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Awasthi S, Sachdeva N, Gupta Y, Anto AG, Asfahan S, Abbou R, Bade S, Sood S, Hegstrom L, Vellanki N, Alger HM, Babu M, Medina-Inojosa JR, McCully RB, Lerman A, Stampehl M, Barve R, Attia ZI, Friedman PA, Soundararajan V, Lopez-Jimenez F. Identification and risk stratification of coronary disease by artificial intelligence-enabled ECG. EClinicalMedicine 2023; 65:102259. [PMID: 38106563 PMCID: PMC10725070 DOI: 10.1016/j.eclinm.2023.102259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 12/19/2023] Open
Abstract
Background Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death worldwide, driven primarily by coronary artery disease (CAD). ASCVD risk estimators such as the pooled cohort equations (PCE) facilitate risk stratification and primary prevention of ASCVD but their accuracy is still suboptimal. Methods Using deep electronic health record data from 7,116,209 patients seen at 70+ hospitals and clinics across 5 states in the USA, we developed an artificial intelligence-based electrocardiogram analysis tool (ECG-AI) to detect CAD and assessed the additive value of ECG-AI-based ASCVD risk stratification to the PCE. We created independent ECG-AI models using separate neural networks including subjects without known history of ASCVD, to identify coronary artery calcium (CAC) score ≥300 Agatston units by computed tomography, obstructive CAD by angiography or procedural intervention, and regional left ventricular akinesis in ≥1 segment by echocardiogram, as a reflection of possible prior myocardial infarction (MI). These were used to assess the utility of ECG-AI-based ASCVD risk stratification in a retrospective observational study consisting of patients with PCE scores and no prior ASCVD. The study period covered all available digitized EHR data, with the first available ECG in 1987 and the last in February 2023. Findings ECG-AI for identifying CAC ≥300, obstructive CAD, and regional akinesis achieved area under the receiver operating characteristic (AUROC) values of 0.88, 0.85, and 0.94, respectively. An ensembled ECG-AI identified 3, 5, and 10-year risk for acute coronary events and mortality independently and additively to PCE. Hazard ratios for acute coronary events over 3-years in patients without ASCVD that tested positive on 1, 2, or 3 versus 0 disease-specific ECG-AI models at cohort entry were 2.41 (2.14-2.71), 4.23 (3.74-4.78), and 11.75 (10.2-13.52), respectively. Similar stratification was observed in cohorts stratified by PCE or age. Interpretation ECG-AI has potential to address unmet need for accessible risk stratification in patients in whom PCE under, over, or insufficiently estimates ASCVD risk, and in whom risk assessment over time periods shorter than 10 years is desired. Funding Anumana.
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Affiliation(s)
- Samir Awasthi
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | - Nikhil Sachdeva
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | - Yash Gupta
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | - Ausath G. Anto
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | - Shahir Asfahan
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | - Ruben Abbou
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | - Sairam Bade
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | - Sanyam Sood
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | - Lars Hegstrom
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | - Nirupama Vellanki
- nference, Inc, One Main Street, Cambridge, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Heather M. Alger
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | - Melwin Babu
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | | | | | | | - Mark Stampehl
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Rakesh Barve
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
| | | | | | - Venky Soundararajan
- Anumana, Inc, One Main Street, Cambridge, MA, USA
- nference, Inc, One Main Street, Cambridge, MA, USA
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Verma N, Gupta P, Pandey AK, Awasthi S. Nasopharyngeal carriage of Streptococcus pneumoniae serotypes among sick and healthy children in northern India: A case-control study. Vaccine 2023; 41:6619-6624. [PMID: 37758571 PMCID: PMC10663590 DOI: 10.1016/j.vaccine.2023.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/29/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Streptococcus pneumoniae is leading bacterial cause of community acquired pneumonia and according to World Health Organization, responsible for 14 % death in children. There is effective vaccine available against Streptococcus pneumoniae. Hence the primary objective was to isolate Streptococcus pneumoniae from nasopharyngeal swabs in children aged 2-59 months with and without community acquired pneumonia and to assess their serotypes. METHODS This case-control study was conducted in tertiary teaching institutes in northern India. Hospitalized children, aged 2-59 months, with World Health Organization-defined community acquired pneumonia were included as cases. Age matched healthy controls were recruited from immunization clinic. All enrolments were done after written informed parental consent. Nasopharyngeal swabs were taken from both cases and controls, and were cultured on 5 % sheep blood agar with gentamycin plate for growth of Streptococcus pneumoniae and incubated in a jar at 370 for 18-24 hrs. Quellung reaction test was used for serotyping. RESULTS From March 2017 to December 2022, 2693 children (1910 cases and 783 controls), were recruited. The median age of cases was 7 months and controls 10 months. Almost all the cases had received antibiotics prior to hospitalization. Streptococcus pneumoniae positivity in nasopharyngeal swab was 8.1 % in cases, of which 56.8 % were vaccine serotypes and 23.6 % in controls, of which 37.8 % were vaccine serotypes. Adjusted odds ratio of isolating vaccine serotypes among cases as compared to controls was 1.77 (95 % CI, 1.09-2.88). CONCLUSION Streptococcus pneumoniae isolation from nasopharyngeal was found to be in lower proportion in cases as compared to control, though colonization with vaccine serotypes was higher in cases as compared to control. Therefore, pneumococcal vaccine coverage must be increased to prevent community acquired pneumonia.
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Affiliation(s)
- N Verma
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - P Gupta
- Department of Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - A K Pandey
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - S Awasthi
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India.
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Iyer PG, Sachdeva K, Leggett CL, Codipilly DC, Abbas H, Anderson K, Kisiel JB, Asfahan S, Awasthi S, Anand P, Kumar M P, Singh SP, Shukla S, Bade S, Mahto C, Singh N, Yadav S, Padhye C. Development of Electronic Health Record-Based Machine Learning Models to Predict Barrett's Esophagus and Esophageal Adenocarcinoma Risk. Clin Transl Gastroenterol 2023; 14:e00637. [PMID: 37698203 PMCID: PMC10584285 DOI: 10.14309/ctg.0000000000000637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/01/2023] [Indexed: 09/13/2023] Open
Abstract
INTRODUCTION Screening for Barrett's esophagus (BE) is suggested in those with risk factors, but remains underutilized. BE/esophageal adenocarcinoma (EAC) risk prediction tools integrating multiple risk factors have been described. However, accuracy remains modest (area under the receiver-operating curve [AUROC] ≤0.7), and clinical implementation has been challenging. We aimed to develop machine learning (ML) BE/EAC risk prediction models from an electronic health record (EHR) database. METHODS The Clinical Data Analytics Platform, a deidentified EHR database of 6 million Mayo Clinic patients, was used to predict BE and EAC risk. BE and EAC cases and controls were identified using International Classification of Diseases codes and augmented curation (natural language processing) techniques applied to clinical, endoscopy, laboratory, and pathology notes. Cases were propensity score matched to 5 independent randomly selected control groups. An ensemble transformer-based ML model architecture was used to develop predictive models. RESULTS We identified 8,476 BE cases, 1,539 EAC cases, and 252,276 controls. The BE ML transformer model had an overall sensitivity, specificity, and AUROC of 76%, 76%, and 0.84, respectively. The EAC ML transformer model had an overall sensitivity, specificity, and AUROC of 84%, 70%, and 0.84, respectively. Predictors of BE and EAC included conventional risk factors and additional novel factors, such as coronary artery disease, serum triglycerides, and electrolytes. DISCUSSION ML models developed on an EHR database can predict incident BE and EAC risk with improved accuracy compared with conventional risk factor-based risk scores. Such a model may enable effective implementation of a minimally invasive screening technology.
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Affiliation(s)
- Prasad G. Iyer
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Karan Sachdeva
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Cadman L. Leggett
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - D. Chamil Codipilly
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Halim Abbas
- Center for Digital Health, Mayo Clinic, Rochester, Minnesota, USA
| | - Kevin Anderson
- Center for Digital Health, Mayo Clinic, Rochester, Minnesota, USA
| | - John B. Kisiel
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
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Asfahan S, Mishra Y, Bade S, Lalam S, Tayal N, Babu M, Prasad A, Barve R, Awasthi S, Soundararajan V. AN ECG AI-BASED MULTI-LABEL CLASSIFICATION MODEL ENABLES THE SCREENING FOR INTERVENABLE STRUCTURAL HEART DISEASE. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)00460-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Soefje SA, Carpenter C, Carlson K, Awasthi S, Lin TS, Kaila S, Tarjan D, Kayal N, Kirkup C, Wagner TE, Gray KS, Kumar S. Clinical Administration Characteristics of Subcutaneous and Intravenous Administration of Daratumumab in Patients With Multiple Myeloma at Mayo Clinic Infusion Centers. JCO Oncol Pract 2023; 19:e542-e549. [PMID: 36758192 PMCID: PMC10101255 DOI: 10.1200/op.22.00421] [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: 02/11/2023] Open
Abstract
PURPOSE Median duration of daratumumab (DARA) administration for treatment of multiple myeloma is 3-7 hours for the intravenous formulation (DARA IV) and 3-5 minutes for the subcutaneous formulation (DARA SC). Here, we describe clinical administration characteristics of DARA using a novel method for data extraction from electronic health records. METHODS Time-based measurements were extracted using a scheduling/pharmacy software program that tracked patient movement through appointments for patients initiating DARA in Mayo Clinic infusion centers from April 5, 2017, to October 14, 2021. Cohorts included patients who received DARA IV or DARA SC, or converted from DARA IV to DARA SC. The DARA SC cohort was further analyzed before (DARA SC initial) and after (DARA SC shortened) a reduction in the postadministration observation time mandated by the treatment plan. Events associated with administration-related reactions (ARRs) were also identified. RESULTS Median total clinic times were 2.7-3.0 hours shorter for DARA SC versus DARA IV. Median clinic times were highest at dose 1 and decreased with subsequent doses. Median total chair times were 2.7-2.8 hours shorter for DARA SC versus DARA IV. Incidences of ARR-related events with DARA SC were low across doses. CONCLUSION Reduced clinic times were observed with DARA SC, indicating that use of DARA SC as a treatment option results in time savings that may free clinic resources. Furthermore, novel methods of electronic health record data extraction can provide insights that may help inform clinic resource optimization.
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Affiliation(s)
- Scott A Soefje
- Department of Pharmacy, Mayo Clinic Rochester, Rochester, MN
| | | | | | | | | | | | | | | | | | | | | | - Shaji Kumar
- Department of Pharmacy, Mayo Clinic Rochester, Rochester, MN
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Gupta P, Awasthi S, Gupta U, Verma N, Rastogi T, Pandey AK, Naziat H, Rahman H, Islam M, Saha S. Nasopharyngeal Carriage of Streptococcus pneumoniae Serotypes Among Healthy Children in Northern India. Curr Microbiol 2022; 80:41. [PMID: 36534266 PMCID: PMC9763132 DOI: 10.1007/s00284-022-03114-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 11/07/2022] [Indexed: 12/23/2022]
Abstract
Streptococcus pneumoniae (SP) infections cause morbidity and mortality among children worldwide. Hence India introduced 13-valent pneumococcal conjugate vaccine (PCV-13) in 2017 in a phased manner. The primary objective of this study was to assess the proportion of healthy children having nasopharyngeal colonization (NP) with SP. Secondary objective was to determine prevalent serotype of SP among the PCV13 vaccinated and non-vaccinated children. This cross-sectional study was conducted in 4 hospitals of Lucknow District, Northern India. Three hundred healthy children (2-59 months) were recruited between July and August 2019 from vaccination-clinics of hospitals. NP specimen was cultured using 5% sheep blood agar plate containing gentamicin. Pneumococcal isolates were identified by optochin sensitivity and bile-solubility tests. Serotyping was done using Quellung Method. Of the 300 healthy children, 56.7% (170/300) were males and 59.3% (181/300) had received at least one dose of PCV13 vaccine. The NP carriage rate of SP among healthy children was 37.7% (113/300). Vaccine serotypes were found in 33.3% (22/66) in PCV vaccinated children and 48.9% (23/47) in non-vaccinated children (p 0.09). Common vaccine serotypes that isolated were: 18C, 19A, 19F, 23F, 3, 4, 6A, 6B, 9 V. Thus more than one-third of healthy children had NP colonization with SP. Adjusting for age, there was a trend for significant reduction in vaccine serotypes in the NP with one doses versus two or more doses (ptrend = 0.04).
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Affiliation(s)
- P Gupta
- Department of Microbiology, King George's Medical University, Uttar Pradesh, Lucknow, India
| | - S Awasthi
- Department of Paediatrics, King George's Medical University, Uttar Pradesh, Lucknow, India.
| | - U Gupta
- Department of Microbiology, King George's Medical University, Uttar Pradesh, Lucknow, India
| | - N Verma
- Department of Paediatrics, King George's Medical University, Uttar Pradesh, Lucknow, India
| | - T Rastogi
- Department of Paediatrics, King George's Medical University, Uttar Pradesh, Lucknow, India
| | - A K Pandey
- Department of Paediatrics, King George's Medical University, Uttar Pradesh, Lucknow, India
| | - H Naziat
- Department of Microbiology, Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh
- Child Health Research Foundation, Dhaka, Bangladesh
| | - H Rahman
- Child Health Research Foundation, Dhaka, Bangladesh
| | - M Islam
- Child Health Research Foundation, Dhaka, Bangladesh
| | - S Saha
- Department of Microbiology, Bangladesh Shishu Hospital & Institute, Dhaka, Bangladesh
- Child Health Research Foundation, Dhaka, Bangladesh
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Tekkis NP, Rafi D, Brown S, Courtney A, Kawka M, Howell AM, McLean K, Gardiner M, Mavroveli S, Hutchinson P, Tekkis P, Wilkinson P, Sam AH, Savva N, Kontovounisios C, Tekkis N, Rafi D, Brown S, Courtney A, Kawka M, Howell A, McLean K, Gardiner M, Mavroveli S, Hutchinson P, Tekkis P, Wilkinson P, Sam AH, Savva N, Kontovounisios C, Tekkis N, Rafi D, Brown S, Courtney A, Kawka M, Howell A, McLean K, Gardiner M, Mavroveli S, Hutchinson P, Tekkis P, Wilkinson P, Sam AH, Savva N, Kontovounisios C, Tekkis N, Brown S, Kawka M, Mclean K, Savva N, Wilkinson P, Sam AH, Singal A, Chia C, Chia W, Ganesananthan S, Ooi SZY, Pengelly S, Wellington J, Mak S, Subbiah Ponniah H, Heyes A, Aberman I, Ahmed T, Al-Shamaa S, Appleton L, Arshad A, Awan H, Baig Q, Benedict K, Berkes S, Citeroni NL, Damani A, de Sancha A, Fisayo T, Gupta S, Haq M, Heer B, Jones A, Khan H, Kim H, Meiyalagan N, Miller G, Minta N, Mirza L, Mohamed F, Ramjan F, Read P, Soni L, Tailor V, Tas RN, Vorona M, Walker M, Winkler T, Bardon A, Acquaah J, Ball T, Bani W, Elmasry A, Hussein F, Kolluri M, Lusta H, Newman J, Nott M, Perwaiz MI, Rayner R, Shah A, Shaw I, Yu K, Cairns M, Clough R, Gaier S, Hirani D, Jeyapalan T, Li Y, Patel CR, Shabir H, Wang YA, Weatherhead A, Dhiran A, Renney O, Wells P, Ferguson S, Joyce A, Mergo A, Adebayo O, Ahmad J, Akande O, Ang G, Aniereobi E, Awasthi S, Banjoko A, Bates J, Chibada C, Clarke N, Craner I, Desai DD, Dixon K, Duffaydar HI, Kuti M, Mughal AZ, Nair D, Pham MC, Preest GG, Reid R, Sachdeva GS, Selvaratnam K, Sheikh J, Soran V, Stoney N, Wheatle M, Howarth K, Knapp-Wilson A, Lee KS, Mampitiya N, Masson C, McAlinden JJ, McGowan N, Parmar SC, Robinson B, Wahid S, Willis L, Risquet R, Adebayo A, Dhingra L, Kathiravelupillai S, Narayanan R, Soni J, Ghafourian P, Hounat A, Lennon KA, Abdi Mohamud M, Chou W, Chong L, Graham CJ, Piya S, Riad AM, Vennard S, Wang J, Kawar L, Maseland C, Myatt R, Tengku Saifudin TNS, Yong SQ, Douglas F, Ogbechie C, Sharma K, Zafar L, Bajomo MO, Byrne MHV, Obi C, Oluyomi DI, Patsalides MA, Rajananthanan A, Richardson G, Clarke A, Roxas A, Adeboye W, Argus L, McSweeney J, Rahman-Chowdhury M, Hettiarachchi DS, Masood MT, Antypas A, Thomas M, de Andres Crespo M, Zimmerman M, Dhillon A, Abraha S, Burton O, Jalal AHB, Bailey B, Casey A, Kathiravelupillai A, Missir E, Boult H, Campen D, Collins JM, Dulai S, Elhassan M, Foster Z, Horton E, Jones E, Mahapatra S, Nancarrow T, Nyamapfene T, Rimmer A, Robberstad M, Robson-Brown S, Saeed A, Sarwar Y, Taylor C, Vetere G, Whelan MK, Williams J, Zahid D, Chand C, Matthews M. The impact of the COVID-19 pandemic on UK medical education. A nationwide student survey. Med Teach 2022; 44:574-575. [PMID: 34428109 DOI: 10.1080/0142159x.2021.1962835] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
| | - Damir Rafi
- School of Medicine, Imperial College London, London, UK
| | - Sam Brown
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Alona Courtney
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Michal Kawka
- School of Medicine, Imperial College London, London, UK
| | - Ann-Marie Howell
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Kenneth McLean
- Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK
| | - Matthew Gardiner
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | | | - Peter Hutchinson
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Paris Tekkis
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Paul Wilkinson
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Amir H Sam
- School of Medicine, Imperial College London, London, UK
| | - Nicos Savva
- Division of Management Science and Operations, London Business School, London, UK
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- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - T Ball
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - W Bani
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - A Elmasry
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - F Hussein
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - M Kolluri
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - H Lusta
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - J Newman
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - M Nott
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - M I Perwaiz
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - R Rayner
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - A Shah
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - I Shaw
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | - K Yu
- Plymouth University Peninsula Schools of Medicine and Dentistry
| | | | | | - S Gaier
- Queen Mary University of London
| | | | | | - Y Li
- Queen Mary University of London
| | | | | | | | | | - A Dhiran
- St George's Hospital Medical School
| | - O Renney
- St George's Hospital Medical School
| | - P Wells
- St George's Hospital Medical School
| | | | - A Joyce
- The Queen's University of Belfast
| | | | | | - J Ahmad
- The University of Birmingham
| | | | - G Ang
- The University of Birmingham
| | | | | | | | - J Bates
- The University of Birmingham
| | | | | | | | | | - K Dixon
- The University of Birmingham
| | | | - M Kuti
- The University of Birmingham
| | | | - D Nair
- The University of Birmingham
| | | | | | - R Reid
- The University of Birmingham
| | | | | | | | - V Soran
- The University of Birmingham
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - J Soni
- The University of Cambridge
| | | | | | | | | | - W Chou
- The University of East Anglia
| | | | | | - S Piya
- The University of Edinburgh
| | | | | | - J Wang
- The University of Edinburgh
| | | | | | | | | | | | | | | | | | | | | | | | - C Obi
- The University of Leicester
| | | | | | | | | | | | | | | | - L Argus
- The University of Manchester
| | | | | | | | | | | | | | | | | | | | | | | | | | - B Bailey
- University of Brighton and Sussex
| | - A Casey
- University of Brighton and Sussex
| | | | - E Missir
- University of Brighton and Sussex
| | - H Boult
- University of Exeter Medical School
| | - D Campen
- University of Exeter Medical School
| | | | - S Dulai
- University of Exeter Medical School
| | | | - Z Foster
- University of Exeter Medical School
| | - E Horton
- University of Exeter Medical School
| | - E Jones
- University of Exeter Medical School
| | | | | | | | - A Rimmer
- University of Exeter Medical School
| | | | | | - A Saeed
- University of Exeter Medical School
| | - Y Sarwar
- University of Exeter Medical School
| | - C Taylor
- University of Exeter Medical School
| | - G Vetere
- University of Exeter Medical School
| | | | | | - D Zahid
- University of Exeter Medical School
| | - C Chand
- University of Hull and the University of York
| | - M Matthews
- University of Hull and the University of York
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Yamoah K, Lee K, Alba P, Awasthi S, Perez C, Gao A, Anglin T, Robison B, Duvall S, Katsoulakis E, Wong Y, Markt S, Rose B, Burri R, Wang C, Aboiralor O, Fink A, Nickols N, Lynch J, Garraway I. Defining Racial Disparities Across the Prostate Cancer Disease Continuum in an Equal Access-to-Care Setting Within the Nation's Largest Healthcare Network. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sandoval M, Latifi K, Parsee A, Andreozzi J, Awasthi S, Fernandez D, Hunt D, Yamoah K. Defining MR-Based Parameters of Treatment Response to Immune-Modulatory Therapy for Grade Group 5 Prostate Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pawlowski C, Rincón-Hekking J, Awasthi S, Pandey V, Lenehan P, Venkatakrishnan AJ, Bade S, O'Horo JC, Virk A, Swift MD, Williams AW, Gores GJ, Badley AD, Halamka J, Soundararajan V. Cerebral Venous Sinus Thrombosis is not Significantly Linked to COVID-19 Vaccines or Non-COVID Vaccines in a Large Multi-State Health System. J Stroke Cerebrovasc Dis 2021; 30:105923. [PMID: 34627592 PMCID: PMC8494567 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105923] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To assess the association of COVID-19 vaccines and non-COVID-19 vaccines with cerebral venous sinus thrombosis (CVST). Materials and method We retrospectively analyzed a cohort of 771,805 vaccination events across 266,094 patients in the Mayo Clinic Health System between 01/01/2017 and 03/15/2021. The primary outcome was a positive diagnosis of CVST, identified either by the presence of a corresponding ICD code or by an NLP algorithm which detected positive diagnosis of CVST within free-text clinical notes. For each vaccine we calculated the relative risk by dividing the incidence of CVST in the 30 days following vaccination to that in the 30 days preceding vaccination. Results We identified vaccination events for all FDA-approved COVID-19 vaccines including Pfizer-BioNTech (n = 94,818 doses), Moderna (n = 36,350 doses) and Johnson & Johnson - J&J (n = 1,745 doses). We also identified vaccinations events for 10 common FDA-approved non-COVID-19 vaccines (n = 771,805 doses). There was no statistically significant difference in the incidence rate of CVST in 30-days before and after vaccination for any vaccine in this population. We further found the baseline CVST incidence in the study population between 2017 and 2021 to be 45 to 98 per million patient years. Conclusions This real-world evidence-based study finds that CVST is rare and is not significantly associated with COVID-19 vaccination in our patient cohort. Limitations include the rarity of CVST in our dataset, a relatively small number of J&J COVID-19 vaccination events, and the use of a population drawn from recipients of a SARS-CoV-2 PCR test in a single health system.
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Affiliation(s)
- Colin Pawlowski
- nference, inc., One Main Street, Suite 400, East Arcade, Cambridge, MA 02142, USA
| | - John Rincón-Hekking
- nference, inc., One Main Street, Suite 400, East Arcade, Cambridge, MA 02142, USA
| | - Samir Awasthi
- nference, inc., One Main Street, Suite 400, East Arcade, Cambridge, MA 02142, USA
| | - Viral Pandey
- nference, inc., One Main Street, Suite 400, East Arcade, Cambridge, MA 02142, USA
| | - Patrick Lenehan
- nference, inc., One Main Street, Suite 400, East Arcade, Cambridge, MA 02142, USA
| | - A J Venkatakrishnan
- nference, inc., One Main Street, Suite 400, East Arcade, Cambridge, MA 02142, USA
| | - Sairam Bade
- nference Labs, 2nd Floor, 22 3rd Cross Rd, Murgesh Pallya, Bengaluru, India
| | | | | | | | | | | | | | | | - Venky Soundararajan
- nference, inc., One Main Street, Suite 400, East Arcade, Cambridge, MA 02142, USA; nference Labs, 2nd Floor, 22 3rd Cross Rd, Murgesh Pallya, Bengaluru, India.
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McMurry R, Lenehan P, Awasthi S, Silvert E, Puranik A, Pawlowski C, Venkatakrishnan AJ, Anand P, Agarwal V, O'Horo JC, Gores GJ, Williams AW, Badley AD, Halamka J, Virk A, Swift MD, Carlson K, Doddahonnaiah D, Metzger A, Kayal N, Berner G, Ramudu E, Carpenter C, Wagner T, Rajasekharan A, Soundararajan V. Real-time analysis of a mass vaccination effort confirms the safety of FDA-authorized mRNA COVID-19 vaccines. Med (N Y) 2021; 2:965-978.e5. [PMID: 34230920 PMCID: PMC8248717 DOI: 10.1016/j.medj.2021.06.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 05/04/2021] [Accepted: 06/15/2021] [Indexed: 02/04/2023]
Abstract
Background As the coronavirus disease 2019 (COVID-19) vaccination campaign unfolds, it is important to continuously assess the real-world safety of Food and Drug Administration (FDA)-authorized vaccines. Curation of large-scale electronic health records (EHRs) enables near-real-time safety evaluations that were not previously possible. Methods In this retrospective study, we deployed deep neural networks over a large EHR system to automatically curate the adverse effects mentioned by physicians in over 1.2 million clinical notes between December 1, 2020 and April 20, 2021. We compared notes from 68,266 individuals who received at least one dose of BNT162b2 (n = 51,795) or mRNA-1273 (n = 16,471) to notes from 68,266 unvaccinated individuals who were matched by demographic, geographic, and clinical features. Findings Individuals vaccinated with BNT162b2 or mRNA-1273 had a higher rate of return to the clinic, but not the emergency department, after both doses compared to unvaccinated controls. The most frequently documented adverse effects within 7 days of each vaccine dose included myalgia, headache, and fatigue, but the rates of EHR documentation for each side effect were remarkably low compared to those derived from active solicitation during clinical trials. Severe events, including anaphylaxis, facial paralysis, and cerebral venous sinus thrombosis, were rare and occurred at similar frequencies in vaccinated and unvaccinated individuals. Conclusions This analysis of vaccine-related adverse effects from over 1.2 million EHR notes of more than 130,000 individuals reaffirms the safety and tolerability of the FDA-authorized mRNA COVID-19 vaccines in practice. Funding This study was funded by nference. This is a study of the mRNA COVID-19 vaccines developed by Pfizer/BioNTech and Moderna. Although these vaccines have been shown to be safe and tolerated in clinical trials, it is important to confirm their safety profiles in practice. The results from this study show that individuals receiving these vaccines are likely to experience muscle and joint soreness, but they are not more likely to seek out emergent clinical care or experience severe medical events than unvaccinated individuals. As one of the largest real-world safety studies of COVID-19 vaccines to date, these data reinforce that we should continue expanding efforts to deliver more vaccines with high confidence in their safety.
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Affiliation(s)
- Reid McMurry
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | - Patrick Lenehan
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | - Samir Awasthi
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | - Eli Silvert
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | - Arjun Puranik
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | - Colin Pawlowski
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | | | - Praveen Anand
- nference Labs, 2nd Floor, 22 3rd Cross Rd, Murgesh Pallya, Bengaluru, Karnataka 560017, India
| | - Vineet Agarwal
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | | | | | | | | | | | | | | | - Katie Carlson
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | | | - Anna Metzger
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | - Nikhil Kayal
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | - Gabi Berner
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | - Eshwan Ramudu
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | | | - Tyler Wagner
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
| | | | - Venky Soundararajan
- nference, One Main Street, East Arcade, Cambridge, MA 02142, USA
- nference Labs, 2nd Floor, 22 3rd Cross Rd, Murgesh Pallya, Bengaluru, Karnataka 560017, India
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Awasthi S, Wagner T, Venkatakrishnan AJ, Puranik A, Hurchik M, Agarwal V, Conrad I, Kirkup C, Arunachalam R, O'Horo J, Kremers W, Kashyap R, Morice W, Halamka J, Williams AW, Faubion WA, Badley AD, Gores GJ, Soundararajan V. Plasma IL-6 levels following corticosteroid therapy as an indicator of ICU length of stay in critically ill COVID-19 patients. Cell Death Discov 2021; 7:55. [PMID: 33723251 PMCID: PMC7958587 DOI: 10.1038/s41420-021-00429-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/14/2020] [Accepted: 12/04/2020] [Indexed: 12/13/2022] Open
Abstract
Intensive care unit (ICU) admissions and mortality in severe COVID-19 patients are driven by "cytokine storms" and acute respiratory distress syndrome (ARDS). Interim clinical trial results suggest that the corticosteroid dexamethasone displays better 28-day survival in severe COVID-19 patients requiring ventilation or oxygen. In this study, 10 out of 16 patients (62.5%) that had an average plasma IL-6 value over 10 pg/mL post administration of corticosteroids also had worse outcomes (i.e., ICU stay >15 days or death), compared to 8 out of 41 patients (19.5%) who did not receive corticosteroids (p-value = 0.0024). Given this potential association between post-corticosteroid IL-6 levels and COVID-19 severity, we hypothesized that the glucocorticoid receptor (GR or NR3C1) may be coupled to IL-6 expression in specific cell types that govern cytokine release syndrome (CRS). Examining single-cell RNA-seq data from BALF of severe COVID-19 patients and nearly 2 million cells from a pan-tissue scan shows that alveolar macrophages, smooth muscle cells, and endothelial cells co-express NR3C1 and IL-6, motivating future studies on the links between the regulation of NR3C1 function and IL-6 levels.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - William Morice
- Mayo Clinic, Rochester, MN, 55905, USA
- Mayo Clinic Laboratories, Rochester, MN, 55905, USA
| | - John Halamka
- Mayo Clinic, Rochester, MN, 55905, USA
- Mayo Clinic Platform, Rochester, MN, 55905, USA
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Yamoah K, Asamoah F, Abrahams A, Awasthi S, Mensah J, Dhillon J, Rebbeck T, Yarney J. Comparative Transcriptomics of Prostate Tumor Show Enrichment of Biologically Distinct Pathways Among Men of African Origin. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ayettey Anie H, Yarney J, Sanuade O, Awasthi S, Akuetteh Ndanu T, Parekh A, Aidoo C, Dadzie M, Vanderpuye V, Yamoah K. Outcome of Treatment After Locoregional Radiation, Neoadjuvant and Adjuvant Chemotherapy for Breast Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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15
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Awasthi S, Berglund A, Rounbehler R, Gerke T, Serna A, Abraham J, Fink A, DeNicola G, Dhillon J, Park J, Yamoah K. Comparative Genomics to Uncover Distinct Immune-oncologic Pathways in African American Men with Prostate Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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16
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Awasthi S, Pan H, LeDoux JE, Cloitre M, Altemus M, McEwen B, Silbersweig D, Stern E. The bed nucleus of the stria terminalis and functionally linked neurocircuitry modulate emotion processing and HPA axis dysfunction in posttraumatic stress disorder. Neuroimage Clin 2020; 28:102442. [PMID: 33070099 PMCID: PMC7569227 DOI: 10.1016/j.nicl.2020.102442] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/22/2022]
Abstract
Task-based functional cooccurrence (tbFC) elucidates role of BNST in human PTSD neurocircuitry. The BNST is hyperactive during the processing of trauma-related words in PTSD. BNST activity correlates to PTSD symptom severity and reduced diurnal cortisol index. The BNST has positive tbFC with negative emotion- and stress-related neurocircuitry. The BNST has negative tbFC with executive function and stress regulation neurocircuitry.
Background The bed nucleus of the stria terminalis (BNST) plays an important role in rodent posttraumatic stress disorder (PTSD), but evidence to support its relevance to human PTSD is limited. We sought to understand the role of the BNST in human PTSD via fMRI, behavioral, and physiological measurements. Methods 29 patients with PTSD (childhood sexual abuse) and 23 healthy controls (HC) underwent BOLD imaging with an emotional word paradigm. Symptom severity was assessed using the Clinician-Administered PTSD Scale and HPA-axis dysfunction was assessed by measuring the diurnal cortisol amplitude index (DCAI). A data-driven multivariate analysis was used to determine BNST task-based functional co-occurrence (tbFC) across individuals. Results In the trauma-versus-neutral word contrast, patients showed increased activation compared to HC in the BNST, medial prefrontal cortex (mPFC), posterior cingulate gyrus (PCG), caudate heads, and midbrain, and decreased activation in dorsolateral prefrontal cortex (DLPFC). Symptom severity positively correlated with activity in the BNST, caudate head, amygdala, hippocampus, dorsal anterior cingulate gyrus (dACG), and PCG, and negatively with activity in the medial orbiotofrontal cortex (mOFC) and DLPFC. Patients and HC showed marked differences in the relationship between the DCAI and BOLD activity in the BNST, septal nuclei, dACG, and PCG. Patients showed stronger tbFC between the BNST and closely linked limbic and subcortical regions, and a loss of negative tbFC between the BNST and DLPFC. Conclusions Based upon novel data, we present a new model of dysexecutive emotion processing and HPA-axis dysfunction in human PTSD that incorporates the role of the BNST and functionally linked neurocircuitry.
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Affiliation(s)
- Samir Awasthi
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hong Pan
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Joseph E LeDoux
- Center for Neural Science, New York University, New York, NY, USA
| | - Marylene Cloitre
- National Center for PTSD, Veteran Affairs Palo Alto Health Care System, USA; Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Margaret Altemus
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - David Silbersweig
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Emily Stern
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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17
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Wagner T, Shweta FNU, Murugadoss K, Awasthi S, Venkatakrishnan AJ, Bade S, Puranik A, Kang M, Pickering BW, O'Horo JC, Bauer PR, Razonable RR, Vergidis P, Temesgen Z, Rizza S, Mahmood M, Wilson WR, Challener D, Anand P, Liebers M, Doctor Z, Silvert E, Solomon H, Anand A, Barve R, Gores G, Williams AW, Morice WG, Halamka J, Badley A, Soundararajan V. Augmented curation of clinical notes from a massive EHR system reveals symptoms of impending COVID-19 diagnosis. eLife 2020; 9:e58227. [PMID: 32633720 PMCID: PMC7410498 DOI: 10.7554/elife.58227] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/06/2020] [Indexed: 01/09/2023] Open
Abstract
Understanding temporal dynamics of COVID-19 symptoms could provide fine-grained resolution to guide clinical decision-making. Here, we use deep neural networks over an institution-wide platform for the augmented curation of clinical notes from 77,167 patients subjected to COVID-19 PCR testing. By contrasting Electronic Health Record (EHR)-derived symptoms of COVID-19-positive (COVIDpos; n = 2,317) versus COVID-19-negative (COVIDneg; n = 74,850) patients for the week preceding the PCR testing date, we identify anosmia/dysgeusia (27.1-fold), fever/chills (2.6-fold), respiratory difficulty (2.2-fold), cough (2.2-fold), myalgia/arthralgia (2-fold), and diarrhea (1.4-fold) as significantly amplified in COVIDpos over COVIDneg patients. The combination of cough and fever/chills has 4.2-fold amplification in COVIDpos patients during the week prior to PCR testing, in addition to anosmia/dysgeusia, constitutes the earliest EHR-derived signature of COVID-19. This study introduces an Augmented Intelligence platform for the real-time synthesis of institutional biomedical knowledge. The platform holds tremendous potential for scaling up curation throughput, thus enabling EHR-powered early disease diagnosis.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - William G Morice
- Mayo ClinicRochesterUnited States
- Mayo Clinic LaboratoriesRochesterUnited States
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Wagner T, Shweta F, Murugadoss K, Awasthi S, Venkatakrishnan AJ, Bade S, Puranik A, Kang M, Pickering BW, O'Horo JC, Bauer PR, Razonable RR, Vergidis P, Temesgen Z, Rizza S, Mahmood M, Wilson WR, Challener D, Anand P, Liebers M, Doctor Z, Silvert E, Solomon H, Anand A, Barve R, Gores G, Williams AW, Morice WG, Halamka J, Badley A, Soundararajan V. Augmented curation of clinical notes from a massive EHR system reveals symptoms of impending COVID-19 diagnosis. eLife 2020; 9:58227. [PMID: 32633720 DOI: 10.1101/2020.04.19.20067660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/06/2020] [Indexed: 05/27/2023] Open
Abstract
Understanding temporal dynamics of COVID-19 symptoms could provide fine-grained resolution to guide clinical decision-making. Here, we use deep neural networks over an institution-wide platform for the augmented curation of clinical notes from 77,167 patients subjected to COVID-19 PCR testing. By contrasting Electronic Health Record (EHR)-derived symptoms of COVID-19-positive (COVIDpos; n = 2,317) versus COVID-19-negative (COVIDneg; n = 74,850) patients for the week preceding the PCR testing date, we identify anosmia/dysgeusia (27.1-fold), fever/chills (2.6-fold), respiratory difficulty (2.2-fold), cough (2.2-fold), myalgia/arthralgia (2-fold), and diarrhea (1.4-fold) as significantly amplified in COVIDpos over COVIDneg patients. The combination of cough and fever/chills has 4.2-fold amplification in COVIDpos patients during the week prior to PCR testing, in addition to anosmia/dysgeusia, constitutes the earliest EHR-derived signature of COVID-19. This study introduces an Augmented Intelligence platform for the real-time synthesis of institutional biomedical knowledge. The platform holds tremendous potential for scaling up curation throughput, thus enabling EHR-powered early disease diagnosis.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - William G Morice
- Mayo Clinic, Rochester, United States
- Mayo Clinic Laboratories, Rochester, United States
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Huda N, Kumar H, Pant A, Awasthi S, Bishnoi S, Islam M. Role of triple injection of Platelet rich plasma as a therapeutic strategy for Osteoarthritis knee: A single blind prospective, hospital based study. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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20
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Awasthi S, Pant BP, Langaas T. Refractive Error Prevalence among School Children in Dadeldhura District of Nepal. Kathmandu Univ Med J (KUMJ) 2020; 18:149-154. [PMID: 33594021] [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: 06/12/2023]
Abstract
Background Uncorrected refractive error is the major cause of visual impairment worldwide. There is no data on refractive error prevalence among school children in hilly region of Far West Nepal. Objective The prevalence of refractive error has been found to vary among children of different caste/ethnic groups and geographical regions. The purpose of this study is to determine the prevalence of refractive error among school children from different caste/ethnic groups in Dadeldhura district of Far West Nepal. Method This is a cross sectional study of refractive error among secondary school children from 2 schools in Dadeldhura district. All children underwent a vision screening consisting of visual acuity, ocular examination and refraction. Myopia was diagnosed for an eye with spherical equivalent refraction (SER) ≤ -0.5 D whereas an eye with SER ≥ +2.0 D was diagnosed as hyperopic. Ethnicity was reported through self administered questionnaire. Result Among children aged 12 to 16 years (14.07 ± 1.4) prevalence of myopia was 3.5%, hyperopia 0.33% and astigmatism 1%. All except three children had spherical equivalent refraction (SER) within ±2 D. Caste/ethnicity was not associated significantly with myopia in either eye (χ2 = 0.27, df= 2, p= 0.87). Conclusion The prevalence of refractive error among secondary school children in Dadeldhura district of Far West Nepal is very low in comparison to myopia prevalence reported in studies from other parts of the world, but slightly lower than myopia prevalence found in other, eastern parts of Nepal.
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Affiliation(s)
- S Awasthi
- Geta Eye Hospital, Geta, Kailali, Nepal. Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | - B P Pant
- Geta Eye Hospital, Geta, Kailali, Nepal
| | - T Langaas
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
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Thein K, Jahan N, Tun A, Sultan A, Swarup S, Mogollon-Duffo F, Yendala R, Quirch M, Htut T, D’Cunha N, Rehman S, Hardwicke F, Awasthi S, Tijani L. MA03.07 First-Line Atezolizumab Chemoimmunotherapy in Advanced Non-Squamous NSCLC Patients Harboring EGFR/ALK Genetic Alterations. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Thein K, Mogollon-Duffo F, Swarup S, Sultan A, Yendala R, Jahan N, Quirch M, Ball S, Htut TW, D’Cunha N, Rehman S, Hardwicke F, Awasthi S, Tijani L. Combination therapy with checkpoint inhibitors for first-line treatment of advanced renal cell carcinoma: A systematic review and meta-analysis of randomized controlled trials. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mogollon-Duffo F, Thein K, Tun A, Swarup S, Jahan N, Adhikari N, Htut TW, Naing T, Hlaing P, Myat YM, Naing P, Hardwicke F, Tijani L, D’Cunha N, Awasthi S. Upfront atezolizumab chemoimmunotherapy-associated immune-related adverse events in patients with advanced non-small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Thein K, Jahan N, Sultan A, Swarup S, Tun A, Yendala R, Ball S, Hlaing P, Htut T, Rehman S, D’Cunha N, Hardwicke F, Tijani L, Awasthi S. P1.04-78 Efficacy of Checkpoint Inhibitors in Combination with Chemotherapy for First-Line Treatment of Advanced Non-Squamous NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sultan A, Thein K, Swarup S, Jahan N, Tun A, Meda S, Arevalo M, Naing T, Htut T, D’Cunha N, Awasthi S, Rehman S, Tijani L, Hardwicke F. P2.04-09 Immune-Related Adverse Events in Advanced Non-Squamous NSCLC Patients Treated with Upfront Checkpoint Inhibitors Combination. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jahan N, Swarup S, Sultan A, Naing T, Mogollon-Duffo F, Ball S, Tun A, Htut T, Dash A, D’Cunha N, Hardwicke F, Awasthi S, Tijani L, Thein K. EP1.01-10 Pembrolizumab in Combination with Chemotherapy as First-Line Treatment of Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Thein KZ, Swarup S, Sultan A, Tijani L, D'Cunha N, Hardwicke FT, Awasthi S, Jones C. Abstract P4-16-06: Incidence of interstitial lung disease in patients with HER2-positive advanced breast cancer treated with everolimus and trastuzumab: A combined analysis of two phase 3 randomized controlled trials. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-16-06] [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: 11/16/2022]
Abstract
Abstract
Background: The human epidermal growth factor receptor 2 (HER2) protein is overexpressed in approximately one fourth of breast tumors. Trastuzumab resistance has been demonstrated via aberrant PI3K/AKT/mTOR signaling due to PTEN loss. To circumvent this resistance mechanism, everolimus, an oral mTOR inhibitor, has been employed in treatment of HER2-positive advanced breast cancer (ABC). Lung toxicity due to everolimus is well established and has been reported with trastuzumab. Yet, the incidence of interstitial lung disease (ILD), when everolimus was added to trastuzumab, has never been reported. We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the incidence of ILD in patients with HER2-positive ABC treated with both everolimus and trastuzumab.
Methods: We systematically conducted a comprehensive literature search using MEDLINE, EMBASE databases and meeting abstracts through January 2018. Phase 3 RCTs that mention ILD as an adverse effect were incorporated in the analysis. The primary meta- analytic approach was a fixed effects model using the Mantel-Haenszel (MH) method. It was used to calculate the estimated pooled risk ratio (RR), and risk difference (RD) with 95% confidence interval (CI).
Results: A total of 1272 patients with HER-2 positive ABC from two phase 3 RCTs were eligible. Studies compared everolimus + paclitaxel + trastuzumab vs paclitaxel + trastuzumab and everolimus + vinorelbine + trastuzumab vs vinorelbine + trastuzumab. The initial dose of everolimus in BOLERO-1 was 10mg per day and in BOLERO-3, 5mg per day was used. The median relative dose intensity of everolimus was reduced to 0.54 in BOLERO-1 due to toxicity related dose reductions and dose interruptions. The randomization ratio of everolimus to placebo was 2 to 1 in BOLERO-1 and 1 to 1 in BOLERO-3. Everolimus was utilized in trastuzumab-resistant ABC after prior taxane therapy in the BOLERO-3 study (n= 562) and as first-line treatment in the BOLERO-1 study (n= 710). The I2 statistic for heterogeneity was 0, and the heterogeneity X2 (Cochran's Q) was 1 (P= 0), suggesting homogeneity among RCT. The incidence of all-grade ILD was 31 (4.122%) in the everolimus group vs 3 (0.577%) in control group and of high-grade ILD was 11 (1.463%) in everolimus arm vs 0 (0%) in the control arm. The pooled RR for all-grade ILD was significant at 7.258 (95% CI: 2.130 – 24.733, p = 0.002) and the absolute RD was 0.035 (95% CI: 0.019 – 0.050, P < 0.001). The pooled RR for high-grade ILD was noted at 7.930 (95% CI: 0.997 – 63.044, p = 0.050) and the absolute RD was 0.014 (95% CI: 0.004 – 0.024, P = 0.004).
Conclusions: Approximately 0.46 and 0.61% of patients on trastuzumab alone have been reported to develop ILD in previous studies. Our study showed that the addition of reduced dose of everolimus to trastuzumab, significantly contributed a higher incidence in all grades of ILD with a relative risk of 7.93 for grade 3 and 4 ILD. More randomized trials are required to determine the definitive incidence and actual relation of ILD as well as the optimal dose of everolimus, when combined with trastuzumab or other chemotherapy.
Citation Format: Thein KZ, Swarup S, Sultan A, Tijani L, D'Cunha N, Hardwicke FT, Awasthi S, Jones C. Incidence of interstitial lung disease in patients with HER2-positive advanced breast cancer treated with everolimus and trastuzumab: A combined analysis of two phase 3 randomized controlled trials [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-16-06.
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Affiliation(s)
- KZ Thein
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - S Swarup
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - A Sultan
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - L Tijani
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - N D'Cunha
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - FT Hardwicke
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - S Awasthi
- Texas Tech University Health Sciences Center, Lubbock, TX
| | - C Jones
- Texas Tech University Health Sciences Center, Lubbock, TX
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Thein KZ, Ball S, Zaw MH, Quirch M, Hardwicke F, Awasthi S, Oo TH, Jones C. Abstract P1-16-04: Risk of venous thromboembolism with abemaciclib based regimen versus other CDK 4/6 inhibitor containing regimens in patients with hormone receptor-positive HER2-negative metastatic breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-16-04] [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: 11/16/2022]
Abstract
Abstract
Background: Approximately 70% of patients with metastatic breast cancer (MBC) are hormone receptor (HR) - positive and the cyclin dependent kinases (CDK) along with their D-type cyclin catalysts, have been shown to play a role in mediating the resistance to endocrine therapy. Several CDK-targeted agents have been recently approved by FDA. Nevertheless, the risk of venous thromboembolism (VTE) with the use of different CDK 4/6 inhibitors has never been reported. We undertook a systematic review and meta-analysis of randomized controlled trials (RCT) to determine the risk of VTE with abemaciclib based regimens versus other CDK 4/6 inhibitor containing regimens in patients with HR-positive HER2-negative MBC.
Methods: We systematically conducted a comprehensive literature search using MEDLINE, EMBASE databases and meeting abstracts through February 2018. The randomized controlled trials that mention deep vein thrombosis and pulmonary embolism as adverse effects of CDK 4/6 inhibitor therapy were incorporated in the analysis. The primary meta- analytic approach was a fixed effects model using the Mantel-Haenszel (MH) method. It was used to calculate the estimated pooled risk ratio (RR) and risk difference (RD) with 95% confidence interval (CI).
Results: Five phase 3 studies and one phase 2 study with a total of 3,159 patients with HR-positive HER2-negative MBC were eligible for analysis. The study arms used palbociclib-letrozole, palbociclib-fulvestrant, ribociclib-letrozole, abemaciclib-fulvestrant, and abemaciclib-nonsteroidal aromatase inhibitors (either letrozole or anastrozole) while the control arms utilized placebo in combination with letrozole or anastrozole or fulvestrant. The randomization ratio was 2 to 1 in PALOMA-2, PALOMA-3, MONARCH-2 and MONARCH-3 studies and 1 to 1 in PALOMA-1 and MONALEESA-2 trials. CDK 4/6 inhibitors were utilized as first line treatment in PALOMA-1, PALOMA-2, MONALEESA-2 and MONARCH-3. The I2 statistic for heterogeneity was 0, and the heterogeneity X2 (Cochran's Q) was 1 (P= 0.707), suggesting homogeneity among RCTs. The VTE incidence was 25 (3.255%) in the abemaciclib group vs 2 (0.520%) in the control group. The pooled relative risk for VTE was 6.222 (95% CI: 1.481 – 26.145, P = 0.013) and the absolute RD was 0.027 (95% CI: 0.013 – 0.042, P < 0.0001). In other CDK 4/6 inhibitor containing regimens, the VTE incidence was reported at 15 (1.243%) vs 2 (0.374%) in the control arm. The pooled RR for VTE was 2.312 (95% CI: 0.852 –6.272, P = 0.100) and the absolute RD was 0.008 (95% CI: - 0.000 – 0.017, P = 0.259).
Conclusion: VTE is a major cause of morbidity and mortality and is particularly common in patients with breast cancer. Our meta-analysis demonstrated that the addition of abemaciclib to endocrine therapy notably contributed to a higher incidence of VTE with a relative risk of 6.22. However, no significant increase in the risk of VTE was noted in other CDK 4/6 inhibitor-based regimen. More randomized trials are required to determine the actual relation and definitive incidence of VTE among different CDK-targeted agents when added to endocrine therapy.
Citation Format: Thein KZ, Ball S, Zaw MH, Quirch M, Hardwicke F, Awasthi S, Oo TH, Jones C. Risk of venous thromboembolism with abemaciclib based regimen versus other CDK 4/6 inhibitor containing regimens in patients with hormone receptor-positive HER2-negative metastatic breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-16-04.
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Affiliation(s)
- KZ Thein
- Texas Tech University Health Sciences Center, Lubbock, TX; Brooklyn Hospital Center, Brooklyn, NY; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Ball
- Texas Tech University Health Sciences Center, Lubbock, TX; Brooklyn Hospital Center, Brooklyn, NY; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - MH Zaw
- Texas Tech University Health Sciences Center, Lubbock, TX; Brooklyn Hospital Center, Brooklyn, NY; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Quirch
- Texas Tech University Health Sciences Center, Lubbock, TX; Brooklyn Hospital Center, Brooklyn, NY; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - F Hardwicke
- Texas Tech University Health Sciences Center, Lubbock, TX; Brooklyn Hospital Center, Brooklyn, NY; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Awasthi
- Texas Tech University Health Sciences Center, Lubbock, TX; Brooklyn Hospital Center, Brooklyn, NY; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - TH Oo
- Texas Tech University Health Sciences Center, Lubbock, TX; Brooklyn Hospital Center, Brooklyn, NY; The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C Jones
- Texas Tech University Health Sciences Center, Lubbock, TX; Brooklyn Hospital Center, Brooklyn, NY; The University of Texas MD Anderson Cancer Center, Houston, TX
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Thein K, Sultan A, Zaw M, Han M, Yu N, Igid H, Jones C, D'Cunha N, Awasthi S, Hardwicke F. Risk of health-related quality of life events and pulmonary toxicities in recurrent ovarian cancer patients treated with poly adenosine diphosphate ribose polymerase (PARP) inhibitors maintenance. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy300.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Thein K, Swarup S, Ball S, Quirch M, Vorakunthada Y, Htwe K, D'Cunha N, Hardwicke F, Awasthi S, Tijani L. Incidence of cardiac toxicities in patients with advanced non-small cell lung cancer treated with osimertinib: A combined analysis of two phase III randomized controlled trials. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Thein K, Sultan A, Zaw M, Han M, Yendala R, Zin M, Awasthi S, D'Cunha N, Hardwicke F, Jones C. Risk of secondary hematological malignancies and hematological toxicities in recurrent ovarian cancer patients treated with poly adenosine diphosphate ribose polymerase (PARP) inhibitors maintenance. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Thein K, Sultan A, Zaw M, Han M, Hein A, Aung H, Awasthi S, Jones C, Hardwicke F, D'Cunha N. A systematic review and meta- analysis of randomized controlled trials to evaluate the risk of gastrointestinal and hepatic toxicities in patients with recurrent ovarian cancer treated with poly adenosine diphosphate ribose polymerase inhibitors maintenance. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Swarup S, Thein K, Ball S, Quirch M, Vorakunthada Y, Sultan A, Hardwicke F, Tijani L, Awasthi S. P3.01-93 Osimertinib-Related Hematological and Pulmonary Toxicities in Advanced NSCLC Patients: Combined Analysis of Phase III Trials. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Greywal T, Haddock N, Awasthi S, Cotton C, Proudfoot J, Tom W. 1294 Pediatric atopic dermatitis: A pilot comparative study across different races and ethnicities. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Thein KZ, Zaw MH, Yendala R, Igid HP, Chai-Adisaksopha C, Hardwicke F, Awasthi S, Radhi S. Abstract P1-17-08: Efficacy of lapatinib and capecitabine combination therapy in brain metastases from HER-2 positive metastatic breast cancer: A systematic review and meta- analysis. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-17-08] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Brain metastases contribute to significant morbidity and mortality in breast cancer. Approximately one fourth of breast tumors overexpress the human epidermal growth factor receptor 2 (HER2) protein and are twice as likely to develop brain metastases. There are currently no systemic therapies approved. We undertook a systematic review and pooled analysis of trials to determine the efficacy of lapatinib and capecitabine combination therapy in brain metastases from HER-2 positive metastatic breast cancer (MBC).
Methods:
We performed a comprehensive literature search using MEDLINE, EMBASE databases, and meeting abstracts through December 31, 2016. Trials that utilized lapatinib and capecitabine combination therapy in brain metastases from HER-2 positive MBC were incorporated in the analysis. The pooled estimated rates were calculated using random effects model. Heterogeneity was assessed using I2 statistic.
Results:
A total of 513 patients with brain metastases from HER-2 positive MBC from 6 trials and a subgroup of another 4 trials were included in our analysis. Lapatinib and capecitabine therapy was used as second-line treatment in 9 studies (n= 468) and as first-line treatment in the LANDSCAPE study (n= 45). Three studies were retrospective evaluations of randomized trials and the rest were phase 2 trials. CNS objective response rate (ORR) was 26% (95% CI: 19 – 33, I2: 65.9%). Complete response (CR) rate was 1% (95% CI: 0 - 2, I2: 0.0%) and partial response (PR) rate was noted at 24% (95% CI: 17- 31, I2: 66.1%). Stable disease (SD) occurred in 37% (95% CI: 29- 45, I2: 66.6%) and progressive disease (PD) in 19% (95% CI: 12- 25, I2: 66.5%). The first line LANDSCAPE study had the highest PR (49%) and ORR (53%) without a significant impact on CR rate; PD was 7%.
Conclusion:
Brain metastases in breast cancer is an area of urgent unmet need. Our meta-analysis showed that lapatinib/capecitabine therapy had some first line or second line activity in brain metastases from HER-2 positive MBC. Nevertheless, further randomized controlled trials are required in this patient population.
Citation Format: Thein KZ, Zaw MH, Yendala R, Igid HP, Chai-Adisaksopha C, Hardwicke F, Awasthi S, Radhi S. Efficacy of lapatinib and capecitabine combination therapy in brain metastases from HER-2 positive metastatic breast cancer: A systematic review and meta- analysis [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-17-08.
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Affiliation(s)
- KZ Thein
- Texas Tech University Health Sciences Center, Lubbock, TX; The Brooklyn Hospital Center, New York, NY; McMaster University, Hamilton, ON, Canada
| | - MH Zaw
- Texas Tech University Health Sciences Center, Lubbock, TX; The Brooklyn Hospital Center, New York, NY; McMaster University, Hamilton, ON, Canada
| | - R Yendala
- Texas Tech University Health Sciences Center, Lubbock, TX; The Brooklyn Hospital Center, New York, NY; McMaster University, Hamilton, ON, Canada
| | - HP Igid
- Texas Tech University Health Sciences Center, Lubbock, TX; The Brooklyn Hospital Center, New York, NY; McMaster University, Hamilton, ON, Canada
| | - C Chai-Adisaksopha
- Texas Tech University Health Sciences Center, Lubbock, TX; The Brooklyn Hospital Center, New York, NY; McMaster University, Hamilton, ON, Canada
| | - F Hardwicke
- Texas Tech University Health Sciences Center, Lubbock, TX; The Brooklyn Hospital Center, New York, NY; McMaster University, Hamilton, ON, Canada
| | - S Awasthi
- Texas Tech University Health Sciences Center, Lubbock, TX; The Brooklyn Hospital Center, New York, NY; McMaster University, Hamilton, ON, Canada
| | - S Radhi
- Texas Tech University Health Sciences Center, Lubbock, TX; The Brooklyn Hospital Center, New York, NY; McMaster University, Hamilton, ON, Canada
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Tiwari PK, Awasthi S, Kumar R, Anand RK, Rai PK, Rai AK. Rapid analysis of pharmaceutical drugs using LIBS coupled with multivariate analysis. Lasers Med Sci 2017; 33:263-270. [PMID: 29080007 DOI: 10.1007/s10103-017-2358-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 10/10/2017] [Indexed: 12/01/2022]
Abstract
Type 2 diabetes drug tablets containing voglibose having dose strengths of 0.2 and 0.3 mg of various brands have been examined, using laser-induced breakdown spectroscopy (LIBS) technique. The statistical methods such as the principal component analysis (PCA) and the partial least square regression analysis (PLSR) have been employed on LIBS spectral data for classifying and developing the calibration models of drug samples. We have developed the ratio-based calibration model applying PLSR in which relative spectral intensity ratios H/C, H/N and O/N are used. Further, the developed model has been employed to predict the relative concentration of element in unknown drug samples. The experiment has been performed in air and argon atmosphere, respectively, and the obtained results have been compared. The present model provides rapid spectroscopic method for drug analysis with high statistical significance for online control and measurement process in a wide variety of pharmaceutical industrial applications.
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Affiliation(s)
- P K Tiwari
- Laser Spectroscopy Research Laboratory, Department of Physics, University of Allahabad, Allahabad, 211002, India
| | - S Awasthi
- Laser Spectroscopy Research Laboratory, Department of Physics, University of Allahabad, Allahabad, 211002, India
| | - R Kumar
- Laser Spectroscopy Research Laboratory, Department of Physics, University of Allahabad, Allahabad, 211002, India
| | - R K Anand
- Laser Spectroscopy Research Laboratory, Department of Physics, University of Allahabad, Allahabad, 211002, India
| | - P K Rai
- Department of Nephrology, N. 10/60-2, Opal Hospital, DLW Road, Kakarmatta, Varanasi, 221004, India
| | - A K Rai
- Laser Spectroscopy Research Laboratory, Department of Physics, University of Allahabad, Allahabad, 211002, India.
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Yamoah K, Rounbehler R, Takhar M, Gerke T, Park J, Awasthi S, Erho N, Davicioni E, Cleveland J, Berglund A. Distinct AR-Dependent Transcriptional Program in TMPRSS2-ERG Fusion Negative Tumors in African-American Men With Prostate Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kosman KA, Lonergan BB, Awasthi S, Hinchman CA, Stern AP. Emerging areas of transcranial magnetic stimulation use in psychiatry. Future Neurology 2017. [DOI: 10.2217/fnl-2017-0004] [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: 11/21/2022]
Abstract
Transcranial magnetic stimulation (TMS) is most widely known clinically as a treatment for medication-refractory major depressive disorder, but it holds promise in a number of other areas. In addition to emerging neurologic areas of investigation such as in mild cognitive impairment, dementia, Parkinson's disease and stroke rehab, novel approaches to psychiatric conditions are also being explored. This review provides a critical condensation of the available data assessing the efficacy of TMS in the treatment of other psychiatric conditions, namely bipolar disorder, substance use, post-traumatic stress disorder and other anxiety disorders. Each section details the field's current accumulation of evidence of the respective condition's pathophysiology in the context of a discussion of the relevant therapeutic target(s) of TMS. Each section then reviews both positive and negative studies evaluating TMS in clinical practice. Given the relative tolerability and proven efficacy of TMS in treatment-resistant depression (TRD), further study to determine its therapeutic effect in other psychiatric entities is warranted.
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Affiliation(s)
- Katherine A Kosman
- Harvard Longwood Psychiatry Residency Training Program, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Rabb-2, Boston, MA 02215, USA
| | - Brady B Lonergan
- Harvard Longwood Psychiatry Residency Training Program, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Rabb-2, Boston, MA 02215, USA
| | - Samir Awasthi
- Harvard Longwood Psychiatry Residency Training Program, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Rabb-2, Boston, MA 02215, USA
| | - Carrie A Hinchman
- Berenson Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, MA, USA
| | - Adam P Stern
- Berenson Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, MA, USA
- Department of Psychiatry, Beth Israel Deaconess Medical Center, MA, USA
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Witt SH, Streit F, Jungkunz M, Frank J, Awasthi S, Reinbold CS, Treutlein J, Degenhardt F, Forstner AJ, Heilmann-Heimbach S, Dietl L, Schwarze CE, Schendel D, Strohmaier J, Abdellaoui A, Adolfsson R, Air TM, Akil H, Alda M, Alliey-Rodriguez N, Andreassen OA, Babadjanova G, Bass NJ, Bauer M, Baune BT, Bellivier F, Bergen S, Bethell A, Biernacka JM, Blackwood DHR, Boks MP, Boomsma DI, Børglum AD, Borrmann-Hassenbach M, Brennan P, Budde M, Buttenschøn HN, Byrne EM, Cervantes P, Clarke TK, Craddock N, Cruceanu C, Curtis D, Czerski PM, Dannlowski U, Davis T, de Geus EJC, Di Florio A, Djurovic S, Domenici E, Edenberg HJ, Etain B, Fischer SB, Forty L, Fraser C, Frye MA, Fullerton JM, Gade K, Gershon ES, Giegling I, Gordon SD, Gordon-Smith K, Grabe HJ, Green EK, Greenwood TA, Grigoroiu-Serbanescu M, Guzman-Parra J, Hall LS, Hamshere M, Hauser J, Hautzinger M, Heilbronner U, Herms S, Hitturlingappa S, Hoffmann P, Holmans P, Hottenga JJ, Jamain S, Jones I, Jones LA, Juréus A, Kahn RS, Kammerer-Ciernioch J, Kirov G, Kittel-Schneider S, Kloiber S, Knott SV, Kogevinas M, Landén M, Leber M, Leboyer M, Li QS, Lissowska J, Lucae S, Martin NG, Mayoral-Cleries F, McElroy SL, McIntosh AM, McKay JD, McQuillin A, Medland SE, Middeldorp CM, Milaneschi Y, Mitchell PB, Montgomery GW, Morken G, Mors O, Mühleisen TW, Müller-Myhsok B, Myers RM, Nievergelt CM, Nurnberger JI, O'Donovan MC, Loohuis LMO, Ophoff R, Oruc L, Owen MJ, Paciga SA, Penninx BWJH, Perry A, Pfennig A, Potash JB, Preisig M, Reif A, Rivas F, Rouleau GA, Schofield PR, Schulze TG, Schwarz M, Scott L, Sinnamon GCB, Stahl EA, Strauss J, Turecki G, Van der Auwera S, Vedder H, Vincent JB, Willemsen G, Witt CC, Wray NR, Xi HS, Tadic A, Dahmen N, Schott BH, Cichon S, Nöthen MM, Ripke S, Mobascher A, Rujescu D, Lieb K, Roepke S, Schmahl C, Bohus M, Rietschel M. Genome-wide association study of borderline personality disorder reveals genetic overlap with bipolar disorder, major depression and schizophrenia. Transl Psychiatry 2017; 7:e1155. [PMID: 28632202 PMCID: PMC5537640 DOI: 10.1038/tp.2017.115] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/10/2017] [Indexed: 01/02/2023] Open
Abstract
Borderline personality disorder (BOR) is determined by environmental and genetic factors, and characterized by affective instability and impulsivity, diagnostic symptoms also observed in manic phases of bipolar disorder (BIP). Up to 20% of BIP patients show comorbidity with BOR. This report describes the first case-control genome-wide association study (GWAS) of BOR, performed in one of the largest BOR patient samples worldwide. The focus of our analysis was (i) to detect genes and gene sets involved in BOR and (ii) to investigate the genetic overlap with BIP. As there is considerable genetic overlap between BIP, major depression (MDD) and schizophrenia (SCZ) and a high comorbidity of BOR and MDD, we also analyzed the genetic overlap of BOR with SCZ and MDD. GWAS, gene-based tests and gene-set analyses were performed in 998 BOR patients and 1545 controls. Linkage disequilibrium score regression was used to detect the genetic overlap between BOR and these disorders. Single marker analysis revealed no significant association after correction for multiple testing. Gene-based analysis yielded two significant genes: DPYD (P=4.42 × 10-7) and PKP4 (P=8.67 × 10-7); and gene-set analysis yielded a significant finding for exocytosis (GO:0006887, PFDR=0.019; FDR, false discovery rate). Prior studies have implicated DPYD, PKP4 and exocytosis in BIP and SCZ. The most notable finding of the present study was the genetic overlap of BOR with BIP (rg=0.28 [P=2.99 × 10-3]), SCZ (rg=0.34 [P=4.37 × 10-5]) and MDD (rg=0.57 [P=1.04 × 10-3]). We believe our study is the first to demonstrate that BOR overlaps with BIP, MDD and SCZ on the genetic level. Whether this is confined to transdiagnostic clinical symptoms should be examined in future studies.
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Affiliation(s)
- S H Witt
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - F Streit
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Jungkunz
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy (IPPP)/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - J Frank
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - S Awasthi
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - C S Reinbold
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - J Treutlein
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - F Degenhardt
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
| | - A J Forstner
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - L Dietl
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - C E Schwarze
- Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
| | - D Schendel
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - J Strohmaier
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - A Abdellaoui
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - T M Air
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - H Akil
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - N Alliey-Rodriguez
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - O A Andreassen
- Division Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
| | - G Babadjanova
- Institute of Pulmonology, Russian State Medical University, Moscow, Russian Federation
| | - N J Bass
- Division of Psychiatry, University College London, London, UK
| | - M Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
| | - B T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - F Bellivier
- Inserm, U1144, AP-HP, GH Saint-Louis, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - S Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - A Bethell
- National Center for Mental Health, Cardiff University, Cardiff, UK
| | - J M Biernacka
- Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - D H R Blackwood
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - M P Boks
- Urain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | | | - P Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - M Budde
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
| | - H N Buttenschøn
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - E M Byrne
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - P Cervantes
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - T-K Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - N Craddock
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - C Cruceanu
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - D Curtis
- Centre for Psychiatry, Queen Mary University of London, London, UK
- UCL Genetics Institute, University College London, London, UK
| | - P M Czerski
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - U Dannlowski
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University of Münste, Münster, Germany
| | - T Davis
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - E J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A Di Florio
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - S Djurovic
- Department of Medical Genetics, Oslo University Hospital Ullevål, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - E Domenici
- Centre for Integrative Biology, Università degli Studi di Trento, Trento, Italy
| | - H J Edenberg
- Indiana University School of Medicine, Department of Biochemistry and Molecular Biology, Indianapolis, IN, USA
- Indiana University School of Medicine, Department of Medical and Molecular Genetics, Indianapolis, IN, USA
| | - B Etain
- Faculté de Médecine, Université Paris Est, Créteil, France
| | - S B Fischer
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - L Forty
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - C Fraser
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - M A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - J M Fullerton
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - K Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
| | - E S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - I Giegling
- Department of Psychiatry, University of Halle, Halle, Germany
| | - S D Gordon
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - K Gordon-Smith
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - H J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - E K Green
- School of Biomedical and Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - T A Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - M Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - J Guzman-Parra
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
| | - L S Hall
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - M Hamshere
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - J Hauser
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - M Hautzinger
- Department of Psychology, Eberhard Karls Universität Tübingen, Tubingen, Germany
| | - U Heilbronner
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
| | - S Herms
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
| | - S Hitturlingappa
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - P Hoffmann
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
| | - P Holmans
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - J-J Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - S Jamain
- Faculté de Médecine, Université Paris Est, Créteil, France
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
| | - I Jones
- National Center for Mental Health, Cardiff University, Cardiff, UK
| | - L A Jones
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - A Juréus
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - R S Kahn
- University Medical Center Utrecht, Division of Neuroscience, Department of Psychiatry, Utrecht, The Netherlands
| | | | - G Kirov
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - S Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - S Kloiber
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Max Planck Institute of Psychiatry, Munich, Germany
| | - S V Knott
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - M Kogevinas
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - M Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - M Leber
- Clinic for Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - M Leboyer
- Inserm U955, Translational Psychiatry Laboratory, AP-HP, DHU PePSY, Department of Psychiatry, Université Paris Est, Créteil, France
| | - Q S Li
- Janssen Research and Development, LLC, Neuroscience Therapeutic Area, Titusville, NJ, USA
| | - J Lissowska
- M. Sklodowska-Curie Cancer Center and Institute of Oncology, Cancer Epidemiology and Prevention, Warsaw, Poland
| | - S Lucae
- Max Planck Institute of Psychiatry, Munich, Germany
| | - N G Martin
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - F Mayoral-Cleries
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
| | - S L McElroy
- Lindner Center of HOPE, Research Institute, Mason, OH, USA
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - J D McKay
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
| | - A McQuillin
- Division of Psychiatry, University College London, London, UK
| | - S E Medland
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - C M Middeldorp
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Y Milaneschi
- VU University Medical Center and GGZ inGeest, Department of Psychiatry, Amsterdam, The Netherlands
| | - P B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, Sydney, NSW, Australia
| | - G W Montgomery
- Institute for Molecular Biology, University of Queensland, Brisbane, QLD, Australia
| | - G Morken
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway
| | - O Mors
- Risskov, Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - T W Mühleisen
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
- Division of Medical Genetics, University of Basel, Basel, Switzerland
| | - B Müller-Myhsok
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- University of Liverpool, Liverpool, UK
| | - R M Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - C M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - J I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - M C O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - L M O Loohuis
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
| | - R Ophoff
- University Medical Center Utrecht, Division of Brain Research, Utrecht, The Netherlands
| | - L Oruc
- Psychiatry Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia-Herzegovina
| | - M J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - S A Paciga
- Pfizer Global Research and Development, Human Genetics and Computational Biomedicine, Groton, CT, USA
| | - B W J H Penninx
- VU University Medical Center and GGZ inGeest, Department of Psychiatry, Amsterdam, The Netherlands
| | - A Perry
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - A Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
| | - J B Potash
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - M Preisig
- Department of Psychiatry, Psychiatric University Hospital of Lausanne, Lausanne, Switzerland
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - F Rivas
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
| | - G A Rouleau
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute and Hospital, Montreal, QC, Canada
| | - P R Schofield
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - T G Schulze
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- NIMH Division of Intramural Research Programs, Human Genetics Branch, Bethesda, MD, USA
| | - M Schwarz
- Psychiatric Center Nordbaden, Wiesloch, Germany
| | - L Scott
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - G C B Sinnamon
- School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - E A Stahl
- Broad Institute of MIT and Harvard, Medical and Population Genetics, Cambridge, MA, USA
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Strauss
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - G Turecki
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - S Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - H Vedder
- Psychiatric Center Nordbaden, Wiesloch, Germany
| | - J B Vincent
- Centre for Addiction and Mental Health, Molecular Neuropsychiatry and Development Laboratory, Toronto, ON, Canada
| | - G Willemsen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - C C Witt
- Department of Anaesthesiology and Operative Intensive Care, University Hospital Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - N R Wray
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - H S Xi
- Pfizer Global Research and Development, Computational Sciences Center of Emphasis, Cambridge, MA, USA
| | - Bipolar Disorders Working Group of the Psychiatric Genomics Consortium
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy (IPPP)/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
- Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Division Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
- Institute of Pulmonology, Russian State Medical University, Moscow, Russian Federation
- Division of Psychiatry, University College London, London, UK
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
- Inserm, U1144, AP-HP, GH Saint-Louis, Département de Psychiatrie et de Médecine Addictologique, Paris, France
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- National Center for Mental Health, Cardiff University, Cardiff, UK
- Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Urain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Medical and Quality Assurance, Clinics of Upper Bavaria, Munich, Germany
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Centre for Psychiatry, Queen Mary University of London, London, UK
- UCL Genetics Institute, University College London, London, UK
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University of Münste, Münster, Germany
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Medical Genetics, Oslo University Hospital Ullevål, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
- Centre for Integrative Biology, Università degli Studi di Trento, Trento, Italy
- Indiana University School of Medicine, Department of Biochemistry and Molecular Biology, Indianapolis, IN, USA
- Indiana University School of Medicine, Department of Medical and Molecular Genetics, Indianapolis, IN, USA
- Faculté de Médecine, Université Paris Est, Créteil, France
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
- Department of Psychiatry, University of Halle, Halle, Germany
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Psychological Medicine, University of Worcester, Worcester, UK
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- School of Biomedical and Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychology, Eberhard Karls Universität Tübingen, Tubingen, Germany
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
- University Medical Center Utrecht, Division of Neuroscience, Department of Psychiatry, Utrecht, The Netherlands
- Center of Psychiatry Weinsberg, Weinsberg, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Max Planck Institute of Psychiatry, Munich, Germany
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Clinic for Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
- Inserm U955, Translational Psychiatry Laboratory, AP-HP, DHU PePSY, Department of Psychiatry, Université Paris Est, Créteil, France
- Janssen Research and Development, LLC, Neuroscience Therapeutic Area, Titusville, NJ, USA
- M. Sklodowska-Curie Cancer Center and Institute of Oncology, Cancer Epidemiology and Prevention, Warsaw, Poland
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- Lindner Center of HOPE, Research Institute, Mason, OH, USA
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
- Division of Psychiatry, University College London, London, UK
- VU University Medical Center and GGZ inGeest, Department of Psychiatry, Amsterdam, The Netherlands
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, Sydney, NSW, Australia
- Institute for Molecular Biology, University of Queensland, Brisbane, QLD, Australia
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway
- Risskov, Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
- Division of Medical Genetics, University of Basel, Basel, Switzerland
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- University of Liverpool, Liverpool, UK
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
- University Medical Center Utrecht, Division of Brain Research, Utrecht, The Netherlands
- Psychiatry Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia-Herzegovina
- Pfizer Global Research and Development, Human Genetics and Computational Biomedicine, Groton, CT, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, Psychiatric University Hospital of Lausanne, Lausanne, Switzerland
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute and Hospital, Montreal, QC, Canada
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- NIMH Division of Intramural Research Programs, Human Genetics Branch, Bethesda, MD, USA
- Psychiatric Center Nordbaden, Wiesloch, Germany
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Broad Institute of MIT and Harvard, Medical and Population Genetics, Cambridge, MA, USA
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Centre for Addiction and Mental Health, Molecular Neuropsychiatry and Development Laboratory, Toronto, ON, Canada
- Department of Anaesthesiology and Operative Intensive Care, University Hospital Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Pfizer Global Research and Development, Computational Sciences Center of Emphasis, Cambridge, MA, USA
- AGAPLESION Elisabethenstift gGmbh, Department of Psychiatry, Psychosomatics and Psychotherapy, Darmstadt, Germany
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Stanley Center for Psychiatric Research and Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy (IPPP)/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
- Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Division Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
- Institute of Pulmonology, Russian State Medical University, Moscow, Russian Federation
- Division of Psychiatry, University College London, London, UK
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
- Inserm, U1144, AP-HP, GH Saint-Louis, Département de Psychiatrie et de Médecine Addictologique, Paris, France
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- National Center for Mental Health, Cardiff University, Cardiff, UK
- Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Urain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Medical and Quality Assurance, Clinics of Upper Bavaria, Munich, Germany
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Centre for Psychiatry, Queen Mary University of London, London, UK
- UCL Genetics Institute, University College London, London, UK
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University of Münste, Münster, Germany
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Medical Genetics, Oslo University Hospital Ullevål, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
- Centre for Integrative Biology, Università degli Studi di Trento, Trento, Italy
- Indiana University School of Medicine, Department of Biochemistry and Molecular Biology, Indianapolis, IN, USA
- Indiana University School of Medicine, Department of Medical and Molecular Genetics, Indianapolis, IN, USA
- Faculté de Médecine, Université Paris Est, Créteil, France
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
- Department of Psychiatry, University of Halle, Halle, Germany
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Psychological Medicine, University of Worcester, Worcester, UK
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- School of Biomedical and Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychology, Eberhard Karls Universität Tübingen, Tubingen, Germany
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
- University Medical Center Utrecht, Division of Neuroscience, Department of Psychiatry, Utrecht, The Netherlands
- Center of Psychiatry Weinsberg, Weinsberg, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Max Planck Institute of Psychiatry, Munich, Germany
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Clinic for Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
- Inserm U955, Translational Psychiatry Laboratory, AP-HP, DHU PePSY, Department of Psychiatry, Université Paris Est, Créteil, France
- Janssen Research and Development, LLC, Neuroscience Therapeutic Area, Titusville, NJ, USA
- M. Sklodowska-Curie Cancer Center and Institute of Oncology, Cancer Epidemiology and Prevention, Warsaw, Poland
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- Lindner Center of HOPE, Research Institute, Mason, OH, USA
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
- Division of Psychiatry, University College London, London, UK
- VU University Medical Center and GGZ inGeest, Department of Psychiatry, Amsterdam, The Netherlands
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, Sydney, NSW, Australia
- Institute for Molecular Biology, University of Queensland, Brisbane, QLD, Australia
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway
- Risskov, Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
- Division of Medical Genetics, University of Basel, Basel, Switzerland
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- University of Liverpool, Liverpool, UK
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
- University Medical Center Utrecht, Division of Brain Research, Utrecht, The Netherlands
- Psychiatry Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia-Herzegovina
- Pfizer Global Research and Development, Human Genetics and Computational Biomedicine, Groton, CT, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, Psychiatric University Hospital of Lausanne, Lausanne, Switzerland
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute and Hospital, Montreal, QC, Canada
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- NIMH Division of Intramural Research Programs, Human Genetics Branch, Bethesda, MD, USA
- Psychiatric Center Nordbaden, Wiesloch, Germany
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Broad Institute of MIT and Harvard, Medical and Population Genetics, Cambridge, MA, USA
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Centre for Addiction and Mental Health, Molecular Neuropsychiatry and Development Laboratory, Toronto, ON, Canada
- Department of Anaesthesiology and Operative Intensive Care, University Hospital Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Pfizer Global Research and Development, Computational Sciences Center of Emphasis, Cambridge, MA, USA
- AGAPLESION Elisabethenstift gGmbh, Department of Psychiatry, Psychosomatics and Psychotherapy, Darmstadt, Germany
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Stanley Center for Psychiatric Research and Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Schizophrenia Working Group of the Psychiatric Genomics Consortium
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy (IPPP)/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
- Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Division Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
- Institute of Pulmonology, Russian State Medical University, Moscow, Russian Federation
- Division of Psychiatry, University College London, London, UK
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
- Inserm, U1144, AP-HP, GH Saint-Louis, Département de Psychiatrie et de Médecine Addictologique, Paris, France
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- National Center for Mental Health, Cardiff University, Cardiff, UK
- Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Urain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Medical and Quality Assurance, Clinics of Upper Bavaria, Munich, Germany
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Centre for Psychiatry, Queen Mary University of London, London, UK
- UCL Genetics Institute, University College London, London, UK
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University of Münste, Münster, Germany
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Medical Genetics, Oslo University Hospital Ullevål, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
- Centre for Integrative Biology, Università degli Studi di Trento, Trento, Italy
- Indiana University School of Medicine, Department of Biochemistry and Molecular Biology, Indianapolis, IN, USA
- Indiana University School of Medicine, Department of Medical and Molecular Genetics, Indianapolis, IN, USA
- Faculté de Médecine, Université Paris Est, Créteil, France
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
- Department of Psychiatry, University of Halle, Halle, Germany
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Psychological Medicine, University of Worcester, Worcester, UK
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- School of Biomedical and Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychology, Eberhard Karls Universität Tübingen, Tubingen, Germany
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
- University Medical Center Utrecht, Division of Neuroscience, Department of Psychiatry, Utrecht, The Netherlands
- Center of Psychiatry Weinsberg, Weinsberg, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Max Planck Institute of Psychiatry, Munich, Germany
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Clinic for Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
- Inserm U955, Translational Psychiatry Laboratory, AP-HP, DHU PePSY, Department of Psychiatry, Université Paris Est, Créteil, France
- Janssen Research and Development, LLC, Neuroscience Therapeutic Area, Titusville, NJ, USA
- M. Sklodowska-Curie Cancer Center and Institute of Oncology, Cancer Epidemiology and Prevention, Warsaw, Poland
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- Lindner Center of HOPE, Research Institute, Mason, OH, USA
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
- Division of Psychiatry, University College London, London, UK
- VU University Medical Center and GGZ inGeest, Department of Psychiatry, Amsterdam, The Netherlands
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, Sydney, NSW, Australia
- Institute for Molecular Biology, University of Queensland, Brisbane, QLD, Australia
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway
- Risskov, Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
- Division of Medical Genetics, University of Basel, Basel, Switzerland
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- University of Liverpool, Liverpool, UK
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
- University Medical Center Utrecht, Division of Brain Research, Utrecht, The Netherlands
- Psychiatry Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia-Herzegovina
- Pfizer Global Research and Development, Human Genetics and Computational Biomedicine, Groton, CT, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, Psychiatric University Hospital of Lausanne, Lausanne, Switzerland
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute and Hospital, Montreal, QC, Canada
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- NIMH Division of Intramural Research Programs, Human Genetics Branch, Bethesda, MD, USA
- Psychiatric Center Nordbaden, Wiesloch, Germany
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Broad Institute of MIT and Harvard, Medical and Population Genetics, Cambridge, MA, USA
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Centre for Addiction and Mental Health, Molecular Neuropsychiatry and Development Laboratory, Toronto, ON, Canada
- Department of Anaesthesiology and Operative Intensive Care, University Hospital Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Pfizer Global Research and Development, Computational Sciences Center of Emphasis, Cambridge, MA, USA
- AGAPLESION Elisabethenstift gGmbh, Department of Psychiatry, Psychosomatics and Psychotherapy, Darmstadt, Germany
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Stanley Center for Psychiatric Research and Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - A Tadic
- AGAPLESION Elisabethenstift gGmbh, Department of Psychiatry, Psychosomatics and Psychotherapy, Darmstadt, Germany
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
| | - N Dahmen
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
| | - B H Schott
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - S Cichon
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
- Division of Medical Genetics, University of Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - M M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
| | - S Ripke
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Stanley Center for Psychiatric Research and Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - A Mobascher
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
| | - D Rujescu
- Department of Psychiatry, University of Halle, Halle, Germany
| | - K Lieb
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
| | - S Roepke
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - C Schmahl
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Bohus
- Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy (IPPP)/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Rietschel
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Awasthi S, Singh J, Pandey C, Kohli N, Agarwal M. Hospital Based Surveillance for Radiological Pneumonia in children under 5 years of age in Uttar Pradesh and Bihar: Project protocol and preliminary results. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Awasthi S, Izu LT, Mao Z, Jian Z, Landas T, Lerner A, Shimkunas R, Woldeyesus R, Bossuyt J, Wood BM, Chen YJ, Matthews DL, Lieu DK, Chiamvimonvat N, Lam KS, Chen-Izu Y, Chan JW. Multimodal SHG-2PF Imaging of Microdomain Ca2+-Contraction Coupling in Live Cardiac Myocytes. Circ Res 2015; 118:e19-28. [PMID: 26643875 DOI: 10.1161/circresaha.115.307919] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 11/06/2015] [Accepted: 12/07/2015] [Indexed: 01/24/2023]
Abstract
RATIONALE Cardiac myocyte contraction is caused by Ca(2+) binding to troponin C, which triggers the cross-bridge power stroke and myofilament sliding in sarcomeres. Synchronized Ca(2+) release causes whole cell contraction and is readily observable with current microscopy techniques. However, it is unknown whether localized Ca(2+) release, such as Ca(2+) sparks and waves, can cause local sarcomere contraction. Contemporary imaging methods fall short of measuring microdomain Ca(2+)-contraction coupling in live cardiac myocytes. OBJECTIVE To develop a method for imaging sarcomere level Ca(2+)-contraction coupling in healthy and disease model cardiac myocytes. METHODS AND RESULTS Freshly isolated cardiac myocytes were loaded with the Ca(2+)-indicator fluo-4. A confocal microscope equipped with a femtosecond-pulsed near-infrared laser was used to simultaneously excite second harmonic generation from A-bands of myofibrils and 2-photon fluorescence from fluo-4. Ca(2+) signals and sarcomere strain correlated in space and time with short delays. Furthermore, Ca(2+) sparks and waves caused contractions in subcellular microdomains, revealing a previously underappreciated role for these events in generating subcellular strain during diastole. Ca(2+) activity and sarcomere strain were also imaged in paced cardiac myocytes under mechanical load, revealing spontaneous Ca(2+) waves and correlated local contraction in pressure-overload-induced cardiomyopathy. CONCLUSIONS Multimodal second harmonic generation 2-photon fluorescence microscopy enables the simultaneous observation of Ca(2+) release and mechanical strain at the subsarcomere level in living cardiac myocytes. The method benefits from the label-free nature of second harmonic generation, which allows A-bands to be imaged independently of T-tubule morphology and simultaneously with Ca(2+) indicators. Second harmonic generation 2-photon fluorescence imaging is widely applicable to the study of Ca(2+)-contraction coupling and mechanochemotransduction in both health and disease.
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Affiliation(s)
- Samir Awasthi
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Leighton T Izu
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Ziliang Mao
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Zhong Jian
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Trevor Landas
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Aaron Lerner
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Rafael Shimkunas
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Rahwa Woldeyesus
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Julie Bossuyt
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Brent M Wood
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Yi-Je Chen
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Dennis L Matthews
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Deborah K Lieu
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Nipavan Chiamvimonvat
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Kit S Lam
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis
| | - Ye Chen-Izu
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis.
| | - James W Chan
- From the Center for Biophotonics (S.A., Z.M., A.L., D.L.M., J.W.C.), Division of Cardiology (D.K.L., N.C., Y.C.-I.), Division of Hematology/Oncology, Department of Internal Medicine (K.S.L.), and Department of Pathology and Laboratory Medicine (J.W.C.), UC Davis School of Medicine, University of California, Davis, Sacramento; and Departments of Pharmacology (L.T.I., Z.J., T.L., J.B., B.W., Y.-J.C., Y.C.-I.), Biomedical Engineering (S.A., R.S., R.W., Y.C.-I.), Biochemistry and Molecular Medicine (K.S.L.), and Microsurgery Core (Y.-J.C.), University of California, Davis.
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Kanchan K, Pati SS, Mohanty S, Mishra SK, Sharma SK, Awasthi S, Venkatesh V, Habib S. Polymorphisms in host genes encoding NOSII, C-reactive protein, and adhesion molecules thrombospondin and E-selectin are risk factors for Plasmodium falciparum malaria in India. Eur J Clin Microbiol Infect Dis 2015; 34:2029-39. [DOI: 10.1007/s10096-015-2448-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 07/01/2015] [Indexed: 12/28/2022]
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Kiran V, Awasthi S, Gaur B. Hydroquinone based sulfonated poly (arylene ether sulfone) copolymer as proton exchange membrane for fuel cell applications. EXPRESS POLYM LETT 2015. [DOI: 10.3144/expresspolymlett.2015.95] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Prabhu VA, Awasthi S, Shanavas R, Kunhikatta V, Thunga G, Acharya R. Acute Respiratory Distress Syndrome: Treatment Pattern and Outcome Analysis. Value Health 2014; 17:A726-A727. [PMID: 27202582 DOI: 10.1016/j.jval.2014.08.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- V A Prabhu
- Manipal College of Pharmaceutical Sciences, Manipal, India
| | - S Awasthi
- Manipal College of Pharmaceutical Sciences, Manipal, India
| | - R Shanavas
- Manipal College of Pharmaceutical Sciences, Manipal, India
| | - V Kunhikatta
- Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India
| | - G Thunga
- Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India
| | - R Acharya
- Kasturba Hospital, Manipal University, Manipal, India
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Narasimhaiah A, Ansari M, Haritwal A, Awasthi S. Fallopian tube papilloma--case report of a rare tumor. Kathmandu Univ Med J (KUMJ) 2014; 11:250-2. [PMID: 24442176 DOI: 10.3126/kumj.v11i3.12515] [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: 11/18/2022]
Abstract
Fallopian tube neoplasms are rare. We report a rare case of fallopian tube papilloma discovered incidentally in a 45 year old female, operated for procidentia. Right tube was dilated at the infundibular region, with friable grey white tissue in the lumen. Microscopy showed delicate branching papillae lined by a single layer of epithelium resembling tubal lining. There were no features to suggest a reactive hyperplasia in response to inflammation or of aggressive behaviour.
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Affiliation(s)
- A Narasimhaiah
- Department of Pathology, TMMC and RC, Moradabad, UP, India
| | - M Ansari
- Department of Pathology, TMMC and RC, Moradabad, UP, India
| | - A Haritwal
- Department of Pathology, TMMC and RC, Moradabad, UP, India
| | - S Awasthi
- Department of Pathology, TMMC and RC, Moradabad, UP, India
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Abstract
Background: EBP1, an ErbB3-binding protein, sensitises breast cancer cells to tamoxifen in part by decreasing ErbB2 protein levels. The p21-regulated serine/threonine kinase PAK1, implicated in tamoxifen resistance, phosphorylates EBP1 in vitro and in vivo at T261. Phosphorylation of EBP1 at this site induces tamoxifen resistance. We thus postulated that inhibition of PAK1 activity, by restoring EBP1 function, could ameliorate the hormone refractory phenotype of ErbB2-overexpressing breast cancer cells. Methods: Effects of EBP1 on ErbB2 levels were measured by western blotting. Effects of EBP1 and IPA-3 on tamoxifen sensitivity were measured using a tetrazolium based cell viability assay. Results: Transient transfection studies indicated that an EBP1 T261E mutant, which mimics EPB1 phosphorylated by PAK1, increased ErbB2 protein levels. An EBP1 T261A mutant, unable to be phosphorylated by PAK1, ameliorated PAK1-induced tamoxifen resistance, suggesting that phosphorylation of EBP1 by PAK1 contributes to tamoxifen resistance. We then tested if pharmacological inhibition of PAK1 activity might render hormone resistant cells, which endogenously overexpress PAK1, tamoxifen sensitive. IPA-3, a specific small MW PAK1 inhibitor, sensitised cells to tamoxifen only when EBP1 was ectopically expressed. IPA had no effect on tamoxifen resistance in T47D cells in which EBP1 protein had been ablated by shRNA. The IPA-induced increase in tamoxifen sensitivity was accompanied by a decrease in ErbB2 levels only in EBP1-overexpressing cells. Conclusion: These studies suggest that phosphorylation of EBP1 may be one mechanism of PAK1-induced hormone resistance and that PAK1 inhibitors may be useful in cells in which EBP1 is overexpressed.
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Affiliation(s)
- A Ghosh
- Greenebaum Cancer Center, University of Maryland School of Medicine, BRB 9-029, 655 W. Baltimore Street, Baltimore, MD 21201, USA
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Awasthi S, Agnihotri K, Chandra H, Singh U, Thakur S. Assessment of Health-Related Quality of Life in school-going adolescents: validation of PedsQL instrument and comparison with WHOQOL-BREF. Natl Med J India 2012; 25:74-79. [PMID: 22686712] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Health-Related Quality of Life (HRQoL) studies are gaining importance. Yet there is a dearth of crossculturally validated generic HRQoL instruments for Indian adolescents. Two HRQoL instruments, namely World Health Organization Quality of Life-Brief (WHOQOL-BREF) and Pediatric Quality of Life inventory™ 4.0 (PedsQL), are widely used internationally, with both measuring four domains (physical, psychological/emotional, social relations and environment/school) but each having different questions with 26 in the former and 23 in the latter. This study was done among adolescents in the city of Lucknow to evaluate the psychometric properties of PedsQL and compare its performance with previously validated and culturally revised WHOQOL-BREF. METHODS This cross-sectional study was conducted in February 2010 after institutional ethical approval. Data were collected by a self-administered, redesigned questionnaire in which items of PedsQL and revised WHOQOL-BREF were intermingled. Reliability, content and construct validity were evaluated for PedsQL. Convergent validity of PedsQL with revised WHOQOL-BREF was calculated for domains with similar questions. RESULTS Parents of 76.5% adolescents (385/503) provided consent. Mean age of adolescents was 13.6 years (1.6 SD and 44.7% were girls). PedsQL showed substantial reliability (Cronbach alpha=0.82, p<0.00001) but poor to fair validity as compared to revised WHOQOL-BREF. CONCLUSIONS For Indian adolescents, PedsQL is a reliable and valid instrument. However, on comparison with revised WHOQOL-BREF, PedsQL has poor to fair validity. We conclude that revised WHOQOL-BREF is a better HRQoL instrument for Indian adolescents.
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Affiliation(s)
- S Awasthi
- Department of Paediatrics, Chhattrapati Shahuji Maharaj Medical University, Shahmina Road, Chowk, Lucknow, Uttar Pradesh 226003,
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Awasthi S, Matthews DL, Li RA, Chiamvimonvat N, Lieu DK, Chan JW. Label-free identification and characterization of human pluripotent stem cell-derived cardiomyocytes using second harmonic generation (SHG) microscopy. J Biophotonics 2012; 5:57-66. [PMID: 22083829 PMCID: PMC3817927 DOI: 10.1002/jbio.201100077] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 10/05/2011] [Accepted: 10/23/2011] [Indexed: 05/31/2023]
Abstract
Pluripotent stem cell-derived cardiomyocytes (PSC-CMs) are a potentially unlimited source of cardiomyocytes (CMs) for cardiac transplantation therapies. The establishment of pure PSC-CM populations is important for this application, but is hampered by a lack of CM-specific surface markers suitable for their identification and sorting. Contemporary purification techniques are either non-specific or require genetic modification. We report a second harmonic generation (SHG) signal detectable in PSC-CMs that is attributable to sarcomeric myosin, dependent on PSC-CM maturity, and retained while PSC-CMs are in suspension. Our study demonstrates the feasibility of developing a SHG-activated flow cytometer for the non-invasive purification of PSC-CMs.
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Affiliation(s)
- Samir Awasthi
- NSF Center for Biophotonics Science and Technology, University of California, Davis, Sacramento, CA 95817, USA
- Department of Biomedical Engineering, University of California, Davis, CA 95616
| | - Dennis L. Matthews
- NSF Center for Biophotonics Science and Technology, University of California, Davis, Sacramento, CA 95817, USA
- Lawrence Livermore National Laboratory, Livermore, CA 94551, USA
| | - Ronald A. Li
- Stem Cell & Regenerative Medicine Consortium, Departments of Medicine and Physiology, LKS Faculty of Medicine, University of Hong Kong
- Cardiovascular Research Center, Mount Sinai School of Medicine, New York, NY 10029
| | | | - Deborah K. Lieu
- Department of Internal Medicine, University of California, Davis, Davis, CA 95616
| | - James W Chan
- NSF Center for Biophotonics Science and Technology, University of California, Davis, Sacramento, CA 95817, USA
- Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento, CA 95817
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Srivastava NM, Awasthi S. SP4-34 Factors associated with qualified medical care for sick neonates among urban poor in Lucknow, northern India. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976p.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Goel A, Kumar S, Natu SM, Dalela D, Sinha RJ, Awasthi S. A cross-sectional pilot study to determine the prevalence of testosterone deficiency syndrome in working population of Indian men. Indian J Urol 2011; 25:190-4. [PMID: 19672344 PMCID: PMC2710062 DOI: 10.4103/0970-1591.52911] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Aim: To determine the prevalence of testosterone deficiency syndrome (TDS) in healthy Indian men employed in a hospital aged above 40 years. Materials and Methods: A general medical health check-up camp was organized for all male employees above 40 years age working in surgical departments. After clinical history and systemic inquiry, subjects were requested to fill the St. Louis University's ADAM Questionnaire based on which the total and free-serum testosterone estimation was then done. Results: One hundred fifty seven healthy volunteers enrolled for the study (mean age 53.1 years; range 40–60). The androgen decline in the aging male (ADAM) Questionnaire detected 106 men (67.5%) to be symptomatic for TDS. Serum testosterone estimation in these subjects revealed 41/106 to have low free-serum testosterone levels and 32/106 to have low total-serum testosterone. In 11 and 6 cases, respectively, the serum free- and total-testosterone levels were found to be low although the subjects were asymptomatic for TDS. Conclusions: The prevalence of symptomatic biochemical hypogonadism was 26.1%. The higher prevalence of symptoms alone of TDS was unusual. It could be because of the nature of the questionnaire. Free-serum testosterone may be a better single test to diagnose symptomatic hypogonadism than total-serum testosterone.
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Affiliation(s)
- Apul Goel
- Department of Urology, King George's Medical University, Lucknow, India
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