant treatment with nab-paclitaxel and gemcitabine (nab-P+GEM) vs gemcitabine alone (GEM) on health-related quality of life (QoL) in patients (pts) with surgically resected pancreatic adenocarcinoma (PA) in the adjuvant pancreatic adenocarcinoma clinical trial (APACT). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
37
|
Ramaswamy R, Joshi N, Khan MA, Siddhara S. Nanosomal docetaxel lipid suspension based chemotherapy in a pregnant MBC patient - a case report. Onco Targets Ther 2019; 12:5679-5685. [PMID: 31406465 PMCID: PMC6642620 DOI: 10.2147/ott.s206573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 06/15/2019] [Indexed: 12/12/2022] Open
Abstract
The current report presents a case of a pregnant woman with breast cancer metastasized to liver and lungs. The standard of care for breast cancer in pregnancy is anthracycline/taxane-based chemotherapy regimens. Docetaxel has shown a favorable toxicity profile during the second and third trimesters of pregnancy. A novel nanosomal docetaxel lipid suspension (NDLS) (DoceAqualip), with a proven efficacy and tolerability profile, has been approved in India for the treatment of advanced solid tumors since 2013. We present here a case of a pregnant woman with metastatic breast cancer managed with NDLS based TAC regimen showing a partial response after six cycles. The patient delivered a healthy male child with normal Apgar score and weight at the 32nd week of gestation.
Collapse
Affiliation(s)
- Rajkumar Ramaswamy
- Department of Medical Oncology, Velammal Medical College and Research Institute, Madurai, Tamil Nadu 625009, India
| | - Nisarg Joshi
- Department of Medical Affairs & Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat 380054, India
| | - Mujtaba A Khan
- Department of Medical Affairs & Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat 380054, India
| | - Seerin Siddhara
- Department of Medical Oncology, Velammal Medical College and Research Institute, Madurai, Tamil Nadu 625009, India
| |
Collapse
|
38
|
Khan MA, Joshi N, Chaturvedi A, Ahmad I. Letter to the editor: 'current advances in development of new docetaxel formulations'. Expert Opin Drug Deliv 2019; 16:773-774. [PMID: 31248298 DOI: 10.1080/17425247.2019.1633755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Mujtaba A Khan
- a Medical Affairs and Clinical Development , Intas Pharmaceuticals Ltd ., Ahmedabad , India
| | - Nisarg Joshi
- a Medical Affairs and Clinical Development , Intas Pharmaceuticals Ltd ., Ahmedabad , India
| | - Alok Chaturvedi
- a Medical Affairs and Clinical Development , Intas Pharmaceuticals Ltd ., Ahmedabad , India
| | - Imran Ahmad
- b Research and Development, Jina Pharmaceuticals Inc ., Libertyville , IL , USA
| |
Collapse
|
39
|
Joshi N, Wandita T, Yang S, Park H, Hwang S. Effects of Supplementing Laying Hens with Purified Amino Acid Prepared from Animal Blood. Trop Anim Sci J 2019. [DOI: 10.5398/tasj.2019.42.1.46] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
40
|
Wandita TG, Joshi N, Kim HH, An SJ, Hwang SG. Pre-Adipocyte Determination and Adipocyte Differentiation of Stromal Vascular Cells Isolated From Intramuscular Tissue of Hanwoo Beef Cattle Treated by Acetate and Propionate. Trop Anim Sci J 2018. [DOI: 10.5398/tasj.2018.41.3.207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
41
|
Zore T, Joshi N, Schon S, Masson P, Wang E, Pisarska M, Chan J. Military access to fertility treatment: an assessment of society for reproductive technology (SART) fertility practice websites. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.762] [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]
|
42
|
Joshi N, Chan J, Wang E, Sauro E, Buttle R, Williams J, Pisarska M. Prenatal diagnostic testing in patients with fertility treatments, differences in indications. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
43
|
|
44
|
Chatzicharalampous C, Jeelani R, Ghoniem K, Najeemuddin S, Joshi N, Morris R, Awonuga A, Abu-Soud H. Bisphenol a exposure negatively impacts embryo development through a mechanism that involves zinc depletion, reactive oxygen species overproduction and induction of apoptosis. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
45
|
Wandita TG, Joshi N, Nam IS, Yang SH, Park HS, Hwang SG. Dietary Supplementation of Purified Amino Acid Derived from Animal Blood on Immune Response and Growth Performance of Broiler Chicken. Trop Anim Sci J 2018. [DOI: 10.5398/tasj.2018.41.2.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
46
|
Rajappa S, Joshi A, Doval DC, Batra U, Rajendranath R, Deo A, Biswas G, Bajpai P, Tilak TVS, Kane S, Kumar K, Kumar M, Talele AD, Devde P, Gupta A, Joshi N, Sejpal J, Bunger D, Khan M. Novel formulations of docetaxel, paclitaxel and doxorubicin in the management of metastatic breast cancer. Oncol Lett 2018; 16:3757-3769. [PMID: 30127986 PMCID: PMC6096158 DOI: 10.3892/ol.2018.9057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 05/24/2018] [Indexed: 12/17/2022] Open
Abstract
The management of breast cancer with advanced disease or metastasis is a common problem in India and other countries. A panel of 13 oncology experts deliberated on the sidelines of the 35th Indian Cooperative Oncology Network Conference held in Mumbai to formulate an expert opinion recommendation on the novel drug delivery system (NDDS) formulations in the treatment of metastatic breast cancer (MBC). The survey comprised of 39 questions related to limitations of conventional formulations and therapeutic positioning of NDDS formulations of docetaxel, paclitaxel and doxorubicin in the management of MBC. The experts used data from published literature and their practical experience to provide expert opinion and recommendations for use by the community oncologists. The experts opined that the newer NDDS formulations should provide a significant efficacy advantage in terms of overall survival and progression-free survival, or demonstrate better tolerability when compared with conventional formulations. The newer NDDS formulations of taxanes should be considered in special circumstances such as diabetes, in patients who have had hypersensitivity reactions and in cases where steroids need to be avoided. The novel formulations of doxorubicin should be used in the elderly and in patients with borderline cardiac function.
Collapse
Affiliation(s)
- Senthil Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana 500034, India
| | - Ashish Joshi
- Nanavati Hospital, Mumbai, Maharashtra 400056, India
| | - Dinesh C Doval
- Rajiv Gandhi Cancer Institute and Research Centre, Delhi 110085, India
| | - Ullas Batra
- Rajiv Gandhi Cancer Institute and Research Centre, Delhi 110085, India
| | | | - Avinash Deo
- Fortis SL Raheja Hospital, Mumbai, Maharashtra 400016, India
| | | | - Peush Bajpai
- Max Super Speciality Hospital, New Delhi 110017, India
| | - T V S Tilak
- Command Hospital, Bangalore, Karnataka 560007, India
| | - Sriram Kane
- Kane Hematology and Oncology Clinic, Nagpur, Maharashtra 440012, India
| | - Kishore Kumar
- Command Hospital, Bangalore, Karnataka 560007, India
| | - Manish Kumar
- Command Hospital, Lucknow, Uttar Pradesh 226002, India
| | | | - Prakash Devde
- Seth Nandlal Dhoot Hospital, Aurangabad, Maharashtra 431210, India
| | - Ashutosh Gupta
- Government Medical College, Jammu, Jammu and Kashmir 180001, India
| | - Nisarg Joshi
- Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat 380061, India
| | - Jaykumar Sejpal
- Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat 380061, India
| | - Deepak Bunger
- Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat 380061, India
| | - Mujtaba Khan
- Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat 380061, India
| |
Collapse
|
47
|
Kaushik D, Joshi N, Kumar R, Gaba S, Sapra R, Kumar K. Negative pressure wound therapy versus gauze dressings for the treatment of contaminated traumatic wounds. J Wound Care 2017; 26:600-606. [PMID: 28976825 DOI: 10.12968/jowc.2017.26.10.600] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This compares hospital suction negative pressure wound therapy (NPWT) with conventional gauze dressings in traumatic soft-tissue injury at a tertiary care centre. METHODS A prospective control study was conducted between September 2012 and November 2014. Patients with one or more traumatic soft-tissue injuries with contaminated wounds were allocated to either a test group (received NPWT) or control group (received conventional gauze). Wounds were assessed by two orthopaedic surgeons. If grade A was achieved, the wound was covered with split-thickness skin graft, flap or delayed primary closure; otherwise, revision debridement and NPWT/saline gauze dressings were applied. Descriptive statistics (mean, standard deviation and proportions) were used to summarise the study variables. The 95% confidence intervals (CI) for difference of mean were used. Chi-square test and Fisher's exact test were used to observe an association between the qualitative data and outcome variables. Unpaired T-Test and Mann-Whitney U test were used for analysis of the quantitative data. A p<0.05 was considered statistically significant. RESULTS A total of 104 patients were included. The mean number of dressings per patient was significantly lower in the NPWT group (3.4) than in the control group (20.7) (p<0.001). The time between injury and complete closure (12.5 versus 21.4 days) as well as duration of hospital stay (17.3 versus 23.8 days) was significantly less in the NPWT group (p<0.05). CONCLUSION NPWT has a role in healing traumatic wounds and can be delivered effectively through hospital suction NPWT, which can also reduce the cost of therapy. We recommend its regular use in all patients presenting with post-traumatic, soft-tissue injuries when primary coverage is not possible.
Collapse
Affiliation(s)
- D Kaushik
- Senior Resident, Sports Injury Centre, Safdarjung Hospital, New Delhi, India
| | - N Joshi
- Professor, Sawai Man Singh Medical College and Hospital, Rajasthan, India
| | - R Kumar
- Assistant Professor, Sawai Man Singh Medical College and Hospital, Rajasthan, India
| | - S Gaba
- Senior Resident; Department of Orthopaedics, AIIMS, New Delhi, India
| | - R Sapra
- Senior Resident, Department of Orthopaedics, Bhagwan Mahavir Hospital, Shalimar Bagh, New Delhi, India
| | - K Kumar
- Sawai Man Singh Medical College and Hospital, Rajasthan, India
| |
Collapse
|
48
|
Joshi N, Zore T, Schon S, Masson P, Chan J. Assessment of society for assisted reproductive technology (SART) member clinic websites on reported embryo transfer (et) procedures. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
49
|
Zore T, Joshi N, Schon S, Masson P, Chan J. Assessment of society assisted reproductive technology (SART) fertility clinic websites on mental health and complementary medicine resources. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.198] [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]
|
50
|
Joshi N, Zore T, Schon S, Masson P, Chan J. Assessment of fertility clinic websites on preimplantation genetic screening (PGS) and preimplantation genetic diagnosis (PGS). Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.852] [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]
|