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Moorman AR, Benitez EK, Cambuli F, Jiang Q, Mahmoud A, Lumish M, Hartner S, Balkaran S, Bermeo J, Asawa S, Firat C, Saxena A, Wu F, Luthra A, Burdziak C, Xie Y, Sgambati V, Luckett K, Li Y, Yi Z, Masilionis I, Soares K, Pappou E, Yaeger R, Kingham P, Jarnagin W, Paty P, Weiser MR, Mazutis L, D'Angelica M, Shia J, Garcia-Aguilar J, Nawy T, Hollmann TJ, Chaligné R, Sanchez-Vega F, Sharma R, Pe'er D, Ganesh K. Progressive plasticity during colorectal cancer metastasis. Nature 2024:10.1038/s41586-024-08150-0. [PMID: 39478232 DOI: 10.1038/s41586-024-08150-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/02/2024] [Indexed: 11/06/2024]
Abstract
As cancers progress, they become increasingly aggressive-metastatic tumours are less responsive to first-line therapies than primary tumours, they acquire resistance to successive therapies and eventually cause death1,2. Mutations are largely conserved between primary and metastatic tumours from the same patients, suggesting that non-genetic phenotypic plasticity has a major role in cancer progression and therapy resistance3-5. However, we lack an understanding of metastatic cell states and the mechanisms by which they transition. Here, in a cohort of biospecimen trios from same-patient normal colon, primary and metastatic colorectal cancer, we show that, although primary tumours largely adopt LGR5+ intestinal stem-like states, metastases display progressive plasticity. Cancer cells lose intestinal cell identities and reprogram into a highly conserved fetal progenitor state before undergoing non-canonical differentiation into divergent squamous and neuroendocrine-like states, a process that is exacerbated in metastasis and by chemotherapy and is associated with poor patient survival. Using matched patient-derived organoids, we demonstrate that metastatic cells exhibit greater cell-autonomous multilineage differentiation potential in response to microenvironment cues compared with their intestinal lineage-restricted primary tumour counterparts. We identify PROX1 as a repressor of non-intestinal lineage in the fetal progenitor state, and show that downregulation of PROX1 licenses non-canonical reprogramming.
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Casanovas-Hoste A, Domingo-Pardo C, Lerendegui-Marco J, Guerrero C, Tarifeño-Saldivia A, Krtička M, Pignatari M, Calviño F, Schumann D, Heinitz S, Dressler R, Köster U, Aberle O, Andrzejewski J, Audouin L, Bécares V, Bacak M, Balibrea-Correa J, Barbagallo M, Barros S, Bečvář F, Beinrucker C, Berthoumieux E, Billowes J, Bosnar D, Brugger M, Caamaño M, Calviani M, Cano-Ott D, Cardella R, Castelluccio DM, Cerutti F, Chen YH, Chiaveri E, Colonna N, Cortés G, Cortés-Giraldo MA, Cosentino L, Damone LA, Diakaki M, Dupont E, Durán I, Fernández-Domínguez B, Ferrari A, Ferreira P, Finocchiaro P, Furman V, Göbel K, García AR, Gawlik-Ramięga A, Glodariu T, Gonçalves IF, González-Romero E, Goverdovski A, Griesmayer E, Gunsing F, Harada H, Heftrich T, Heyse J, Jenkins DG, Jericha E, Käppeler F, Kadi Y, Katabuchi T, Kavrigin P, Ketlerov V, Khryachkov V, Kimura A, Kivel N, Kokkoris M, Leal-Cidoncha E, Lederer-Woods C, Leeb H, Lo Meo S, Lonsdale SJ, Losito R, Macina D, Marganiec J, Martínez T, Massimi C, Mastinu P, Mastromarco M, Matteucci F, Maugeri EA, Mendoza E, Mengoni A, Milazzo PM, Mingrone F, Mirea M, Montesano S, Musumarra A, Nolte R, Oprea A, Patronis N, Pavlik A, Perkowski J, Porras I, Praena J, Quesada JM, Rajeev K, Rauscher T, Reifarth R, Riego-Perez A, Romanets Y, Rout PC, Rubbia C, Ryan JA, Sabaté-Gilarte M, Saxena A, Schillebeeckx P, Schmidt S, Sedyshev P, Smith AG, Stamatopoulos A, Tagliente G, Tain JL, Tassan-Got L, Tsinganis A, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Vlachoudis V, Vlastou R, Wallner A, Warren S, Weigand M, Weiss C, Wolf C, Woods PJ, Wright T, Žugec P. Shedding Light on the Origin of ^{204}Pb, the Heaviest s-Process-Only Isotope in the Solar System. PHYSICAL REVIEW LETTERS 2024; 133:052702. [PMID: 39159101 DOI: 10.1103/physrevlett.133.052702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 03/09/2024] [Accepted: 06/07/2024] [Indexed: 08/21/2024]
Abstract
Asymptotic giant branch stars are responsible for the production of most of the heavy isotopes beyond Sr observed in the solar system. Among them, isotopes shielded from the r-process contribution by their stable isobars are defined as s-only nuclei. For a long time the abundance of ^{204}Pb, the heaviest s-only isotope, has been a topic of debate because state-of-the-art stellar models appeared to systematically underestimate its solar abundance. Besides the impact of uncertainties from stellar models and galactic chemical evolution simulations, this discrepancy was further obscured by rather divergent theoretical estimates for the neutron capture cross section of its radioactive precursor in the neutron-capture flow, ^{204}Tl (t_{1/2}=3.78 yr), and by the lack of experimental data on this reaction. We present the first ever neutron capture measurement on ^{204}Tl, conducted at the CERN neutron time-of-flight facility n_TOF, employing a sample of only 9 mg of ^{204}Tl produced at the Institute Laue Langevin high flux reactor. By complementing our new results with semiempirical calculations we obtained, at the s-process temperatures of kT≈8 keV and kT≈30 keV, Maxwellian-averaged cross sections (MACS) of 580(168) mb and 260(90) mb, respectively. These figures are about 3% lower and 20% higher than the corresponding values widely used in astrophysical calculations, which were based only on theoretical calculations. By using the new ^{204}Tl MACS, the uncertainty arising from the ^{204}Tl(n,γ) cross section on the s-process abundance of ^{204}Pb has been reduced from ∼30% down to +8%/-6%, and the s-process calculations are in agreement with the latest solar system abundance of ^{204}Pb reported by K. Lodders in 2021.
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Kumar A, Saxena A, Anand M. Subtle membrane changes in cryopreserved bull spermatozoa when modified temperature drop rates are used during the first phase of freezing. CRYO LETTERS 2024; 45:212-220. [PMID: 38809785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND Cryopreservation of spermatozoa involves reduction of temperature to a subzero level, leading to increased longevity. However, temperature reduction has a significant effect on sperm membranes. OBJECTIVE To evaluate the impact of the rate of temperature drop during the first phase of freezing on subtle membrane changes in cryopreserved bull spermatozoa. MATERIALS AND METHODS Thirty-two ejaculates from four bulls (eight ejaculates/bull) were collected using artificial vagina while keeping a 3 to 4 days gap between two collections. Diluted semen samples were equilibrated at 5 degree C for 4 hours. The samples were then placed in a pre-programmed semen freezer. The first phase of freezing, that is, 5 degree C till -10 degree C was subjected to three different temperature drop rates: accelerated (F1), moderate (F2), and slow (F3), at 20 degree C per min, 10 degree C per min and 5 degree C per min, respectively. After thawing, spermatozoa were assessed for percentage live, plasma, and acrosomal membrane integrity, along with the external appearance of phosphatidyl serine, indicating apoptosis. RESULTS A significant difference (p < 0.05) in viability, plasma membrane integrity (HOS test), and acrosome membrane integrity (PSA test) was observed between F3 and the other groups. However, the parameters did not significantly differ between F1 and F2. The annexin V-PI assay (AN/PI) categorized four types of sperm populations: non-apoptotic and viable (AN-/PI-), apoptotic and viable (AN+/PI-), non-apoptotic and non-viable (AN-/PI+), and apoptotic and non-viable (AN+/PI+). The proportion of spermatozoa with (AN-/PI-) and (AN+/PI+) differed significantly (p < 0.05) between F3 and the other groups. The values for apoptotic and viable (AN+/PI-) and non-apoptotic and non-viable (AN-/PI+) sperm were not significantly different among all freezing categories. CONCLUSION A slower temperature drop rate (freezing rate) during the first phase of freezing results in less damaging, subtle membrane changes. Doi.org/10.54680/fr24410110312.
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Amaducci S, Colonna N, Cosentino L, Cristallo S, Finocchiaro P, Krtička M, Massimi C, Mastromarco M, Mazzone A, Maugeri EA, Mengoni A, Roederer IU, Straniero O, Valenta S, Vescovi D, Aberle O, Alcayne V, Andrzejewski J, Audouin L, Babiano-Suarez V, Bacak M, Barbagallo M, Bennett S, Berthoumieux E, Billowes J, Bosnar D, Brown A, Busso M, Caamaño M, Caballero-Ontanaya L, Calviño F, Calviani M, Cano-Ott D, Casanovas A, Cerutti F, Chiaveri E, Cortés G, Cortés-Giraldo MA, Damone LA, Davies PJ, Diakaki M, Dietz M, Domingo-Pardo C, Dressler R, Ducasse Q, Dupont E, Durán I, Eleme Z, Fernández-Domínguez B, Ferrari A, Furman V, Göbel K, Garg R, Gawlik-Ramięga A, Gilardoni S, Gonçalves IF, González-Romero E, Guerrero C, Gunsing F, Harada H, Heinitz S, Heyse J, Jenkins DG, Junghans A, Käppeler F, Kadi Y, Kimura A, Knapová I, Kokkoris M, Kopatch Y, Kurtulgil D, Ladarescu I, Lederer-Woods C, Leeb H, Lerendegui-Marco J, Lonsdale SJ, Macina D, Manna A, Martínez T, Masi A, Mastinu P, Mendoza E, Michalopoulou V, Milazzo PM, Mingrone F, Moreno-Soto J, Musumarra A, Negret A, Nolte R, Ogállar F, Oprea A, Patronis N, Pavlik A, Perkowski J, Petrone C, Piersanti L, Pirovano E, Porras I, Praena J, Quesada JM, Ramos-Doval D, Rauscher T, Reifarth R, Rochman D, Rubbia C, Sabaté-Gilarte M, Saxena A, Schillebeeckx P, Schumann D, Sekhar A, Smith AG, Sosnin NV, Sprung P, Stamatopoulos A, Tagliente G, Tain JL, Tarifeño-Saldivia A, Tassan-Got L, Thomas T, Torres-Sánchez P, Tsinganis A, Ulrich J, Urlass S, Vannini G, Variale V, Vaz P, Ventura A, Vlachoudis V, Vlastou R, Wallner A, Woods PJ, Wright T, Žugec P. Measurement of the ^{140}Ce(n,γ) Cross Section at n_TOF and Its Astrophysical Implications for the Chemical Evolution of the Universe. PHYSICAL REVIEW LETTERS 2024; 132:122701. [PMID: 38579210 DOI: 10.1103/physrevlett.132.122701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/09/2023] [Accepted: 01/31/2024] [Indexed: 04/07/2024]
Abstract
^{140}Ce(n,γ) is a key reaction for slow neutron-capture (s-process) nucleosynthesis due to being a bottleneck in the reaction flow. For this reason, it was measured with high accuracy (uncertainty ≈5%) at the n_TOF facility, with an unprecedented combination of a high purity sample and low neutron-sensitivity detectors. The measured Maxwellian averaged cross section is up to 40% higher than previously accepted values. Stellar model calculations indicate a reduction around 20% of the s-process contribution to the Galactic cerium abundance and smaller sizeable differences for most of the heavier elements. No variations are found in the nucleosynthesis from massive stars.
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Kim AY, Woo W, Saxena A, Tanidir IC, Yao A, Kurniawati Y, Thakur V, Shin YR, Shin JI, Jung JW, Barron DJ. Treatment of hypoplastic left heart syndrome: a systematic review and meta-analysis of randomised controlled trials. Cardiol Young 2024; 34:659-666. [PMID: 37724575 DOI: 10.1017/s1047951123002986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND This meta-analysis aimed to consolidate existing data from randomised controlled trials on hypoplastic left heart syndrome. METHODS Hypoplastic left heart syndrome specific randomised controlled trials published between January 2005 and September 2021 in MEDLINE, EMBASE, and Cochrane databases were included. Regardless of clinical outcomes, we included all randomised controlled trials about hypoplastic left heart syndrome and categorised them according to their results. Two reviewers independently assessed for eligibility, relevance, and data extraction. The primary outcome was mortality after Norwood surgery. Study quality and heterogeneity were assessed. A random-effects model was used for analysis. RESULTS Of the 33 included randomised controlled trials, 21 compared right ventricle-to-pulmonary artery shunt and modified Blalock-Taussig-Thomas shunt during the Norwood procedure, and 12 regarded medication, surgical strategy, cardiopulmonary bypass tactics, and ICU management. Survival rates up to 1 year were superior in the right ventricle-to-pulmonary artery shunt group; this difference began to disappear at 3 years and remained unchanged until 6 years. The right ventricle-to-pulmonary artery shunt group had a significantly higher reintervention rate from the interstage to the 6-year follow-up period. Right ventricular function was better in the modified Blalock-Taussig-Thomas shunt group 1-3 years after the Norwood procedure, but its superiority diminished in the 6-year follow-up. Randomised controlled trials regarding medical treatment, surgical strategy during cardiopulmonary bypass, and ICU management yielded insignificant results. CONCLUSIONS Although right ventricle-to-pulmonary artery shunt appeared to be superior in the early period, the two shunts applied during the Norwood procedure demonstrated comparable long-term prognosis despite high reintervention rates in right ventricle-to-pulmonary artery shunt due to pulmonary artery stenosis. For medical/perioperative management of hypoplastic left heart syndrome, further randomised controlled trials are needed to deliver specific evidence-based recommendations.
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Yarlagadda S, Kutuk T, Saxena A, Roy M, Tolakanahalli RP, Appel H, La Rosa de Los Rios AF, Tom MC, Hall MD, Wieczorek DJ, Lee YC, McDermott MW, Ahluwalia M, Gutierrez A, Mehta MP, Kotecha R. Stereotactic Radiosurgery for Small Intact Brain Metastasis: A Comparative Evaluation of 3 Different Single Fraction Prescription Doses. Int J Radiat Oncol Biol Phys 2023; 117:e159-e160. [PMID: 37784753 DOI: 10.1016/j.ijrobp.2023.06.989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) While single-fraction stereotactic radiosurgery (SRS) in the treatment of small brain metastases (SBM, ≤ 2 cm) is well established, prescription dosing varies considerably across institutions and clinical trials. The choice of prescription dose is a delicate balance between local failure (LF) and radiation necrosis (RN) risks. In the modern era, historically-established dosing thresholds may no longer be applicable. To evaluate the impact of prescription dose on outcomes, we performed a comparative analysis of patients with SBM treated with definitive SRS using three different prescriptions, at a single tertiary institution. MATERIALS/METHODS Consecutive patients with intact SBM treated with SRS from January 2017 and December 2021 were analyzed. Baseline patient characteristics and dosing parameters were abstracted from the medical record. To limit the integral brain dose when treating multiple brain metastases, the institutional practice was to reduce prescription dose as the total number of lesions increased (i.e., 24 Gy for ≤10 lesions, 22 Gy for 11-20, and 20 Gy for >20). A per lesion analysis, where each lesion was followed from the date of SRS to the last follow-up, was conducted with primary endpoints of LF and RN. Gray's test was used to compare the cumulative incidence of the LF and RN, with death as a competing risk. Factors affecting LF were analyzed using Cox hazard regression analysis. RESULTS A total of 1318 SBM in 250 patients received SRS and met the inclusion criteria. The median age was 62 years (range: 18-90), median KPS was 90 (range: 50-100) and 66% were female. The most common primary tumors were lung (55.5%) and breast cancers (26.4%). With a median follow-up of 12 months, 136 (11%) LF in 44 patients and 70 (5.7%) RN events in 46 patients occurred. The actuarial 1-year cumulative rate of LF was lower in lesions treated with 24 Gy (6.4%, 95% CI: 4.7-8.6%) or 22 Gy (5.8%, 95% CI: 3.7-8.7%) compared to 20 Gy (15.4%, 95% CI: 10.9-20.5%) (p<0.01). 22 Gy and 24 Gy prescription doses were associated with a 44% and 52% reduction in risk in LF compared to 20 Gy (HR: 0.56; 95% CI: 0.36-0.9; p = 0.01 and HR: 0.48; 95% CI: 0.31-0.74; p<0.01, respectively). In a subset analysis of radiosensitive tumors, 1-year LF rate was still lower with 24 Gy (7.4%, 95% CI: 5.3-9.9%) and 22 Gy (6.1%, 95% CI: 3.7-9.4%) than 20 Gy (15.7%, 95% CI: 11.2-21%) (p = 0.01). The cumulative 1-year RN rate numerically declined with dose, but was not statistically significantly different, with 3.6% (95% CI: 2.3-5.3%) for 24 Gy, 2.6% (95% CI: 1.3-4.8%) for 22 Gy and 1.4% (95% CI: 0.4-3.7%) for 20 Gy. CONCLUSION Patients treated with single fraction SRS to intact SBM were at increased risk of LF with prescription doses of 20 Gy compared to 22-24 Gy, without an increased risk of RN. Even in patients with radiosensitive histologies, higher LF rates were still observed following 20 Gy compared to 22-24 Gy.
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Kutuk T, Yarlagadda S, Tolakanahalli RP, Roy M, Saxena A, Hall MD, La Rosa A, Tom MC, Wieczorek DJ, Lee Y, Appel H, McDermott MW, Ahluwalia M, Gutierrez A, Mehta MP, Kotecha R. A Comparison of Local Failure and Necrosis Following Different Radiosurgery Strategies for Large Brain Metastases. Int J Radiat Oncol Biol Phys 2023; 117:e121-e122. [PMID: 37784670 DOI: 10.1016/j.ijrobp.2023.06.911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Large brain metastases (LBMs) are associated with poor local control with single-fraction stereotactic radiosurgery (SRS) alone. Various alternative strategies have been developed, including fractionated SRS (FSRS) and staged SRS (SSRS) for intact LBMs, and resection with postoperative-SRS (postop-SRS) or preoperative-SRS (preop-SRS) for operable LBMs. The objective of this study is to compare local failure (LF) and radiation necrosis (RN) outcomes among these four management strategies to determine the optimal treatment paradigm. MATERIALS/METHODS Consecutive patients diagnosed with LBM (≥2 cm in maximum dimension) between July 2017 and January 2022 and treated with one of the aforementioned strategies at a single tertiary institution were evaluated. All immobilization, target contouring, margins, dose- and prescription selection followed pre-defined institutional guidelines. Primary endpoints included LF, symptomatic RN, or a composite endpoint of these two variables. Gray's test was used to compare the cumulative incidence of the LF and the composite endpoint, with death as a competing risk. RESULTS A total of 234 LBMs in 188 consecutive patients met the inclusion criteria. The median age was 65 years (range: 31-98), the median KPS was 80 (range: 50-100), and 58% were female. The most common primary tumors were lung (48%) and breast cancer (17%). The median maximum tumor diameter was 3.0 cm (range: 2.0-5.6). 47 (20%) lesions were treated with FSRS, 66 (28%) with SSRS, 74 (32%) with postop-SRS, and 47 (20%) with preop-SRS. With a median follow-up of 12 months, 22 (9%) LF and 11 (5%) RN events occurred. The 6-month and 1-year cumulative incidences of LF for the entire cohort were 5% (95% CI: 3%-9%) and 8% (95% CI: 5%-12%), respectively. The 6-month and 1-year LF rates were 4% (95% CI: 1%-13%) and 8% (95% CI: 3%-20%) for FSRS; 8% (95% CI: 3%-20%) and 8% (95% CI: 3%-20%) for SSRS; 7% (95% CI: 3%-15%) and 8% (95% CI: 3%-16%) for postop-SRS; 0 and 7% (95% CI: 2%-20%) for preop-SRS (p>0.05). The 1-year OS rates were favorable in resected patients (61% for postop-SRS and 82% for preop-SRS) compared to SRS alone strategies (45% for FSRS and 56% for SSRS) (p = 0.004). Similarly, RN events were significantly lower in resected patients treated with either bimodality approach (0 for postop-SRS and 4% for preop-SRS) than SRS standalone strategies (9% for FSRS and 8% SSRS) (p = 0.024). At 12 months, the cumulative probabilities of the composite endpoint were 13% (95% CI: 5%-25%) for FSRS, 15% (95% CI: 7%-25%) for SSRS, 9% (95% CI: 3%-17%) for postop-SRS, and 12% (95% CI: 4%-24%) for preop-SRS and not significantly different between the groups. CONCLUSION For medically operable patients with surgically resectable LBMs, a strategy of surgery and SRS, regardless of timing, is associated with favorable local control and reduced risk for RN. For unresected patients, either SSRS or FSRS is associated with similar local control, but slightly higher RN risk. Prospective comparative evaluation is warranted.
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Moorman AR, Cambuli F, Benitez EK, Jiang Q, Xie Y, Mahmoud A, Lumish M, Hartner S, Balkaran S, Bermeo J, Asawa S, Firat C, Saxena A, Luthra A, Sgambati V, Luckett K, Wu F, Li Y, Yi Z, Masilionis I, Soares K, Pappou E, Yaeger R, Kingham P, Jarnagin W, Paty P, Weiser MR, Mazutis L, D'Angelica M, Shia J, Garcia-Aguilar J, Nawy T, Hollmann TJ, Chaligné R, Sanchez-Vega F, Sharma R, Pe'er D, Ganesh K. Progressive plasticity during colorectal cancer metastasis. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.18.553925. [PMID: 37662289 PMCID: PMC10473595 DOI: 10.1101/2023.08.18.553925] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Metastasis is the principal cause of cancer death, yet we lack an understanding of metastatic cell states, their relationship to primary tumor states, and the mechanisms by which they transition. In a cohort of biospecimen trios from same-patient normal colon, primary and metastatic colorectal cancer, we show that while primary tumors largely adopt LGR5 + intestinal stem-like states, metastases display progressive plasticity. Loss of intestinal cell states is accompanied by reprogramming into a highly conserved fetal progenitor state, followed by non-canonical differentiation into divergent squamous and neuroendocrine-like states, which is exacerbated by chemotherapy and associated with poor patient survival. Using matched patient-derived organoids, we demonstrate that metastatic cancer cells exhibit greater cell-autonomous multilineage differentiation potential in response to microenvironment cues than their intestinal lineage-restricted primary tumor counterparts. We identify PROX1 as a stabilizer of intestinal lineage in the fetal progenitor state, whose downregulation licenses non-canonical reprogramming.
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Dubey N, Anjum S, Saxena A, Soni D, Marothiya S, Prakash A, Bharti C. 38. Effect of Chlorhexidine Rinsed Blood Contamination on Bond Strength of Brackets Bonded with Self-etch Primer- An in Vitro Study. Mymensingh Med J 2023; 32:550-555. [PMID: 37002770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
The present invitro type of study has done to check the effect of blood contamination & chlorhexidine combination on the bond strength of brackets bonded with self-etch primer technique. The study consisted of ninety sound human upper premolars (extracted for orthodontic purpose) fixed in a self-cure acrylic block and segregated into three groups of 30 samples each. 0.022 slot metal MBT brackets (Gemini series-3M unitek) were bonded with self-etch primer using Transbond XT composite, CA, USA and light cure for 40 seconds) on clean buccal surface. Teeth were divided into 3 groups-Group A/Control group, Group B, Group C. A computer was used to record the force applied to debond the bonded bracket in the unit of Newton. The analysis of variance indicated that there were significant differences (F value = 6.891, p value=0.002) in bond strengths between the various groups tested. The highest value of shear bond strength occurred when chlorhexidine (Group C) was used to remove the blood contamination (mean=15.874 MPa). When bonding was done in ideal condition (Group A), shear bond strength obtained was slightly lower (mean=14.497 MPa) as compared to Group C. On the other hand, lowest shear bond strength among all three groups occurred when blood contamination (Group B) was removed with water (mean=11.059 MPa). Analysis of the study showed that shear bond strength of orthodontic brackets to enamel significantly decreased during bonding with self-etch primer in blood contamination condition. Self-etch primer displayed considerably superior performance with the use of chlorhexidine instead of water to wash the blood contamination.
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Khan R, Nijhawan A, Shick C, Salazar S, Pourmoussa A, Saxena A, Hasan M, Schiro B. Abstract No. 181 Evaluation of Carotid Artery Stenosis Using 3D/4D Vessel Cast. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Saxena A, Dariya SS, Chandra KP, Patil A, Kumar D, Gupta M, Singh NK, Patni B, Sheohara R, Meenakshisundaram L, Hiramath VS, Maheshwari A, Aslam M, Surajeet SK. LDL cholesterol an unmet target in diabetic, hypertensive population pan India exposing susceptive cardiovascular disorder risk. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Management and pathophysiology of diabetes and hypertension has always been the centre of research, with new insights being found consistently. CVD is the major cause of mortality in patients with type 2 diabetes and affects approximately 32.2% of people with type 2 diabetes. Southeast Asia stands out with a higher prevalence of CAD (29.4%) compared with other regions.
Purpose
The purpose of this EHR based real world study was to identify the proportion of patients with LDL-C out of control in people living with diabetes and hypertension who were under regular care of physicians. Specialized clinical care by super-specialists ensures management of specific disorders, yet risk factors for overall cardiovascular health continue to be expressed uncontrolled.
Methods
Patients reporting for routine care in 14 centers across the country were eligible to participate in the study. Patient recruitment at each site required informed consent signature, history of at least 6 months of diabetes mellitus type 2, was sequential and independent of other sites. An EMR (Medeva) integrated research proforma was created only for this study which collected data on medical history, comorbidities, diabetic complications, medications and laboratory values of relevance to the study. The recruitment started in March 2022 and ended in August 2022 (6 months).
Results
Average age of these patients was 54.36 years, and 1238 were male and 964 were female patients. Out of this sample, 1388 patients were only diabetic and 814 patients had diabetes as well as hypertension. 256 patients 44.8% patients had LDL-C within acceptable limits and the remaining 51.2% had hyperdyslipidemia. Average LDL-C value for all patients was 107.07, average LDL-C levels in only diabetic patients was 116.51, and LDL in patients with diabetes and hypertension is 90.97. In diabetes only patients, 37% patients had LDL-C under control whereas in diabetes and hypertension group 58% patients had LDL-C under control.
Conclusion
Although diabetic patients are under regular clinical care, their LDL-C values were higher in 55.2% of the patients. This is an alarming signal that calls all the stakeholders - diabetologists, researchers, educators, dieticians, policymakers, government agencies and people with diabetes must contribute towards the management of lipid profile for prevention of cardiovascular events. Also, the proportion of patients with LDL-C under control is lesser in patients who are only diabetic as compared to patients who are both diabetic and hypertensive. This finding suggests that there is either lesser focus or inadequate on lipid profile of patients who are only diabetic; more holistic management is an unprecedented requirement. More research is needed in this direction to recognize the loopholes, manage them and prevent them adequately.
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Lederer-Woods C, Aberle O, Andrzejewski J, Audouin L, Bécares V, Bacak M, Balibrea J, Barbagallo M, Barros S, Battino U, Bečvář F, Beinrucker C, Berthoumieux E, Billowes J, Bosnar D, Brugger M, Caamaño M, Calviño F, Calviani M, Cano-Ott D, Cardella R, Casanovas A, Castelluccio DM, Cerutti F, Chen YH, Chiaveri E, Colonna N, Cortés G, Cortés-Giraldo MA, Cosentino L, Damone LA, Diakaki M, Domingo-Pardo C, Dressler R, Dupont E, Durán I, Fernández-Domínguez B, Ferrari A, Ferreira P, Finocchiaro P, Furman V, Göbel K, García AR, Gawlik-Ramięga A, Glodariu T, Gonçalves IF, González-Romero E, Goverdovski A, Griesmayer E, Guerrero C, Gunsing F, Harada H, Heftrich T, Heinitz S, Heyse J, Jenkins DG, Jericha E, Käppeler F, Kadi Y, Katabuchi T, Kavrigin P, Ketlerov V, Khryachkov V, Kimura A, Kivel N, Kokkoris M, Krtička M, Leal-Cidoncha E, Leeb H, Lerendegui-Marco J, Meo SL, Lonsdale SJ, Losito R, Macina D, Marganiec J, Martínez T, Massimi C, Mastinu P, Mastromarco M, Matteucci F, Maugeri EA, Mendoza E, Mengoni A, Milazzo PM, Mingrone F, Mirea M, Montesano S, Musumarra A, Nolte R, Oprea A, Patronis N, Pavlik A, Perkowski J, Porras I, Praena J, Quesada JM, Rajeev K, Rauscher T, Reifarth R, Riego-Perez A, Rout PC, Rubbia C, Ryan JA, Sabaté-Gilarte M, Saxena A, Schillebeeckx P, Schmidt S, Schumann D, Sedyshev P, Smith AG, Stamatopoulos A, Tagliente G, Tain JL, Tarifeño-Saldivia A, Tassan-Got L, Tsinganis A, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Vlachoudis V, Vlastou R, Wallner A, Warren S, Weigand M, Weiss C, Wolf C, Woods PJ, Wright T, Žugec P. 74 Ge( n , γ ) cross section below 70 keV measured at n_TOF CERN. THE EUROPEAN PHYSICAL JOURNAL. A, HADRONS AND NUCLEI 2022; 58:239. [PMID: 36514540 PMCID: PMC9734248 DOI: 10.1140/epja/s10050-022-00878-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/31/2022] [Indexed: 06/17/2023]
Abstract
Neutron capture reaction cross sections on74 Ge are of importance to determine74 Ge production during the astrophysical slow neutron capture process. We present new resonance data on74 Ge( n , γ ) reactions below 70 keV neutron energy. We calculate Maxwellian averaged cross sections, combining our data below 70 keV with evaluated cross sections at higher neutron energies. Our stellar cross sections are in agreement with a previous activation measurement performed at Forschungszentrum Karlsruhe by Marganiec et al., once their data has been re-normalised to account for an update in the reference cross section used in that experiment.
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Conle né Gaudin R, Saxena A. Insertional Achilles Tendon Repair with Bioabsorbable Anchors and Suture. Muscles Ligaments Tendons J 2022. [DOI: 10.32098/mltj.04.2022.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Oldham A, Oxborrow N, Woolfson P, Jenkins P, Gadepalli C, Ashworth J, Saxena A, Rothera M, Hendriksz C, Tol G, Jovanovic A. MPS VII - Extending the classical phenotype. Mol Genet Metab Rep 2022; 33:100922. [PMID: 36299251 PMCID: PMC9589197 DOI: 10.1016/j.ymgmr.2022.100922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 11/11/2022] Open
Abstract
Mucopolysaccharidosis VII (or Sly syndrome) is an autosomal recessive disorder characterised by a deficiency in the enzyme Beta-glucuronidase (GUSB). Partial degradation of glycosaminoglycans (GAGs); chondroitin sulfate (CS), dermatan sulfate (DS) and heparan sulfate (HS) results in the accumulation of these fragments in the lysosomes of many tissues, eventually leading to multisystem damage. In some cases, early diagnosis on clinical grounds alone can be difficult due to the extreme variability of the clinical presentation and disease progression. We present a case report of a 31-year-old male patient diagnosed with MPS VII at the age of 28, who multiple specialists saw without suspecting the diagnosis due to the unusual presentation. The patient presented with a history of developmental delay, scoliosis, kyphosis, corneal clouding, abnormal gait, short stature, hearing impairment, slightly coarse facial features and progressive deterioration of fine motor skills since childhood. The patient had inguinal hernia repair at around 12 months, bilateral hearing impairment with a left bone-anchored hearing aid, and spinal surgery. During spinal surveillance MPS VII was suspected by a spinal surgeon with interest in MPS, and the diagnosis confirmed with a deficiency in beta-glucuronidase in leucocytes and marginally elevated urinary GAGs. Next-generation sequencing identified two mutations in the GUSB gene (OMIM 611499), c.526C > T p.(Leu176Phe) and c.1820G > C p.(Gly607Ala). Although the patient exhibited features of the severe form of non-classical manifestations, his metabolic condition has remained reasonably stable, surviving into adulthood with only symptomatic treatment. We present the ever-expanding phenotypic spectrum of this ultra-rare disease.
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Veluswamy R, Bhalla S, Samstein R, Marron T, Gomez J, Doroshow D, Sabari J, Shum E, Saxena A, Namakydoust A, Chachoua A, Wisnivesky J, Mandeli J, Bhardwaj N, Hirsch F, Merad M, Reddy E. 1018P Phase I/II trial of rigosertib and nivolumab for KRAS mutated non-small cell lung cancer (NSCLC) patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Saxena A, Teng YKO, Collins C, England N, Leher H. POS0186 VOCLOSPORIN FOR LUPUS NEPHRITIS: RESULTS OF THE TWO-YEAR AURORA 2 CONTINUATION STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundVoclosporin (VCS), a novel calcineurin inhibitor, was approved in the US in January 2021 for the treatment of adult patients with active lupus nephritis (LN) in combination with background immunosuppressive therapy. The Phase 3 AURORA 1 study showed that the addition of VCS to mycophenolate mofetil (MMF) and low-dose steroids in patients with LN significantly increased rates of complete renal response at 52 weeks.ObjectivesHere we report the results of the completed continuation study, AURORA 2, which assessed the long-term safety and tolerability of VCS compared to placebo in patients with LN receiving treatment for an additional 24 months following completion of the AURORA 1 studyMethodsKey inclusion criteria for the parent AURORA 1 study included a diagnosis of biopsy-proven active LN (Class III, IV, or V ± III/IV), proteinuria ≥1.5 mg/mg (≥2 mg/mg for Class V) and estimated glomerular filtration rate (eGFR) >45 mL/min/1.73 m2. Patients who completed AURORA 1 and who elected and were eligible to enter AURORA 2 continued on the same blinded therapy as at the end of AURORA 1 (either VCS or placebo twice daily in combination with MMF and low-dose steroids). Safety and tolerability were monitored, and eGFR, serum creatinine (SCr), and urine protein creatinine ratio (UPCR) were also assessed.ResultsIn total, 116 and 100 patients in the VCS and control arms enrolled in AURORA 2, with 92 (79.3%) and 73 (73.0%) patients in each respective arm receiving treatment to the end of AURORA 2. There were no unexpected safety signals in the VCS arm compared to control, with similar rates of serious adverse events reported in both arms (VCS [18.1%] vs. control [23.0%]; Table 1). Eight patients in each arm experienced serious adverse events of infection; serious coronavirus infections were observed in 2 patients in the voclosporin arm and 5 patients in the control arm. There were 4 and 2 adverse events by preferred term of renal impairment reported in the VCS and control arms, respectively, none of which were considered serious, and no reports of acute kidney injury by preferred term in either arm. There were no deaths in the VCS arm during AURORA 2; four deaths were reported in the control arm (pulmonary embolism [n=1], coronavirus infection [n=3]). Mean eGFR and SCr levels remained stable through the end of AURORA 2. The difference between the VCS and control arms in LS mean change from baseline in eGFR was 2.7 mL/min/1.73 m2 at 4 weeks following study drug discontinuation (Figure 1). The mean reductions in UPCR observed in patients treated with VCS in AURORA 1 were maintained in AURORA 2 with no increase in UPCR noted at the follow-up visit 4 weeks after study drug discontinuation.Table 1.Overall Summary of Adverse EventsControl(n=100)Voclosporin(n=116)n (%)n (%)Any AE80 (80.0)100 (86.2) Renal Impairment2 (2.0)4 (3.4) Acute Kidney Injury00Treatment-related AE21 (21.0)28 (24.1)Serious AE23 (23.0)21 (18.1)Serious Treatment-related AE2 (2.0)1 (0.9)AE Leading to Study Drug Discontinuation17 (17.0)11 (9.5)Death4 (4.0)0Treatment-related Death00Figure 1.LS Mean eGFR over TimeConclusionVoclosporin was well-tolerated over 3 years of treatment with no unexpected safety signals detected. Further, eGFR remained stable throughout the study period, and the significant and meaningful reductions in proteinuria achieved in AURORA 1 were maintained. These data provide evidence of a long-term treatment benefit of VCS in patients with LN.Includes adverse events starting on or after the first dose of study drug in AURORA 2 up to 30 days after the last dose and all events of death reported during study follow-up. Adverse events were aggregated by System Organ Class and Preferred Term and coded using Medical Dictionary for Regulatory Activities (MedDRA) Version 20.0. AE, adverse event.Disclosure of InterestsAmit Saxena Speakers bureau: Aurinia Pharmaceuticals Inc., Consultant of: Aurinia Pharmaceuticals Inc., Y.K. Onno Teng Consultant of: Aurinia Pharmaceuticals Inc., Chris Collins Shareholder of: Aurinia Pharmaceuticals, Employee of: Aurinia Pharmaceuticals, Nicole England Shareholder of: Aurinia Pharmaceuticals, Employee of: Aurinia Pharmaceuticals, Henry Leher Shareholder of: Aurinia Pharmaceuticals, Employee of: Aurinia Pharmaceuticals
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Mithun T, Kevrekidis PG, Saxena A, Bishop AR. Measurement and memory in the periodically driven complex Ginzburg-Landau equation. Phys Rev E 2022; 105:034210. [PMID: 35428065 DOI: 10.1103/physreve.105.034210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
In the present work we illustrate that classical but nonlinear systems may possess features reminiscent of quantum ones, such as memory, upon suitable external perturbation. As our prototypical example, we use the two-dimensional complex Ginzburg-Landau equation in its vortex glass regime. We impose an external drive as a perturbation mimicking a quantum measurement protocol, with a given "measurement rate" (the rate of repetition of the drive) and "mixing rate" (characterized by the intensity of the drive). Using a variety of measures, we find that the system may or may not retain its coherence, statistically retrieving its original glass state, depending on the strength and periodicity of the perturbing field. The corresponding parametric regimes and the associated energy cascade mechanisms involving the dynamics of vortex waveforms and domain boundaries are discussed.
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Babiano-Suarez V, Balibrea-Correa J, Caballero-Ontanaya L, Domingo-Pardo C, Ladarescu I, Lerendegui-Marco J, Tain JL, Calviño F, Casanovas A, Tarifeño-Saldivia A, Guerrero C, Aberle O, Alcayne V, Amaducci S, Andrzejewski J, Audouin L, Bacak M, Barbagallo M, Bennett S, Berthoumieux E, Billowes J, Bosnar D, Brown A, Busso M, Caamaño M, Calviani M, Cano-Ott D, Cerutti F, Chiaveri E, Colonna N, Cortés G, CortésGiraldo MA, Cosentino L, Cristallo S, Damone LA, Davies PJ, Diakaki M, Dietz M, Dressler R, Ducasse Q, Dupont E, Durán I, Eleme Z, Fernández-Domínguez B, Ferrari A, Finocchiaro P, Furman V, Göbel K, Garg R, Gawlik-Ramięga A, Gilardoni S, Gonçalves IF, González-Romero E, Gunsing F, Harada H, Heinitz S, Heyse J, Jenkins DG, Junghans A, Käppeler F, Kadi Y, Kimura A, Knapová I, Kokkoris M, Kopatch Y, Krtička M, Kurtulgil D, Lederer-Woods C, Leeb H, Lonsdale SJ, Macina D, Manna A, Martínez T, Masi A, Massimi C, Mastinu P, Mastromarco M, Maugeri EA, Mazzone A, Mendoza E, Mengoni A, Michalopoulou V, Milazzo PM, Mingrone F, Moreno-Soto J, Musumarra A, Negret A, Nolte R, Ogállar F, Oprea A, Patronis N, Pavlik A, Perkowski J, Persanti L, Petrone C, Pirovano E, Porras I, Praena J, Quesada JM, Ramos-Doval D, Rauscher T, Reifarth R, Rochman D, Romanets Y, Rubbia C, Sabaté-Gilarte M, Saxena A, Schillebeeckx P, Schumann D, Sekhar A, Smith AG, Sosnin NV, Sprung P, Stamatopoulos A, Tagliente G, Tassan-Got L, Thomas T, Torres-Sánchez P, Tsinganis A, Ulrich J, Urlass S, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Vescovi D, Vlachoudis V, Vlastou R, Wallner A, Woods PJ, Wright T, Žugec P. First 80Se(n, γ) cross section measurement with high resolution in the full stellar energy range 1 eV - 100 keV and its astrophysical implications for the s-process. EPJ WEB OF CONFERENCES 2022. [DOI: 10.1051/epjconf/202226011026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Most elements heavier than iron have been generated in the stellar media by means of neutron capture reactions, approximately half are produced by the slow neutron capture or s-process. Radiative neutron capture cross section measurements are of fundamental importance for the study of this mechanism. In this contribution we present a brief summary on the measurement and results for the 80Se(n,γ) cross-section. The experiment was carried out at CERN n_TOF EAR1 via the time of flight (ToF) technique, using four C6D6 scintillation detectors with very fast response. More than a hundred new resonances have been analyzed for the first time with a high accuracy. The MACS obtained at kT = 8 keV is 36% smaller than the recommended value in KADo-NiS. Some of the astrophysical implications of this result are elucidated in this contribution.
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Vaswani S, Kumar V, Anand M, Kumar M, Kushwaha R, Kumar A, Saxena A, Gupta P, Kumar S. Effect of Tinospora cordifolia as phytogenic feed additive on performance parameters of sahiwal heifers. ANIM NUTR FEED TECHN 2022. [DOI: 10.5958/0974-181x.2022.00021.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Virk S, Saxena A, Henham P, Jeremy R, Bannon P. The Impact of Pre-Existing Atrial Fibrillation on Outcomes after Percutaneous Mitral Valve Repair. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Saxena A, Shou L, Fournier M. Results of Lisfranc’s Surgery in Athletic Patients. Muscles Ligaments Tendons J 2021. [DOI: 10.32098/mltj.04.2021.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Amoura Z, Furie R, Rovin B, Houssiau F, Contreras G, Malvar A, Saxena A, Yu X, Teng O, Van Paassen P, Ginzler E, Kamen D, Oldham M, Bass D, Van Maurik A, Welch M, Green Y, Ji B, Roth D. Effets du belimumab sur la fonction rénale, le contrôle global et les biomarqueurs du lupus systémique. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Saxena A, Mina-Osorio P, Mela C, Berardi V. POS0681 VOCLOSPORIN FOR LUPUS NEPHRITIS: INTERIM ANALYSIS OF THE AURORA 2 EXTENSION STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Voclosporin, a novel calcineurin inhibitor (CNI), has been tested successfully in two pivotal trials in adult patients with lupus nephritis.Previously reported results from the Phase 3 AURORA 1 study and the Phase 2 AURA-LV study showed that compared with mycophenolate mofetil (MMF) and low-dose steroids alone, the addition of voclosporin significantly increased the renal response rate and reduced proteinuria, as measured by urine protein creatinine ratio (UPCR), in patients with lupus nephritis (LN) at approximately one year of treatment (48 weeks in AURA-LV and 52 weeks in AURORA 1).Objectives:Patients that completed one year of treatment in the AURORA 1 study were eligible to enroll into the two-year, blinded, controlled extension study, AURORA 2. Here we report the first interim analysis of the ongoing AURORA 2 study.Methods:Patients completing AURORA 1 were eligible to continue the same randomized treatment of voclosporin (23.7 mg BID) or placebo, in combination with MMF (1 g BID) and low-dose oral steroids in the AURORA 2 extension. This interim analysis evaluated UPCR and estimated glomerular filtration rate (eGFR) in patients with up to two years of total treatment: one year from AURORA 1 and up to one year in AURORA 2.Results:116 patients in the voclosporin arm and 100 patients in the control arm enrolled in the extension study, of which 73 patients in the voclosporin arm and 51 patients in the control arm had received two years of treatment at the time of this interim analysis. Mean UPCR at pre-treatment (AURORA 1) baseline was 3.94 mg/mg in the voclosporin arm (n=116) and 3.87 mg/mg in the control arm (n=100). The LS mean change in UPCR from pre-treatment baseline to year two was -3.1 mg/mg for the voclosporin arm (n=73) and -2.1 mg/mg for control arm (n=51; Table 1). Mean eGFR at pre-treatment (AURORA 1) baseline was 79.6 mL/min for the voclosporin arm (n=116) and 78.9 mL/min for the control arm (n=100) and at year two, was 79.0 mL/min for the voclosporin arm (n=73) and 82.9 mL/min for the control arm (n=51). There was a small early decrease in mean eGFR in the first four weeks of treatment (in AURORA 1) after which eGFR remained stable throughout year one and year two. Additionally, there were no unexpected new AEs observed in patients who continued with voclosporin treatment compared to control-treated patients for more than one year.Table 1.UPCRControl (n=100)Voclosporin (n=116)Treatment Comparison of Voclosporin to ControlnUPCR (mg/mg)nUPCR (mg/mg)UPCR (mg/mg)p-valuePre-treatment baseline, mean1003.871163.94NCNCChange from pre-treatment baseline, LS mean Year 1100-2.4116-3.0-0.60.0080 Year 251-2.173-3.1-1.00.0004LS, least squares; NC, not calculated; UPCR, urine protein creatinine ratio.Mixed effects model for repeated measures (MMRM) analysis of LS mean change from pre-treatment baseline for UPCR included terms for baseline covariate, treatment, visit and treatment by visit interaction. Integrated results include data from pre-treatment baseline of AURORA 1, the one-year treatment period in AURORA 1 and up to a one-year treatment period in AURORA 2.Conclusion:Patients in the voclosporin treatment arm maintained meaningful reductions in proteinuria with no change in mean eGFR at two years of treatment. Additional AURORA 2 efficacy and safety data will be provided at the conclusion of the study.Disclosure of Interests:Amit Saxena: None declared, Paola Mina-Osorio Shareholder of: Aurinia Pharmaceuticals Inc., Employee of: Aurinia Pharmaceuticals Inc., Christopher Mela Shareholder of: Aurinia Pharmaceuticals Inc., Employee of: Aurinia Pharmaceuticals Inc., Vanessa Berardi Shareholder of: Aurinia Pharmaceuticals Inc., Employee of: Aurinia Pharmaceuticals Inc.
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Ojha V, Verma M, Kumar S, Saxena A. Imaging of the spectrum of abnormal systemic arterial supply to the lungs using dual-source CT. Clin Radiol 2020; 76:235.e1-235.e14. [PMID: 33293026 DOI: 10.1016/j.crad.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 11/03/2020] [Indexed: 10/22/2022]
Abstract
Abnormal systemic arterial supply to the lungs can be seen in various congenital and acquired diseases. Identification and characterisation of aberrant vascular supply is essential for further management and treatment. Multidetector computed tomography (CT) with its multiplanar capabilities and volume-rendering techniques provides precise information regarding the anatomy and spatial relationship of arterial vascular channels. The following concise review elucidates the characteristic imaging findings of conditions in which systemic arteries are seen supplying the lung parenchyma on dual-source CT.
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Guerrero C, Lerendegui-Marco J, Paul M, Tessler M, Heinitz S, Domingo-Pardo C, Cristallo S, Dressler R, Halfon S, Kivel N, Köster U, Maugeri EA, Palchan-Hazan T, Quesada JM, Rochman D, Schumann D, Weissman L, Aberle O, Amaducci S, Andrzejewski J, Audouin L, Bécares V, Bacak M, Balibrea J, Barak A, Barbagallo M, Barros S, Bečvář F, Beinrucker C, Berkovits D, Berthoumieux E, Billowes J, Bosnar D, Brugger M, Buzaglo Y, Caamaño M, Calviño F, Calviani M, Cano-Ott D, Cardella R, Casanovas A, Castelluccio DM, Cerutti F, Chen YH, Chiaveri E, Colonna N, Cortés G, Cortés-Giraldo MA, Cosentino L, Dafna H, Damone A, Diakaki M, Dietz M, Dupont E, Durán I, Eisen Y, Fernández-Domínguez B, Ferrari A, Ferreira P, Finocchiaro P, Furman V, Göbel K, García AR, Gawlik A, Glodariu T, Gonçalves IF, González-Romero E, Goverdovski A, Griesmayer E, Gunsing F, Harada H, Heftrich T, Heyse J, Hirsh T, Jenkins DG, Jericha E, Käppeler F, Kadi Y, Kaizer B, Katabuchi T, Kavrigin P, Ketlerov V, Khryachkov V, Kijel D, Kimura A, Kokkoris M, Kriesel A, Krtička M, Leal-Cidoncha E, Lederer-Woods C, Leeb H, Lo Meo S, Lonsdale SJ, Losito R, Macina D, Manna A, Marganiec J, Martínez T, Massimi C, Mastinu P, Mastromarco M, Matteucci F, Mendoza E, Mengoni A, Milazzo PM, Millán-Callado MA, Mingrone F, Mirea M, Montesano S, Musumarra A, Nolte R, Oprea A, Patronis N, Pavlik A, Perkowski J, Piersanti L, Porras I, Praena J, Rajeev K, Rauscher T, Reifarth R, Rodríguez-González T, Rout PC, Rubbia C, Ryan JA, Sabaté-Gilarte M, Saxena A, Schillebeeckx P, Schmidt S, Shor A, Sedyshev P, Smith AG, Stamatopoulos A, Tagliente G, Tain JL, Tarifeño-Saldivia A, Tassan-Got L, Tsinganis A, Valenta S, Vannini G, Variale V, Vaz P, Ventura A, Vlachoudis V, Vlastou R, Wallner A, Warren S, Weigand M, Weiss C, Wolf C, Woods PJ, Wright T, Žugec P. Neutron Capture on the s-Process Branching Point ^{171}Tm via Time-of-Flight and Activation. PHYSICAL REVIEW LETTERS 2020; 125:142701. [PMID: 33064503 DOI: 10.1103/physrevlett.125.142701] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 07/02/2020] [Accepted: 07/29/2020] [Indexed: 06/11/2023]
Abstract
The neutron capture cross sections of several unstable nuclides acting as branching points in the s process are crucial for stellar nucleosynthesis studies. The unstable ^{171}Tm (t_{1/2}=1.92 yr) is part of the branching around mass A∼170 but its neutron capture cross section as a function of the neutron energy is not known to date. In this work, following the production for the first time of more than 5 mg of ^{171}Tm at the high-flux reactor Institut Laue-Langevin in France, a sample was produced at the Paul Scherrer Institute in Switzerland. Two complementary experiments were carried out at the neutron time-of-flight facility (n_TOF) at CERN in Switzerland and at the SARAF liquid lithium target facility at Soreq Nuclear Research Center in Israel by time of flight and activation, respectively. The result of the time-of-flight experiment consists of the first ever set of resonance parameters and the corresponding average resonance parameters, allowing us to make an estimation of the Maxwellian-averaged cross sections (MACS) by extrapolation. The activation measurement provides a direct and more precise measurement of the MACS at 30 keV: 384(40) mb, with which the estimation from the n_TOF data agree at the limit of 1 standard deviation. This value is 2.6 times lower than the JEFF-3.3 and ENDF/B-VIII evaluations, 25% lower than that of the Bao et al. compilation, and 1.6 times larger than the value recommended in the KADoNiS (v1) database, based on the only previous experiment. Our result affects the nucleosynthesis at the A∼170 branching, namely, the ^{171}Yb abundance increases in the material lost by asymptotic giant branch stars, providing a better match to the available pre-solar SiC grain measurements compared to the calculations based on the current JEFF-3.3 model-based evaluation.
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