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Plattner P, Wood E, Al Ayoubi L, Beliuskina O, Bissell ML, Blaum K, Campbell P, Cheal B, de Groote RP, Devlin CS, Eronen T, Filippin L, Garcia Ruiz RF, Ge Z, Geldhof S, Gins W, Godefroid M, Heylen H, Hukkanen M, Imgram P, Jaries A, Jokinen A, Kanellakopoulos A, Kankainen A, Kaufmann S, König K, Koszorús Á, Kujanpää S, Lechner S, Malbrunot-Ettenauer S, Müller P, Mathieson R, Moore I, Nörtershäuser W, Nesterenko D, Neugart R, Neyens G, Ortiz-Cortes A, Penttilä H, Pohjalainen I, Raggio A, Reponen M, Rinta-Antila S, Rodríguez LV, Romero J, Sánchez R, Sommer F, Stryjczyk M, Virtanen V, Xie L, Xu ZY, Yang XF, Yordanov DT. Nuclear Charge Radius of ^{26m}Al and Its Implication for V_{ud} in the Quark Mixing Matrix. Phys Rev Lett 2023; 131:222502. [PMID: 38101341 DOI: 10.1103/physrevlett.131.222502] [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] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/09/2023] [Indexed: 12/17/2023]
Abstract
Collinear laser spectroscopy was performed on the isomer of the aluminium isotope ^{26m}Al. The measured isotope shift to ^{27}Al in the 3s^{2}3p ^{2}P_{3/2}^{○}→3s^{2}4s ^{2}S_{1/2} atomic transition enabled the first experimental determination of the nuclear charge radius of ^{26m}Al, resulting in R_{c}=3.130(15) fm. This differs by 4.5 standard deviations from the extrapolated value used to calculate the isospin-symmetry breaking corrections in the superallowed β decay of ^{26m}Al. Its corrected Ft value, important for the estimation of V_{ud} in the Cabibbo-Kobayashi-Maskawa matrix, is thus shifted by 1 standard deviation to 3071.4(1.0) s.
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Affiliation(s)
- P Plattner
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Universität Innsbruck, Innrain 52, 6020 Innsbruck, Austria
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - E Wood
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - L Al Ayoubi
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - O Beliuskina
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - M L Bissell
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Department of Physics and Astronomy, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - K Blaum
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - P Campbell
- Department of Physics and Astronomy, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - B Cheal
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - R P de Groote
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - C S Devlin
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - T Eronen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - L Filippin
- Spectroscopy, Quantum Chemistry and Atmospheric Remote Sensing (SQUARES), Université libre de Bruxelles, 1050 Brussels, Belgium
| | - R F Garcia Ruiz
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, Massachusetts 02139, USA
| | - Z Ge
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - S Geldhof
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
| | - W Gins
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - M Godefroid
- Spectroscopy, Quantum Chemistry and Atmospheric Remote Sensing (SQUARES), Université libre de Bruxelles, 1050 Brussels, Belgium
| | - H Heylen
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
| | - M Hukkanen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - P Imgram
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - A Jaries
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - A Jokinen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - A Kanellakopoulos
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
| | - A Kankainen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - S Kaufmann
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - K König
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - Á Koszorús
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
| | - S Kujanpää
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - S Lechner
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
| | - S Malbrunot-Ettenauer
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - P Müller
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - R Mathieson
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - I Moore
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - W Nörtershäuser
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - D Nesterenko
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - R Neugart
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
- Institut für Kernchemie, Universität Mainz, Fritz-Straßmann-Weg 2, 55128 Mainz, Germany
| | - G Neyens
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
| | - A Ortiz-Cortes
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - H Penttilä
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - I Pohjalainen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - A Raggio
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - M Reponen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - S Rinta-Antila
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - L V Rodríguez
- ISOLDE, CERN Experimental Physics Department, Geneva 23, 1211 Genevè, Switzerland
- Max-Planck-Institut für Kernphysik, Saupfercheckweg 1, 69117 Heidelberg, Germany
- IJCLab, CNRS/IN2P3, Université Paris-Saclay, 91400 Orsay, France
| | - J Romero
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - R Sánchez
- GSI Helmholtzzentrum für Schwerionenforschung, Planckstraße 1, 64291 Darmstadt, Germany
| | - F Sommer
- Institut für Kernphysik, Technische Universität Darmstadt, Schlossgartenstraße 9, 64289 Darmstadt, Germany
| | - M Stryjczyk
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - V Virtanen
- Department of Physics, University of Jyväskylä, P.O. Box 35 FI-40014, Jyväskylä, Finland
| | - L Xie
- Department of Physics and Astronomy, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - Z Y Xu
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
| | - X F Yang
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001 Leuven, Belgium
- School of Physics and State Key Laboratory of Nuclear Physics and Technology, Peking University, 209 Chengfu Road, 100871 Beijing, China
| | - D T Yordanov
- IJCLab, CNRS/IN2P3, Université Paris-Saclay, 91400 Orsay, France
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Kelsey E, Holmes A, Tissot S, Campbell P, McLeod K. Management of recurrent localised bladder amyloid, has methotrexate helped? Urol Case Rep 2023; 51:102577. [PMID: 37811541 PMCID: PMC10551828 DOI: 10.1016/j.eucr.2023.102577] [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: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023] Open
Abstract
Background Amyloidosis of the bladder is a benign condition which can present with a multitude of symptoms including bladder mass, irritative voiding symptoms and haematuria. Case presentation We report on the investigation and management of a patient with recurrent localised amyloidosis of the bladder, which appears to have been managed fortuitously by concurrent methotrexate prescribed for another indication. Conclusion We provide further assessment and management with a focus on the possible benefit of methotrexate for management of localised bladder amyloidosis.
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Affiliation(s)
- E. Kelsey
- Department of Urology, University Hospital Geelong, Barwon Health, Australia
| | - A. Holmes
- Department of Urology, University Hospital Geelong, Barwon Health, Australia
| | - S. Tissot
- Department of Urology, University Hospital Geelong, Barwon Health, Australia
| | - P. Campbell
- Department of Haematology, University Hospital Geelong, Barwon Health, Australia
- Deakin University School of Medicine, Australia
| | - K. McLeod
- Department of Urology, University Hospital Geelong, Barwon Health, Australia
- Deakin University School of Medicine, Australia
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Solis-Trapala I, Campbell P, Lacey R, Rowlands G, Dunn K, Protheroe J. Are childhood factors predictive of adult health literacy? A longitudinal birth cohort analysis. SSM Popul Health 2023; 23:101426. [PMID: 37252287 PMCID: PMC10220279 DOI: 10.1016/j.ssmph.2023.101426] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 05/31/2023] Open
Abstract
Health literacy (HL), defined as the ability of an individual to understand and appraise health information to make informed decisions on their health, helps maintain and improve one's health and thus reduce the use of healthcare services. There is a recognised global effort to address insufficient HL in early life and understand how HL develops. This study examined the association of a range of factors including educational, speech and language ability, health and healthcare engagement, sleep problems, mental health, demographic, environmental, and maternal factors at different childhood stages (from 5 years to 11 years) with later adult HL at age 25. HL was measured using a HL ordinal score (insufficient, limited, or sufficient) derived from the European Literacy Survey Questionnaire-short version (HLS-EU-Q16) within a large UK based birth cohort (Avon Longitudinal Study of Parents and Children: ALSPAC study). Univariate proportional odds logistic regression models for the probability of having higher levels of HL were developed. Results of analysis of 4248 participants showed that poorer speech and language ability (aged 9 years, OR 0.18 95% CI 0.04 to 0.78), internalising in child (age 11 years, OR 0.62 95% CI 0.5 to 0.78), child depression (age 9 years, OR 0.67 95% CI 0.52 to 0.86), and the presence of maternal depression (child age 5, OR 0.80 95% CI 0.66 to 0.96), reduced the odds of sufficient HL when adult. Our results suggest some useful markers to identify children at potential risk of low HL that could be targeted for research into future interventions within school settings, for example, child's speech and language capability. In addition, this study identified child and maternal mental health as factors associated with later development of limited HL and future research should consider what potential mechanisms might explain this link.
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Affiliation(s)
- I. Solis-Trapala
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - P. Campbell
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
- Midlands Partnership NHS Foundation Trust, St Georges' Hospital, Stafford, ST16 3AG, UK
| | - R.J. Lacey
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - G. Rowlands
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK
| | - K.M. Dunn
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
| | - J. Protheroe
- School of Medicine, Keele University, Staffordshire, ST5 5BG, UK
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Baker RI, Gilmore G, Chen V, Young L, Merriman E, Curnow J, Joseph J, Tiao JY, Chih J, McRae S, Harper P, Tan CW, Brighton T, Royle G, Hugman A, Hankey GJ, Crowther H, Boey J, Gallus A, Campbell P, Tran H. Direct oral anticoagulants or vitamin K antagonists in emergencies: comparison of management in an observational study. Res Pract Thromb Haemost 2023; 7:100196. [PMID: 37601024 PMCID: PMC10439397 DOI: 10.1016/j.rpth.2023.100196] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/17/2023] [Accepted: 05/11/2023] [Indexed: 08/22/2023] Open
Abstract
Background Restoring hemostasis in patients on oral anticoagulants presenting with major hemorrhage (MH) or before surgical intervention has changed, with the replacement of vitamin K antagonist (VKA) with direct oral anticoagulants (DOACs). Objectives To observe the difference in urgent hemostatic management between patients on VKA and those on DOACs. Methods A multicenter observational study evaluated the variation in laboratory testing, hemostatic management, mortality, and hospital length of stay (LOS) in patients on VKA or DOACs presenting with MH or urgent hemostatic restoration. Results Of the 1194 patients analyzed, 783 had MH (61% VKA) and 411 required urgent hemostatic restoration before surgery (56% VKA). Compared to the international normalized ratio (97.6%), plasma DOAC levels were measured less frequently (<45%), and the time taken from admission for the coagulation sample to reach the laboratory varied widely (median, 52.3 minutes; IQR, 24.8-206.7). No significant plasma DOAC level (<50 ng/mL) was found in up to 19% of patients. There was a poor relationship between plasma DOAC level and the usage of a hemostatic agent. When compared with patients receiving VKA (96.5%) or dabigatran (93.7%), fewer patients prescribed a factor Xa inhibitor (75.5%) received a prohemostatic reversal agent. The overall 30-day mortality for MH (mean: 17.8%) and length of stay (LOS) (median: 8.7 days) was similar between VKA and DOAC patients. Conclusion In DOAC patients, when compared to those receiving VKA, plasma DOAC levels were measured less frequently than the international normalized ratio and had a poor relationship with administering a hemostatic reversal agent. In addition, following MH, mortality and LOS were similar between VKA and DOAC patients.
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Affiliation(s)
- Ross I. Baker
- Western Australia Centre for Thrombosis and Haemostasis, Murdoch University, Perth, Australia
- Perth Blood Institute, Perth, Australia
- Hollywood Hospital Haemophilia Centre, Perth, Australia
| | - Grace Gilmore
- Western Australia Centre for Thrombosis and Haemostasis, Murdoch University, Perth, Australia
- Perth Blood Institute, Perth, Australia
| | - Vivien Chen
- Concord Repatriation General Hospital, Concord Clinical School, Faculty of Health and Medicine, University of Sydney, Sydney, Australia
| | - Laura Young
- Auckland City Hospital, Grafton, Auckland, New Zealand
| | | | | | - Joanne Joseph
- St Vincent’s Hospital and School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, Australia
| | - Jim Y. Tiao
- Western Australia Centre for Thrombosis and Haemostasis, Murdoch University, Perth, Australia
- Perth Blood Institute, Perth, Australia
| | - Jun Chih
- Curtin School of Population Health, Perth, Australia
| | - Simon McRae
- Perth Blood Institute, Perth, Australia
- Hollywood Hospital Haemophilia Centre, Perth, Australia
| | - Paul Harper
- Palmerston North Hospital, Palmerston North, New Zealand
| | - Chee W. Tan
- Royal Adelaide Hospital, University of Adelaide, Adelaide, Australia
| | | | | | | | - Graeme J. Hankey
- Perron Institute for Neurological and Translational Science and The University of Western Australia, Perth, Australia
| | | | - Jirping Boey
- Flinders Medical Centre, Flinders University, Adelaide, Australia
| | - Alexander Gallus
- Flinders Medical Centre, Flinders University, Adelaide, Australia
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Brendefur Corwin LM, Campbell P, Jakobsen K, Müller F, Lai X, Unemo M, Leegaard TM, Vildershøj Bjørnholt J, Olsen AO. Improvement in Neisseria gonorrhoeae culture rates by bedside inoculation and incubation at a clinic for sexually transmitted infections. Ann Clin Microbiol Antimicrob 2023; 22:27. [PMID: 37072830 PMCID: PMC10114361 DOI: 10.1186/s12941-023-00576-0] [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: 06/30/2022] [Accepted: 03/28/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Culture of Neisseria gonorrhoeae is essential for surveillance of complete antimicrobial susceptibility profiles. In 2014, the culture success rate of N. gonorrhoeae from samples taken at the clinic for sexually transmitted infections (STI clinic), Oslo University Hospital, Norway, was only 20%. The present study aimed to improve gonococcal culture rates using bedside inoculation of patient samples on gonococcal agar plates and incubation at the STI clinic. METHODS This prospective quality improvement study was conducted by the STI clinic and the Department of Microbiology at Oslo University Hospital from May 2016 - October 2017. When culture of N. gonorrhoeae was clinically indicated, we introduced a parallel 'bedside culture' at the STI clinic and compared results with the standard culture at the microbiology department. Samples were taken from urethra, anorectum, pharynx and cervix. Culture rates were compared across symptomatic and asymptomatic anatomical sites. RESULTS From 596 gonococcal-positive PCR samples, bedside culture had a significantly higher success rate of 57% compared to 41% with standard culture (p < 0.05). Overall, culture rate from symptomatic sites was 91% v. 45% from asymptomatic sites. The culture rates from different anatomical sites were as follows: urethra 93%, anorectum 64%, pharynx 28% and cervix 70%. Bedside culture significantly (p < 0.05) improved the culture rates for symptomatic urethral and asymptomatic pharyngeal samples. CONCLUSIONS Where feasible, bedside inoculation on gonococcal agar plates and incubation of samples from patients with gonorrhoea is recommended. This will improve the culture diagnostics and provide additional gonococcal isolates for antimicrobial resistance surveillance.
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Affiliation(s)
- L M Brendefur Corwin
- Department of Microbiology, Oslo University Hospital, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - P Campbell
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
- National Advisory Unit for Sexually Transmitted Infections, Oslo University Hospital, Oslo, Norway
| | - K Jakobsen
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - F Müller
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - X Lai
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - M Unemo
- WHO Collaborating Centre for Gonorrhoea and other STIs, National Reference Laboratory for STIs, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Institute for Global Health, University College London (UCL), London, UK
| | - T M Leegaard
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway
| | - J Vildershøj Bjørnholt
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - A O Olsen
- Section for Respiratory, Blood-borne and Sexually Transmitted Infections, Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Koszorús Á, Block M, Campbell P, Cheal B, de Groote RP, Gins W, Moore ID, Ortiz-Cortes A, Raggio A, Warbinek J. High-precision measurements of the hyperfine structure of cobalt ions in the deep ultraviolet range. Sci Rep 2023; 13:4783. [PMID: 36959230 PMCID: PMC10036477 DOI: 10.1038/s41598-023-31378-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
High-precision hyperfine structure measurements were performed on stable, singly-charged [Formula: see text]Co ions at the IGISOL facility in Jyväskylä, Finland using the collinear laser spectroscopy technique. A newly installed light collection setup enabled the study of transitions in the 230 nm wavelength range from low-lying states below 6000 cm[Formula: see text]. We report a 100-fold improvement on the precision of the hyperfine A parameters, and furthermore present newly measured hyperfine B paramaters.
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Affiliation(s)
- Á Koszorús
- Department of Physics, University of Liverpool, Liverpool, L69 7ZE, United Kingdom.
- Experimental Physics Department, CERN, CH1211, Geneva 23, Switzerland.
| | - M Block
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
- Helmholtz Institute Mainz, 55099, Mainz, Germany
- Department of Chemistry - TRIGA site, University of Mainz, 55099, Mainz, Germany
| | - P Campbell
- Department of Physics and Astronomy, University of Manchester, Manchester, M13 9PL, United Kingdom
| | - B Cheal
- Department of Physics, University of Liverpool, Liverpool, L69 7ZE, United Kingdom
| | - R P de Groote
- Department of Physics, University of Jyväskylä, PB 35(YFL), 40351, Jyväskylä, Finland
- Instituut voor Kern- en Stralingsfysica, KU Leuven, 3001, Leuven, Belgium
| | - W Gins
- Department of Physics, University of Jyväskylä, PB 35(YFL), 40351, Jyväskylä, Finland
| | - I D Moore
- Department of Physics, University of Jyväskylä, PB 35(YFL), 40351, Jyväskylä, Finland
| | - A Ortiz-Cortes
- Department of Physics, University of Jyväskylä, PB 35(YFL), 40351, Jyväskylä, Finland
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, Caen, France
| | - A Raggio
- Department of Physics, University of Jyväskylä, PB 35(YFL), 40351, Jyväskylä, Finland
| | - J Warbinek
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291, Darmstadt, Germany
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Tan JLC, Wellard C, Moore EM, Mollee P, Rajagopal R, Quach H, Harrison SJ, McDonald EJ, Ho PJ, Prince HM, Augustson BM, Campbell P, McQuilten ZK, Wood EM, Spencer A. The second revision of the International Staging System (R2-ISS) stratifies progression-free and overall survival in multiple myeloma: Real world data results in an Australian and New Zealand Population. Br J Haematol 2023; 200:e17-e21. [PMID: 36321478 DOI: 10.1111/bjh.18536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Joanne L C Tan
- The Alfred Hospital, Monash University and Australian Centre for Blood Diseases, Melbourne, Victoria, Australia
| | - Cameron Wellard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Elizabeth M Moore
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter Mollee
- Princess Alexandra Hospital, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Hang Quach
- St. Vincent's Hospital, Melbourne, Victoria, Australia
| | - Simon James Harrison
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | | | - P Joy Ho
- Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - H Miles Prince
- Epworth Healthcare and Sir Peter MacCallum Department of Oncology University of Melbourne, Parkville, Victoria, Australia
| | | | | | - Zoe K McQuilten
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Erica M Wood
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Andrew Spencer
- The Alfred Hospital, Monash University and Australian Centre for Blood Diseases, Melbourne, Victoria, Australia
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Boamah B, Barnsley S, Finch L, Briens J, Siciliano S, Hogan N, Hecker M, Hanson M, Campbell P, Peters R, Manek A, Al-Dissi AN, Weber L. Target Organ Toxicity in Rats After Subchronic Oral Exposure to Soil Extracts Containing a Complex Mixture of Contaminants. Arch Environ Contam Toxicol 2023; 84:85-100. [PMID: 36577861 DOI: 10.1007/s00244-022-00972-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Complex mixtures of unknown contaminants present a challenge to identify toxicological risks without using large numbers of animals and labor-intensive screens of all organs. This study examined soil extracts from a legacy-contaminated pesticide packaging and blending site. HepG2 cytotoxicity was used as an initial screen of 18 soil samples; then, three extracts (A, B and C) from different locations at the study site were used for testing in animals. The first two extracts were identified as the most toxic in vitro, and the latter extract obtained from a location further from these two toxic sampling sites. Then, target organ toxicities were identified following biweekly oral gavage for one month of three soil extracts (0.1% in polyethylene glycol or PEG) compared to vehicle control in male Sprague-Dawley rats (n = 9-10/group). Exposure to extract A significantly increased neutrophils and lymphocytes compared to control. In contrast, all extracts increased plasma α-2 macroglobulin and caused mild-to-moderate lymphocytic proliferation within the spleen white pulp, all indicative of inflammation. Rats exposed to all soil extracts exhibited acute tubular necrosis. Cholinesterase activity was significantly reduced in plasma, but not brain, after exposure to extract A compared to control. Increased hepatic ethoxyresorufin-o-deethylase activity compared to control was observed following exposure to extracts A and B. Exposure to soil extract C in rats showed a prolonged QTc interval in electrocardiography as well as increased brain lipid peroxidation. Candidate contaminants are organochlorine, organophosphate/carbamate pesticides or metabolites. Overall, HepG2 cytotoxicity did not successfully predict the neurotoxicity and cardiotoxicity observed with extract C but was more successful with suspected hydrocarbon toxicities in extracts A and B. Caution should be taken when extrapolating the observation of no effects from in vitro cell culture to in vivo toxicity, and better cell culture lines or assays should be explored.
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Affiliation(s)
- B Boamah
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - S Barnsley
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - L Finch
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - J Briens
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - S Siciliano
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - N Hogan
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - M Hecker
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada
| | - M Hanson
- Environment and Geography, University of Manitoba, Winnipeg, MB, Canada
| | - P Campbell
- Wood Environment & Infrastructure Solutions, Winnipeg, MB, Canada
| | - R Peters
- Federated Co-Operatives Limited, Saskatoon, SK, Canada
| | - A Manek
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - A N Al-Dissi
- Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - L Weber
- Toxicology Centre, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK, S7N 5B4, Canada.
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Burbury K, Brooks P, Gilham L, Solo I, Piper A, Underhill C, Campbell P, Blum R, Brown S, Barnett F, Torres J, Wang X, Poole W, Grobler A, Johnston G, Beer C, Cross H, Wong ZW. Telehealth in cancer care during the COVID-19 pandemic. J Telemed Telecare 2022:1357633X221136305. [PMID: 36484151 PMCID: PMC9742741 DOI: 10.1177/1357633x221136305] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/14/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The Victorian COVID-19 Cancer Network (VCCN) Telehealth Expert Working Group aimed to evaluate the telehealth (TH) experience for cancer patients, carers and clinicians with the rapid uptake of TH in early 2020 during the COVID-19 pandemic. METHODS We conducted a prospective multi-centre cross-sectional survey involving eight Victorian regional and metropolitan cancer services and three consumer advocacy groups. Patients or their carers and clinicians who had TH consultations between 1 July 2020 and 31 December 2020 were invited to participate in patient and clinician surveys, respectively. These surveys were opened from September to December 2020. RESULTS The acceptability of TH via both video (82.9%) and phone (70.4%) were high though acceptability appeared to decrease in older phone TH users. Video was associated with higher satisfaction compared to phone (87.1% vs 79.7%) even though phone was more commonly used. Various themes from the qualitative surveys highlighted barriers and enablers to rapid TH implementation. DISCUSSION The high TH acceptability supports this as a safe and effective strategy for continued care and should persist beyond the pandemic environment, where patient preferences are considered and clinically appropriate. Ongoing support to health services for infrastructure and resources, as well as expansion of reimbursement eligibility criteria for patients and health professionals, including allied health and nursing, are crucial for sustainability.
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Affiliation(s)
- Kate Burbury
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Department of Haematology Peter MacCallum Cancer Centre, Melbourne Health, Victoria, Australia
| | - Peter Brooks
- Centre for Health Policy, University of Melbourne School of Population and Global Health, Parkville, Victoria, Australia
- Northern Health, Epping, Victoria, Australia
| | - Leslie Gilham
- Breast Cancer Network Australia, Camberwell, Victoria, Australia
| | - Ilana Solo
- Loddon Mallee Integrated Cancer Service, Bendigo Health
| | - Amanda Piper
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Craig Underhill
- Border Medical Oncology, Research Unit, Albury, NSW, Australia
- Latrobe University, Wodonga, Victoria, Australia
- Victorian Comprehensive Cancer Centre Alliance, Parkville, Australia
- UNSW School of Clinical Medicine, Rural Clinical Campus, Albury, NSW, Australia
| | - Philip Campbell
- Barwon Health, Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Robert Blum
- Bendigo Health Cancer Centre, Bendigo, Victoria, Australia
| | - Stephen Brown
- Ballarat Regional Integrated Cancer Centre, Ballarat, Victoria, Australia
| | - Frances Barnett
- Cancer Services, Northern Hospital, Epping, Victoria, Australia
| | - Javier Torres
- Goulburn Valley Health, Shepparton, West Hume Integrated Cancer Services, Melbourne University - Shepparton Clinical School, Victoria, Australia
| | - Xiaofang Wang
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | | | - Anneke Grobler
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | | | - Cassandra Beer
- Victorian Comprehensive Cancer Centre Alliance, Parkville, Australia
| | - Hannah Cross
- Victorian Comprehensive Cancer Centre Alliance, Parkville, Australia
| | - Zee Wan Wong
- Peninsula Health, Frankston, Victoria, Australia
- Monash University, Peninsula Clinical School, Frankston, Victoria, Australia
- Southern Melbourne Integrated Cancer Service, Melbourne, Victoria, Australia
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Ghia P, Pluta A, Wach M, Lysak D, Šimkovič M, Kriachok I, Illés Á, de la Serna J, Dolan S, Campbell P, Musuraca G, Jacob A, Avery EJ, Lee JH, Usenko G, Wang MH, Yu T, Jurczak W. Acalabrutinib Versus Investigator’s Choice in Relapsed/Refractory Chronic Lymphocytic Leukemia: Final ASCEND Trial Results. Hemasphere 2022; 6:e801. [PMID: 36398134 PMCID: PMC9666115 DOI: 10.1097/hs9.0000000000000801] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022] Open
Abstract
Acalabrutinib is a Bruton tyrosine kinase inhibitor approved for patients with chronic lymphocytic leukemia (CLL). ASCEND is the pivotal phase 3 study of acalabrutinib versus investigator’s choice of idelalisib plus rituximab (IdR) or bendamustine plus rituximab (BR) in patients with relapsed/refractory (R/R) CLL. In the primary ASCEND analysis (median 16.1-month follow-up), acalabrutinib showed superior efficacy with an acceptable tolerability profile versus IdR/BR; here, we report final ~4 year follow-up results. Patients with R/R CLL received oral acalabrutinib 100 mg twice daily until progression or unacceptable toxicity, or investigator’s choice of IdR or BR. A total of 310 patients (acalabrutinib, n = 155; IdR, n = 119; BR, n = 36) were enrolled. At median follow-up of 46.5 months (acalabrutinib) and 45.3 months (IdR/BR), acalabrutinib significantly prolonged investigator-assessed progression-free survival (PFS) versus IdR/BR (median, not reached [NR] vs 16.8 months; P < 0.001); 42-month PFS rates were 62% (acalabrutinib) versus 19% (IdR/BR). Median overall survival (OS) was NR (both arms); 42-month OS rates were 78% (acalabrutinib) versus 65% (IdR/BR). Adverse events led to drug discontinuation in 23%, 67%, and 17% of patients in the acalabrutinib, IdR, and BR arms, respectively. Events of clinical interest (acalabrutinib vs IdR/BR) included all-grade atrial fibrillation/flutter (8% vs 3%), all-grade hypertension (8% vs 5%), all-grade major hemorrhage (3% vs 3%), grade ≥3 infections (29% vs 29%), and second primary malignancies excluding nonmelanoma skin cancer (7% vs 2%). At ~4 years follow-up, acalabrutinib maintained favorable efficacy versus standard-of-care regimens and a consistent tolerability profile in patients with R/R CLL.
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Simas V, Orr R, Schram B, Canetti E, Campbell P, Pope R. Occupational factors associated with the development of spondylosis in physically demanding occupations: a rapid review. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Campbell P, Canetti E, Simas V, Schram B, Pope R, Orr R. Risk factors for the development of glenohumeral dislocations in tactical populations: a systematic review. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Canetti E, Schram B, Simas V, Campbell P, Orr R, Pope R. Risk factors for the development of femoroacetabular impingement in physically demanding occupations: a systematic review. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Schram B, Canetti E, Simas V, Campbell P, Pope R, Orr R. Occupational risk factors for the development of disc herniation in physically demanding occupations: a rapid review. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Campbell P, Canetti E, Simas V, Schram B, Pope R, Orr R. Risk factors for the development of Superior Labrum Anterior to Posterior (SLAP) tears in physically demanding occupations: a systematic review and meta-analysis. J Sci Med Sport 2022. [DOI: 10.1016/j.jsams.2022.09.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Stevens KN, Creanor S, Jeffery A, Whone A, Zajicek J, Foggo A, Jones B, Chapman R, Cocking L, Wilks J, Webb D, Carroll C, Inches J, Underwood D, Frost J, James A, Schofield C, James R, O’Reilly C, Sheridan R, Statton S, Goff A, Russell T, Whitcher A, Craw S, Lewis A, Sophia R, Amar K, Hernandez R, Pitcher A, Carvey S, Hamlin R, Lyell V, Aubry L, Carey G, Coebergh J, Mojela I, Molloy S, Berceruelo Bergaz Y, Camera B, Campbell P, Morris H, Samakomva T, Schrag A, Fuller S, Misbahuddin A, Parker L, Visentin E, Gallehawk S, Rudd J, Singh S, Wilson S, Creven J, Croucher Y, Tluk S, Watts P, Hargreaves S, Johnson D, Worboys L, Worth P, Brooke J, Kobylecki C, Parker V, Johnson L, Joseph R, Melville J, Raw J, Birt J, Hare M, Shaik S, Alty J, Cosgrove J, Burn D, Green A, McNichol A, Pavese N, Pilkington H, Price M, Walker K, Chaudhuri R, Podlewska A, Reddy P, Trivedi D, Bandmann O, Clegg R, Cole G, Emery A, Dostal V, Graham J, Keshet-Price J, Mamutse G, Miller-Fik A, Wiltshire A, Wright C, Dixon K, Abdelhafiz A, Rose J. Evaluation of Simvastatin as a Disease-Modifying Treatment for Patients With Parkinson Disease: A Randomized Clinical Trial. JAMA Neurol 2022; 79:1232-1241. [PMID: 36315128 PMCID: PMC9623477 DOI: 10.1001/jamaneurol.2022.3718] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Importance Current treatments manage symptoms of Parkinson disease (PD), but no known treatment slows disease progression. Preclinical and epidemiological studies support the potential use of statins as disease-modifying therapy. Objective To determine whether simvastatin has potential as a disease-modifying treatment for patients with moderate PD. Design, Setting, and Participants This randomized clinical trial, a double-blind, parallel-group, placebo-controlled futility trial, was conducted between March 2016 and May 2020 within 23 National Health Service Trusts in England. Participants aged 40 to 90 years with a diagnosis of idiopathic PD, with a modified Hoehn and Yahr stage of 3.0 or less while taking medication, and taking dopaminergic medication with wearing-off phenomenon were included. Data were analyzed from May 2020 to September 2020, with additional analysis in February 2021. Interventions Participants were allocated 1:1 to simvastatin or matched placebo via a computer-generated random sequence, stratified by site and Hoehn and Yahr stage. In the simvastatin arm, participants entered a 1-month phase of simvastatin, 40 mg daily, followed by 23 months of simvastatin, 80 mg daily, before a 2-month washout period. Main Outcomes and Measures The prespecified primary outcome was 24-month change in Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) part III score measured while not taking medication (high scores indicate worse outcome). The primary futility analysis included participants who commenced the 80-mg phase and had valid primary outcome data. The safety analysis included all participants who commenced trial treatment and is reported by dose at time of event. Results Of 332 patients assessed for eligibility, 32 declined and 65 were ineligible. Of 235 recruited participants, 97 (41%) were female, 233 (99%) were White, and the mean (SD) age was 65.4 (9.4) years. A total of 216 patients progressed to the 80-mg dose. Primary outcome analysis (n = 178) indicated the simvastatin group had an additional deterioration in MDS-UPDRS III score while not taking medication at 24 months compared with the placebo group (1.52 points; 2-sided 80% CI, -0.77 to 3.80; 1-sided futility test P = .006). A total of 37 serious adverse events (AEs), including 3 deaths, and 171 AEs were reported for participants receiving 0-mg simvastatin; 37 serious AEs and 150 AEs were reported for participants taking 40 mg or 80 mg of simvastatin. Four participants withdrew from the trial because of an AE. Conclusions and Relevance In this randomized clinical trial, simvastatin was futile as a disease-modifying therapy in patients with PD of moderate severity, providing no evidence to support proceeding to a phase 3 trial. Trial Registration ISRCTN Identifier: 16108482.
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Affiliation(s)
- Kara N. Stevens
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom,Exploristics Ltd, Belfast, United Kingdom
| | - Siobhan Creanor
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Alison Jeffery
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Alan Whone
- Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - John Zajicek
- School of Medicine, Medical and Biological Sciences, University of St Andrews, St Andrews, United Kingdom
| | - Andy Foggo
- School of Biological and Marine Sciences, Faculty of Science and Engineering, University of Plymouth, Plymouth, United Kingdom
| | - Ben Jones
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Rebecca Chapman
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Laura Cocking
- NIHR BioResource, University of Cambridge, Cambridge, United Kingdom
| | - Jonny Wilks
- MAC Clinical Research, Blackpool, United Kingdom
| | - Doug Webb
- Bristol Trials Centre, University of Bristol, Bristol, United Kingdom
| | - Camille Carroll
- Faculty of Health, University of Plymouth, Plymouth, United Kingdom
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Jasinska-Piadlo A, Bond R, Biglarbeigi P, Brisk R, Campbell P, Browne F, McEneaneny D. Data-driven versus a domain-led approach to k-means clustering on an open heart failure dataset. Int J Data Sci Anal 2022. [DOI: 10.1007/s41060-022-00346-9] [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: 10/16/2022]
Abstract
AbstractDomain-driven data mining of health care data poses unique challenges. The aim of this paper is to explore the advantages and the challenges of a ‘domain-led approach’ versus a data-driven approach to a k-means clustering experiment. For the purpose of this experiment, clinical experts in heart failure selected variables to be used during the k-means clustering, whilst during the ‘data-driven approach’ feature selection was performed by applying principal component analysis to the multidimensional dataset. Six out of seven features selected by physicians were amongst 26 features that contributed most to the significant principal components within the k-means algorithm. The data-driven approach showed advantage over the domain-led approach for feature selection by removing the risk of bias that can be introduced by domain experts. Whilst the ‘domain-led approach’ may potentially prohibit knowledge discovery that can be hidden behind variables not routinely taken into consideration as clinically important features, the domain knowledge played an important role at the interpretation stage of the clustering experiment providing insight into the context and preventing far fetched conclusions. The “data-driven approach” was accurate in identifying clusters with distinct features at the physiological level. To promote the domain-led data mining approach, as a result of this experiment we developed a practical checklist guiding how to enable the integration of the domain knowledge into the data mining project.
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Jurczak W, Pluta A, Wach M, Lysak D, Simkovic M, Kriachok I, Illés Á, De La Serna J, Dolan S, Campbell P, Musuraca G, Jacob A, Avery EJ, Lee JH, Usenko G, Wang MH, Yu T, Ghia P. Acalabrutinib versus rituximab plus idelalisib or bendamustine in relapsed/refractory chronic lymphocytic leukemia: ASCEND results at 4 years of follow-up. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7538 Background: Acalabrutinib (acala) is a next-generation, highly selective, covalent Bruton tyrosine kinase (BTK) inhibitor approved for patients (pts) with chronic lymphocytic leukemia (CLL). In the primary analysis of ASCEND (median follow-up 16.1 mo), acala showed superior efficacy with an acceptable tolerability profile vs idelalisib (Id) plus rituximab (R) (IdR) or bendamustine (B) plus R (BR) in pts with relapsed/refractory (R/R) CLL (Ghia et al. J Clin Oncol. 2020;38:2849-2861). We report the results of the ASCEND study at ~4 years of follow-up. Methods: In this multicenter, randomized, open-label, phase 3 study (NCT02970318), pts with R/R CLL received oral (PO) acala 100 mg BID until progression or unacceptable toxicity or investigator’s (INV) choice of IdR (Id: 150 mg PO BID until progression or unacceptable toxicity; R: 375 mg/m2 x1 then 500 mg/m2 IV [8 total infusions]) or BR (B: 70 mg/m2 IV; R: 375 mg/m2 x1 then 500 mg/m2 IV [6 cycles]). Progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and safety were assessed. Results: A total of 310 pts (acala, n=155; IdR, n=119; BR, n=36) were randomized (median age 67 y; del(17p) 15%, unmutated IGHV 74%, Rai stage 3/4 42%). At median follow-up of 46.5 mo (acala) and 45.3 mo (IdR/BR), acala significantly prolonged INV-assessed PFS vs IdR/BR (median not reached [NR] vs 16.8 mo; P<0.0001); 42-mo PFS rates were 62% for acala vs 19% for IdR/BR. In pts with del(17p), median PFS was NR (acala) vs 13.8 mo (IdR/BR; P<0.0001). In pts with unmutated IGHV, median PFS was NR (acala) vs 16.2 mo (IdR/BR; P<0.0001). Median OS was NR in both arms; 42-mo OS rates were 78% (acala) vs 65% (IdR/BR). ORR was 83% (acala) vs 84% (IdR/BR) (ORR + partial response with lymphocytosis: 92% [acala] vs 88% [IdR/BR]). AEs led to drug discontinuation in 23% of acala, 67% of IdR, and 17% of BR pts. Events of clinical interest (acala vs IdR/BR) included all-grade atrial fibrillation/flutter (8% vs 3%), all-grade hypertension (8% vs 5%), all-grade major hemorrhage (3% vs 3%), and grade ≥3 infections (29% vs 29%). Conclusions: At ~4 years of follow-up, acala maintained efficacy compared with standard-of-care regimens and a consistent tolerability profile in R/R CLL. Clinical trial information: NCT02970318. [Table: see text]
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Affiliation(s)
- Wojciech Jurczak
- Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, Poland
| | - Andrzej Pluta
- Department of Hematological Oncology, Oncology Specialist Hospital, Brzozow, Poland
| | - Malgorzata Wach
- Department of Hemato-Oncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Daniel Lysak
- Fakultní Nemocnice Plzen, Pilsen, Czech Republic
| | - Martin Simkovic
- University Hospital Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | | | - Árpád Illés
- University of Debrecen, Faculty of Medicine, Department of Hematology, Debrecen, Hungary
| | | | - Sean Dolan
- Saint John Regional Hospital, University of New Brunswick, New Brunswick, NB, Canada
| | - Philip Campbell
- Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia
| | - Gerardo Musuraca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy
| | - Abraham Jacob
- The Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
| | | | - Jae Hoon Lee
- Gachon University Gil Medical Center, Inchon, South Korea
| | - Ganna Usenko
- City Clinical Hospital No. 4 DCC, Dnipro, Ukraine
| | | | - Ting Yu
- AstraZeneca, South San Francisco, CA
| | - Paolo Ghia
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
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Batlevi CL, Park SI, Phillips TJ, Amengual J, Andorsky DJ, Campbell P, McKay P, Leonard JP, Sondhi M, Yang J, Chen Y, O'Connor H, Slatcher P, Morschhauser F. Updated interim analysis of the randomized phase 1b/3 study of tazemetostat in combination with lenalidomide and rituximab in patients with relapsed/refractory follicular lymphoma. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7572 Background: Tazemetostat (TAZ), an enhancer of zeste homolog 2 (EZH2) inhibitor, showed antitumor activity as monotherapy in patients with relapsed or refractory (R/R) follicular lymphoma (FL) who received ≥2 prior lines of therapy. In clinical studies in patients with R/R FL, lenalidomide and rituximab (R2) demonstrated an objective response rate (ORR) of 73%–78% and median progression-free survival (PFS) of 36–39 months. This global, multicenter phase 1b/3 study is designed to determine the recommended phase 3 dose (RP3D), efficacy, and safety of TAZ + R2 in patients with R/R FL after ≥1 prior therapy. We report an updated interim analysis of the phase 1b safety run-in where we assess the clinical activity and pharmacokinetics (PK) of TAZ when administered with R2 in patients with R/R FL. Methods: Phase 1b evaluated TAZ at 3 dose levels (400, 600, and 800 mg orally twice daily) in 28-day cycles with standard-dose R2 (NCT04224493). In addition to PK and safety, preliminary efficacy analysis was performed on the response-evaluable population, including best overall response, PFS, and duration of response (DOR) per investigator assessment according to Lugano 2014 response criteria. Results: As of January 22, 2022, 43 patients were enrolled and receiving TAZ + R2 (400 [n = 4], 600 [n = 18], and 800 mg [n = 21]). These patients had a median age of 67 years (range, 39–83) and received a median of 1 prior therapy (range, 1–4). Overall, 15/43 (34.9%) patients were refractory to rituximab, 10/39 (25.6%) had POD24, and 6/41 (14.6%) had mutant-type EZH2. Median duration of treatment exposure was 32.0 weeks (range, 4.1–68.1). Mean Cmax and AUC0–t of TAZ 800 mg + R2 at steady state were similar to those found for TAZ as monotherapy. PK of TAZ was not altered by concomitant administration of daily oral lenalidomide 20 mg, and PK of lenalidomide was not altered by concomitant administration of TAZ. No dose-limiting toxicities were observed in phase 1b, and no new safety signals were identified as of the January 2022 data cutoff. Serious treatment-emergent adverse events (TEAEs) were observed in 14 (32.6%) patients. Grade 3–4 TEAEs were observed in 24 (55.8%) patients; the most common grade 3–4 TEAE was neutrophil count decrease (n = 13; 30.2%). Of 38 patients evaluable for tumor assessment, 19 (50.0%) had a complete response, 17 (44.7%) had a partial response, and 2 (5.3%) had stable disease. ORR was 94.7% (n = 36). With a median follow-up of 5.8 months, median PFS and DOR were not reached and appeared to be similar, regardless of mutation status. Conclusions: TAZ + R2 combination demonstrates consistent and unaltered PK for TAZ and lenalidomide as well as a favorable safety profile and efficacy trend. The 2-arm randomized phase 3 portion will further explore the efficacy and safety of TAZ RP3D 800 mg + R2 in ≈500 patients with R/R FL. Clinical trial information: NCT04224493.
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Affiliation(s)
| | | | | | | | | | - Philip Campbell
- Barwon Health, University Hospital Geelong, Geelong, VIC, Australia
| | - Pamela McKay
- Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom
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Campbell P, Harvey J, Morris H, Schapira A. 236 Systemic mitochondrial dysfunction in monogenic Parkinson’s disease as a potential biomarker for stratification. J Neurol Neurosurg Psychiatry 2022. [DOI: 10.1136/jnnp-2022-abn.265] [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: 11/04/2022]
Abstract
To investigate the use of PBMCs as a biomarker of mitochondrial dysfunction in Parkinson disease (PD) fresh peripheral blood mononuclear cells (PBMCs) were isolated using Ficoll gradient separation from PD patients with pathogenic biallelic parkin mutations as well as healthy controls (HC). PBMC mitochondrial function was analysed using Seahorse XF respirometry and flow cytometric assessment of mitochondrial membrane potential (Δψm) using TMRE staining.Nine parkin PD patients (average age 45.2yrs, 66% male) and 41 healthy controls (average age 57.8yrs, 58% female) were sampled for the study. Parkin patients had increased oxygen consumption related to proton leak, reduced maximal respiration and reduced spare respiratory after correction for age (p<0.01). Additionally Parkin patients were found to have reduced resting Δψm and reduced oxygen consumption related to ATP production (p<0.01). Basal oxygen consumption was similar between Parkin patients and healthy controls.These findings are in keeping with parkin’s role in removing dysfunctional mitochondria through mitophagy. The finding of normal basal oxygen consumption suggests that dysfunction is most pronounced when cells are under stress, during high ATP demand. This ‘signature’ of mitochondrial dysfunction could be applied to idiopathic PD patients to define a mitochondrial subgroup, in which personalised, stratified therapeutics could be targeted.p.campbell@ucl.ac.uk
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Geldhof S, Kortelainen M, Beliuskina O, Campbell P, Caceres L, Cañete L, Cheal B, Chrysalidis K, Devlin CS, de Groote RP, de Roubin A, Eronen T, Ge Z, Gins W, Koszorus A, Kujanpää S, Nesterenko D, Ortiz-Cortes A, Pohjalainen I, Moore ID, Raggio A, Reponen M, Romero J, Sommer F. Impact of Nuclear Deformation and Pairing on the Charge Radii of Palladium Isotopes. Phys Rev Lett 2022; 128:152501. [PMID: 35499902 DOI: 10.1103/physrevlett.128.152501] [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] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/01/2022] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
The impact of nuclear deformation can been seen in the systematics of nuclear charge radii, with radii generally expanding with increasing deformation. In this Letter, we present a detailed analysis of the precise relationship between nuclear quadrupole deformation and the nuclear size. Our approach combines the first measurements of the changes in the mean-square charge radii of well-deformed palladium isotopes between A=98 and A=118 with nuclear density functional calculations using Fayans functionals, specifically Fy(std) and Fy(Δr,HFB), and the UNEDF2 functional. The changes in mean-square charge radii are extracted from collinear laser spectroscopy measurements on the 4d^{9}5s ^{3}D_{3}→4d^{9}5p ^{3}P_{2} atomic transition. The analysis of the Fayans functional calculations reveals a clear link between a good reproduction of the charge radii for the neutron-rich Pd isotopes and the overestimated odd-even staggering: Both aspects can be attributed to the strength of the pairing correlations in the particular functional which we employ.
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Affiliation(s)
- S Geldhof
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
- KU Leuven, Instituut voor Kern- en Stralingsfysica, 3001 Leuven, Belgium
| | - M Kortelainen
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - O Beliuskina
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - P Campbell
- Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, United Kingdom
| | - L Caceres
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, 14000 Caen, France
| | - L Cañete
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - B Cheal
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | | | - C S Devlin
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - R P de Groote
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - A de Roubin
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - T Eronen
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - Z Ge
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - W Gins
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - A Koszorus
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - S Kujanpää
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - D Nesterenko
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - A Ortiz-Cortes
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
- Grand Accélérateur National d'Ions Lourds (GANIL), CEA/DSM-CNRS/IN2P3, 14000 Caen, France
| | - I Pohjalainen
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, 64291 Darmstadt, Germany
| | - I D Moore
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - A Raggio
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - M Reponen
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
| | - J Romero
- Accelerator Laboratory, Department of Physics, University of Jyväskylä, 40014 Jyväskylä, Finland
- Department of Physics, University of Liverpool, Liverpool L69 7ZE, United Kingdom
| | - F Sommer
- Institut für Kernphysik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
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Jasinska-Piadlo A, Bond R, Biglarbeigi P, Brisk R, Campbell P, McEneaneny D. What can machines learn about heart failure? A systematic literature review. Int J Data Sci Anal 2021. [DOI: 10.1007/s41060-021-00300-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AbstractThis paper presents a systematic literature review with respect to application of data science and machine learning (ML) to heart failure (HF) datasets with the intention of generating both a synthesis of relevant findings and a critical evaluation of approaches, applicability and accuracy in order to inform future work within this field. This paper has a particular intention to consider ways in which the low uptake of ML techniques within clinical practice could be resolved. Literature searches were performed on Scopus (2014-2021), ProQuest and Ovid MEDLINE databases (2014-2021). Search terms included ‘heart failure’ or ‘cardiomyopathy’ and ‘machine learning’, ‘data analytics’, ‘data mining’ or ‘data science’. 81 out of 1688 articles were included in the review. The majority of studies were retrospective cohort studies. The median size of the patient cohort across all studies was 1944 (min 46, max 93260). The largest patient samples were used in readmission prediction models with the median sample size of 5676 (min. 380, max. 93260). Machine learning methods focused on common HF problems: detection of HF from available dataset, prediction of hospital readmission following index hospitalization, mortality prediction, classification and clustering of HF cohorts into subgroups with distinctive features and response to HF treatment. The most common ML methods used were logistic regression, decision trees, random forest and support vector machines. Information on validation of models was scarce. Based on the authors’ affiliations, there was a median 3:1 ratio between IT specialists and clinicians. Over half of studies were co-authored by a collaboration of medical and IT specialists. Approximately 25% of papers were authored solely by IT specialists who did not seek clinical input in data interpretation. The application of ML to datasets, in particular clustering methods, enabled the development of classification models assisting in testing the outcomes of patients with HF. There is, however, a tendency to over-claim the potential usefulness of ML models for clinical practice. The next body of work that is required for this research discipline is the design of randomised controlled trials (RCTs) with the use of ML in an intervention arm in order to prospectively validate these algorithms for real-world clinical utility.
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Bradshaw AV, Campbell P, Schapira AHV, Morris HR, Taanman JW. The PINK1-Parkin mitophagy signalling pathway is not functional in peripheral blood mononuclear cells. PLoS One 2021; 16:e0259903. [PMID: 34762687 PMCID: PMC8584748 DOI: 10.1371/journal.pone.0259903] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/28/2021] [Indexed: 12/25/2022] Open
Abstract
Mutations in the PINK1 and PRKN genes are the most common cause of early-onset familial Parkinson disease. These genes code for the PINK1 and Parkin proteins, respectively, which are involved in the degradation of dysfunctional mitochondria through mitophagy. An early step in PINK1 –Parkin mediated mitophagy is the ubiquitination of the mitofusin proteins MFN1 and -2. The ubiquitination of MFN1 and -2 in patient samples may therefore serve as a biomarker to determine the functional effects of PINK1 and PRKN mutations, and to screen idiopathic patients for potential mitophagy defects. We aimed to characterise the expression of the PINK1 –Parkin mitophagy machinery in peripheral blood mononuclear cells (PBMCs) and assess if these cells could serve as a platform to evaluate mitophagy via analysis of MFN1 and -2 ubiquitination. Mitophagy was induced through mitochondrial depolarisation by treatment with the protonophore CCCP and ubiquitinated MFN proteins were analysed by western blotting. In addition, PINK1 and PRKN mRNA and protein expression levels were characterised with reverse transcriptase quantitative PCR and western blotting, respectively. Whilst CCCP treatment led to MFN ubiquitination in primary fibroblasts, SH-SY5Y neuroblastoma cells and Jurkat leukaemic cells, treatment of PBMCs did not induce ubiquitination of MFN. PRKN mRNA and protein was readily detectable in PBMCs at comparable levels to those observed in Jurkat and fibroblast cells. In contrast, PINK1 protein was undetectable and PINK1 mRNA levels were remarkably low in control PBMCs. Our findings suggest that the PINK1 –Parkin mitophagy signalling pathway is not functional in PBMCs. Therefore, PBMCs are not a suitable biosample for analysis of mitophagy function in Parkinson disease patients.
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Affiliation(s)
- Aaron V. Bradshaw
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Philip Campbell
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Anthony H. V. Schapira
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Huw R. Morris
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jan-Willem Taanman
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom
- * E-mail:
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Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
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Connaire S, Elchinova E, Bucciarelli-Ducci C, Campbell P. Cardiac tamponade secondary to Dressler's syndrome. BMJ Case Rep 2021; 14:e243577. [PMID: 34380681 PMCID: PMC8359500 DOI: 10.1136/bcr-2021-243577] [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] [Accepted: 07/27/2021] [Indexed: 11/03/2022] Open
Abstract
A 56-year-old woman presented to hospital with chest pain. Following review and investigations in the medical assessment unit, she was diagnosed with costochondritis and discharged home. She represented 10 days later and was mottled and hypotensive with a high lactate, raised inflammatory markers, an acute kidney injury and bilateral loin pain. A CT of the thorax, abdomen and pelvis showed pleural effusions and a large pericardial effusion with features of cardiac tamponade on subsequent echocardiography. A pericardiocentesis was performed and she was admitted to intensive care for haemofiltration. Once the patient was stable, an inpatient cardiac MRI was requested to further investigate an enhancing pericardium and echo-bright areas in the inferior, inferoseptal and inferolateral walls of the left ventricle demonstrated on echocardiography. The cardiac MRI showed evidence of a recent infarction in the right coronary artery (RCA) territory with pericardial inflammation and a resolved pericardial effusion. Overall, the findings were in keeping with Dressler's syndrome.
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Kalff A, Khong T, Ramachandran M, Walker P, Schwarer A, Roberts AW, Campbell P, Filshie R, Norton S, Reynolds J, Young M, Pierceall W, Thakurta A, Guo M, Oppermann U, Wang M, Ren Y, Kennedy N, Parekh S, Spencer A. Cereblon pathway biomarkers and immune profiles in patients with myeloma receiving post-ASCT lenalidomide maintenance (LEOPARD). Leuk Lymphoma 2021; 62:2981-2991. [PMID: 34263697 DOI: 10.1080/10428194.2021.1948030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
LEOPARD was a single arm, phase II study of lenalidomide (LEN) and alternate day prednisolone maintenance in patients with newly diagnosed multiple myeloma (MM) following autologous stem cell transplantation (ASCT). Sixty patients were enrolled. Estimated median potential follow-up was 44 m, median PFS was 38.3 m, median OS was not reached (landmark 36 m OS: 71.4%). Correlative immunohistochemistry performed on pre-ASCT trephines demonstrated high MM tumor cereblon (total/cytoplasmic) was associated with superior OS (p = .045, p = .031, respectively), whereas high c-Myc was associated with inferior PFS (p = .04). Patients with high cereblon (total/nuclear) were more likely to improve depth of response, whereas patients with high c-Myc were less likely, suggesting alternative/more effective post-ASCT strategies for patients with high c-Myc need identification. Peripheral blood immune profiling (mass cytometry) informed a more sustained response to LEN maintenance, demonstrating enrichment of activated/cytotoxic NK cells and cytotoxic T cells in patients with durable responses, contrasting with enrichment of B-regs in early relapsers.
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Affiliation(s)
- Anna Kalff
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia.,Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Australia.,Department of Clinical Haematology, Monash University, Clayton, Australia
| | - Tiffany Khong
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia.,Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Australia
| | - Malarmathy Ramachandran
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia.,Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Australia
| | - Patricia Walker
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia
| | | | - Andrew W Roberts
- Clinical Haematology Department, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Australia
| | | | | | | | - John Reynolds
- Epidemiology and Preventive Medicine Department, Alfred Health - Monash University, Melbourne, Australia
| | - Mary Young
- Bristol-Myers Squibb Corporation, Summit, NJ, USA
| | | | | | - Manman Guo
- Botnar Research Centre, University of Oxford, Oxford, UK
| | - Udo Oppermann
- Botnar Research Centre, University of Oxford, Oxford, UK
| | - Maria Wang
- Bristol-Myers Squibb Corporation, Summit, NJ, USA
| | - Yan Ren
- Bristol-Myers Squibb Corporation, Summit, NJ, USA
| | - Nola Kennedy
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia
| | - Samir Parekh
- Icahn School of Medicine, Mt Sinai Hospital, New York City, NY, USA
| | - Andrew Spencer
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia.,Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Australia.,Department of Clinical Haematology, Monash University, Clayton, Australia
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Mateos MV, Dimopoulos MA, Cavo M, Suzuki K, Knop S, Doyen C, Lucio P, Nagy Z, Pour L, Grosicki S, Crepaldi A, Liberati AM, Campbell P, Yoon SS, Iosava G, Fujisaki T, Garg M, Iida S, Bladé J, Ukropec J, Pei H, Van Rampelbergh R, Kudva A, Qi M, San-Miguel J. Daratumumab Plus Bortezomib, Melphalan, and Prednisone Versus Bortezomib, Melphalan, and Prednisone in Transplant-Ineligible Newly Diagnosed Multiple Myeloma: Frailty Subgroup Analysis of ALCYONE. Clin Lymphoma Myeloma Leuk 2021; 21:785-798. [PMID: 34344638 DOI: 10.1016/j.clml.2021.06.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND In the phase 3 ALCYONE study, daratumumab plus bortezomib/melphalan/prednisone (D-VMP) versus bortezomib/melphalan/prednisone (VMP) significantly improved progression-free survival (PFS) and overall survival (OS) in transplant-ineligible, newly diagnosed multiple myeloma (NDMM) patients. We present a subgroup analysis of ALCYONE by patient frailty status. PATIENTS AND METHODS Frailty assessment was performed retrospectively using age, Charlson comorbidity index, and baseline Eastern Cooperative Oncology Group performance status score. Patients were classified as fit (0), intermediate (1), or frail (≥2); a nonfrail category combined fit and intermediate patients. RESULTS Among randomized patients (D-VMP, n = 350; VMP, n = 356), 391 (55.4%) were nonfrail (D-VMP, 187 [53.4%]; VMP, 204 [57.3%]) and 315 (44.6%) were frail (163 [46.6%]; 152 [42.7%]). After 40.1-months median follow-up, nonfrail patients had longer PFS and OS than frail patients, but benefits of D-VMP versus VMP were maintained across subgroups: PFS nonfrail (median, 45.7 vs. 19.1 months; hazard ratio [HR], 0.36; P < .0001), frail (32.9 vs. 19.5 months; HR, 0.51; P < .0001); OS nonfrail (36-month rate, 83.6% vs. 74.5%), frail (71.4% vs. 59.0%). Improved greater than or equal to complete response and minimal residual disease (10-5)-negativity rates were observed for D-VMP versus VMP across subgroups. The 2 most common grade 3/4 treatment-emergent adverse events were neutropenia (nonfrail: 39.2% [D-VMP] and 42.4% [VMP]; frail: 41.3% and 34.4%) and thrombocytopenia (nonfrail: 32.8% and 36.9%; frail: 36.9% and 39.1%). CONCLUSION Our findings support the clinical benefit of D-VMP in transplant-ineligible NDMM patients enrolled in ALCYONE, regardless of frailty status.
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Affiliation(s)
- Maria-Victoria Mateos
- University Hospital of Salamanca/IBSAL, Cancer Research Center IBMCC (USAL-CSIC), Salamanca, Spain.
| | | | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università degli Studi, Bologna, Italy
| | - Kenshi Suzuki
- Japanese Red Cross Medical Center, Department of Hematology, Tokyo, Japan
| | - Stefan Knop
- Würzburg University Medical Center, Würzburg, Germany
| | | | - Paulo Lucio
- Champalimaud Centre for the Unknown, Lisbon, Portugal
| | | | - Ludek Pour
- University Hospital Brno, Brno-Bohunice-Brno-Starý Lískovec, Czech Republic
| | - Sebastian Grosicki
- Department of Hematology and Cancer Prevention in Chorzów, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | | | - Anna Marina Liberati
- Università degli Studi di Perugia Azienda Ospedaliera "Santa Maria," Terni, Italy
| | - Philip Campbell
- Andrew Love Cancer Centre, University Hospital Geelong, Geelong, VIC, Australia
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | | | | | - Mamta Garg
- Leicester Royal Infirmary - Haematology, Leicester, United Kingdom
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku Nagoya, Japan
| | - Joan Bladé
- Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | - Huiling Pei
- Janssen Research & Development, LLC, Titusville, NJ
| | | | - Anupa Kudva
- Janssen Research & Development, LLC, Raritan, NJ
| | - Ming Qi
- Janssen Research & Development, LLC, Spring House, PA
| | - Jesus San-Miguel
- Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada (CIMA), Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Navarra, Spain
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Batlevi CL, Salles G, Tilly H, Chaidos A, McKay P, Phillips T, Assouline S, Campbell P, Ribrag V, Damaj GL, Dickinson M, Jurczak W, Kaźmierczak M, Opat S, Radford JR, Schmitt A, Rajarethinam A, Shang G, Morschhauser F. CHARACTERISTICS OF PATIENTS ACHIEVING COMPLETE OR PARTIAL RESPONSE (CR/PR) WITH TAZEMETOSTAT (TAZ) IN WILD‐TYPE RELAPSED/REFRACTORY (R/R) FOLLICULAR LYMPHOMA (FL). Hematol Oncol 2021. [DOI: 10.1002/hon.21_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- C. L. Batlevi
- Memorial Sloan Kettering Cancer Center Lymphoma Service Department of Medicine New York USA
| | - G. Salles
- Lyon‐Sud Hospital University of Lyon Hematology Pierre‐Bénite France
| | - H. Tilly
- Centre Henri Becquerel and Rouen University Department of Haematology and INSERM U1245 Rouen France
| | - A. Chaidos
- Imperial College Healthcare NHS Trust Hammersmith Hospital Department of Medicine London UK
| | - P. McKay
- Beatson West of Scotland Cancer Centre Department of Hematology Glasgow UK
| | - T. Phillips
- University of Michigan Hematology and Oncology Ann Arbor USA
| | - S. Assouline
- Division of Hematology Sir Mortimer B. Davis‐Jewish General Hospital Oncology Montreal Canada
| | - P. Campbell
- Barwon Health University Hospital Geelong Department of Clinical Haematology Geelong Australia
| | - V. Ribrag
- Gustave Roussy Hematology Villejuif France
| | - G. Laurent Damaj
- Hematology Institute University Hospital School of Medicine Hematology Caen France
| | - M. Dickinson
- Peter MacCallum Cancer Centre Royal Melbourne Hospital Department of Clinical Haematology Melbourne Australia
| | - W. Jurczak
- Maria Sklodowska‐Curie National Research Institute of Oncology Department of Hematology Kraków Poland
| | - M. Kaźmierczak
- Poznań University of Medical Sciences Department of Hematology and Bone Marrow Transplantation Poznań Poland
| | - S. Opat
- Monash University Department of Haematology Victoria Australia
| | - J. R. Radford
- University of Manchester NIHR Manchester Clinical Research Facility Manchester Academic Health Science Centre The Christie NHS Foundation Trust Department of Medical Oncology Manchester UK
| | - A. Schmitt
- Institut Bergonié Department of Hematology Bordeaux France
| | | | - G. Shang
- Epizyme, Inc. Medical Affairs Cambridge USA
| | - F. Morschhauser
- Groupe de Recherche sur les formes Injectables et les Technologies Associées CHU de Lille Université de Lille Oncology Lille France
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29
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Er J, Routledge D, Hempton J, Wood C, Joyce T, Harrison S, Campbell P. Autologous stem cell transplantation in elderly multiple myeloma patients aged ≥65 years: a two-centre Australian experience. Intern Med J 2021; 51:280-283. [PMID: 33631863 DOI: 10.1111/imj.15182] [Citation(s) in RCA: 2] [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] [Received: 04/03/2020] [Revised: 12/29/2020] [Accepted: 01/10/2021] [Indexed: 01/03/2023]
Abstract
There are currently limited Australian data on the outcomes of autologous stem cell transplantation (ASCT) in elderly multiple myeloma (MM) patients. We present the largest cohort of elderly MM patients aged ≥65 years undergoing ASCT in Australia and report their outcomes based on our two-centre experience. Our study affirms that ASCT is well tolerated, safe and effective in elderly MM patients aged ≥65 years and should be considered an important component of treatment in patients who are fit enough for the procedure.
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Affiliation(s)
- Jeremy Er
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - David Routledge
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.,Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer Hempton
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Colin Wood
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Trish Joyce
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Simon Harrison
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Philip Campbell
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.,Deakin University, Geelong, Victoria, Australia
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30
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Quach H, Lasica M, Routledge D, Kalff A, Lim A, Low M, Estell JA, Sidiqi MH, Campbell P, Eek RW, Lai HC, McCaughan GJ, D'Rozario J, Browlett P, Rajagopal R, Heenan J, Murphy NE, Renwick W, Huan G, Mollee P. A randomized, open-label, phase 3 study of low-dose selinexor and lenalidomide (Len) versus len maintenance post autologous stem cell transplant (ASCT) for newly diagnosed multiple myeloma (NDMM): ALLG MM23, Sealand. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.tps8055] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS8055 Background: Len maintenance post ASCT is standard of care for patients (pts) with NDMM. Deep responses (CR or better) post ASCT correlates with better progression free survival (PFS). In a meta-analysis of len maintenance post ASCT (McCarthy PL et al. J Clin Oncol. 2017), only 10.7% of pts achieve CR post ASCT, and 72% of pts who discontinued len maintenance did so because of progressive disease (PD). Selinexor is a selective inhibitor of nuclear export that blocks exportin 1, thus retaining tumour suppressor proteins within the nucleus while blocking proto-oncoprotein translation. It is approved in combination with bortezomib and dexamethasone (dex) for pts with MM who have had at least 1 prior line of treatment, or with dex for pts with penta-refractory MM by the FDA. The oral bioavailability and weekly schedule of selinexor makes it suitable in combination with len for maintenance therapy. Given the encouraging activity (ORR 92%) and tolerability of selinexor, len and dex from the phase 1b/2 STOMP study, we hypothesise that combination low-dose selinexor and len (XR) will be well tolerated and effective, increasing CR and MRD negativity rate post ASCT, thus prolonging PFS compared to len. Methods: ALLG MM23 SeaLAND, is an ongoing randomised, multi-centre, phase 3 trial. Eligible pts ( > 17 years of age) have measurable disease, have undergone 3-6 cycles (C) of induction containing a proteasome inhibitor (PI) and/or immunomodulatory drug and recovered post melphalan-conditioned ASCT with adequate haematopoiesis, renal and liver function, and with ECOG performance status. Registration occurs prior to ASCT with screening between 75 to 115 days post ASCT. The study includes a lead-in safety phase of 20 patients with XR: Len 10mg daily days 1 to 21 and Selinexor 40mg weekly in a 28-day cycle. If well tolerated, Selinexor escalates to 60mg po weekly from C2 and Len to 15mg po daily from C4. Two safety reviews will occur after the 10th and 20th patients completes C2, respectively. Upon meeting safety criteria, a sample size of 290 pts will be randomised 1:1 to XR or lenalidomide (R). Therapy will continue until PD. The primary endpoint is PFS at 3 years post randomisation. Secondary endpoints include ORR and MRD-negativity rate (International Myeloma Working Group Response Criteria), PFS on next treatment line (PFS2), OS, safety and tolerability, quality of life, and cost effectiveness. Main analysis occurs after 232 patients complete 3-years of follow-up. Exploratory objective is to correlate immunological and molecular profiles to treatment response and resistance. ALLG MM23 SeaLAND is a multisite bi-national investigator-initiated trial lead by Australia and New Zealand’s national cooperative group, the Australasian Leukaemia & Lymphoma Group. Clinical trial registration: ACTRN12620000291987p. Clinical trial information: 12620000291987.
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Affiliation(s)
- Hang Quach
- St. Vincent’s Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Masa Lasica
- St. Vincent’s Hospital Sydney, Darlinghurst, Australia
| | | | | | - Andrew Lim
- Austin & Repatriation Medical Center, Heidelberg, Victoria, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Georgina Huan
- Australasian Leukaemia & Lymphoma Group (ALLG), Richmond, Australia
| | - Peter Mollee
- Princess Alexandra Hospital, Brisbane, Australia
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31
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Wong D, Barrett R, Rose H, Campbell P. Microangiopathic haemolytic anaemia in metastatic renal cell carcinoma: a tale of two distinct pathophysiologies. Intern Med J 2021; 50:768-769. [PMID: 32537922 DOI: 10.1111/imj.14853] [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] [Received: 06/16/2019] [Revised: 08/30/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Daniel Wong
- Department of Clinical Haematology, University Hospital Geelong, Geelong, Victoria, Australia.,Department of Haematology, Australian Clinical Labs Pathology, Geelong, Victoria, Australia
| | - Rebecca Barrett
- Department of Clinical Haematology, University Hospital Geelong, Geelong, Victoria, Australia.,Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Hannah Rose
- Department of Clinical Haematology, University Hospital Geelong, Geelong, Victoria, Australia.,Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Philip Campbell
- Department of Clinical Haematology, University Hospital Geelong, Geelong, Victoria, Australia.,Deakin University School of Medicine, Geelong, Victoria, Australia
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32
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Matheson LM, Pitson G, Yap CH, Singh M, Collins I, Campbell P, Patrick A, Rogers MJ. Measuring the quality of cancer care in the Barwon South Western region, Victoria, Australia. Int J Qual Health Care 2021; 33:5983668. [PMID: 33196785 DOI: 10.1093/intqhc/mzaa145] [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: 06/30/2020] [Revised: 09/29/2020] [Accepted: 10/29/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The implementation of clinical quality indicators for monitoring cancer care in regional, rural and remote areas. DESIGN Retrospective data from a population-based Clinical Quality Registry for lung, colorectal and breast cancers. SETTING All major health services in the Barwon South Western region, Victoria, Australia. PARTICIPANTS All patients who were diagnosed with cancer and who presented to a health service. INTERVENTION(S) Clinical subgroups to review variations. MAIN OUTCOME MEASURES(S) Clinical quality indicators for lung, colorectal and breast cancers. RESULTS Clinical indicators included the following: discussion at multidisciplinary meetings, the timeliness of care provided and the type of care for different stages of the disease and survival outcomes. Many of the derived clinical indicator targets were reached. However, variations led to an improvement in the tumour stage being recorded in the medical record; an improved awareness of the need for adjuvant chemotherapy for colorectal cancer; a reduction in time to treatment for lung cancer and a reduced time to surgery for breast cancer, and the 30-day mortality post-treatment for all of the tumour streams was highlighted. CONCLUSIONS Clinical quality indicators allow for valuable insights into patterns of care. These indicators are easily reproduced and may be of use to other cancer centres and health services.
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Affiliation(s)
- L M Matheson
- Barwon South Western Regional Integrated Cancer Services, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - G Pitson
- Andrew Love Cancer Centre, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - C H Yap
- Cardiothoracic Surgery, University Hospital Geelong, Geelong, VIC 3220, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - M Singh
- Andrew Love Cancer Centre, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - I Collins
- Dept of Oncology, South West Healthcare, Warrnambool, VIC 3280, Australia and.,School of Medicine, Deakin University, Geelong, VIC 3216, Australia
| | - P Campbell
- Andrew Love Cancer Centre, 70 Swanston Street, Geelong, VIC 3220, Australia.,School of Medicine, Deakin University, Geelong, VIC 3216, Australia
| | - A Patrick
- Barwon South Western Regional Integrated Cancer Services, 70 Swanston Street, Geelong, VIC 3220, Australia
| | - M J Rogers
- Barwon South Western Regional Integrated Cancer Services, 70 Swanston Street, Geelong, VIC 3220, Australia
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33
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Herbst S, Campbell P, Harvey J, Bernard EM, Papayannopoulos V, Wood NW, Morris HR, Gutierrez MG. LRRK2 activation controls the repair of damaged endomembranes in macrophages. EMBO J 2020; 39:e104494. [PMID: 32643832 PMCID: PMC7507578 DOI: 10.15252/embj.2020104494] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [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: 01/17/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 01/15/2023] Open
Abstract
Cells respond to endolysosome damage by either repairing the damage or targeting damaged endolysosomes for degradation via lysophagy. However, the signals regulating the decision for repair or lysophagy are poorly characterised. Here, we show that the Parkinson's disease (PD)‐related kinase LRRK2 is activated in macrophages by pathogen‐ or sterile‐induced endomembrane damage. LRRK2 recruits the Rab GTPase Rab8A to damaged endolysosomes as well as the ESCRT‐III component CHMP4B, thereby favouring ESCRT‐mediated repair. Conversely, in the absence of LRRK2 and Rab8A, damaged endolysosomes are targeted to lysophagy. These observations are recapitulated in macrophages from PD patients where pathogenic LRRK2 gain‐of‐function mutations result in the accumulation of endolysosomes which are positive for the membrane damage marker Galectin‐3. Altogether, this work indicates that LRRK2 regulates endolysosomal homeostasis by controlling the balance between membrane repair and organelle replacement, uncovering an unexpected function for LRRK2, and providing a new link between membrane damage and PD.
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Affiliation(s)
- Susanne Herbst
- Host-Pathogen Interactions in Tuberculosis Laboratory, The Francis Crick Institute, London, UK
| | - Philip Campbell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, UCL Movement Disorders Centre, University College London, London, UK
| | - John Harvey
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, UCL Movement Disorders Centre, University College London, London, UK
| | - Elliott M Bernard
- Host-Pathogen Interactions in Tuberculosis Laboratory, The Francis Crick Institute, London, UK
| | | | - Nicholas W Wood
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, UCL Movement Disorders Centre, University College London, London, UK
| | - Huw R Morris
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, UCL Movement Disorders Centre, University College London, London, UK
| | - Maximiliano G Gutierrez
- Host-Pathogen Interactions in Tuberculosis Laboratory, The Francis Crick Institute, London, UK
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34
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Mullin S, Smith L, Lee K, D'Souza G, Woodgate P, Elflein J, Hällqvist J, Toffoli M, Streeter A, Hosking J, Heywood WE, Khengar R, Campbell P, Hehir J, Cable S, Mills K, Zetterberg H, Limousin P, Libri V, Foltynie T, Schapira AHV. Ambroxol for the Treatment of Patients With Parkinson Disease With and Without Glucocerebrosidase Gene Mutations: A Nonrandomized, Noncontrolled Trial. JAMA Neurol 2020; 77:427-434. [PMID: 31930374 PMCID: PMC6990847 DOI: 10.1001/jamaneurol.2019.4611] [Citation(s) in RCA: 181] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Question Does ambroxol cross the blood-brain barrier, and what are the biochemical changes associated with ambroxol therapy in patients with Parkinson disease with and without glucocerebrosidase gene mutations? Findings In this open-label clinical trial of 17 patients with Parkinson disease, ambroxol crossed the blood-brain barrier and bound to the β-glucocerebrosidase enzyme, and it increased β-glucocerebrosidase enzyme protein levels and cerebrospinal fluid α-synuclein levels in patients both with and without glucocerebrosidase gene mutations. Meaning Ambroxol therapy has potential for study as a neuroprotective compound for the treatment of patients with Parkinson disease both with and without glucocerebrosidase gene mutations. Importance Mutations of the glucocerebrosidase gene, GBA1 (OMIM 606463), are the most important risk factor for Parkinson disease (PD). In vitro and in vivo studies have reported that ambroxol increases β-glucocerebrosidase (GCase) enzyme activity and reduces α-synuclein levels. These observations support a potential role for ambroxol therapy in modifying a relevant pathogenetic pathway in PD. Objective To assess safety, tolerability, cerebrospinal fluid (CSF) penetration, and target engagement of ambroxol therapy with GCase in patients with PD with and without GBA1 mutations. Interventions An escalating dose of oral ambroxol to 1.26 g per day. Design, Setting, and Participants This single-center open-label noncontrolled clinical trial was conducted between January 11, 2017, and April 25, 2018, at the Leonard Wolfson Experimental Neuroscience Centre, a dedicated clinical research facility and part of the University College London Queen Square Institute of Neurology in London, United Kingdom. Participants were recruited from established databases at the Royal Free London Hospital and National Hospital for Neurology and Neurosurgery in London. Twenty-four patients with moderate PD were evaluated for eligibility, and 23 entered the study. Of those, 18 patients completed the study; 1 patient was excluded (failed lumbar puncture), and 4 patients withdrew (predominantly lumbar puncture–related complications). All data analyses were performed from November 1 to December 14, 2018. Main Outcomes and Measures Primary outcomes at 186 days were the detection of ambroxol in the CSF and a change in CSF GCase activity. Results Of the 18 participants (15 men [83.3%]; mean [SD] age, 60.2 [9.7] years) who completed the study, 17 (8 with GBA1 mutations and 9 without GBA1 mutations) were included in the primary analysis. Between days 0 and 186, a 156-ng/mL increase in the level of ambroxol in CSF (lower 95% confidence limit, 129 ng/mL; P < .001) was observed. The CSF GCase activity decreased by 19% (0.059 nmol/mL per hour; 95% CI, –0.115 to –0.002; P = .04). The ambroxol therapy was well tolerated, with no serious adverse events. An increase of 50 pg/mL (13%) in the CSF α-synuclein concentration (95% CI, 14-87; P = .01) and an increase of 88 ng/mol (35%) in the CSF GCase protein levels (95% CI, 40-137; P = .002) were observed. Mean (SD) scores on part 3 of the Movement Disorders Society Unified Parkinson Disease Rating Scale decreased (ie, improved) by 6.8 (7.1) points (95% CI, –10.4 to –3.1; P = .001). These changes were observed in patients with and without GBA1 mutations. Conclusions and Relevance The study results suggest that ambroxol therapy was safe and well tolerated; CSF penetration and target engagement of ambroxol were achieved, and CSF α-synuclein levels were increased. Placebo-controlled clinical trials are needed to examine whether ambroxol therapy is associated with changes in the natural progression of PD. Trial Registration ClinicalTrials.gov identifier: NCT02941822; EudraCT identifier: 2015-002571-24
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Affiliation(s)
- Stephen Mullin
- Department of Clinical and Movement Neurosciences, University College London Institute of Neurology, London, United Kingdom.,Institute of Translational and Stratified Medicine, University of Plymouth School of Medicine, Plymouth, United Kingdom
| | - Laura Smith
- Department of Clinical and Movement Neurosciences, University College London Institute of Neurology, London, United Kingdom
| | - Katherine Lee
- Department of Clinical and Movement Neurosciences, University College London Institute of Neurology, London, United Kingdom
| | - Gayle D'Souza
- NIHR UCLH Clinical Research Facility, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Philip Woodgate
- NIHR UCLH Clinical Research Facility, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Josh Elflein
- NIHR UCLH Clinical Research Facility, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Jenny Hällqvist
- Translational Mass Spectrometry Research Group, University College London Institute of Child Health, London, United Kingdom
| | - Marco Toffoli
- Department of Clinical and Movement Neurosciences, University College London Institute of Neurology, London, United Kingdom
| | - Adam Streeter
- Department of Medical Statistics, University of Plymouth School of Medicine, Plymouth, United Kingdom
| | - Joanne Hosking
- Department of Medical Statistics, University of Plymouth School of Medicine, Plymouth, United Kingdom
| | - Wendy E Heywood
- Translational Mass Spectrometry Research Group, University College London Institute of Child Health, London, United Kingdom
| | - Rajeshree Khengar
- NIHR UCLH Clinical Research Facility, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Philip Campbell
- Department of Clinical and Movement Neurosciences, University College London Institute of Neurology, London, United Kingdom
| | - Jason Hehir
- Neurogenetics Unit, National Hospital for Neurology and Neurosurgery, UCLH NHS Foundation Trust, London, United Kingdom
| | - Sarah Cable
- Department of Clinical and Movement Neurosciences, University College London Institute of Neurology, London, United Kingdom
| | - Kevin Mills
- Translational Mass Spectrometry Research Group, University College London Institute of Child Health, London, United Kingdom
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, University College London Institute of Neurology, London, United Kingdom.,UK Dementia Research Institute at University College London, London, United Kingdom.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Molndal, Sweden.,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Molndal, Sweden
| | - Patricia Limousin
- Department of Clinical and Movement Neurosciences, University College London Institute of Neurology, London, United Kingdom
| | - Vincenzo Libri
- NIHR UCLH Clinical Research Facility, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Tom Foltynie
- Department of Clinical and Movement Neurosciences, University College London Institute of Neurology, London, United Kingdom
| | - Anthony H V Schapira
- Department of Clinical and Movement Neurosciences, University College London Institute of Neurology, London, United Kingdom
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35
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Ghia P, Pluta A, Wach M, Lysak D, Kozak T, Simkovic M, Kaplan P, Kraychok I, Illes A, De La Serna J, Dolan S, Campbell P, Musuraca G, Jacob A, Avery EJ, Lee JH, Wang D, Patel P, Quah CS, Jurczak W. Acalabrutinib (Acala) versus idelalisib plus rituximab (IdR) or bendamustine plus rituximab (BR) in relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL): ASCEND final results. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.8015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8015 Background: Acala is a next-generation, highly selective, covalent Bruton tyrosine kinase inhibitor approved for patients (pts) with CLL including those with R/R CLL. The efficacy and safety of acala alone vs IdR or BR were shown in R/R CLL pts in a preplanned interim analysis of ASCEND; final results are reported herein. Methods: In this randomized, multicenter, phase 3, open-label study (NCT02970318), R/R CLL pts were randomized 1:1 to receive oral (PO) acala 100 mg BID or investigator’s (INV) choice of IdR (Id: 150 mg PO BID until progression or toxicity; R: 375 x1 then 500 mg/m2 intravenously [IV] for 8 total infusions) or BR (B: 70 mg/m2 IV and R: 375 x1 then 500 mg/m2 IV for 6 total cycles) until progression or toxicity. Progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and safety were assessed. Results: 310 pts (acala, n=155; IdR, n=119; BR, n=36) were enrolled (median age: 67 y; del(17p) 16%, del(11q) 27%, Rai stage 3/4 42%). At a median follow-up of 22.0 m, acala significantly prolonged INV-assessed PFS vs IdR/BR (median: not reached vs 16.8 m; hazard ratio: 0.27, P<0.0001); 18-m PFS rates were 82% for acala and 48% for IdR/BR. 18-m OS rate was 88% for both treatment regimens. ORR was 80% with acala vs 84% with IdR/BR (ORR + partial response with lymphocytosis: 92% vs 88%, respectively). Common adverse events (AEs) are listed in the Table. AEs led to drug discontinuation in 16% of acala, 56% of IdR, and 17% of BR pts. AEs of interest included atrial fibrillation (acala 6%, IdR/BR 3%), major hemorrhage (all grade; acala 3%, IdR/BR 3%), grade ≥3 infections (acala 20%, IdR/BR 25%), and second primary malignancies excluding non-melanoma skin cancer (acala 5%, IdR/BR 2%). Conclusions: Final ASCEND results with additional follow-up confirm earlier findings and support the favorable efficacy and safety of acala compared with standard-of-care regimens in R/R CLL pts. Clinical trial information: NCT02970318 . [Table: see text]
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Affiliation(s)
- Paolo Ghia
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrzej Pluta
- Department of Hematological Oncology, Oncology Specialist Hospital, Brzozow, Poland
| | - Malgorzata Wach
- Department of Hemato-Oncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Daniel Lysak
- Fakultní Nemocnice Plzen, Pilsen, Czech Republic
| | - Tomas Kozak
- Fakultní Nemocnice Královske Vinohrady, Prague, Czech Republic
| | - Martin Simkovic
- University Hospital Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | | | | | - Arpad Illes
- University of Debrecen, Faculty of Medicine, Department of Hematology, Debrecen, Hungary
| | | | - Sean Dolan
- Saint John Regional Hospital, University of New Brunswick, Saint John, NB, Canada
| | - Philip Campbell
- Barwon Health, University Hospital Geelong, Geelong, VIC, Australia
| | - Gerardo Musuraca
- Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori, Meldola, Italy
| | - Abraham Jacob
- The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, United Kingdom
| | | | - Jae Hoon Lee
- Gachon University Gil Medical Center, Incheon, South Korea
| | | | | | | | - Wojciech Jurczak
- Maria Sklodowska-Curie National Institute of Oncology, Krakow, Poland
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Saunders B, Hill J, Foster N, Cooper V, Protheroe J, Chudyk A, Graham CC, Campbell P, Bartlam B. Patients’ and general practitioners’ views of stratified care for musculoskeletal pain: qualitative findings from the STarT MSK pilot trial. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.076] [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: 10/24/2022]
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Ruswa N, Mavhunga F, Roscoe JC, Beukes A, Shipiki E, van Gorkom J, Sawadogo S, Agolory S, Menzies H, Tiruneh D, Makumbi B, Bayer B, Zezai A, Campbell P, Alexander H, Kalisvaart N, Forster N. Second nationwide anti-tuberculosis drug resistance survey in Namibia. Int J Tuberc Lung Dis 2020; 23:858-864. [PMID: 31439119 DOI: 10.5588/ijtld.18.0526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: Namibia ranks among the 30 high TB burden countries worldwide. Here, we report results of the second nationwide anti-TB drug resistance survey.OBJECTIVE: To assess the prevalence and trends of multidrug-resistant TB (MDR-TB) in Namibia.METHODS: From 2014 to 2015, patients with presumptive TB in all regions of Namibia had sputum subjected to mycobacterial culture and phenotypic drug susceptibility testing (DST) for rifampicin, isoniazid, ethambutol and streptomycin if positive on smear microscopy and/or Xpert MTB/RIF.RESULTS: Of the 4124 eligible for culture, 3279 (79.5%) had Mycobacterium tuberculosis isolated. 3126 (95%) had a first-line DST completed (2392 new patients, 699 previously treated patients, 35 with unknown treatment history). MDR-TB was detected in 4.5% (95%CI 3.7-5.4) of new patients, and 7.9% (95%CI 6.0-10.1) of individuals treated previously. MDR-TB was significantly associated with previous treatment (OR 1.8, 95%CI 1.3-2.5) but not with HIV infection, sex, age or other demographic factors. Prior treatment failure demonstrated the strongest association with MDR-TB (OR 17.6, 95%CI 5.3-58.7).CONCLUSION: The prevalence of MDR-TB among new TB patients in Namibia is high and, compared with the first drug resistance survey, has decreased significantly among those treated previously. Namibia should implement routine screening of drug resistance among all TB patients.
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Affiliation(s)
- N Ruswa
- Ministry of Health and Social Services, Windhoek, Namibia, KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - F Mavhunga
- Ministry of Health and Social Services, Windhoek, Namibia
| | - J C Roscoe
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Beukes
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - E Shipiki
- Namibia Institute of Pathology, Windhoek, Namibia
| | - J van Gorkom
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - S Sawadogo
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S Agolory
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - H Menzies
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - D Tiruneh
- World Health Organization, Geneva, Switzerland
| | - B Makumbi
- Namibia Institute of Pathology, Windhoek, Namibia
| | - B Bayer
- Ministry of Health and Social Services, Windhoek, Namibia
| | - A Zezai
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - P Campbell
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - H Alexander
- US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - N Kalisvaart
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - N Forster
- Ministry of Health and Social Services, Windhoek, Namibia, International Training & Education Center for Health, Department of Global Health, University of Washington, Seattle, WA, USA
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Bastuba M, Cohen M, Bastuba A, Campbell P. MICROFLUIDIC SPERM SEPARATION DEVICE DRAMATICALLY LOWERS DFI. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.02.096] [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: 10/24/2022]
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Vieira SRL, Toffoli M, Campbell P, Schapira AHV. Biofluid Biomarkers in Parkinson's Disease: Clarity Amid Controversy. Mov Disord 2020; 35:1128-1133. [PMID: 32220025 DOI: 10.1002/mds.28030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/21/2020] [Accepted: 03/03/2020] [Indexed: 01/15/2023] Open
Affiliation(s)
- Sophia R L Vieira
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - Marco Toffoli
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - Philip Campbell
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, United Kingdom
| | - Anthony H V Schapira
- Department of Clinical and Movement Neurosciences, University College London Queen Square Institute of Neurology, London, United Kingdom
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Macintyre AK, Torrens C, Campbell P, Maxwell M, Pollock A, Biggs H, Woodhouse A, Williams JM, McLean J. Socioeconomic inequalities and the equity impact of population-level interventions for adolescent health: an overview of systematic reviews. Public Health 2020; 180:154-162. [PMID: 31923881 DOI: 10.1016/j.puhe.2019.11.008] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 10/29/2019] [Accepted: 11/12/2019] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Despite robust evidence on health inequalities in adulthood, less attention has been paid to inequalities in adolescence. The aim of this overview was to examine systematic review (SR) evidence on the equity impact of population-level interventions intended to improve health, happiness and wellbeing for adolescents. STUDY DESIGN An overview (review of systematic reviews). METHODS Eleven electronic databases were systematically searched to identify SRs of population-level interventions for adolescent health. A secondary data analysis of socioeconomic inequality was conducted to identify whether SRs reported on primary studies in terms of disadvantage, by measures of socioeconomic status (SES) and by differential effects. RESULTS 35,310 review titles were screened; 566 full texts were retrieved and 140 SRs met the predefined selection criteria. Differential intervention effects were considered in 42/140 (30%) SRs, 18/140 (13%) reported primary studies using an SES measure and 16/140 (11%) explicitly reported differential effects. 15/140 SRs (11%) explicitly focused on socioeconomic inequalities; of these 4/15 reported differential intervention effects in more detail, 7/15 concluded there was insufficient primary evidence to identify the impact of interventions on socioeconomic inequalities and 4/15 planned to examine differential effects by SES, but this was not reported further. CONCLUSIONS Our overview identifies that there is limited SR evidence on the equity impact of population-level interventions for adolescent health. Strengthening the evidence on whether interventions narrow or widen inequalities for adolescents must be a priority for public health research.
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Affiliation(s)
- A K Macintyre
- Centre for Health Policy, University of Strathclyde, Lord Hope Building, 141 St. James Road, Glasgow, G4 0LT, UK.
| | - C Torrens
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK
| | - P Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK
| | - M Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, University of Stirling, Unit 13 Scion House, University of Stirling Innovation Park, Stirling, FK9 4NF, UK
| | - A Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK
| | - H Biggs
- Mental Health Foundation, Merchants House, 30 George Square, Glasgow, G2 1EG, UK
| | - A Woodhouse
- Children in Scotland, Level 1, Rosebery House, 9 Haymarket Terrace, Edinburgh, EH12 5EZ, UK
| | - J M Williams
- University of Edinburgh, Room 2.4, Doorway 6, Medical Quad, Teviot Place, Edinburgh, EH8 9AG, UK
| | - J McLean
- Mental Health Foundation, Merchants House, 30 George Square, Glasgow, G2 1EG, UK
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Mateos MV, Cavo M, Blade J, Dimopoulos MA, Suzuki K, Jakubowiak A, Knop S, Doyen C, Lucio P, Nagy Z, Pour L, Cook M, Grosicki S, Crepaldi A, Liberati AM, Campbell P, Shelekhova T, Yoon SS, Iosava G, Fujisaki T, Garg M, Krevvata M, Chen Y, Wang J, Kudva A, Ukropec J, Wroblewski S, Qi M, Kobos R, San-Miguel J. Overall survival with daratumumab, bortezomib, melphalan, and prednisone in newly diagnosed multiple myeloma (ALCYONE): a randomised, open-label, phase 3 trial. Lancet 2020; 395:132-141. [PMID: 31836199 DOI: 10.1016/s0140-6736(19)32956-3] [Citation(s) in RCA: 259] [Impact Index Per Article: 64.8] [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: 11/04/2019] [Revised: 11/20/2019] [Accepted: 11/28/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Standard-of-care treatment for patients with newly diagnosed multiple myeloma includes combination therapies for patients who are not eligible for autologous stem-cell transplantation. At the primary analysis for progression-free survival of the phase 3 ALCYONE trial, progression-free survival was significantly longer with daratumumab in combination with bortezomib, melphalan, and prednisone (D-VMP) versus bortezomib, melphalan, and prednisone (VMP) alone in patients with transplant-ineligible, newly diagnosed multiple myeloma. Here we report updated efficacy and safety results from a prespecified, interim, overall survival analysis of ALCYONE with more than 36 months of follow-up. METHODS ALCYONE was a multicentre, randomised, open-label, active-controlled, phase 3 trial that enrolled patients between Feb 9, 2015, and July 14, 2016, at 162 sites in 25 countries across North America, South America, Europe, and the Asia-Pacific region. Patients were eligible for inclusion if they had newly diagnosed multiple myeloma and were ineligible for high-dose chemotherapy with autologous stem-cell transplantation, because of their age (≥65 years) or because of substantial comorbidities. Patients were randomly assigned in a 1:1 ratio and by permuted block randomisation to receive D-VMP or VMP. An interactive web-based randomisation system was used. Randomisation was stratified by International Staging System disease stage, geographical region, and age. There was no masking to treatment assignments. All patients received up to nine 6-week cycles of subcutaneous bortezomib (1·3 mg/m2 of body surface area on days 1, 4, 8, 11, 22, 25, 29, and 32 of cycle one and on days 1, 8, 22, and 29 of cycles two through nine), oral melphalan (9 mg/m2 once daily on days 1 through 4 of each cycle), and oral prednisone (60 mg/m2 once daily on days 1 through 4 of each cycle). Patients in the D-VMP group also received intravenous daratumumab (16 mg/kg of bodyweight, once weekly during cycle one, once every 3 weeks in cycles two through nine, and once every 4 weeks thereafter as maintenance therapy until disease progression or unacceptable toxicity). The primary endpoint was progression-free survival, which has been reported previously. Results presented are from a prespecified interim analysis for overall survival. The primary analysis population (including for overall survival) was the intention-to-treat population of all patients who were randomly assigned to treatment. The safety population included patients who received any dose of study treatment. This trial is registered with ClinicalTrials.gov, NCT02195479. FINDINGS 706 patients were randomly assigned to treatment groups (350 to the D-VMP group, 356 to the VMP group). At a median follow-up of 40·1 months (IQR 37·4-43·1), a significant benefit in overall survival was observed for the D-VMP group. The hazard ratio (HR) for death in the D-VMP group compared with the VMP group was 0·60 (95% CI 0·46-0·80; p=0·0003). The Kaplan-Meier estimate of the 36-month rate of overall survival was 78·0% (95% CI 73·2-82·0) in the D-VMP group and 67·9% (62·6-72·6) in the VMP group. Progression-free survival, the primary endpoint, remained significantly improved for the D-VMP group (HR 0·42 [0·34-0·51]; p<0·0001). The most frequent adverse events during maintenance daratumumab monotherapy in patients in the D-VMP group were respiratory infections (54 [19%] of 278 patients had upper respiratory tract infections; 42 [15%] had bronchitis, 34 [12%] had viral upper respiratory tract infections), cough (34 [12%]), and diarrhoea (28 [10%]). INTERPRETATION D-VMP prolonged overall survival in patients with newly diagnosed multiple myeloma who were ineligible for stem-cell transplantation. With more than 3 years of follow-up, the D-VMP group continued to show significant improvement in progression-free survival, with no new safety concerns. FUNDING Janssen Research & Development.
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Affiliation(s)
- Maria-Victoria Mateos
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Universitario de Salamanca, Salamanca, Spain.
| | - Michele Cavo
- Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy
| | - Joan Blade
- Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | - Kenshi Suzuki
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | | | - Stefan Knop
- Würzburg University Medical Center, Würzburg, Germany
| | - Chantal Doyen
- CHU UCL Namur, Université catholique de Louvain, Yvoir, Belgium
| | - Paulo Lucio
- Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Zsolt Nagy
- 1st Department of Medicine, Semmelweis University, Budapest, Hungary
| | - Ludek Pour
- University Hospital Brno, Brno, Czech Republic
| | - Mark Cook
- University Hospitals Birmingham NHS Trust, Birmingham, UK
| | - Sebastian Grosicki
- Department of Hematology and Cancer Prevention, Chorzów School of Public Health, Medical University of Silesia, Katowice, Poland
| | - Andre Crepaldi
- Clínica de tratamento e pesquisa em Hematologia e Oncologia, Cuiaba, Brazil
| | | | | | | | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | | | | | - Mamta Garg
- Department of Haematology, Leicester Royal Infirmary, Leicester, UK
| | | | - Ying Chen
- Janssen Research & Development, Raritan, NJ, USA
| | | | - Anupa Kudva
- Janssen Research & Development, Raritan, NJ, USA
| | - Jon Ukropec
- Janssen Global Medical Affairs, Horsham, PA, USA
| | | | - Ming Qi
- Janssen Research & Development, Spring House, PA, USA
| | - Rachel Kobos
- Janssen Research & Development, Raritan, NJ, USA
| | - Jesus San-Miguel
- Centro de Investigación Médica Aplicada (CIMA), Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IDISNA), Centro de Investigación Biomédica en Red de Oncología (CIBERONC), Pamplona, Spain
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Paterson K, Metcalf B, Campbell P, Wrigley T, Kasza J, Bennell K, Hinman R. Associations between static foot posture, in-shoe plantar forces and knee pain in people with medial knee osteoarthritis. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.220] [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]
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Kamper SJ, Michaleff ZA, Campbell P, Dunn KM, Yamato TP, Hodder RK, Wiggers J, Williams CM. Back pain, mental health and substance use are associated in adolescents. J Public Health (Oxf) 2019; 41:487-493. [PMID: 30204888 DOI: 10.1093/pubmed/fdy129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/27/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND During adolescence, prevalence of pain and health risk factors such as smoking, alcohol use and poor mental health all rise sharply. The aim of this study was to describe the relationship between back pain and health risk factors in adolescents. METHODS Cross-sectional data from the Healthy Schools Healthy Futures study, and the Australian Child Wellbeing Project was used, mean age: 14-15 years. Children were stratified according to back pain frequency. Within each strata, the proportion of children that reported drinking alcohol or smoking or that experienced feelings of anxiety or depression was reported. Test-for-trend analyses assessed whether increasing frequency of pain was associated with health risk factors. RESULTS Data was collected from ~2500 and 3900 children. Larger proportions of children smoked or drank alcohol within each strata of increasing pain frequency. The trend with anxiety and depression was less clear, although there was a marked difference between the children that reported no pain, and pain more frequently. CONCLUSION Two large, independent samples show adolescents that experience back pain more frequently are also more likely to smoke, drink alcohol and report feelings of anxiety and depression. Pain appears to be part of the picture of general health risk in adolescents.
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Affiliation(s)
- S J Kamper
- Centre for Pain, Health and Lifestyle, New South Wales, Australia.,School of Public Health, University of Sydney, Sydney, Australia
| | - Z A Michaleff
- Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - P Campbell
- Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK.,South Staffordshire and Shropshire NHS Foundation Trust, St George's Hospital, Stafford, Staffordshire, UK
| | - K M Dunn
- Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - T P Yamato
- Centre for Pain, Health and Lifestyle, New South Wales, Australia.,School of Public Health, University of Sydney, Sydney, Australia
| | - R K Hodder
- Centre for Pain, Health and Lifestyle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.,School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Australia
| | - J Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.,School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Australia
| | - C M Williams
- Centre for Pain, Health and Lifestyle, New South Wales, Australia.,Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia.,School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Australia
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Ratnasingam S, Casan J, Shortt J, Hawkes E, Gilbertson M, McQuilten Z, Grigoriadis G, Htun KT, Htet SM, Campbell P, Chai KL, Quach H, Patil S, Opat S. Cytarabine-based induction immunochemotherapy in the front-line treatment of older patients with mantle cell lymphoma. Sci Rep 2019; 9:13544. [PMID: 31537857 PMCID: PMC6753133 DOI: 10.1038/s41598-019-49776-9] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 08/30/2019] [Indexed: 11/09/2022] Open
Abstract
The role of cytarabine-based induction and autologous stem cell transplantation (ASCT) in front-line treatment of younger patients with mantle cell lymphoma (MCL) is well established, however the utility of intensive approaches in older patients remains unclear. This retrospective study compared first line treatment outcomes in patients aged 60 years or more, treated at six tertiary centres between 2000-2015. 70 patients included had a median age of 69 (60-91) and most (94%) demonstrated advanced stage disease. Treatment regimens included: R-CHOP-like (n = 39), alternating R-CHOP/R-DHAC (n = 10), R-HyperCVAD/R-MA (n = 7), R-CHOP/Cytarabine (Nordic Protocol) (n = 10) and other (n = 4). 16 patients underwent an ASCT. The median follow-up for surviving patients was 37 months. Compared to R-CHOP-like therapies, cytarabine-based regimens were associated with an improved overall response rate (ORR) of 70% vs 33% (p < 0.001) and overall survival (OS) (HR 0.541, [0.292-1.001], p = 0.05). No difference in efficacy between different cytarabine-based regimens was detected, but R-HyperCVAD/R-MA was associated with increased hospitalisation and transfusion requirements. Patients undergoing ASCT demonstrated an improved median OS (HR 0.108 [0.015-0.796], p = 0.029) but were significantly younger. These results reaffirm the use of cytarabine in MCL for selected patients aged over 60. Such regimens should be strongly considered for this population in frontline therapy.
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Affiliation(s)
- Sumita Ratnasingam
- Department of Haematology, Monash Health, Melbourne, Australia.,Department of Haematology, Andrew Love Cancer Centre, University Hospital Geelong, Geelong, Australia
| | - Joshua Casan
- Department of Haematology, Monash Health, Melbourne, Australia. .,School of Clinical Sciences, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia.
| | - Jake Shortt
- Department of Haematology, Monash Health, Melbourne, Australia.,School of Clinical Sciences, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
| | - Eliza Hawkes
- Department of Medical Oncology and Clinical Haematology, Olivia Newton John Cancer and Wellness Centre, Austin Hospital, Melbourne, Australia.,Department of Medical Oncology, Eastern Health, Melbourne, Australia
| | | | - Zoe McQuilten
- Department of Haematology, Monash Health, Melbourne, Australia
| | - George Grigoriadis
- Department of Haematology, Monash Health, Melbourne, Australia.,Department of Haematology, Alfred Health, Melbourne, Australia.,School of Clinical Sciences, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
| | - Kay Thwe Htun
- Department of Haematology, Alfred Health, Melbourne, Australia
| | - Swe Myo Htet
- Department of Haematology, Andrew Love Cancer Centre, University Hospital Geelong, Geelong, Australia
| | - Philip Campbell
- Department of Haematology, Andrew Love Cancer Centre, University Hospital Geelong, Geelong, Australia
| | - Khai Li Chai
- Department of Haematology, St Vincent's Hospital, Melbourne, Australia
| | - Hang Quach
- Department of Haematology, St Vincent's Hospital, Melbourne, Australia
| | - Sushrut Patil
- Department of Haematology, Alfred Health, Melbourne, Australia
| | - Stephen Opat
- Department of Haematology, Monash Health, Melbourne, Australia.,School of Clinical Sciences, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
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Joshi M, Taper J, Forsyth C, Rowlings P, Campbell P, Crispin P, Harvey M, Underhill C, Bayley A, Byth K, Huang G, Hertzberg M. Outpatient rituximab, ifosfamide, etoposide (R-IE) in patients older than 60 years with relapsed or refractory diffuse large B-cell lymphoma who are not candidates for stem cell transplantation. Leuk Lymphoma 2019; 61:91-97. [DOI: 10.1080/10428194.2019.1660968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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)
- Maansi Joshi
- Department of Haematology, Nepean Hospital, Kingswood, Australia
| | - John Taper
- Department of Haematology, Nepean Hospital, Kingswood, Australia
| | | | - Philip Rowlings
- Calvary Mater Newcastle Hospital, Newcastle, Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Philip Campbell
- Andrew Love Cancer Centre, University Hospital Geelong, Geelong, Australia
| | - Philip Crispin
- The Canberra Hospital, Canberra, Australia
- Australian National University Medical School, Canberra, Australia
| | | | - Craig Underhill
- Albury Wodonga Health Service and Border Oncology, Albury, Australia
| | | | | | | | - Mark Hertzberg
- Department of Haematology, Prince of Wales Hospital, Sydney, Australia
- University of NSW, Sydney, Australia
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Harris L, Axinte L, Campbell P, Amin N. Computer Tomography (CT) for head injury: adherence to the National Institute for Health and Care Excellence (NICE) criteria. Brain Inj 2019; 33:1539-1544. [PMID: 31442088 DOI: 10.1080/02699052.2019.1658130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Objective Head injury is a common presentation to the emergency department yet adherence to guidelines for management is suboptimal. Our study assesses adherence to National Institute for Health and Care Excellence (NICE) computed tomography (CT) head guidelines at a teaching hospital in the United Kingdom. It critically evaluates the efficacy of interventions. Methods We performed a quality improvement project to improve adherence to NICE CT head scan guidelines following head injury. Data was collected over one-month in 2014, and 2017. Interventions included education of the multidisciplinary team, information sheets, team engagement and tri-annual education sessions for junior doctors. The success of these interventions in the adult population was assessed objectively during the second cycle and subjectively via a junior doctor survey. Results 171 patients were included in the study. Following interventions, there was a statistically significant decrease of 23% in the number of CT heads requested with no clear indication (P = 0.00027). The mean time to scan for the one-hour indications decreased from 73 to 55 minutes. The mean time to report all scans decreased from 89 to 57 minutes. The survey results were encouraging. Conclusion Adherence to NICE guidelines for head injury is inadequate but can be improved by interventions.
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Affiliation(s)
- Lauren Harris
- Emergency Department, Royal Free Hospital , London , UK
| | - Laura Axinte
- Emergency Department, Royal Free Hospital , London , UK
| | - Philip Campbell
- Emergency Department, Royal Free Hospital , London , UK.,Department of Clinical Neuroscience, University College London Institute of Neurology , London , UK
| | - Nishal Amin
- Emergency Department, Royal Free Hospital , London , UK
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47
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Ghia P, Pluta A, Wach M, Lysak D, Kozak T, Simkovic M, Kaplan P, Kraychok I, Illes A, De La Serna J, Dolan S, Campbell P, Musuraca G, Jacob A, Avery E, Lee J, Chen T, Liang W, Patel P, Jurczak W. Acalabrutinib vs Rituximab Plus Idelalisib (IdR) or Bendamustine (BR) by Investigator Choice in Relapsed/Refractory (RR) Chronic Lymphocytic Leukemia: Phase 3 ASCEND Study. Hematol Oncol 2019. [DOI: 10.1002/hon.54_2629] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- P. Ghia
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele; Milano Italy
| | - A. Pluta
- Department of Hematological Oncology; Oncology Specialist Hospital; Brzozow Poland
| | - M. Wach
- Department of Hemato-Oncology and Bone Marrow Transplantation; Medical University of Lublin; Lublin Poland
| | - D. Lysak
- Fakultní Nemocnice Plzeň; Pilsen Czech Republic
| | - T. Kozak
- Fakultní Nemocnice Královske Vinohrady; Prague Czech Republic
| | - M. Simkovic
- University Hospital Hradec Kralove; Charles University; Hradec Kralove Czech Republic
| | - P. Kaplan
- Dnipropetrovsk City Clinical Hospital No. 4; Dnipropetrovsk Ukraine
| | | | - A. Illes
- University of Debrecen, Faculty of Medicine; Department of Hematology; Hungary
| | | | - S. Dolan
- Saint John Regional Hospital; University of New Brunswick; New Brunswick Canada
| | - P. Campbell
- Barwon Health; University Hospital Geelong; Geelong Victoria Australia
| | - G. Musuraca
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori; Meldola Italy
| | - A. Jacob
- The Royal Wolverhampton NHS Trust; Wolverhampton United Kingdom
| | - E.J. Avery
- Nebraska Hematology Oncology; Lincoln NE
| | - J.H. Lee
- Gachon University Gil Medical Center; Incheon South Korea
| | - T. Chen
- Acerta Pharma; South San Francisco CA USA
| | - W. Liang
- Acerta Pharma; South San Francisco CA USA
| | - P. Patel
- Acerta Pharma; South San Francisco CA USA
| | - W. Jurczak
- Department of Hematology; Jagiellonian University Medical College; Krakow Poland
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48
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Morschhauser F, Tilly H, Chaidos A, Phillips T, Ribrag V, Campbell P, Ghandi Laurent D, Jurczak W, McKay P, Opat S, Radford J, Rajarethinam A, Yang J, Howell H, Newberry K, Adib D, Salles G. INTERIM UPDATE FROM A PHASE 2 MULTICENTER STUDY OF TAZEMETOSTAT, AN EZH2 INHIBITOR, IN PATIENTS WITH RELAPSED OR REFRACTORY FOLLICULAR LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.111_2629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- F. Morschhauser
- Hematology-Transfusion; Centre Hospitalier Universitaire; Lille France
| | - H. Tilly
- Hematology; Centre de Lutte Contre le Cancer Henri Becquerel; Rouen France
| | - A. Chaidos
- Medicine, Centre for Haematology, Department of Medicine, Imperial College London, Imperial College Healthcare NHS Trust; Hammersmith Hospital; London United Kingdom
| | - T. Phillips
- Hematology and Oncology; University of Michigan; Ann Arbor United States
| | - V. Ribrag
- DITEP; Gustave Roussy; Villejuif France
| | - P. Campbell
- Hematology; Barwon Health; Geelong Australia
| | - D. Ghandi Laurent
- Hematology; Hematology Institute University Hospital School of Medicine; Caen France
| | | | - P. McKay
- Hematology; Beatson West of Scotland Cancer Centre; Glasgow United Kingdom
| | - S. Opat
- Hematology; Monash University; Clayton Australia
| | - J. Radford
- Medical Oncology; University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre; Manchester United Kingdom
| | | | - J. Yang
- Biostatistics; Epizyme; Cambridge United States
| | - H. Howell
- Clinical Operations; Epizyme; Cambridge United States
| | | | - D. Adib
- Clinical Development; Epizyme; Cambridge United States
| | - G. Salles
- Hematology; Lyon-Sud Hospital Centre; Pierre-Bénite France
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49
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Campbell P, Kaski D, Saifee TA. Susac syndrome presenting with acute hemibody paraesthesia. JRSM Cardiovasc Dis 2019; 8:2048004019844687. [PMID: 31041097 PMCID: PMC6482645 DOI: 10.1177/2048004019844687] [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: 03/07/2018] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 11/25/2022] Open
Abstract
Susac syndrome is an orphan disease characterised by encephalopathy, branch retinal artery occlusion and sensorineural hearing loss. As the clinical triad is rarely present at symptom onset, it is often initially misdiagnosed and appropriate treatment is often delayed. Herewith, we report a case of Susac syndrome in a 47-year-old man presenting with acute hemisensory loss and highlight the challenges of early diagnosis, particularly relevant in the era of hyperacute stroke management.
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Affiliation(s)
- Philip Campbell
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, Royal Free Hospital, London, UK
| | - Diego Kaski
- Department of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Tabish A Saifee
- Department of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.,Department of Neurology, Northwick Park Hospital, Harrow, Middlesex, UK
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50
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Lynch G, Campbell P, Taggart C. Modernising the Mental Health Act: getting the balance right. Lancet 2018; 392:2532-2534. [PMID: 30528658 DOI: 10.1016/s0140-6736(18)33140-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Gerard Lynch
- Royal College of Psychiatrists in Northern Ireland, Belfast BT15 1ES, UK.
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