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Chan PY, Corrie PG. Curing Stage IV Melanoma: Where Have We Been and Where Are We? Am Soc Clin Oncol Educ Book 2024; 44:e438654. [PMID: 38669609 DOI: 10.1200/edbk_438654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Little more than 10 years ago, metastatic melanoma was considered to have one of the poorest cancer outcomes, associated with a median overall survival of 6-8 months. Cytotoxic chemotherapy offered modest response rates of 20%-30%, but no clear survival benefit. Patients were routinely enrolled in clinical trials as their first-line therapy in the search for effective novel therapeutics. Remarkable developments in molecular biology, cancer genomics, immunology, and drug discovery have dominated the early part of the 21st century, and nowhere have the benefits been better realized than in the transformation of outcomes for patients with metastatic melanoma: since 2011, 14 new agents have been approved that significantly increase survival, with long-term remissions and, possibly now, potential for cure. Even so, there is still much work to be done, given that most treated patients still die of their disease. Although most survival gains have so far been realized for cutaneous melanoma, improving treatment options for those 10% of patients with rarer, noncutaneous melanomas is a high priority. Key novel therapeutic approaches aimed at improving outcomes with potential for curing patients with melanoma are considered.
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Affiliation(s)
- Pui Ying Chan
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Pippa G Corrie
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
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2
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Lash MK, Latham NH, Chan PY, Foote MM, Garcia EA, Silverstein MF, Wong M, Alexander M, Alroy KA, Bajaj L, Chen K, Howard JS, Jones LE, Lee EH, Watkins JL, McPherson TD. Racial and Socioeconomic Equity of Tecovirimat Treatment during the 2022 Mpox Emergency, New York, New York, USA. Emerg Infect Dis 2023; 29:2353-2357. [PMID: 37796277 PMCID: PMC10617352 DOI: 10.3201/eid2911.230814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
We assessed tecovirimat treatment equity for 3,740 mpox patients in New York, New York, USA, during the 2022 mpox emergency; 32.4% received tecovirimat. Treatment rates by race/ethnicity were 38.8% (White), 31.3% (Black/African American), 31.0% (Hispanic/Latino), and 30.1% (Asian/Pacific Islander/other). Future public health emergency responses must prioritize institutional and structural racism mitigation.
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Affiliation(s)
| | | | - Pui Ying Chan
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Mary M.K. Foote
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Elizabeth A. Garcia
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Matthew F. Silverstein
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Marcia Wong
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Mark Alexander
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Karen A. Alroy
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Lovedeep Bajaj
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Kuan Chen
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - James Steele Howard
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Lucretia E. Jones
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Ellen H. Lee
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Julian L. Watkins
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
| | - Tristan D. McPherson
- New York City Department of Health and Mental Hygiene, Queens, New York, USA (M.K. Lash, N.H. Latham, P.Y. Chan, M.M.K. Foote, E.A. Garcia, M.F. Silverstein, M. Wong, M. Alexander, K.A. Alroy, L. Bajaj, K. Chen, J.S. Howard, L.E. Jones, E.H. Lee, J.L. Watkins, T.D. McPherson)
- Columbia University, New York, New York, USA (N.H. Latham)
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Romo ML, Jordan P, McVeigh KH, Chan PY, Stingone JA, Lim S, Askew GL. Early intervention and special education in New York City: Patterns of service use and disparities affecting children of colour. Child Care Health Dev 2023; 49:119-129. [PMID: 35733292 DOI: 10.1111/cch.13024] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/20/2022] [Accepted: 06/20/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Compliance with the requirements of the Individuals with Disabilities Education Act (IDEA) in the United States is monitored through review of cross-sectional reports from three discrete, age-defined programmes (early intervention [EI], early childhood special education [ECSE)] and school-age special education [SE]) to promote the timely, efficient and effective delivery of appropriate services to all eligible children. Analysis of longitudinal data is required to discern how children use services across programmes to provide the necessary context for IDEA oversight and to identify areas for programme or policy interventions to reduce barriers to service use and promote equity. METHODS We applied sequence analysis to a data linkage across five public record systems among 15 626 New York City children born in 1998 who had records from birth through third grade. RESULTS Five predominant patterns of service use were identified: (1) multiple therapies across EI/ECSE/SE (13%), (2) EI without transition to Department of Education schools or services (24%), (3) EI and intermittent ECSE/SE (16%), (4) older entry into EI and both speech and occupational therapy throughout ECSE/SE (9%) and (5) limited EI use and mostly speech therapy in ECSE/SE (38%). Each pattern had distinct demographics (e.g., pattern 2 was disproportionately White and from low poverty neighbourhoods; pattern 4 was disproportionately male and Black; pattern 5 was disproportionately Latino) and academic outcomes (e.g., pattern 1 had largest proportion in a SE school and not tested in third grade; pattern 3 had third grade tests scores that were similar to overall citywide mean scores). CONCLUSIONS The differences in demographic profiles across the five patterns of service use illustrate the systemic inequities in the delivery of these important services. Delayed entry and limited use of EI services among children of colour underscore the need for equity goals to increase early referral and optimize service use.
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Affiliation(s)
- Matthew L Romo
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Phoebe Jordan
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Katharine H McVeigh
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Pui Ying Chan
- Division of Epidemiology Services, New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Jeanette A Stingone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA
| | - Sungwoo Lim
- Division of Epidemiology Services, New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - George L Askew
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, Queens, New York, USA
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Chan PY, Ryan NP, Chen D, McNeil J, Hopper I. Novel wearable and contactless heart rate, respiratory rate, and oxygen saturation monitoring devices: a systematic review and meta-analysis. Anaesthesia 2022; 77:1268-1280. [PMID: 35947876 DOI: 10.1111/anae.15834] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 11/28/2022]
Abstract
We performed a systematic review and meta-analysis to identify, classify and evaluate the body of evidence on novel wearable and contactless devices that measure heart rate, respiratory rate and oxygen saturations in the clinical setting. We included any studies of hospital inpatients, including sleep study clinics. Eighty-four studies were included in the final review. There were 56 studies of wearable devices and 29 of contactless devices. One study assessed both types of device. A high risk of patient selection and rater bias was present in proportionally more studies assessing contactless devices compared with studies assessing wearable devices (p = 0.023 and p < 0.0001, respectively). There was high but equivalent likelihood of blinding bias between the two types of studies (p = 0.076). Wearable device studies were commercially available devices validated in acute clinical settings by clinical staff and had more real-time data analysis (p = 0.04). Contactless devices were more experimental, and data were analysed post-hoc. Pooled estimates of mean (95%CI) heart rate and respiratory rate bias in wearable devices were 1.25 (-0.31-2.82) beats.min-1 (pooled 95% limits of agreement -9.36-10.08) and 0.68 (0.05-1.32) breaths.min-1 (pooled 95% limits of agreement -5.65-6.85). The pooled estimate for mean (95%CI) heart rate and respiratory rate bias in contactless devices was 2.18 (3.31-7.66) beats.min-1 (pooled limits of agreement -6.71-10.88) and 0.30 (-0.26-0.87) breaths.min-1 (pooled 95% limits of agreement -3.94-4.29). Only two studies of wearable devices measured Sp O2 ; these reported mean measurement biases of 3.54% (limits of agreement -5.65-11.45%) and 2.9% (-7.4-1.7%). Heterogeneity was observed across studies, but absent when devices were grouped by measurement modality and reference standard. We conclude that, while studies of wearable devices were of slightly better quality than contactless devices, in general all studies of novel devices were of low quality, with small (< 100) patient datasets, typically not blinded and often using inappropriate statistical techniques. Both types of devices were statistically equivalent in accuracy and precision, but wearable devices demonstrated less measurement bias and more precision at extreme vital signs. The statistical variability in precision and accuracy between studies is partially explained by differences in reference standards.
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Affiliation(s)
- P Y Chan
- Department of Intensive Care Medicine, Eastern Health, Melbourne, Vic., Australia
| | - N P Ryan
- Department of Intensive Care Medicine, Eastern Health, Melbourne, Vic., Australia
| | - D Chen
- Department of Intensive Care Medicine, Eastern Health, Melbourne, Vic., Australia
| | - J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
| | - I Hopper
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic., Australia
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Chan PY, Phillips MM, Ellis S, Johnston A, Feng X, Arora A, Hay G, Cohen VML, Sagoo MS, Bomalaski JS, Sheaff MT, Szlosarek PW. A Phase 1 study of ADI-PEG20 (pegargiminase) combined with cisplatin and pemetrexed in ASS1-negative metastatic uveal melanoma. Pigment Cell Melanoma Res 2022; 35:461-470. [PMID: 35466524 PMCID: PMC9322321 DOI: 10.1111/pcmr.13042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 12/14/2022]
Abstract
Metastatic uveal melanoma (UM) is a devastating disease with few treatment options. We evaluated the safety, tolerability and preliminary activity of arginine depletion using pegylated arginine deiminase (ADI‐PEG20; pegargiminase) combined with pemetrexed (Pem) and cisplatin (Cis) chemotherapy in a phase 1 dose‐expansion study of patients with argininosuccinate synthetase (ASS1)‐deficient metastatic UM. Eligible patients received up to six cycles of Pem (500 mg/m2) and Cis (75 mg/m2) every 3 weeks plus weekly intramuscular ADI (36 mg/m2), followed by maintenance ADI until progression (NCT02029690). Ten of fourteen ASS1‐deficient patients with UM liver metastases and a median of one line of prior immunotherapy received ADIPemCis. Only one ≥ grade 3 adverse event of febrile neutropenia was reported. Seven patients had stable disease with a median progression‐free survival of 3.0 months (range, 1.3–8.1) and a median overall survival of 11.5 months (range, 3.2–36.9). Despite anti‐ADI‐PEG20 antibody emergence, plasma arginine concentrations remained suppressed by 18 weeks with a reciprocal increase in plasma citrulline. Tumour rebiopsies at progression revealed ASS1 re‐expression as an escape mechanism. ADIPemCis was well tolerated with modest disease stabilisation in metastatic UM. Further investigation of arginine deprivation is indicated in UM including combinations with immune checkpoint blockade and additional anti‐metabolite strategies.
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Affiliation(s)
- Pui Ying Chan
- Department of Medical Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.,Wellcome Sanger Institute, Hinxton, Cambridgeshire, UK
| | - Melissa M Phillips
- Department of Medical Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Stephen Ellis
- Department of Medical Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | | | - Xiaoxing Feng
- Polaris Pharmaceuticals Inc, San Diego, California, USA
| | - Amit Arora
- Department of Ocular Oncology, Moorfields Eye Hospital, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Gordon Hay
- Department of Ocular Oncology, Moorfields Eye Hospital, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Victoria M L Cohen
- Department of Ocular Oncology, Moorfields Eye Hospital, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Mandeep S Sagoo
- Department of Ocular Oncology, Moorfields Eye Hospital, Moorfields Eye Hospital NHS Foundation Trust, London, UK.,NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and University College London Institute of Ophthalmology, London, UK
| | | | - Michael T Sheaff
- Department of Histopathology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Peter W Szlosarek
- Department of Medical Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.,Centre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, UK
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Conderino S, Bendik S, Richards TB, Pulgarin C, Chan PY, Townsend J, Lim S, Roberts TR, Thorpe LE. The use of electronic health records to inform cancer surveillance efforts: a scoping review and test of indicators for public health surveillance of cancer prevention and control. BMC Med Inform Decis Mak 2022; 22:91. [PMID: 35387655 PMCID: PMC8985310 DOI: 10.1186/s12911-022-01831-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/27/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION State cancer prevention and control programs rely on public health surveillance data to set objectives to improve cancer prevention and control, plan interventions, and evaluate state-level progress towards achieving those objectives. The goal of this project was to evaluate the validity of using electronic health records (EHRs) based on common data model variables to generate indicators for surveillance of cancer prevention and control for these public health programs. METHODS Following the methodological guidance from the PRISMA Extension for Scoping Reviews, we conducted a literature scoping review to assess how EHRs are used to inform cancer surveillance. We then developed 26 indicators along the continuum of the cascade of care, including cancer risk factors, immunizations to prevent cancer, cancer screenings, quality of initial care after abnormal screening results, and cancer burden. Indicators were calculated within a sample of patients from the New York City (NYC) INSIGHT Clinical Research Network using common data model EHR data and were weighted to the NYC population using post-stratification. We used prevalence ratios to compare these estimates to estimates from the raw EHR of NYU Langone Health to assess quality of information within INSIGHT, and we compared estimates to results from existing surveillance sources to assess validity. RESULTS Of the 401 identified articles, 15% had a study purpose related to surveillance. Our indicator comparisons found that INSIGHT EHR-based measures for risk factor indicators were similar to estimates from external sources. In contrast, cancer screening and vaccination indicators were substantially underestimated as compared to estimates from external sources. Cancer screenings and vaccinations were often recorded in sections of the EHR that were not captured by the common data model. INSIGHT estimates for many quality-of-care indicators were higher than those calculated using a raw EHR. CONCLUSION Common data model EHR data can provide rich information for certain indicators related to the cascade of care but may have substantial biases for others that limit their use in informing surveillance efforts for cancer prevention and control programs.
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Affiliation(s)
- Sarah Conderino
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA.
| | - Stefanie Bendik
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA
| | - Thomas B Richards
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA
| | - Claudia Pulgarin
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA
| | - Pui Ying Chan
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY, 11101, USA
| | - Julie Townsend
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA
| | - Sungwoo Lim
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY, 11101, USA
| | - Timothy R Roberts
- Health Sciences Library, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Lorna E Thorpe
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Ave, New York, NY, 10016, USA
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Montesano MPM, Johnson K, Tang A, Slutsker JS, Chan PY, Guerra K, MacGregor J, Grossman J, Kennelly M, Thompson CN. Successful, Easy to Access, Online Publication of COVID-19 Data During the Pandemic, New York City, 2020. Am J Public Health 2021; 111:S193-S196. [PMID: 34709870 PMCID: PMC8561066 DOI: 10.2105/ajph.2021.306446] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2021] [Indexed: 11/04/2022]
Abstract
Making public health data easier to access, understand, and use makes it more likely that the data will be influential. Throughout the COVID-19 pandemic, the New York City (NYC) Department of Health and Mental Hygiene's Web-based data communication became a cornerstone of NYC's response and allowed the public, journalists, and researchers to access and understand the data in a way that supported the pandemic response and brought attention to the deeply unequal patterns of COVID-19's morbidity and mortality in NYC. (Am J Public Health. 2021;111(S3):S193-S196. https://doi.org/10.2105/AJPH.2021.306446).
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Affiliation(s)
- Matthew Peter Mannix Montesano
- Matthew Peter Mannix Montesano, Kimberly Johnson, Andrew Tang, Jennifer Sanderson Slutsker, Pui Ying Chan, Kevin Guerra, Jennifer MacGregor, Jeffrey Grossman, Maura Kennelly, and Corinne N. Thompson are with the New York City Department of Health and Mental Hygiene, New York, NY
| | - Kimberly Johnson
- Matthew Peter Mannix Montesano, Kimberly Johnson, Andrew Tang, Jennifer Sanderson Slutsker, Pui Ying Chan, Kevin Guerra, Jennifer MacGregor, Jeffrey Grossman, Maura Kennelly, and Corinne N. Thompson are with the New York City Department of Health and Mental Hygiene, New York, NY
| | - Andrew Tang
- Matthew Peter Mannix Montesano, Kimberly Johnson, Andrew Tang, Jennifer Sanderson Slutsker, Pui Ying Chan, Kevin Guerra, Jennifer MacGregor, Jeffrey Grossman, Maura Kennelly, and Corinne N. Thompson are with the New York City Department of Health and Mental Hygiene, New York, NY
| | - Jennifer Sanderson Slutsker
- Matthew Peter Mannix Montesano, Kimberly Johnson, Andrew Tang, Jennifer Sanderson Slutsker, Pui Ying Chan, Kevin Guerra, Jennifer MacGregor, Jeffrey Grossman, Maura Kennelly, and Corinne N. Thompson are with the New York City Department of Health and Mental Hygiene, New York, NY
| | - Pui Ying Chan
- Matthew Peter Mannix Montesano, Kimberly Johnson, Andrew Tang, Jennifer Sanderson Slutsker, Pui Ying Chan, Kevin Guerra, Jennifer MacGregor, Jeffrey Grossman, Maura Kennelly, and Corinne N. Thompson are with the New York City Department of Health and Mental Hygiene, New York, NY
| | - Kevin Guerra
- Matthew Peter Mannix Montesano, Kimberly Johnson, Andrew Tang, Jennifer Sanderson Slutsker, Pui Ying Chan, Kevin Guerra, Jennifer MacGregor, Jeffrey Grossman, Maura Kennelly, and Corinne N. Thompson are with the New York City Department of Health and Mental Hygiene, New York, NY
| | - Jennifer MacGregor
- Matthew Peter Mannix Montesano, Kimberly Johnson, Andrew Tang, Jennifer Sanderson Slutsker, Pui Ying Chan, Kevin Guerra, Jennifer MacGregor, Jeffrey Grossman, Maura Kennelly, and Corinne N. Thompson are with the New York City Department of Health and Mental Hygiene, New York, NY
| | - Jeffrey Grossman
- Matthew Peter Mannix Montesano, Kimberly Johnson, Andrew Tang, Jennifer Sanderson Slutsker, Pui Ying Chan, Kevin Guerra, Jennifer MacGregor, Jeffrey Grossman, Maura Kennelly, and Corinne N. Thompson are with the New York City Department of Health and Mental Hygiene, New York, NY
| | - Maura Kennelly
- Matthew Peter Mannix Montesano, Kimberly Johnson, Andrew Tang, Jennifer Sanderson Slutsker, Pui Ying Chan, Kevin Guerra, Jennifer MacGregor, Jeffrey Grossman, Maura Kennelly, and Corinne N. Thompson are with the New York City Department of Health and Mental Hygiene, New York, NY
| | - Corinne N Thompson
- Matthew Peter Mannix Montesano, Kimberly Johnson, Andrew Tang, Jennifer Sanderson Slutsker, Pui Ying Chan, Kevin Guerra, Jennifer MacGregor, Jeffrey Grossman, Maura Kennelly, and Corinne N. Thompson are with the New York City Department of Health and Mental Hygiene, New York, NY
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Chan PY, Greene SK, Lim SW, Fine A, Thompson CN. Persistent disparities in SARS-CoV-2 test percent positivity by neighborhood in New York City, March 1-July 25, 2020. Ann Epidemiol 2021; 63:46-51. [PMID: 34391928 DOI: 10.1016/j.annepidem.2021.07.032] [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: 02/17/2021] [Revised: 06/17/2021] [Accepted: 07/31/2021] [Indexed: 11/15/2022]
Abstract
PURPOSE To examine neighborhood-level disparities in SARS-CoV-2 molecular test percent positivity in New York City (NYC) by demographics and socioeconomic status over time to better understand COVID-19 inequities. METHODS Across 177 neighborhoods, we calculated the Spearman correlation of neighborhood characteristics with SARS-CoV-2 molecular test percent positivity during March 1-July 25, 2020 by five periods defined by trend in case counts: increasing, declining, and three plateau periods to account for differential testing capacity and reopening status. RESULTS Percent positivity was positively correlated with neighborhood racial and ethnic characteristics and socioeconomic status, including the proportion of the population who were Latino and Black non-Latino, uninsured, Medicaid enrollees, transportation workers, or had low educational attainment. Correlations were generally consistent over time despite increasing testing rates. Neighborhoods with high proportions of these correlates had median percent positivity values of 62.6%, 28.7%, 6.4%, 2.8%, and 2.2% in the five periods, respectively, compared with 40.6%, 11.7%, 1.7%, 0.9%, and 1.0% in neighborhoods with low proportions of these correlates. CONCLUSIONS Disparities in SARS-CoV-2 molecular test percent positivity persisted in disadvantaged neighborhoods during multiple phases of the first few months of the COVID-19 epidemic in NYC. Mitigation of the COVID-19 burden is still urgently needed in disproportionately affected communities.
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Key Words
- ACS, American community survey
- CI, confidence interval
- COVID-19, SARS-CoV-2, Health status disparities, Race factors, Residence characteristics, Socioeconomic factors, Population surveillance, Epidemiology, Abbreviations, SES, socioeconomic status
- NYC DOHMH, New York City Department of Health and Mental Hygiene
- NYC, New York City
- modZCTA, modified ZIP Code tabulation area
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Affiliation(s)
- Pui Ying Chan
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY.
| | - Sharon K Greene
- Division of Disease Control, New York City Department of Health and Mental Hygiene, Long Island City, NY
| | - Sung Woo Lim
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY
| | - Anne Fine
- Division of Disease Control, New York City Department of Health and Mental Hygiene, Long Island City, NY
| | - Corinne N Thompson
- Division of Disease Control, New York City Department of Health and Mental Hygiene, Long Island City, NY
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9
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Szlosarek PW, Wimalasingham AG, Phillips MM, Hall PE, Chan PY, Conibear J, Lim L, Rashid S, Steele J, Wells P, Shiu CF, Kuo CL, Feng X, Johnston A, Bomalaski J, Ellis S, Grantham M, Sheaff M. Phase 1, pharmacogenomic, dose-expansion study of pegargiminase plus pemetrexed and cisplatin in patients with ASS1-deficient non-squamous non-small cell lung cancer. Cancer Med 2021; 10:6642-6652. [PMID: 34382365 PMCID: PMC8495293 DOI: 10.1002/cam4.4196] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/13/2021] [Accepted: 07/13/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction We evaluated the arginine‐depleting enzyme pegargiminase (ADI‐PEG20; ADI) with pemetrexed (Pem) and cisplatin (Cis) (ADIPemCis) in ASS1‐deficient non‐squamous non‐small cell lung cancer (NSCLC) via a phase 1 dose‐expansion trial with exploratory biomarker analysis. Methods Sixty‐seven chemonaïve patients with advanced non‐squamous NSCLC were screened, enrolling 21 ASS1‐deficient subjects from March 2015 to July 2017 onto weekly pegargiminase (36 mg/m2) with Pem (500 mg/m2) and Cis (75 mg/m2), every 3 weeks (four cycles maximum), with maintenance Pem or pegargiminase. Safety, pharmacodynamics, immunogenicity, and efficacy were determined; molecular biomarkers were annotated by next‐generation sequencing and PD‐L1 immunohistochemistry. Results ADIPemCis was well‐tolerated. Plasma arginine and citrulline were differentially modulated; pegargiminase antibodies plateaued by week 10. The disease control rate was 85.7% (n = 18/21; 95% CI 63.7%–97%), with a partial response rate of 47.6% (n = 10/21; 95% CI 25.7%–70.2%). The median progression‐free and overall survivals were 4.2 (95% CI 2.9–4.8) and 7.2 (95% CI 5.1–18.4) months, respectively. Two PD‐L1‐expressing (≥1%) patients are alive following subsequent pembrolizumab immunotherapy (9.5%). Tumoral ASS1 deficiency enriched for p53 (64.7%) mutations, and numerically worse median overall survival as compared to ASS1‐proficient disease (10.2 months; n = 29). There was no apparent increase in KRAS mutations (35.3%) and PD‐L1 (<1%) expression (55.6%). Re‐expression of tumoral ASS1 was detected in one patient at progression (n = 1/3). Conclusions ADIPemCis was safe and highly active in patients with ASS1‐deficient non‐squamous NSCLC, however, survival was poor overall. ASS1 loss was co‐associated with p53 mutations. Therapies incorporating pegargiminase merit further evaluation in ASS1‐deficient and treatment‐refractory NSCLC.
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Affiliation(s)
- Peter W Szlosarek
- Center for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute (BCI) - A Cancer Research UK Center of Excellence, Queen Mary University of London, John Vane Science Center, London, UK.,Department of Medical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Akhila G Wimalasingham
- Department of Medical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Melissa M Phillips
- Department of Medical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Peter E Hall
- Department of Medical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Pui Ying Chan
- Department of Medical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - John Conibear
- Department of Clinical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Louise Lim
- Department of Medical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Sukaina Rashid
- Department of Medical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Jeremy Steele
- Department of Medical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Paula Wells
- Department of Clinical Oncology, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | | | - Chih-Ling Kuo
- Polaris Pharmaceuticals, Inc., San Diego, California, USA
| | - Xiaoxing Feng
- Polaris Pharmaceuticals, Inc., San Diego, California, USA
| | | | - John Bomalaski
- Polaris Pharmaceuticals, Inc., San Diego, California, USA
| | - Stephen Ellis
- Department of Diagnostic Imaging, Barts Health NHS Trust, St Bartholomew's Hospital, London, UK
| | - Marianne Grantham
- Cytogenetics and Molecular Haematology, Pathology and Pharmacy Building, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - Michael Sheaff
- Department of Histopathology, Pathology and Pharmacy Building, Barts Health NHS Trust, Royal London Hospital, London, UK
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10
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Sood RK, Bae JY, Sabety A, Chan PY, Heindrichs C. ActionHealthNYC: Effectiveness of a Health Care Access Program for the Uninsured, 2016-2017. Am J Public Health 2021; 111:1318-1327. [PMID: 34111367 DOI: 10.2105/ajph.2021.306271] [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: 11/04/2022]
Abstract
Objectives. To evaluate the effectiveness of a novel health care access program (ActionHealthNYC) for uninsured immigrants. Methods. The evaluation was conducted as a randomized controlled trial in New York City from May 2016 through June 2017. Using baseline and follow-up survey data, we assessed health care access, patient experience, and health status. Results. At baseline, 25% of participants had a regular source of care; two thirds had visited a doctor in the past year and reported 2.5 visits in the past 12 months, on average. Nine to 12 months later, intervention participants were 1.2 times more likely to report having a primary care provider (58% vs 46%), were 1.2 times more likely to have seen a doctor in the past 9 months (91% vs 77%), and had 1.5 times more health care visits (4.1 vs 2.9) compared with control participants. Conclusions. ActionHealthNYC increased health care access among program participants. Public Health Implications. State and local policymakers should build on the progress that has been made over the last decade to expand and improve access to health care for uninsured immigrants.
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Affiliation(s)
- Rishi K Sood
- Rishi K. Sood is with the Bureau of Equitable Health Systems, New York City Department of Health and Mental Hygiene, Queens, NY. Jin Yung Bae and Caroline Heindrichs were with the Bureau of Primary Care Access and Planning, New York City Department of Health and Mental Hygiene. Adrienne Sabety was with the Interfaculty Initiative in Health Policy at Harvard University, Cambridge, MA. Pui Ying Chan is with the Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene
| | - Jin Yung Bae
- Rishi K. Sood is with the Bureau of Equitable Health Systems, New York City Department of Health and Mental Hygiene, Queens, NY. Jin Yung Bae and Caroline Heindrichs were with the Bureau of Primary Care Access and Planning, New York City Department of Health and Mental Hygiene. Adrienne Sabety was with the Interfaculty Initiative in Health Policy at Harvard University, Cambridge, MA. Pui Ying Chan is with the Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene
| | - Adrienne Sabety
- Rishi K. Sood is with the Bureau of Equitable Health Systems, New York City Department of Health and Mental Hygiene, Queens, NY. Jin Yung Bae and Caroline Heindrichs were with the Bureau of Primary Care Access and Planning, New York City Department of Health and Mental Hygiene. Adrienne Sabety was with the Interfaculty Initiative in Health Policy at Harvard University, Cambridge, MA. Pui Ying Chan is with the Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene
| | - Pui Ying Chan
- Rishi K. Sood is with the Bureau of Equitable Health Systems, New York City Department of Health and Mental Hygiene, Queens, NY. Jin Yung Bae and Caroline Heindrichs were with the Bureau of Primary Care Access and Planning, New York City Department of Health and Mental Hygiene. Adrienne Sabety was with the Interfaculty Initiative in Health Policy at Harvard University, Cambridge, MA. Pui Ying Chan is with the Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene
| | - Caroline Heindrichs
- Rishi K. Sood is with the Bureau of Equitable Health Systems, New York City Department of Health and Mental Hygiene, Queens, NY. Jin Yung Bae and Caroline Heindrichs were with the Bureau of Primary Care Access and Planning, New York City Department of Health and Mental Hygiene. Adrienne Sabety was with the Interfaculty Initiative in Health Policy at Harvard University, Cambridge, MA. Pui Ying Chan is with the Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene
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11
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Romo ML, McVeigh KH, Jordan P, Stingone JA, Chan PY, Askew GL. Birth characteristics of children who used early intervention and special education services in New York City. J Public Health (Oxf) 2020; 42:e401-e411. [PMID: 31884516 DOI: 10.1093/pubmed/fdz179] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Early intervention (EI) and special education (SE) are beneficial for children with developmental disabilities and/or delays and their families, yet there are disparities in service use. We sought to identify the birth characteristics that predict EI/SE service use patterns. METHODS We conducted a retrospective cohort study using linked administrative data from five sources for all children born in 1998 to New York City resident mothers. Multinomial regression was used to identify birth characteristics that predicted predominant patterns of service use. RESULTS Children with service use patterns characterized by late or limited/no EI use were more likely to be first-born children and have Black or Latina mothers. Children born with a gestational age ≤31 weeks were more likely to enter services early. Early term gestational age was associated with patterns of service use common to children with pervasive developmental delay, and maternal obesity was associated with the initiation of speech therapy at the time of entry into school. CONCLUSIONS Maternal racial disparities existed for patterns of EI/SE service use. Specific birth characteristics, such as parity and gestational age, may be useful to better identify children who are at risk for suboptimal EI use.
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Affiliation(s)
- Matthew L Romo
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - Katharine H McVeigh
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - Phoebe Jordan
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Jeanette A Stingone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Pui Ying Chan
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
| | - George L Askew
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, New York, NY, 11101, USA
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12
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Thompson CN, Baumgartner J, Pichardo C, Toro B, Li L, Arciuolo R, Chan PY, Chen J, Culp G, Davidson A, Devinney K, Dorsinville A, Eddy M, English M, Fireteanu AM, Graf L, Geevarughese A, Greene SK, Guerra K, Huynh M, Hwang C, Iqbal M, Jessup J, Knorr J, Lall R, Latash J, Lee E, Lee K, Li W, Mathes R, McGibbon E, McIntosh N, Montesano M, Moore MS, Murray K, Ngai S, Paladini M, Paneth-Pollak R, Parton H, Peterson E, Pouchet R, Ramachandran J, Reilly K, Sanderson Slutsker J, Van Wye G, Wahnich A, Winters A, Layton M, Jones L, Reddy V, Fine A. COVID-19 Outbreak - New York City, February 29-June 1, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1725-1729. [PMID: 33211680 PMCID: PMC7676643 DOI: 10.15585/mmwr.mm6946a2] [Citation(s) in RCA: 153] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
New York City (NYC) was an epicenter of the coronavirus disease 2019 (COVID-19) outbreak in the United States during spring 2020 (1). During March-May 2020, approximately 203,000 laboratory-confirmed COVID-19 cases were reported to the NYC Department of Health and Mental Hygiene (DOHMH). To obtain more complete data, DOHMH used supplementary information sources and relied on direct data importation and matching of patient identifiers for data on hospitalization status, the occurrence of death, race/ethnicity, and presence of underlying medical conditions. The highest rates of cases, hospitalizations, and deaths were concentrated in communities of color, high-poverty areas, and among persons aged ≥75 years or with underlying conditions. The crude fatality rate was 9.2% overall and 32.1% among hospitalized patients. Using these data to prevent additional infections among NYC residents during subsequent waves of the pandemic, particularly among those at highest risk for hospitalization and death, is critical. Mitigating COVID-19 transmission among vulnerable groups at high risk for hospitalization and death is an urgent priority. Similar to NYC, other jurisdictions might find the use of supplementary information sources valuable in their efforts to prevent COVID-19 infections.
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Affiliation(s)
- Corinne N Thompson
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Jennifer Baumgartner
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Carolina Pichardo
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Brian Toro
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Lan Li
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Robert Arciuolo
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Pui Ying Chan
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Judy Chen
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Gretchen Culp
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Alexander Davidson
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Katelynn Devinney
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Alan Dorsinville
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Meredith Eddy
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Michele English
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Ana Maria Fireteanu
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Laura Graf
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Anita Geevarughese
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Sharon K Greene
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Kevin Guerra
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Mary Huynh
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Christina Hwang
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Maryam Iqbal
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Jillian Jessup
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Jillian Knorr
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Ramona Lall
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Julia Latash
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Ellen Lee
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Kristen Lee
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Wenhui Li
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Robert Mathes
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Emily McGibbon
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Natasha McIntosh
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Matthew Montesano
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Miranda S Moore
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Kenya Murray
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Stephanie Ngai
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Marc Paladini
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Rachel Paneth-Pollak
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Hilary Parton
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Eric Peterson
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Renee Pouchet
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Jyotsna Ramachandran
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Kathleen Reilly
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | | | - Gretchen Van Wye
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Amanda Wahnich
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Ann Winters
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Marcelle Layton
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Lucretia Jones
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Vasudha Reddy
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Anne Fine
- New York City Department of Health and Mental Hygiene, Long Island City, New York
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13
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Simpson JP, Wong DN, Verco L, Carter R, Dzidowski M, Chan PY. Measurement of airborne particle exposure during simulated tracheal intubation using various proposed aerosol containment devices during the COVID-19 pandemic. Anaesthesia 2020; 75:1587-1595. [PMID: 32559315 PMCID: PMC7323428 DOI: 10.1111/anae.15188] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2020] [Indexed: 01/25/2023]
Abstract
The COVID‐19 pandemic has led to the production of novel devices intended to protect airway managers during the aerosol‐generating procedure of tracheal intubation. Using an in‐situ simulation model, we evaluated laryngoscopist exposure of airborne particles sized 0.3 ‐ 5.0 microns using five aerosol containment devices (aerosol box; sealed box with and without suction; vertical drape; and horizontal drape) compared with no aerosol containment device. Nebulised saline was used as the aerosol‐generating model for 300 s, at which point, the devices were removed to assess particle spread. Primary outcome was the quantity and size of airborne particles measured at the level of the laryngoscopist’s head at 30, 60, 120 and 300 s, as well as 360 s (60 s after device removal). Airborne particles sizes of 0.3, 0.5, 1.0, 2.5 and 5.0 microns were quantified using an electronic airborne particle counter. Compared with no device use, the sealed intubation box with suction resulted in a decrease in 0.3, 0.5, 1.0 and 2.5 micron, but not 5.0 micron, particle exposure over all time‐periods (p = 0.003 for all time periods). Compared with no device use, the aerosol box showed an increase in 1.0, 2.5 and 5.0 micron airborne particle exposure at 300 s (p = 0.002, 0.008, 0.002, respectively). Compared with no device use, neither horizontal nor vertical drapes showed any difference in any particle size exposure at any time. Finally, when the patient coughed, use of the aerosol box resulted in a marked increase in airborne particle exposure compared with other devices or no device use. In conclusion, novel devices intended to protect the laryngoscopist require objective testing to ensure they are fit for purpose and do not result in increased airborne particle exposure.
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Affiliation(s)
- J P Simpson
- Intensive Care Services and Department of Anaesthesia and Perioperative Medicine, Eastern Health, Melbourne, Victoria, Australia.,Department of Anaesthesia and Perioperative Medicine, Eastern Health, Melbourne, Victoria, Australia
| | - D N Wong
- Department of Anaesthesia and Perioperative Medicine, Eastern Health, Melbourne, Victoria, Australia
| | - L Verco
- Department of Anaesthesia and Perioperative Medicine, Eastern Health, Melbourne, Victoria, Australia
| | - R Carter
- Ascent Vision Systems, Melbourne, Victoria, Australia
| | - M Dzidowski
- Ascent Vision Systems, Melbourne, Victoria, Australia
| | - P Y Chan
- Intensive Care Services and Department of Anaesthesia and Perioperative Medicine, Eastern Health, Melbourne, Victoria, Australia.,Intensive Care Services, Eastern Health, Melbourne, Victoria, Australia
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14
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Wan JCM, Heider K, Gale D, Murphy S, Fisher E, Mouliere F, Ruiz-Valdepenas A, Santonja A, Morris J, Chandrananda D, Marshall A, Gill AB, Chan PY, Barker E, Young G, Cooper WN, Hudecova I, Marass F, Mair R, Brindle KM, Stewart GD, Abraham JE, Caldas C, Rassl DM, Rintoul RC, Alifrangis C, Middleton MR, Gallagher FA, Parkinson C, Durrani A, McDermott U, Smith CG, Massie C, Corrie PG, Rosenfeld N. ctDNA monitoring using patient-specific sequencing and integration of variant reads. Sci Transl Med 2020; 12:eaaz8084. [PMID: 32554709 DOI: 10.1126/scitranslmed.aaz8084] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/10/2020] [Accepted: 05/28/2020] [Indexed: 02/11/2024]
Abstract
Circulating tumor-derived DNA (ctDNA) can be used to monitor cancer dynamics noninvasively. Detection of ctDNA can be challenging in patients with low-volume or residual disease, where plasma contains very few tumor-derived DNA fragments. We show that sensitivity for ctDNA detection in plasma can be improved by analyzing hundreds to thousands of mutations that are first identified by tumor genotyping. We describe the INtegration of VAriant Reads (INVAR) pipeline, which combines custom error-suppression methods and signal-enrichment approaches based on biological features of ctDNA. With this approach, the detection limit in each sample can be estimated independently based on the number of informative reads sequenced across multiple patient-specific loci. We applied INVAR to custom hybrid-capture sequencing data from 176 plasma samples from 105 patients with melanoma, lung, renal, glioma, and breast cancer across both early and advanced disease. By integrating signal across a median of >105 informative reads, ctDNA was routinely quantified to 1 mutant molecule per 100,000, and in some cases with high tumor mutation burden and/or plasma input material, to parts per million. This resulted in median area under the curve (AUC) values of 0.98 in advanced cancers and 0.80 in early-stage and challenging settings for ctDNA detection. We generalized this method to whole-exome and whole-genome sequencing, showing that INVAR may be applied without requiring personalized sequencing panels so long as a tumor mutation list is available. As tumor sequencing becomes increasingly performed, such methods for personalized cancer monitoring may enhance the sensitivity of cancer liquid biopsies.
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Affiliation(s)
- Jonathan C M Wan
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Katrin Heider
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Davina Gale
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Suzanne Murphy
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | - Eyal Fisher
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Florent Mouliere
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pathology, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands
| | - Andrea Ruiz-Valdepenas
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Angela Santonja
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - James Morris
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Dineika Chandrananda
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Andrea Marshall
- Warwick Clinical Trials Unit, University of Warwick, Coventry CV4 7AL, UK
| | - Andrew B Gill
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Pui Ying Chan
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Emily Barker
- Cambridge Clinical Trials Unit-Cancer Theme, Cambridge CB2 0QQ, UK
| | - Gemma Young
- Cambridge Clinical Trials Unit-Cancer Theme, Cambridge CB2 0QQ, UK
| | - Wendy N Cooper
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Irena Hudecova
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Francesco Marass
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Richard Mair
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Kevin M Brindle
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Department of Biochemistry, University of Cambridge, Cambridge CB2 1QW, UK
| | - Grant D Stewart
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Department of Surgery, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Jean E Abraham
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Carlos Caldas
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - Doris M Rassl
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Royal Papworth Hospital NHS Foundation Trust, Cambridge CB2 0AY, UK
| | - Robert C Rintoul
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Royal Papworth Hospital NHS Foundation Trust, Cambridge CB2 0AY, UK
- Department of Oncology, University of Cambridge Hutchison-MRC Research Centre, Box 197, Cambridge Biomedical Campus, Cambridge CB2 0XZ, UK
| | | | - Mark R Middleton
- National Institute for Health Research Biomedical Research Centre, Oxford OX4 2PG, UK
| | - Ferdia A Gallagher
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Pathology, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands
| | | | - Amer Durrani
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
| | | | - Christopher G Smith
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Charles Massie
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
- Department of Oncology, University of Cambridge Hutchison-MRC Research Centre, Box 197, Cambridge Biomedical Campus, Cambridge CB2 0XZ, UK
| | - Pippa G Corrie
- Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
| | - Nitzan Rosenfeld
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK.
- Cancer Research UK Major Centre-Cambridge, Cancer Research UK Cambridge Institute, Li Ka Shing Centre, Robinson Way, Cambridge CB2 0RE, UK
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Chan PY, Perlman SE, Lee DC, Smolen JR, Lim S. Neighborhood-Level Chronic Disease Surveillance: Utility of Primary Care Electronic Health Records and Emergency Department Claims Data. J Public Health Manag Pract 2020; 28:E109-E118. [PMID: 32487918 DOI: 10.1097/phh.0000000000001142] [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: 11/25/2022]
Abstract
CONTEXT Disease burden may vary substantively across neighborhoods in an urban setting. Yet, data available for monitoring chronic conditions at the neighborhood level are scarce. Large health care data sets have potential to complement population health surveillance. Few studies have examined the utility of health care data for neighborhood-level surveillance. OBJECTIVE We examined the use of primary care electronic health records (EHRs) and emergency department (ED) claims for identifying neighborhoods with higher chronic disease burden and neighborhood-level prevalence estimation. DESIGN Comparison of hypertension and diabetes estimates from EHRs and ED claims with survey-based estimates. SETTING Forty-two United Hospital Fund neighborhoods in New York City. PARTICIPANTS The EHR sample comprised 708 452 patients from the Hub Population Health System (the Hub) in 2015, and the ED claim sample comprised 1 567 870 patients from the Statewide Planning and Research Cooperative System in 2015. We derived survey-based estimates from 2012 to 2016 Community Health Survey (n = 44 189). MAIN OUTCOME MEASURE We calculated hypertension and diabetes prevalence estimates by neighborhood from each data source. We obtained Pearson correlation and absolute difference between EHR-based or claims-based estimates and survey-based estimates. RESULTS Both EHR-based and claims-based estimates correlated strongly with survey-based estimates for hypertension (0.91 and 0.72, respectively) and diabetes (0.83 and 0.82, respectively) and identified similar neighborhoods of higher burden. For hypertension, 10 and 17 neighborhoods from the EHRs and ED claims, respectively, had an absolute difference of more than 5 percentage points from the survey-based estimate. For diabetes, 15 and 4 neighborhoods from the EHRs and ED claims, respectively, differed from the survey-based estimate by more than 5 percentage points. CONCLUSIONS Both EHRs and ED claims data are useful for identifying neighborhoods with greater disease burden and have potential for monitoring chronic conditions at the neighborhood level.
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Affiliation(s)
- Pui Ying Chan
- Divisions of Epidemiology (Ms Chan and Perlman and Dr Lim) and Prevention and Primary Care (Ms Smolen), New York City Department of Health and Mental Hygiene, Long Island City, New York; and Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York, New York (Dr Lee)
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Chan PY, Kaba F, Lim S, Katyal M, MacDonald R. Identifying demographic and health profiles of young adults with frequent jail incarceration in New York City during 2011-2017. Ann Epidemiol 2020; 46:41-48.e1. [PMID: 32451196 DOI: 10.1016/j.annepidem.2020.04.006] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/21/2020] [Accepted: 04/26/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of this study was to investigate incarceration patterns among young adults in New York City jails from mid-2011 through 2017, with an aim that identification of frequently incarcerated young "hot spotters" may inform early interventions. METHODS We examined electronic health records for 3114 individuals with no known prior jail admission and admitted within 4.5 years after turning age 18 years. We used group-based trajectory analysis to identify hot spotters and compared their characteristics with those of other trajectory groups. We repeated the analysis for three older adult groups for additional comparison. RESULTS Five percent of the young individuals became hot spotters (mean = 7.7 incarcerations). They were more likely to be homeless (27.1% vs. 7.2%-16.4% in other trajectory groups), have substance use disorders (95.2% vs. 73.2%-89.8%), and mental health needs (65.7% vs. 28.5%-53.3%), and be incarcerated for theft-related charges (52.7% vs. 32.0%-49.6%) and misdemeanors (34.8 vs. 25.5%-29.4%). They differed in charge profile and homelessness compared with older hot spotters. CONCLUSIONS Some young adults are at risk of frequent incarceration. Tailored health- and behavior-related interventions may preclude cyclical incarceration and address barriers to well-being and stability.
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Affiliation(s)
- Pui Ying Chan
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY.
| | - Fatos Kaba
- Correctional Health Services, New York City Health + Hospitals, New York, NY
| | - Sungwoo Lim
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY
| | - Monica Katyal
- Correctional Health Services, New York City Health + Hospitals, New York, NY
| | - Ross MacDonald
- Correctional Health Services, New York City Health + Hospitals, New York, NY
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Abstract
Introduction: Suicide attempts by poisoning are increasing and suicide occurrence may be associated with seasonality. We performed a retrospective analysis of poisoning exposure data from a single Poison Control Center (PCC) to determine if suicide attempts were associated with season, day of the week, and/or US holidays.Methods: We analyzed exposure cases identified as "intentional overdose - suspected suicide attempt" over 2009-2012. We used singular spectrum analysis (SSA) to detect cyclic patterns in the data and then performed Poisson regression and t-tests to determine if the number of cases were associated with season, day of the week, and US holidays.Results: There were 42,578 cases of "intentional overdose - suspected suicide" during the study period. Singular Spectrum Analysis (SSA) showed that the number of cases associated with poisoning suicide attempts peaked in the Spring and dipped in the Fall. Regression analysis showed higher numbers of suspected suicide attempts from intentional overdose in spring compared with winter by 1.07 times (p = 0.003), and on Sunday (p < 0.001), Monday (p < 0.001), and Thursday (p = 0.02) compared with Saturday by at least 1.09 times. No significant difference was seen for most holidays except for lower numbers of cases around Christmas (3 days before and after; 22.0 vs. 32.3 on control dates, p < 0.001).Conclusions: Suicide attempts by poisoning are associated with season of the year and some days of the week. Further research is required determine reasons for these associations and implementation of public health interventions.
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Affiliation(s)
- Mark K Su
- New York City Poison Control Center, New York, NY, USA.,Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, NY, USA
| | - Pui Ying Chan
- Bureau of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Robert S Hoffman
- Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU School of Medicine, New York, NY, USA
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Wimalasingham AG, Phillips MM, Lim L, Rashid S, Hall PE, Khadeir R, Steele JPC, Conibear J, Feng X, Ellis S, Chan PY, Thomson J, Johnston AL, Bomalaski JS, Pacey S, Sheaff M, Szlosarek PW. Phase 1 dose-expansion study of pegylated arginine deiminase, cisplatin, and pemetrexed in patients with argininosuccinate synthetase 1 (ASS1)–deficient non-squamous non-small cell lung cancer. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.9097] [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
9097 Background: Pegylated arginine deiminase (ADI-PEG20) targets ASS1-ve tumors, including non–small-cell lung cancer (NSCLC), by potentiating pemetrexed cytotoxicity via arginine depletion. In Beddowes et al (JCO 2017) we showed a 100% disease control rate in thoracic cancers treated with ADI-PEG20, cisplatin and pemetrexed (ADIPemCis). Thus, we tested ADIPemCis in a phase I dose-expansion cohort study of patients (pts) with non-squamous NSCLC. Methods: Good performance (ECOG 0-1) advanced non-squamous NSCLC pts were enrolled at the maximum tolerated dose (MTD) of ADIPemCis, using tumoral ASS1 loss as a selection biomarker. Pem (500mg/m2) and Cis (75mg/m2) were given every 3 weeks with weekly IM ADI-PEG20 (36mg/m2) for up to 4 cycles with maintenance ADI-PEG20 or Pem in responding pts. Primary endpoint was tumor response rate (RR by RECIST 1.1), with secondary endpoints including progression-free survival (PFS), overall survival (OS), and toxicity. We also measured plasma [arginine] and [citrulline], anti-ADI-PEG20 antibodies, and PD-L1 expression. Results: 21 of 70 screened pts (median age 60.1) were enrolled between April 15 and August 17. A confirmed partial response (PR) was observed in 55.6 % (n = 10/18 evaluable pts). Median PFS and OS were 4 months (95% CI 2.9-4.8) and 7.2 months (95% CI 5.1-18.4), respectively. 9% (n = 2/21) remain alive on subsequent therapies. 43% (n = 9/21) experienced grade 3/4 treatment-related toxicities, commonly non-febrile neutropenia. Plasma [arginine] declined rapidly and [citrulline] increased; both changes persisted at 16 weeks. 55% of pts’ tumors (n = 6/11 ) were PD-L1 < 1% by immunohistochemistry. Conclusions: The ADIPemCis regimen is active and safe in ASS1-ve NSCLC pts almost doubling the expected RR. However, the short survival compared with ASS1-agnostic historical controls indicates that ASS1 (and frequent PD-L1) loss selects for a biologically more aggressive and immunorefractory NSCLC phenotype. The iTRAP study opening Q2 of 2019 will assess the safety and tolerability of ADIPemPlatinum(Carbo) with atezolizumab in pts with ASS1-deficient non-squamous NSCLC. Clinical trial information: NCT02029690.
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Affiliation(s)
| | | | - Louise Lim
- Barts Health NHS Trust, London, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | | - Simon Pacey
- University of Cambridge, Cambridge, United Kingdom
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Terashima S, Yu L, Ong HJ, Tanihata I, Adachi S, Aoi N, Chan PY, Fujioka H, Fukuda M, Geissel H, Gey G, Golak J, Haettner E, Iwamoto C, Kawabata T, Kamada H, Le XY, Sakaguchi H, Sakaue A, Scheidenberger C, Skibiński R, Sun BH, Tamii A, Tang TL, Tran DT, Topolnicki K, Wang TF, Watanabe YN, Weick H, Witała H, Zhang GX, Zhu LH. Dominance of Tensor Correlations in High-Momentum Nucleon Pairs Studied by (p,pd) Reaction. Phys Rev Lett 2018; 121:242501. [PMID: 30608744 DOI: 10.1103/physrevlett.121.242501] [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: 09/07/2018] [Indexed: 06/09/2023]
Abstract
The isospin character of p-n pairs at large relative momentum has been observed for the first time in the ^{16}O ground state. A strong population of the J,T=1,0 state and a very weak population of the J,T=0,1 state were observed in the neutron pickup domain of ^{16}O(p,pd) at 392 MeV. This strong isospin dependence at large momentum transfer is not reproduced by the distorted-wave impulse approximation calculations with known spectroscopic amplitudes. The results indicate the presence of high-momentum protons and neutrons induced by the tensor interactions in the ground state of ^{16}O.
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Affiliation(s)
- S Terashima
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191 Beijing, China
- International Research Center for Nuclei and Particles in Cosmos, Beihang University, 100191 Beijing, China
| | - L Yu
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191 Beijing, China
| | - H J Ong
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - I Tanihata
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191 Beijing, China
- International Research Center for Nuclei and Particles in Cosmos, Beihang University, 100191 Beijing, China
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - S Adachi
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - N Aoi
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - P Y Chan
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - H Fujioka
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - M Fukuda
- Department of Physics, Osaka University, 1-5 Machikaneyama-cho, Toyonaka, Osaka 560-0043, Japan
| | - H Geissel
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planskstraße 1, 64291 Darmstadt, Germany
- Justus-Liebig-Universität Gießen, Heinrich-Buff-Ring 16, 35392 Gießen, Germany
| | - G Gey
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - J Golak
- M. Smoluchowski Institute of Physics, Jagiellonian University, PL-30348 Kraków, Poland
| | - E Haettner
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planskstraße 1, 64291 Darmstadt, Germany
- Justus-Liebig-Universität Gießen, Heinrich-Buff-Ring 16, 35392 Gießen, Germany
| | - C Iwamoto
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - T Kawabata
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - H Kamada
- Department of Physics, Faculty of Engineering, Kyushu Institute of Technology, Kitakyushu 804-8550, Japan
| | - X Y Le
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191 Beijing, China
- International Research Center for Nuclei and Particles in Cosmos, Beihang University, 100191 Beijing, China
| | - H Sakaguchi
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - A Sakaue
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - C Scheidenberger
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planskstraße 1, 64291 Darmstadt, Germany
- Justus-Liebig-Universität Gießen, Heinrich-Buff-Ring 16, 35392 Gießen, Germany
| | - R Skibiński
- M. Smoluchowski Institute of Physics, Jagiellonian University, PL-30348 Kraków, Poland
| | - B H Sun
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191 Beijing, China
- International Research Center for Nuclei and Particles in Cosmos, Beihang University, 100191 Beijing, China
- Beijing Advanced Innovation Center for Big Data based Precision Medicine, Beihang University, 100083 Beijing, China
| | - A Tamii
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - T L Tang
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - D T Tran
- RCNP, Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
- Institute of Physics, Vietnam Academy of Science and Technology, Hanoi 100000, Vietnam
| | - K Topolnicki
- M. Smoluchowski Institute of Physics, Jagiellonian University, PL-30348 Kraków, Poland
| | - T F Wang
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191 Beijing, China
- International Research Center for Nuclei and Particles in Cosmos, Beihang University, 100191 Beijing, China
| | - Y N Watanabe
- Department of Physics, University of Tokyo, Tokyo 113-0033, Japan
| | - H Weick
- GSI Helmholtzzentrum für Schwerionenforschung GmbH, Planskstraße 1, 64291 Darmstadt, Germany
| | - H Witała
- M. Smoluchowski Institute of Physics, Jagiellonian University, PL-30348 Kraków, Poland
| | - G X Zhang
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191 Beijing, China
- International Research Center for Nuclei and Particles in Cosmos, Beihang University, 100191 Beijing, China
| | - L H Zhu
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191 Beijing, China
- International Research Center for Nuclei and Particles in Cosmos, Beihang University, 100191 Beijing, China
- Beijing Advanced Innovation Center for Big Data based Precision Medicine, Beihang University, 100083 Beijing, China
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Chan PY, Zhao Y, Lim S, Perlman SE, McVeigh KH. Using Calibration to Reduce Measurement Error in Prevalence Estimates Based on Electronic Health Records. Prev Chronic Dis 2018; 15:E155. [PMID: 30576279 PMCID: PMC6307836 DOI: 10.5888/pcd15.180371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Increasing adoption of electronic health record (EHR) systems by health care providers presents an opportunity for EHR-based population health surveillance. EHR data, however, may be subject to measurement error because of factors such as data entry errors and lack of documentation by physicians. We investigated the use of a calibration model to reduce bias of prevalence estimates from the New York City (NYC) Macroscope, an EHR-based surveillance system. METHODS We calibrated 6 health indicators to the 2013-2014 NYC Health and Nutrition Examination Survey (NYC HANES) data: hypertension, diabetes, smoking, obesity, influenza vaccination, and depression. We classified indicators into having low measurement error or high measurement error on the basis of whether the proportion of misclassification (ie, false-negative or false-positive cases) was greater than 15% in 190 reviewed charts. We compared bias (ie, absolute difference between NYC Macroscope estimates and NYC HANES estimates) before and after calibration. RESULTS The health indicators with low measurement error had the same bias after calibration as before calibration (diabetes, 2.5 percentage points; smoking, 2.5 percentage points; obesity, 3.5 percentage points; hypertension, 1.1 percentage points). For indicators with high measurement error, bias decreased from 10.8 to 2.5 percentage points for depression, and from 26.7 to 8.4 percentage points for influenza vaccination. CONCLUSION The calibration model has the potential to reduce bias of prevalence estimates from EHR-based surveillance systems for indicators with high measurement errors. Further research is warranted to assess the utility of the current calibration model for other EHR data and additional indicators.
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Affiliation(s)
- Pui Ying Chan
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, New York.,42-09 28th St, CN# 07-099, Long Island City, NY 11101.
| | - Yihong Zhao
- Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Massachusetts
| | - Sungwoo Lim
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Sharon E Perlman
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Katharine H McVeigh
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, Long Island City, New York
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Choi AWM, Chan PY, Lo RTF, Wong LCL, Wong JYH, Tang DHM. Freeing Chinese Abused Women From Stereotype: A Pretest-Posttest Comparison Study on Group Intervention in Refuge Centers. ACTA ACUST UNITED AC 2018; 15:599-616. [PMID: 30142306 DOI: 10.1080/23761407.2018.1509409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The efficacy of heal-change group (HCG) intervention-brief trauma-recovery group intervention applying a gender-specific cognitive behavioral approach-for Chinese-abused women in refuge centers was examined in a pretest-posttest comparison study. METHODS A total of 100 women at three refuge centers in Hong Kong participated. Among them, 50 women from two centers joined the HCG and 50 women from the remaining center participated in a comparison mutual support group. Participants and interviewers were blinded to the group assignment. Both groups were six sessions long. Linear regression analyses were performed using the intention-to-treat framework. RESULTS Significant improvements in PTSD symptoms (overall mean change of -1.6, p < .001; subdomain scores; p < .001 to < .01) and depressive symptoms (BDI-II mean change; p < .01) were recorded in the intervention group. CONCLUSION The results suggest HCG is beneficial to Chinese-abused women. Further research is needed to determine the intervention's effectiveness in improving longer-term outcomes in these women.
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Affiliation(s)
- Anna W M Choi
- a Department of Social and Behavioural Sciences , City University of Hong Kong , Hong Kong SAR
| | - P Y Chan
- b Department of Social Work and Social Administration , The University of Hong Kong , Hong Kong SAR
| | - Ruby T F Lo
- b Department of Social Work and Social Administration , The University of Hong Kong , Hong Kong SAR
| | - Liz C L Wong
- b Department of Social Work and Social Administration , The University of Hong Kong , Hong Kong SAR
| | - Janet Y H Wong
- c School of Nursing, Li Ka Shing Faculty of Medicine , The University of Hong Kong, Hong Kong SAR
| | - Debbie H M Tang
- d Integrated Family Services (Family Crisis Support) , Po Leung Kuk, Hong Kong SAR
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Chan PY, Phillips MM, Khadeir R, Ellis S, Thomson J, Johnston A, Feng X, Wu BW, Bomalaski JS, Sheaff M, Szlosarek PW. Phase 1 study of pegargiminase combined with cisplatin and pemetrexed in patients with ASS1-deficient uveal melanoma. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.2589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Ramsay Khadeir
- Queen Mary, University of London, London, United Kingdom
| | | | | | | | | | - Bor-Wen Wu
- Polaris Pharmaceuticals Inc., San Diego, CA
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Tran DT, Ong HJ, Hagen G, Morris TD, Aoi N, Suzuki T, Kanada-En'yo Y, Geng LS, Terashima S, Tanihata I, Nguyen TT, Ayyad Y, Chan PY, Fukuda M, Geissel H, Harakeh MN, Hashimoto T, Hoang TH, Ideguchi E, Inoue A, Jansen GR, Kanungo R, Kawabata T, Khiem LH, Lin WP, Matsuta K, Mihara M, Momota S, Nagae D, Nguyen ND, Nishimura D, Otsuka T, Ozawa A, Ren PP, Sakaguchi H, Scheidenberger C, Tanaka J, Takechi M, Wada R, Yamamoto T. Evidence for prevalent Z = 6 magic number in neutron-rich carbon isotopes. Nat Commun 2018; 9:1594. [PMID: 29686394 PMCID: PMC5913314 DOI: 10.1038/s41467-018-04024-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 03/28/2018] [Indexed: 11/08/2022] Open
Abstract
The nuclear shell structure, which originates in the nearly independent motion of nucleons in an average potential, provides an important guide for our understanding of nuclear structure and the underlying nuclear forces. Its most remarkable fingerprint is the existence of the so-called magic numbers of protons and neutrons associated with extra stability. Although the introduction of a phenomenological spin-orbit (SO) coupling force in 1949 helped in explaining the magic numbers, its origins are still open questions. Here, we present experimental evidence for the smallest SO-originated magic number (subshell closure) at the proton number six in 13-20C obtained from systematic analysis of point-proton distribution radii, electromagnetic transition rates and atomic masses of light nuclei. Performing ab initio calculations on 14,15C, we show that the observed proton distribution radii and subshell closure can be explained by the state-of-the-art nuclear theory with chiral nucleon-nucleon and three-nucleon forces, which are rooted in the quantum chromodynamics.
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Affiliation(s)
- D T Tran
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
- Institute of Physics, Vietnam Academy of Science and Technology, Hanoi, 10000, Vietnam
| | - H J Ong
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan.
| | - G Hagen
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
- Department of Physics and Astronomy, University of Tennessee, Knoxville, TN, 37996, USA
| | - T D Morris
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
- Department of Physics and Astronomy, University of Tennessee, Knoxville, TN, 37996, USA
| | - N Aoi
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
| | - T Suzuki
- Department of Physics, College of Humanities and Sciences, Nihon University, Tokyo, 156-8550, Japan
- National Astronomical Observatory of Japan, Tokyo, 181-8588, Japan
| | - Y Kanada-En'yo
- Department of Physics, Kyoto University, Kyoto, 606-8502, Japan
| | - L S Geng
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191, Beijing, China
| | - S Terashima
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191, Beijing, China
| | - I Tanihata
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
- School of Physics and Nuclear Energy Engineering, Beihang University, 100191, Beijing, China
| | - T T Nguyen
- Pham Ngoc Thach University of Medicine, Ho Chi Minh, 700000, Vietnam
- Faculty of Physics and Engineering, VNUHCM-University of Science, Ho Chi Minh City, 70250, Vietnam
- Sungkyunkwan University, Gyeonggi-do, 16419, South Korea
| | - Y Ayyad
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
| | - P Y Chan
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
| | - M Fukuda
- Department of Physics, Osaka University, Osaka, 560-0043, Japan
| | - H Geissel
- GSI Helmholtzzentrum für Schwerionenforschung, 64291, Darmstadt, Germany
- Justus Liebig University, 35392, Giessen, Germany
| | - M N Harakeh
- GSI Helmholtzzentrum für Schwerionenforschung, 64291, Darmstadt, Germany
- KVI Center for Advanced Radiation Technology, University of Groningen, 9747 AA, Groningen, The Netherlands
| | - T Hashimoto
- Rare Isotope Science Project, Institute for Basic Science, Daejeon, 34047, Korea
| | - T H Hoang
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
- Institute of Physics, Vietnam Academy of Science and Technology, Hanoi, 10000, Vietnam
| | - E Ideguchi
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
| | - A Inoue
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
| | - G R Jansen
- Physics Division, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
- National Center for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - R Kanungo
- Astronomy and Physics Department, Saint Mary's University, Halifax, NS, B3H 3C3, Canada
| | - T Kawabata
- Department of Physics, Kyoto University, Kyoto, 606-8502, Japan
| | - L H Khiem
- Institute of Physics, Vietnam Academy of Science and Technology, Hanoi, 10000, Vietnam
| | - W P Lin
- Institute of Modern Physics, Chinese Academy of Sciences, 730000, Lanzhou, China
| | - K Matsuta
- Department of Physics, Osaka University, Osaka, 560-0043, Japan
| | - M Mihara
- Department of Physics, Osaka University, Osaka, 560-0043, Japan
| | - S Momota
- Kochi University of Technology, Kochi, 782-8502, Japan
| | - D Nagae
- RIKEN Nishina Center, Saitama, 351-0198, Japan
| | - N D Nguyen
- Dong Nai University, Dong Nai, 81000, Vietnam
| | - D Nishimura
- Tokyo University of Science, Chiba, 278-8510, Japan
| | - T Otsuka
- Department of Physics, University of Tokyo, Tokyo, 113-0033, Japan
| | - A Ozawa
- Institute of Physics, University of Tsukuba, Ibaraki, 305-8571, Japan
| | - P P Ren
- Institute of Modern Physics, Chinese Academy of Sciences, 730000, Lanzhou, China
| | - H Sakaguchi
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
| | - C Scheidenberger
- GSI Helmholtzzentrum für Schwerionenforschung, 64291, Darmstadt, Germany
- Justus Liebig University, 35392, Giessen, Germany
| | - J Tanaka
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
| | - M Takechi
- Department of Physics, Niigata University, Niigata, 950-2181, Japan
| | - R Wada
- Institute of Modern Physics, Chinese Academy of Sciences, 730000, Lanzhou, China
- Cyclotron Institute, Texas A&M University, College Station, TX, 77840, USA
| | - T Yamamoto
- Research Center for Nuclear Physics, Osaka University, Osaka, 567-0047, Japan
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24
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Ng TW, Chan PY, Chan TT, Wu H, Lai KM. Skin squames contribute to ammonia and volatile fatty acid production from bacteria colonizing in air-cooling units with odor complaints. Indoor Air 2018; 28:258-265. [PMID: 29130534 DOI: 10.1111/ina.12439] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 11/05/2017] [Indexed: 06/07/2023]
Abstract
One of the most notable Indoor Air Quality problems is odor emission. This study investigated the potential contribution of skin squames to the production of ammonia (NH3 ) and volatile organic acids (VFAs) by 7 bacteria isolated from air-cooling (AC) units with complaints of urine and body odors. Our previous study showed that keratinolytic activity is higher in AC units with odor complaints than those without. In the offices where these units are located, the most likely source of keratins is from human skin squames. Most bacteria can produce NH3 and VFAs in the skin squame culture. Some correlations between the levels of NH3 , NH4+, VFAs, and keratinolytic activity were found. The odor production pathway with skin squames was proposed. Staphylococcus haemolyticus was abundant in the AC units with odor problems and had a high level of keratinolytic activity in addition to odor production. For long-term odor control, it is important to reduce the level of skin squames entering the AC units.
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Affiliation(s)
- T W Ng
- Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong Special Administrative Region, China
| | - P Y Chan
- Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong Special Administrative Region, China
| | - T T Chan
- Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong Special Administrative Region, China
| | - H Wu
- Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong Special Administrative Region, China
| | - K M Lai
- Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong Special Administrative Region, China
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25
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Lim S, Chan PY, Walters S, Culp G, Huynh M, Gould LH. Impact of residential displacement on healthcare access and mental health among original residents of gentrifying neighborhoods in New York City. PLoS One 2017; 12:e0190139. [PMID: 29272306 PMCID: PMC5741227 DOI: 10.1371/journal.pone.0190139] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 12/09/2017] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES As gentrification continues in New York City as well as other urban areas, residents of lower socioeconomic status maybe at higher risk for residential displacement. Yet, there have been few quantitative assessments of the health impacts of displacement. The objective of this paper is to assess the association between displacement and healthcare access and mental health among the original residents of gentrifying neighborhoods in New York City. METHODS We used 2 data sources: 1) 2005-2014 American Community Surveys to identify gentrifying neighborhoods in New York City, and 2) 2006-2014 Statewide Planning and Research Cooperative System. Our cohort included 12,882 residents of gentrifying neighborhoods in 2006 who had records of emergency department visits or hospitalization at least once every 2 years in 2006-2014. Rates of emergency department visits and hospitalizations post-baseline were compared between residents who were displaced and those who remained. RESULTS During 2006-2014, 23% were displaced. Compared with those who remained, displaced residents were more likely to make emergency department visits and experience hospitalizations, mainly due to mental health (Rate Ratio = 1.8, 95% confidence interval = 1.5, 2.2), after controlling for baseline demographics, health status, healthcare utilization, residential movement, and the neighborhood of residence in 2006. CONCLUSIONS These findings suggest negative impacts of displacement on healthcare access and mental health, particularly among adults living in urban areas and with a history of frequent emergency department visits or hospitalizations.
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Affiliation(s)
- Sungwoo Lim
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
- * E-mail:
| | - Pui Ying Chan
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
| | - Sarah Walters
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
| | - Gretchen Culp
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
| | - Mary Huynh
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
| | - L. Hannah Gould
- Division of Epidemiology, New York City Department of Health and Mental Hygiene, Queens, New York, United States of America
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26
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Tai PH, Lau WS, Chan PY, Ng SY, Lam YC, Mak HT, Mak YT. Nurse Performed Ultrasonography in Confirming the Position of Nasogastric Tube in the Emergency Department: A Prospective Single Group Diagnostic Test Study. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791602300603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction Emergency nurses often encounter patients with nasogastric tube (NGT) dislodgements who require reinsertion. Empirical evidence supporting the use of ultrasonography in verifying the position of NGT in local accident and emergency departments (AED) is scanty. There is also a lack of validation of nurse performed ultrasonography in Hong Kong. With the support from hospitals and medical personnel, a prospective, single group diagnostic test study was conducted to review the possibility of nurse performed ultrasonography in verifying the position of NGT in AED. Methods This study was conducted in the AED of three local hospitals. Investigators with specific ultrasound training performed ultrasonography scans to the subjects in addition to conventional pH test and “whoosh” test. Results were compared with chest or abdominal X-ray for evaluation of accuracies. Results This study confirmed a high sensitivity and specificity of nurse performed ultrasonography in confirming the position of NGT in the AED. The high positive predictive value and positive likelihood ratio supported the confirmation of NGT position by bedside ultrasound. The high specificities and minimal negative likelihood ratios of ultrasonography tests also suggested the application of bedside ultrasound in ruling out patients with misplaced NGTs. Conclusions Nurse performed ultrasonography allows immediate bedside confirmation of the position of NGT in the overcrowded AED. Considered the limitations of conventional methods, nurse performed ultrasonography can be incorporated into daily practice for providing extra evidence for the confirmation of NGT position.
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Affiliation(s)
| | | | - PY Chan
- Yan Chai Hospital, Accident and Emergency Department, 7-11 Yan Chai Street, Tsuen Wan, N.T., Hong Kong
| | - SY Ng
- Yan Chai Hospital, Accident and Emergency Department, 7-11 Yan Chai Street, Tsuen Wan, N.T., Hong Kong
| | - YC Lam
- Tseung Kwan O Hospital, Accident and Emergency Department, 2 Po Ning Lane, Hang Hau, Tseung Kwan O, N.T., Hong Kong
| | - HT Mak
- Tseung Kwan O Hospital, Accident and Emergency Department, 2 Po Ning Lane, Hang Hau, Tseung Kwan O, N.T., Hong Kong
| | - YT Mak
- Tseung Kwan O Hospital, Accident and Emergency Department, 2 Po Ning Lane, Hang Hau, Tseung Kwan O, N.T., Hong Kong
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27
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Xu L, Mao X, Guo T, Chan PY, Shaw G, Hines J, Stankiewicz E, Wang Y, Oliver RTD, Ahmad AS, Berney D, Shamash J, Lu YJ. The Novel Association of Circulating Tumor Cells and Circulating Megakaryocytes with Prostate Cancer Prognosis. Clin Cancer Res 2017; 23:5112-5122. [PMID: 28615267 DOI: 10.1158/1078-0432.ccr-16-3081] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/10/2017] [Accepted: 06/07/2017] [Indexed: 11/16/2022]
Abstract
Purpose: To develop an approach for the investigation of different subtypes of circulating tumor cells (CTC) and other cells to evaluate their potential prognostic value of prostate cancer.Experimental Design: Malignancy of CTCs undergoing epithelial-to-mesenchymal transition (EMT) was confirmed by repeated FISH. Subgroups of CTCs in 81 patients with prostate cancer (43 castration resistant and 38 untreated localized) were correlated to disease aggressiveness parameters. AUC analysis was applied to compare the performance for metastasis prediction between serum PSA level alone and a combined risk score using both PSA and EMTing CTC count. Circulating megakaryocytes and cancer patient survival association was performed using Cox model.Results: The majority of vimentin (VIM)+/CD45- cells were malignant, with genomic alterations in several genomic regions. The number of cytokeratin (CK)-/VIM+/CD45- CTCs correlated with disease burden, tumor aggressiveness, and poorer survival. Meanwhile, CK+/VIM+/CD45- CTCs were associated with metastases better than other subtypes of CTCs in these limited samples. Combination of PSA level and the number of CK+/VIM+/CD45- CTCs enhanced the prediction of cancer metastases [AUC, 0.921; 95% confidence interval (CI), 0.858-0.985]. The number of circulating megakaryocytes was potentially associated with good patient survival in advanced prostate cancer (HR, 0.849; 95% CI, 0.628-1.146, per cell increase), and the difference between the number of mesenchymal CTCs and megakaryocytes strongly correlated to poor survival (HR, 10.17; 95% CI, 2.164-47.789, if score ≥2.0).Conclusions: This CTC analysis approach and the potential association of megakaryocytes with cancer prognosis may greatly enhance our ability to investigate the cancer metastasis process and to predict/monitor cancer progression. Clin Cancer Res; 23(17); 5112-22. ©2017 AACR.
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Affiliation(s)
- Lei Xu
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom.,Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xueying Mao
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Tianyu Guo
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Pui Ying Chan
- Department of Medical Oncology, Barts Health NHS, London, United Kingdom
| | - Greg Shaw
- Department of Urology, Barts Health NHS, London, United Kingdom
| | - John Hines
- Department of Urology, Barts Health NHS, London, United Kingdom
| | - Elzbieta Stankiewicz
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Yuqin Wang
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - R Tim D Oliver
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Amar Sabri Ahmad
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Daniel Berney
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Jonathan Shamash
- Department of Medical Oncology, Barts Health NHS, London, United Kingdom
| | - Yong-Jie Lu
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom.
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28
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Chan PY, Hall P, Hay G, Cohen VML, Szlosarek PW. A major responder to ipilimumab and nivolumab in metastatic uveal melanoma with concomitant autoimmunity. Pigment Cell Melanoma Res 2017. [PMID: 28640512 DOI: 10.1111/pcmr.12607] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The use of immune checkpoint inhibition has led to major improvements in outcome for patients with metastatic cutaneous melanoma. The combination of ipilimumab and nivolumab has demonstrated greater activity over single-agent immunotherapy in phase III trials. Clinical trials of combination CTLA-4 and PD-1 inhibition are underway in uveal melanoma, for which there are currently no data. Here, we present the case of a 74-year-old male patient with metastatic uveal melanoma, who was treated with a combination of ipilimumab and nivolumab. He developed sequential autoimmune transaminitis, diabetes and uveitis, which necessitated discontinuation of maintenance nivolumab 3 months after commencement of treatment. The patient continues to demonstrate an ongoing partial response 10 months from the initial combination immunotherapy, with the evidence of depigmentation of the primary ocular tumour.
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Affiliation(s)
- Pui Ying Chan
- Department of Medical Oncology, St Bartholomew's Hospital, London, UK
| | - Peter Hall
- Department of Medical Oncology, St Bartholomew's Hospital, London, UK
| | - Gordon Hay
- Department of Ocular Oncology, Moorfields Eye Hospital, London, UK.,UCL Institute of Ophthalmology, London, UK
| | - Victoria M L Cohen
- Department of Ocular Oncology, Moorfields Eye Hospital, London, UK.,Department of Ocular Oncology, St Bartholomew's Hospital, London, UK
| | - Peter W Szlosarek
- Department of Medical Oncology, St Bartholomew's Hospital, London, UK.,Centre for Molecular Oncology, Barts Cancer Institute, London, UK
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29
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Tatem KS, Romo ML, McVeigh KH, Chan PY, Lurie-Moroni E, Thorpe LE, Perlman SE. Comparing Prevalence Estimates From Population-Based Surveys to Inform Surveillance Using Electronic Health Records. Prev Chronic Dis 2017; 14:E44. [PMID: 28595032 PMCID: PMC5467464 DOI: 10.5888/pcd14.160516] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Electronic health record (EHR) systems provide an opportunity to use a novel data source for population health surveillance. Validation studies that compare prevalence estimates from EHRs and surveys most often use difference testing, which can, because of large sample sizes, lead to detection of significant differences that are not meaningful. We explored a novel application of the two one-sided t test (TOST) to assess the equivalence of prevalence estimates in 2 population-based surveys to inform margin selection for validating EHR-based surveillance prevalence estimates derived from large samples. METHODS We compared prevalence estimates of health indicators in the 2013 Community Health Survey (CHS) and the 2013-2014 New York City Health and Nutrition Examination Survey (NYC HANES) by using TOST, a 2-tailed t test, and other goodness-of-fit measures. RESULTS A ±5 percentage-point equivalence margin for a TOST performed well for most health indicators. For health indicators with a prevalence estimate of less than 10% (extreme obesity [CHS, 3.5%; NYC HANES, 5.1%] and serious psychological distress [CHS, 5.2%; NYC HANES, 4.8%]), a ±2.5 percentage-point margin was more consistent with other goodness-of-fit measures than the larger percentage-point margins. CONCLUSION A TOST with a ±5 percentage-point margin was useful in establishing equivalence, but a ±2.5 percentage-point margin may be appropriate for health indicators with a prevalence estimate of less than 10%. Equivalence testing can guide future efforts to validate EHR data.
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Affiliation(s)
- Kathleen S Tatem
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Matthew L Romo
- New York City Department of Health and Mental Hygiene, Long Island City, New York
- City University of New York School of Public Health, New York, New York
| | - Katharine H McVeigh
- Division of Family and Child Health, New York City Department of Health and Mental Hygiene, 42-09 28th St, CN 24, Long Island City, New York 11101-4132.
| | - Pui Ying Chan
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | | | - Lorna E Thorpe
- City University of New York School of Public Health, New York, New York
- New York University School of Medicine, Department of Population Health, New York, New York
| | - Sharon E Perlman
- New York City Department of Health and Mental Hygiene, Long Island City, New York
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30
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Beddowes E, Spicer J, Chan PY, Khadeir R, Corbacho JG, Repana D, Steele JP, Schmid P, Szyszko T, Cook G, Diaz M, Feng X, Johnston A, Thomson J, Sheaff M, Wu BW, Bomalaski J, Pacey S, Szlosarek PW. Phase 1 Dose-Escalation Study of Pegylated Arginine Deiminase, Cisplatin, and Pemetrexed in Patients With Argininosuccinate Synthetase 1-Deficient Thoracic Cancers. J Clin Oncol 2017; 35:1778-1785. [PMID: 28388291 PMCID: PMC6141244 DOI: 10.1200/jco.2016.71.3230] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [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] [Indexed: 12/29/2022] Open
Abstract
Purpose Pegylated arginine deiminase (ADI-PEG 20) depletes essential amino acid levels in argininosuccinate synthetase 1 (ASS1) -negative tumors by converting arginine to citrulline and ammonia. The main aim of this study was to determine the recommended dose, safety, and tolerability of ADI-PEG 20, cisplatin, and pemetrexed in patients with ASS1-deficient malignant pleural mesothelioma (MPM) or non-small-cell lung cancer (NSCLC). Patients and Methods Using a 3 + 3 + 3 dose-escalation study, nine chemotherapy-naïve patients (five MPM, four NSCLC) received weekly ADI-PEG 20 doses of 18 mg/m2, 27 mg/m2, or 36 mg/m2, together with pemetrexed 500 mg/m2 and cisplatin 75 mg/m2 which were given every three weeks (maximum of six cycles). Patients achieving stable disease or better could continue ADI-PEG 20 monotherapy until disease progression or withdrawal. Adverse events were assessed by Common Terminology Criteria for Adverse Events version 4.03, and pharmacodynamics and immunogenicity were also evaluated. Tumor response was assessed by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 for NSCLC and by modified RECIST criteria for MPM. Results No dose-limiting toxicities were reported; nine of 38 reported adverse events (all grade 1 or 2) were related to ADI-PEG 20. Circulating arginine concentrations declined rapidly, and citrulline levels increased; both changes persisted at 18 weeks. Partial responses were observed in seven of nine patients (78%), including three with either sarcomatoid or biphasic MPM. Conclusion Target engagement with depletion of arginine was maintained throughout treatment with no dose-limiting toxicities. In this biomarker-selected group of patients with ASS1-deficient cancers, clinical activity was observed in patients with poor-prognosis tumors. Therefore, we recommend a dose for future studies of weekly ADI-PEG 20 36 mg/m2 plus three-weekly cisplatin 75 mg/m2 and pemetrexed 500 mg/m2.
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Affiliation(s)
- Emma Beddowes
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - James Spicer
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Pui Ying Chan
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Ramsay Khadeir
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Javier Garcia Corbacho
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Dimitra Repana
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Jeremy P. Steele
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Peter Schmid
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Teresa Szyszko
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Gary Cook
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Monica Diaz
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Xiaoxing Feng
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Amanda Johnston
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Jim Thomson
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Michael Sheaff
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Bor-Wen Wu
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - John Bomalaski
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Simon Pacey
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
| | - Peter W. Szlosarek
- Emma Beddowes, Javier Garcia Corbacho, and Simon Pacey, University of Cambridge, Cambridge; James Spicer, Dimitra Repana, Teresa Szyszko, and Gary Cook, King's College London; Pui Ying Chan, Jeremy P. Steele, Peter Schmid, Michael Sheaff, and Peter W. Szlosarek, St Bartholomew’s Hospital; Ramsay Khadeir, Peter Schmid, and Peter W. Szlosarek, Queen Mary University of London, London, United Kindgom; and Monica Diaz, Xiaoxing Feng, Amanda Johnston, Jim Thomson, Bor-Wen Wu, and John Bomalaski, Polaris Pharmaceuticals, San Diego, CA
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McVeigh KH, Newton-Dame R, Chan PY, Thorpe LE, Schreibstein L, Tatem KS, Chernov C, Lurie-Moroni E, Perlman SE. Can Electronic Health Records Be Used for Population Health Surveillance? Validating Population Health Metrics Against Established Survey Data. EGEMS (Wash DC) 2016; 4:1267. [PMID: 28154837 PMCID: PMC5226379 DOI: 10.13063/2327-9214.1267] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Electronic health records (EHRs) offer potential for population health surveillance but EHR-based surveillance measures require validation prior to use. We assessed the validity of obesity, smoking, depression, and influenza vaccination indicators from a new EHR surveillance system, the New York City (NYC) Macroscope. This report is the second in a 3-part series describing the development and validation of the NYC Macroscope. The first report describes in detail the infrastructure underlying the NYC Macroscope; design decisions that were made to maximize data quality; characteristics of the population sampled; completeness of data collected; and lessons learned from doing this work. This second report, which addresses concerns related to sampling bias and data quality, describes the methods used to evaluate the validity and robustness of NYC Macroscope prevalence estimates; presents validation results for estimates of obesity, smoking, depression and influenza vaccination; and discusses the implications of our findings for NYC and for other jurisdictions embarking on similar work. The third report applies the same validation methods described in this report to metabolic outcomes, including the prevalence, treatment and control of diabetes, hypertension and hyperlipidemia. METHODS NYC Macroscope prevalence estimates, overall and stratified by sex and age group, were compared to reference survey estimates for adult New Yorkers who reported visiting a doctor in the past year. Agreement was evaluated against 5 a priori criteria. Sensitivity and specificity were assessed by examining individual EHR records in a subsample of 48 survey participants. RESULTS Among adult New Yorkers in care, the NYC Macroscope prevalence estimate for smoking (15.2%) fell between estimates from NYC HANES (17.7 %) and CHS (14.9%) and met all 5 a priori criteria. The NYC Macroscope obesity prevalence estimate (27.8%) also fell between the NYC HANES (31.3%) and CHS (24.7%) estimates, but met only 3 a priori criteria. Sensitivity and specificity exceeded 0.90 for both the smoking and obesity indicators. The NYC Macroscope estimates of depression and influenza vaccination prevalence were more than 10 percentage points lower than the estimates from either reference survey. While specificity was > 0.90 for both of these indicators, sensitivity was < 0.70. DISCUSSION Through this work we have demonstrated that EHR data from a convenience sample of providers can produce acceptable estimates of smoking and obesity prevalence among adult New Yorkers in care; gained a better understanding of the challenges involved in estimating depression prevalence from EHRs; and identified areas for additional research regarding estimation of influenza vaccination prevalence. We have also shared lessons learned about how EHR indicators should be constructed and offer methodologic suggestions for validating them. CONCLUSIONS This work adds to a rapidly emerging body of literature about how to define, collect and interpret EHR-based surveillance measures and may help guide other jurisdictions.
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Affiliation(s)
| | | | - Pui Ying Chan
- New York City Department of Health and Mental Hygiene
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Thorpe LE, McVeigh KH, Perlman S, Chan PY, Bartley K, Schreibstein L, Rodriguez-Lopez J, Newton-Dame R. Monitoring Prevalence, Treatment, and Control of Metabolic Conditions in New York City Adults Using 2013 Primary Care Electronic Health Records: A Surveillance Validation Study. EGEMS (Wash DC) 2016; 4:1266. [PMID: 28154836 PMCID: PMC5226388 DOI: 10.13063/2327-9214.1266] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Introduction: Electronic health records (EHRs) can potentially extend chronic disease surveillance, but few EHR-based initiatives tracking population-based metrics have been validated for accuracy. We designed a new EHR-based population health surveillance system for New York City (NYC) known as NYC Macroscope. This report is the third in a 3-part series describing the development and validation of that system. The first report describes governance and technical infrastructure underlying the NYC Macroscope. The second report describes validation methods and presents validation results for estimates of obesity, smoking, depression and influenza vaccination. In this third paper we present validation findings for metabolic indicators (hypertension, hyperlipidemia, diabetes). Methods: We compared EHR-based estimates to those from a gold standard surveillance source - the 2013–2014 NYC Health and Nutrition Examination Survey (NYC HANES) - overall and stratified by sex and age group, using the two one-sided test of equivalence and other validation criteria. Results: EHR-based hypertension prevalence estimates were highly concordant with NYC HANES estimates. Diabetes prevalence estimates were highly concordant when measuring diagnosed diabetes but less so when incorporating laboratory results. Hypercholesterolemia prevalence estimates were less concordant overall. Measures to assess treatment and control of the 3 metabolic conditions performed poorly. Discussion: While indicator performance was variable, findings here confirm that a carefully constructed EHR-based surveillance system can generate prevalence estimates comparable to those from gold-standard examination surveys for certain metabolic conditions such as hypertension and diabetes. Conclusions: Standardized EHR metrics have potential utility for surveillance at lower annual costs than surveys, especially as representativeness of contributing clinical practices to EHR-based surveillance systems increases.
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Affiliation(s)
| | | | | | - Pui Ying Chan
- New York City Department of Health and Mental Hygiene
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Rudd P, Hines J, Cathcart P, Wilkinson K, Shaw G, Wilson P, Shamash J, Richards TM, Wells P, Kelly JD, Chan PY, Green J, Powles T, Tipples K. Results of the first thousand patients from a multidisciplinary prostate cancer clinic. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e16602] [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: 11/20/2022] Open
Affiliation(s)
- Pandora Rudd
- St. Bartholomew's Hospital, London, United Kingdom
| | - John Hines
- St. Bartholomew's Hospital, London, United Kingdom
| | | | | | - Greg Shaw
- St. Bartholomew's Hospital, London, United Kingdom
| | - Peter Wilson
- St. Bartholomew's Hospital, London, United Kingdom
| | | | | | - Paula Wells
- St. Bartholomew's Hospital, London, United Kingdom
| | | | | | - James Green
- St. Bartholomew's Hospital, London, United Kingdom
| | - Thomas Powles
- Barts Cancer Institute, Barts Health, and The Royal Free London NHS Foundation Trust, London, United Kingdom
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Karydis I, Chan PY, Wheater M, Arriola E, Szlosarek PW, Ottensmeier CH. Clinical activity and safety of Pembrolizumab in Ipilimumab pre-treated patients with uveal melanoma. Oncoimmunology 2016; 5:e1143997. [PMID: 27467964 PMCID: PMC4910726 DOI: 10.1080/2162402x.2016.1143997] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 01/12/2016] [Accepted: 01/14/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Untreated metastatic uveal melanoma (UM) carries a grave prognosis. Unlike cutaneous melanoma (CM), there are no established treatments known to significantly improve outcomes for a meaningful proportion of patients. Inhibition of the PD1-PDL1 axis has shown promise in the management of CM and we here report a two center experience of UM patients receiving pembrolizumab. METHODS To assess the efficacy and safety of pembrolizumab, we retrospectively analyzed outcome data of 25 consecutive UM patients participating in the MK3475 expanded access program (EAP) who received pembrolizumab at 2 mg/kg 3 weekly. Tumor assessment was evaluated using RECIST 1.1 and immune-related Response Criteria (irRC) by CT scanning. Toxicity was recorded utilizing Common Terminology Criteria for Adverse Events ("CTCAE") v4.03. RESULTS Twenty-five patients were identified receiving a median of six cycles of treatment. Two patients achieved a partial response and six patients stable disease. After a median follow-up of 225 d median progression free survival (PFS) was 91 d and overall survival (OS) was not reached. There was a significant trend for improved outcomes in patients with extrahepatic disease progression as opposed to liver only progression at the outset. Five patients experienced grade 3 or 4 adverse events (AEs); there were no treatment related deaths. CONCLUSIONS Pembrolizumab 2mg/kg q3w is a safe option in UM patients. Disease control rates, particularly in the subgroup of patients without progressive liver disease at the outset are promising; these results merit further investigation in clinical trials possibly incorporating liver targeted treatment modalities.
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Affiliation(s)
- Ioannis Karydis
- Cancer Sciences Academic Unit, University of Southampton, Southampton, United Kingdom
| | - Pui Ying Chan
- Department of Medical Oncology, St Bartholomew's Hospital, London
| | - Matthew Wheater
- Medical Oncology, University Hospital Southampton, Southampton, United Kingdom
| | - Edurne Arriola
- Medical Oncology, University Hospital Southampton, Southampton, United Kingdom
| | - Peter W. Szlosarek
- Department of Medical Oncology, St Bartholomew's Hospital, London
- Barts Cancer Institute, Queen Mary University of London, London
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Romo ML, Chan PY, Lurie-Moroni E, Perlman SE, Newton-Dame R, Thorpe LE, McVeigh KH. Characterizing Adults Receiving Primary Medical Care in New York City: Implications for Using Electronic Health Records for Chronic Disease Surveillance. Prev Chronic Dis 2016; 13:E56. [PMID: 27126554 PMCID: PMC4856483 DOI: 10.5888/pcd13.150500] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction Electronic health records (EHRs) from primary care providers can be used for chronic disease surveillance; however, EHR-based prevalence estimates may be biased toward people who seek care. This study sought to describe the characteristics of an in-care population and compare them with those of a not-in-care population to inform interpretation of EHR data. Methods We used data from the 2013–2014 New York City Health and Nutrition Examination Survey (NYC HANES), considered the gold standard for estimating disease prevalence, and the 2013 Community Health Survey, and classified participants as in care or not in care, on the basis of their report of seeing a health care provider in the previous year. We used χ2 tests to compare the distribution of demographic characteristics, health care coverage and access, and chronic conditions between the 2 populations. Results According to the Community Health Survey, approximately 4.1 million (71.7%) adults aged 20 or older had seen a health care provider in the previous year; according to NYC HANES, approximately 4.7 million (75.1%) had. In both surveys, the in-care population was more likely to be older, female, non-Hispanic, and insured compared with the not-in-care population. The in-care population from the NYC HANES also had a higher prevalence of diabetes (16.7% vs 6.9%; P < .001), hypercholesterolemia (35.7% vs 22.3%; P < .001), and hypertension (35.5% vs 26.4%; P < .001) than the not-in-care population. Conclusion Systematic differences between in-care and not-in-care populations warrant caution in using primary care data to generalize to the population at large. Future efforts to use primary care data for chronic disease surveillance need to consider the intended purpose of data collected in these systems as well as the characteristics of the population using primary care.
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Affiliation(s)
- Matthew L Romo
- New York City Department of Health and Mental Hygiene, Long Island City, New York, and City University of New York School of Public Health, New York, New York
| | - Pui Ying Chan
- Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, 42-09 28th St, 07-99, Long Island City, New York, 11101-4132.
| | | | - Sharon E Perlman
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Remle Newton-Dame
- New York City Department of Health and Mental Hygiene, Long Island City, New York
| | - Lorna E Thorpe
- City University of New York School of Public Health, New York, New York
| | - Katharine H McVeigh
- New York City Department of Health and Mental Hygiene, Long Island City, New York
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Pacey S, Spicer JF, Chan PY, Hategan M, Repana D, Steele JP, Schmid P, Cook GJR, Diaz M, Johnston A, Baird R, Barba A, Khadeir R, Sheaff M, Roca J, Szyszko T, Bomalaski J, Szlosarek PW. Abstract B23: A phase 1 study in patients with mesothelioma or non small cell lung tumours requiring arginine to assess ADI-PEG 20 with pemetrexed and cisplatin (TRAP study). Clin Trials 2016. [DOI: 10.1158/1535-7163.targ-15-b23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Szlosarek PW, Spicer JF, Szyszko T, Cook GJR, Chan PY, Hategan M, Repana D, Steele JP, Schmid P, Diaz M, Johnston A, Sheaff M, Khadeir R, Bomalaski JS, Pacey S. Phase I study of ADI-PEG 20 in combination with pemetrexed and cisplatin (TRAP) in patients with ASS1-deficient mesothelioma and non-squamous lung cancer. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.tps2612] [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: 11/20/2022] Open
Affiliation(s)
| | | | | | - Gary J. R. Cook
- Division of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | | | | | - Dimitra Repana
- Department of Medical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | - Peter Schmid
- Queen Mary, University of London, London, United Kingdom
| | | | | | | | - Ramsay Khadeir
- Queen Mary, University of London, London, United Kingdom
| | | | - Simon Pacey
- The University of Cambridge, Addenbrookes Hospital, Cambridge, United Kingdom
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Chan PY, Latip LS. A case control study in factors that affect mammogram compliance. Med J Malaysia 2011; 66:456-461. [PMID: 22390101] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- P Y Chan
- Hospital Pakar Sultanah Fatimah, Jalan Salleh, Muar, Johor 84000, Malaysia.
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Abstract
In the sequencing process, reads of the sequence are generated, then assembled to form contigs. New technologies can produce reads faster with lower cost and higher coverage. However, these reads are shorter. With errors, short reads make the assembly step more difficult. Chaisson et al. (2004) proposed an algorithm to correct the reads prior to the assembly step. The result is not satisfactory when the error rate is high (e.g., >or=3%). We improve their approach to handle reads of higher error rates. Experimental results show that our approach is much more effective in correcting errors, producing contigs of higher quality.
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Affiliation(s)
- Thomas K F Wong
- Faculty of Engineering, Department of Computer Science, The University of Hong Kong, Pokfulam Road, Hong Kong.
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Abstract
BACKGROUND AND OBJECTIVES The para-Bombay phenotype (also known as H-deficient secretor) is characterized by a lack of ABH antigens on red cells, but ABH substances are found in saliva. Molecular genetic analysis was performed for five Chinese individuals serologically typed as para-Bombay. MATERIALS AND METHODS ABO genotyping and mutational analysis of both FUT1 (or H) and FUT2 (or Se) loci were performed for these individuals using the polymerase chain reaction, single-strand conformation polymorphism analysis and direct DNA sequencing. RESULTS The ABO genotypes of these para-Bombay individuals correlated with the types of ABH substances found in the saliva. Their FUT1 genotypes were h1h2 (three individuals), h2h2 (one individual) and h2h6 (one individual). Alleles h1 (547-552delAG) and h2 (880-882delTT) were known frameshift mutations, while h6 (522C > A) was a missense mutation (Phe174Leu) not previously reported. These three mutations were rare sequence variations, each with an allele frequency of less than 0.005. Phe174 might be functionally important because this residue is conserved from mouse to human. Their FUT2 genotypes were Se357se357,385 for the h2h6 individual and Se357Se357) for the others. Both FUT2 alleles were known: one functional (Se357) and one weakly functional (se357,385). That they carried at least one copy of a functional FUT2 allele was consistent with their secretor status. As FUT1 and FUT2 are adjacent on 19q13.3, there are three possible haplotypes in these para-Bombay individuals: h1-Se357; h2-Se357; and h6-se357,385. CONCLUSIONS A novel non-functional FUT1 allele (522C > A, or Phe174Leu) was identified in a para-Bombay individual and on a se357,385 haplotype background.
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Affiliation(s)
- S P Yip
- Department of Nursing and Health Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
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Zhu P, Ong SY, Chan PY, Poon YF, Leung KH, Phillips DL. Transient-resonance Raman and density functional theory investigation of 4-biphenylylnitrenium, 2-fluorenylnitrenium, and diphenylnitrenium ions. Chemistry 2001; 7:4928-36. [PMID: 11763461 DOI: 10.1002/1521-3765(20011119)7:22<4928::aid-chem4928>3.0.co;2-c] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We present transient-resonance Raman spectra for the 4-biphenylylnitrenium, diphenylnitrenium, and 2-fluorenylnitrenium ions. These spectra display a number of fundamental vibrational bands whose frequencies exhibit good agreement with those computed using BPW91/cc-PVDZ density functional theory calculations for the singlet ground states of the 4-biphenylylnitrenium, diphenylnitrenium, and 2-fluorenylnitrenium ions. Comparison of these arylnitrenium ions with each other and with previous results for structurally similar biphenyl radical cations indicates that the degree of iminocyclohexadienyl character observed in these arylnitrenium ions depends on the relative orientation of the two phenyl rings, the nature of the nitrenium ion moiety, and the ability of the biphenyl-like group to accommodate positive charge through formation of a more planar-like structure with quinoidal-like character.
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Affiliation(s)
- P Zhu
- Department of Chemistry, University of Hong Kong, Hong Kong
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Zhu P, Ong SY, Chan PY, Leung KH, Phillips DL. Transient resonance Raman and density functional theory investigation of the 2-fluorenylnitrenium ion. J Am Chem Soc 2001; 123:2645-9. [PMID: 11456934 DOI: 10.1021/ja003839n] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report a transient resonance Raman spectrum for the 2-fluorenylnitrenium ion obtained after photolysis of 2-azidofluorene. The 10 experimental Raman band frequencies of the transient spectrum show very good agreement with the computed frequencies from BPW91/cc-PVDZ density functional theory calculations for the 2-fluorenylnitrenium ion. Our results confirm the assignment of the approximately 460 nm transient absorption band formed after photolysis of 2-azidofluorene in water/acetonitrile or water solution to the singlet ground electronic state 2-fluorenylnitrenium ion. Our study indicates the 2-fluorenylnitrenium has a large degree of iminocyclohexadienyl cation character with significant delocalization of the charge over both phenyl rings of the fluorene moiety. We compare our results for the 2-fluoreneylnitrenium ion to those previously reported for several other arylnitrenium ions.
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Affiliation(s)
- P Zhu
- Department of Chemistry, The University of Hong Kong, Pokfulam Road, Hong Kong S. A. R., P. R. China
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43
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Murukeshan VM, Chan PY, Ong LS, Asundi A. Intracore fiber bragg gratings for strain measurement in embedded composite structures. Appl Opt 2001; 40:145-149. [PMID: 18356985 DOI: 10.1364/ao.40.000145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
An intracore Bragg grating written on a photosensitive fiber core is used for strain measurement in composite specimens under load. The strain information is directly related to the absolute change in the Bragg-reflected wavelength. Fiber Bragg grating (FBG) sensors (fibers with intracore gratings) are thus sensitive to strain that is caused by changes in temperature as well as to load-induced changes. Thus these sensors can be made to be independent of source intensity variations and losses. FBG sensors used for load-induced strain sensing in composite structures and the effects of temperature on them are discussed. A detailed account of the use of such embedded structures as self-monitoring nondestructive testing devices is given.
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Affiliation(s)
- A K Leung
- Department of Pediatrics, University of Calgary, Alberta Children's Hospital, and Asian Medical Centre (affiliated with the University of Calgary Medical Clinic), Canada
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45
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Leung AK, Wong BE, Chan PY, Cho HY. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc 1999; 91:329-32. [PMID: 10388258 PMCID: PMC2608508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
The records of 2527 healthy children seen in an ambulatory care clinic were evaluated for nocturnal leg cramps in the preceding 12 months, frequency and duration of the cramps, whether the cramps affected one leg or both legs at a time, whether there was associated muscle cramps in feet, whether the cramps occurred when the child was awake or asleep, and whether there was residual tenderness in the affected muscles. Nocturnal leg cramps were present in 185 children for an overall incidence of 7.3%. Leg cramps were noted only in children aged > or = 8 years. The incidence increased at 12 years and peaked at 16 to 18 years of age. A majority (81.6%) of the affected children had nocturnal leg cramps 1 to 4 times per year. The mean duration of episodes was 1.7 minutes. Leg cramps were unilateral in 98.9% of cases and the ipsilateral foot also was involved in 18.9% of cases. One hundred thirty-five (73%) children had leg cramps while asleep, and the remaining 23 (12.4%) children had leg cramps in either state. Fifty-seven (30.8%) children had residual tenderness in the affected muscles. The mean duration of residual tenderness was 33.2 minutes (range: 2 minutes-1 day). We conclude that nocturnal leg cramps are common in children aged > 12 years. A majority of the affected children have leg cramps 1 to 4 times per year. The cramps are usually unilateral and occur when the children are asleep. Normal duration of the leg cramp is < 2 minutes. Residual tenderness is present in approximately 30% of the affected children. Residual tenderness, if present, usually lasts for half an hour.
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Affiliation(s)
- A K Leung
- Department of Pediatrics, University of Calgary, Alberta, Canada
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46
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Abstract
Hypohidrosis has many causes. The condition may be generalised or segmental, acute or progressive and central or peripheral in origin. Most of the causes can be diagnosed from the history and physical examination. Laboratory investigations are usually not necessary. Treatment should be directed at the underlying cause whenever possible.
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Affiliation(s)
- A K Leung
- Department of Pediatrics, University of Calgary, Asian Medical Centre
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Abstract
Pruritus is the most common of all dermatological complaints. Although pruritus is usually due to a primary skin disease, it may be a manifestation of a systemic illness. The majority of causes can be diagnosed from the history and physical examination. Laboratory investigations are usually not necessary. Treatment should be directed at the underlying cause whenever possible.
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Abstract
Most leg cramps are benign and self-limited. Idiopathic nocturnal leg cramp is the most common from of cramps. Occasionally, leg cramps may signify a significant systemic disorder. Investigations are usually not necessary unless indicated by the history or physical examination. Symptomatic treatment consists of stretching the affected calf muscle by forcible dorsiflexion of the foot.
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Affiliation(s)
- A K Leung
- Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Alberta, Canada
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49
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Leung AK, Chan PY, Cho HY. Constipation in children. Am Fam Physician 1996; 54:611-8, 627. [PMID: 8701840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Constipation is a common childhood condition, estimated to occur in 5 to 10 percent of children. In most cases, the cause is functional. However, constipation may occasionally indicate a significant organic disorder, which can usually be determined by a thorough history and physical examination. Constipation that is present from birth or that begins in the neonatal period is most likely to be congenital in origin. Acute constipation usually has an organic cause, while chronic constipation usually has a functional cause. Failure to thrive and gross distention of the abdomen suggest the diagnosis of Hirschsprung's disease. Rectal examination of a child with constipation usually reveals a distended rectum that is full of stool. In patients with Hirschsprung's disease, the rectum is usually empty and tight. Laboratory investigations are usually not necessary in patients with mild constipation. Treatment should be directed at the underlying cause. Functional constipation can be managed by changes in diet, regular bowel habits and, if necessary, pharmacologic therapy and biofeedback training.
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Affiliation(s)
- A K Leung
- Alberta Children's Hospital, Calgary, Canada
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50
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Dustin ML, Ferguson LM, Chan PY, Springer TA, Golan DE. Visualization of CD2 interaction with LFA-3 and determination of the two-dimensional dissociation constant for adhesion receptors in a contact area. J Biophys Biochem Cytol 1996; 132:465-74. [PMID: 8636222 PMCID: PMC2120727 DOI: 10.1083/jcb.132.3.465] [Citation(s) in RCA: 205] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Many adhesion receptors have high three-dimensional dissociation constants (Kd) for counter-receptors compared to the KdS of receptors for soluble extracellular ligands such as cytokines and hormones. Interaction of the T lymphocyte adhesion receptor CD2 with its counter-receptor, LFA-3, has a high solution-phase Kd (16 microM at 37 degrees C), yet the CD2/LFA-3 interaction serves as an effective adhesion mechanism. We have studied the interaction of CD2 with LFA-3 in the contact area between Jurkat T lymphoblasts and planar phospholipid bilayers containing purified, fluorescently labeled LFA-3. Redistribution and lateral mobility of LFA-3 were measured in contact areas as functions of the initial LFA-3 surface density and of time after contact of the cells with the bilayers. LFA-3 accumulated at sites of contact with a half-time of approximately 15 min, consistent with the previously determined kinetics of adhesion strengthening. The two-dimensional Kd for the CD2/LFA-3 interaction was 21 molecules/microns 2, which is lower than the surface densities of CD2 on T cells and LFA-3 on most target or stimulator cells. Thus, formation of CD2/LFA-3 complexes should be highly favored in physiological interactions. Comparison of the two-dimensional (membrane-bound) and three-dimensional (solution-phase) KdS suggest that cell-cell contact favors CD2/LFA-3 interaction to a greater extent than that predicted by the three-dimensional Kd and the intermembrane distance at the site of contact. LFA-3 molecules in the contact site were capable of lateral diffusion in the plane of the phospholipid bilayer and did not appear to be irreversibly trapped in the contact area, consistent with a rapid off-rate. These data provide insights into the function of low affinity interactions in adhesion.
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Affiliation(s)
- M L Dustin
- Center for Immunology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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