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Logan R, Andrews C. FIT for the future. Frontline Gastroenterol 2024; 15:181-182. [PMID: 38668983 PMCID: PMC11042431 DOI: 10.1136/flgastro-2023-102586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/05/2024] [Indexed: 04/28/2024] Open
Affiliation(s)
- Robert Logan
- Gastroenterology, King's College Hospital NHS Foundation Trust, London, UK
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Boshoff M, Lopez-Villalobos N, Andrews C, Turner SA. Modeling daily yields of milk, fat, protein, and lactose of New Zealand dairy goats undergoing standard and extended lactations. J Dairy Sci 2024; 107:1500-1509. [PMID: 37863292 DOI: 10.3168/jds.2023-23926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/28/2023] [Indexed: 10/22/2023]
Abstract
This study aimed to assess the milk production data for New Zealand dairy goats in either a standard lactation (SL; ≤305 d in milk [DIM]) or extended lactation (EL; >305 and ≤670 DIM) using a random regression (RR) with third- and fifth-order Legendre polynomials, respectively. Persistency of EL was defined as (B/A) × 100, where A was the accumulated yield from d 1 to 305, and B was the accumulated yield from d 366 to 670. On average, goats in SL produced 1,183 kg of milk, 37 kg of fat, 37 kg of protein, and 54 kg of lactose. The average production of milk, fat, protein, and lactose in EL were 2,473 kg, 78 kg, 79 kg, and 112 kg, respectively. The average persistences for milk, fat, protein, and lactose yields during EL were 98%, 98%, 102%, and 96%, respectively. The relative prediction errors were close to 10% and the concordance correlation coefficients >0.92, indicating that the RR model with Legendre polynomials is adequate for modeling lactation curves for both SL and EL. Total yields and persistency were analyzed with a mixed model that included the fixed effects (year, month of kidding, parity, and proportion of Saanen) as covariates and the random effects of animal and residual errors. Effects of year, month of kidding, and parity were significant on the total yields of milk, fat, protein, and lactose for both SL and EL. The total milk yield of first-parity goats with SL was 946 kg and the total milk yield of second-parity goats with SL was 1,284 kg, making a total of 2,230 kg over 2 years. The total milk yield of a first-parity goat with EL was 2,140 kg. Thus, on average, a goat with SL for the first and second parity produced 90 kg more milk than a first-parity goat subjected to EL. However, a second-parity goat subjected to EL produced 43 kg more milk (2,639 kg) than a goat with SL following the second and third parity (1,284 kg + 1,312 kg). These data, along with the various other benefits of EL (e.g., fewer offspring born and reduced risk of mastitis, lameness, and metabolic problems in early lactation), indicate that EL as a management strategy holds the potential to improve dairy goat longevity and lifetime efficiency without compromising milk production.
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Affiliation(s)
- M Boshoff
- School of Agriculture and Environment, Massey University, Palmerston North 4410, New Zealand
| | - N Lopez-Villalobos
- School of Agriculture and Environment, Massey University, Palmerston North 4410, New Zealand.
| | - C Andrews
- School of Agriculture and Environment, Massey University, Palmerston North 4410, New Zealand
| | - S-A Turner
- Dairy Goat Co-operative (NZ) Limited, Hamilton 3206, New Zealand
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Andrews C, Pade A, Flenady V, Moore J, Tindal K, Farrant B, Stewart S, Loughnan S, Robinson N, Oba Y, Pollock D. Improving the capacity of researchers and bereaved parents to co-design and translate stillbirth research together. Women Birth 2024; 37:403-409. [PMID: 38155062 DOI: 10.1016/j.wombi.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/06/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Working with bereaved parents in co-designed stillbirth research, policy and practice is essential to improving care and outcomes. PROBLEM Effective parent engagement is often lacking. This may be due to bereaved parents not feeling adequately and appropriately supported to be involved. AIM To consult bereaved parents with the aim to understand their experiences, attitudes, and needs around involvement in stillbirth research and gain feedback about the usefulness and appropriateness of a proposed co-designed guide to support their involvement, including content and design aspects of this resource. METHODS An online co-designed survey was disseminated via Australian parent support organisations social media in August 2022. FINDINGS All 90 respondents were bereaved parents, 94% (n = 85) were female. Two-thirds (67%, n = 60) had never participated in stillbirth research, 80% (n = 72) agreed involvement of bereaved parents in research was important or extremely important and 81% (n = 73) were interested in future research involvement. Common motivations for involvement were wanting to leave a legacy for their baby and knowing research outcomes. Common barriers included not having been asked to participate or not knowing how. Most (89%, n = 80) agreed the proposed guide would be useful. Highly valued topics were the importance of bereaved parents' voices in stillbirth research and how they can make a difference. CONCLUSION The majority of bereaved parents we surveyed want to be involved in stillbirth research and would value a resource to support this. The proposed concept and content for a co-designed guide to aid engagement was well supported.
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Affiliation(s)
- C Andrews
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia.
| | - A Pade
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - J Moore
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - K Tindal
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia; The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
| | - B Farrant
- Telethon Kids Institute, The University of Western Australia, Nedlands, Australia
| | - S Stewart
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - S Loughnan
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - N Robinson
- The Phoebe Joan Foundation Australia, Stanthorpe, Australia
| | - Y Oba
- Centre of Research Excellence in Stillbirth, Mater Research, University of Queensland, Brisbane, Australia
| | - D Pollock
- Health Evidence Synthesis, Recommendations and Impact (HESRI), School of Public Health, Faculty of Health and Medical Science, University of Adelaide, Australia
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Medeiros PB, Bailey C, Pollock D, Liley H, Gordon A, Andrews C, Flenady V. Neonatal near-miss audits: a systematic review and a call to action. BMC Pediatr 2023; 23:573. [PMID: 37978460 PMCID: PMC10655277 DOI: 10.1186/s12887-023-04383-6] [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: 06/20/2023] [Accepted: 10/24/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Neonatal near-miss (NNM) can be considered as an end of a spectrum that includes stillbirths and neonatal deaths. Clinical audits of NNM might reduce perinatal adverse outcomes. The aim of this review is to evaluate the effectiveness of NNM audits for reducing perinatal mortality and morbidity and explore related contextual factors. METHODS PubMed, Embase, Scopus, CINAHL, LILACS and SciELO were searched in February/2023. Randomized and observational studies of NNM clinical audits were included without restrictions on setting, publication date or language. PRIMARY OUTCOMES perinatal mortality, morbidity and NNM. SECONDARY OUTCOMES factors contributing to NNM and measures of quality of care. Study characteristics, methodological quality and outcome were extracted and assessed by two independent reviewers. Narrative synthesis was performed. RESULTS Of 3081 titles and abstracts screened, 36 articles had full-text review. Two studies identified, rated, and classified contributing care factors and generated recommendations to improve the quality of care. No study reported the primary outcomes for the review (change in perinatal mortality, morbidity and NNM rates resulting from an audit process), thus precluding meta-analysis. Three studies were multidisciplinary NNM audits and were assessed for additional contextual factors. CONCLUSION There was little data available to determine the effectiveness of clinical audits of NNM. While trials randomised at patient level to test our research question would be difficult or unethical for both NNM and perinatal death audits, other strategies such as large, well-designed before-and-after studies within services or comparisons between services could contribute evidence. This review supports a Call to Action for NNM audits. Adoption of formal audit methodology, standardised NNM definitions, evaluation of parent's engagement and measurement of the effectiveness of quality improvement cycles for improving outcomes are needed.
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Affiliation(s)
- P B Medeiros
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia.
- Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia.
| | - C Bailey
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - D Pollock
- JBI, School of Public Health, University of Adelaide, Adelaide, SA, Australia
| | - H Liley
- Mater Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - A Gordon
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
- University of Sydney, Sydney, NSW, Australia
| | - C Andrews
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
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Pattnaik DP, Andrews C, Cropper MD, Gabbitas A, Balanov AG, Savel'ev S, Borisov P. Gamma radiation-induced nanodefects in diffusive memristors and artificial neurons. Nanoscale 2023; 15:15665-15674. [PMID: 37724437 DOI: 10.1039/d3nr01853a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Gamma photons with an average energy of 1.25 MeV are well-known to generate large amounts of defects in semiconductor electronic devices. Here we investigate the novel effect of gamma radiation on diffusive memristors based on metallic silver nanoparticles dispersed in a dielectric matrix of silica. Our experimental findings show that after exposure to radiation, the memristors and artificial neurons made of them demonstrate much better performance in terms of stable volatile resistive switching and higher spiking frequencies, respectively, compared to the pristine samples. At the same time we observe partial oxidation of silver and reduction of silicon within the switching silica layer. We propose nanoinclusions of reduced silicon distributed across the silica layer to be the backbone for metallic nanoparticles to form conductive filaments, as supported by our theoretical simulations of radiation-induced changes in the diffusion process. Our findings propose a new opportunity to engineer the required characteristics of diffusive memristors in order to emulate biological neurons and develop bio-inspired computational technology.
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Affiliation(s)
- D P Pattnaik
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
| | - C Andrews
- University of Manchester, Dalton Cumbrian Facility, Westlakes Science Park, Moor Row, CA24 3HA, UK
| | - M D Cropper
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
| | - A Gabbitas
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
| | - A G Balanov
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
| | - S Savel'ev
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
| | - P Borisov
- Department of Physics, Loughborough University, Loughborough, LE11 3TU, UK.
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Chalela JA, Hill M, Snelgrove D, Kapoor N, Andrews C. Peripheral Insertion of Pediatric Central Venous Catheters in Adults with Difficult I.V. Access. J Emerg Med 2023:S0736-4679(23)00161-0. [PMID: 37331917 DOI: 10.1016/j.jemermed.2023.03.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/19/2023] [Accepted: 03/11/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Difficult intravenous access is a frequent occurrence in critical care and emergency medicine. Prior intravenous access, chemotherapy use, and obesity are a few factors associated with difficult access. Alternatives to peripheral access are often contraindicated, not feasible, or not readily available. OBJECTIVES To describe the feasibility and safety of peripheral insertion of peripherally inserted pediatric central venous catheters (PIPCVC) in a cohort of adult critical care patients with difficult intravenous access. METHODS Prospective observational study of adult patients with difficult intravenous access who underwent peripheral insertion of pediatric PIPCVCs at a large university hospital. RESULTS During a 1-year period, 46 patients were evaluated for PIPCVC; 40 catheters were placed successfully. The median age of the patients was 59 years (range 19-95 years) and 20 (50%) were female. The median body mass index was 27.2 (range 17.1-41.8). The basilic vein was accessed in 25/40 (63%) patients, the cephalic in 10/40 (25%), and the accessed vessel was missing in 5/40 (13%) cases. The PIPCVCs were in place for a median of 8 days (range 1-32). One superficial thrombosis and one deep occurred; pulmonary embolism did not occur. CONCLUSIONS PIPCVC placement seems to be a feasible option in patients in whom peripheral intravenous access is difficult. The safety of this technique needs to be evaluated in prospective studies.
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Affiliation(s)
- Julio A Chalela
- Neurosurgery Department, Medical University of South Carolina, Charleston, South Carolina
| | - Melissa Hill
- Neurosurgery Department, Medical University of South Carolina, Charleston, South Carolina
| | - Danuel Snelgrove
- Neurosurgery Department, Medical University of South Carolina, Charleston, South Carolina
| | - Niren Kapoor
- Neurosurgery Department, Medical University of South Carolina, Charleston, South Carolina
| | - Charles Andrews
- Neurosurgery Department, Medical University of South Carolina, Charleston, South Carolina
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Guo H, Hamilton P, Enns E, Gupta M, Andrews C, Nasser Y, Bredenoord A, Dellon E, Ma C. A142 APPROPRIATENESS OF POST-ENDOSCOPY CARE IN PATIENTS PRESENTING WITH FOOD BOLUS IMPACTIONS OVERNIGHT: A POPULATION-BASED MULTICENTER COHORT STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991086 DOI: 10.1093/jcag/gwac036.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Appropriate management of esophageal food bolus impactions includes endoscopic evaluation and follow-up for potential underlying esophageal pathology. Patients who present with impactions at night may not receive optimal long-term post-endoscopy care due to patient-, physician-, or system-related factors. Purpose We aimed to evaluate the appropriateness of care for patients who present with food bolus impactions after regular daytime hours. Method We conducted a retrospective, population-based, multi-center cohort study of adult patients undergoing endoscopy for food impaction between 19:00-06:59 from 2016-2018 in the Calgary Health Zone, Canada. Appropriate post-endoscopy care was defined by a composite of a follow-up clinic visit, repeat endoscopy, other appropriate investigations (e.g., manometry), or appropriate medical treatment (e.g., proton pump inhibitor). Predictors of inappropriate care were assessed using multivariable logistic regression, expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Result(s) A total of 323 patients underwent an after-hours or overnight endoscopy for food bolus impaction. 25.4% (82/323) of patients did not receive appropriate post-endoscopy care. Predictors of inappropriate care included rural residence (aOR 2.66 [95% CI: 1.18-6.01], p=0.02), first food bolus presentation (aOR 2.38 [95% CI: 1.04-5.44], p=0.04), and absence of a specific pathology during the index procedure (aOR 3.01 [95% CI: 0.97-9.29], p=0.05), suggesting a potential association with clinician cognitive bias. Among patients who were followed, 18.9% (35/185) had a change in the original diagnosis. Image ![]()
Conclusion(s) One quarter of patients presenting with a food bolus impaction at night do not receive appropriate post-endoscopy care. System-based interventions should target this high-risk population as the diagnosis and management may change with follow-up. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
- H Guo
- Division of Gastroenterology and Hepatology
| | - P Hamilton
- Department of Medicine, University of Calgary
| | - E Enns
- Department of Medicine, Alberta Health Services
| | - M Gupta
- Division of Gastroenterology and Hepatology
| | - C Andrews
- Division of Gastroenterology and Hepatology
| | - Y Nasser
- Division of Gastroenterology and Hepatology,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Canada
| | - A Bredenoord
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, Netherlands
| | - E Dellon
- Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, United States
| | - C Ma
- Department of Medicine, Alberta Health Services,Department of Community Health Sciences, University of Calgary, Calgary, Canada
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Chalela JA, Andrews C, Bashmakov A, Kapoor N, Snelgrove D. Reports of Guillain-Barre Syndrome Following COVID-19 Vaccination in the USA: An Analysis of the VAERS Database. J Clin Neurol 2023; 19:179-185. [PMID: 36854334 PMCID: PMC9982177 DOI: 10.3988/jcn.2022.0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND AND PURPOSE An association between Guillain-Barre syndrome and its variants (GBS/V) and vaccines has led to hesitancy toward vaccination. COVID-19 vaccines could theoretically provoke GBS/V via immune activation. We analyzed reports of GBS/V after COVID-19 vaccination in the vaccine adverse event reporting system (VAERS). METHODS The VAERS database is a surveillance system used to report vaccination events in the USA, and is open for consumers and physicians to access. It was queried for reports of GBS/V following COVID-19 vaccination. Reports were reviewed by four neurologists. Modified diagnostic criteria were used to classify reports into definite, possible, and not GBS/V or insufficient data. Descriptive statistics were used to describe the sample, chi-square tests and one-way ANOVAs were used to compare intergroup differences, and t-test were used to compare group means. RESULTS In 2021, 815 reports of GBS/V were filed. The completion rate for the variables in VAERS was 93.5%. The median age was 55 years (interquartile range [IQR]=5-86 years) and 50% of the subjects were male. The median time of onset was 10 days (IQR=0-298 days), 11% reported onset on the day of vaccination, and 13% reported onset after 6 weeks. Hospitalization was reported by 77%, with a median stay of 7 days (IQR=1-150 days). Lack of recovery, permanent disability, and death constituted 57%, 46%, and 2% of the reports, respectively. Based on GBS/V criteria, 47% of the cases were definite, 16% were possible, and 37% were not GBS/V or insufficient data. An alternate diagnosis was provided in 9% of cases. CONCLUSIONS GBS/V reports following COVID-19 vaccination were common, but many occurred outside of the expected timelines for GBS/V. Only 47% of cases represented definite GBS/V.
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Affiliation(s)
- Julio A. Chalela
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Charles Andrews
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Anna Bashmakov
- Department of Neurology, Medical University of South Carolina, Charleston, SC, USA
| | - Niren Kapoor
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Danuel Snelgrove
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
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Omole T, Cardona J, Fraser NJ, Pagnussat S, Mularski R, Andrews C, Daboul N, Sapre A, Li J, Fernsler D, Xu W, Gallagher N, Hall L, Platt H. P09 A Phase 2, randomized, double-blind study to evaluate the safety, tolerability, and immunogenicity of a 21-valent pneumococcal conjugate vaccine (V116) in adults ≥50 years. JAC Antimicrob Resist 2023. [DOI: 10.1093/jacamr/dlac133.013] [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: 01/20/2023] Open
Abstract
Abstract
Background
V116 is an investigational 21-valent PCV containing the following pneumococcal polysaccharides: 3, 6A, 7F, 8, 9N, 10A, 11A,12F, 15A, 16F, 17F, 19A, 20, 22F, 23A, 23B, 24F, 31, 33F, 35B, and a de-O-acetylated 15B (deOAc15B). This phase 2 study evaluated the safety, tolerability, and immunogenicity of V116 in pneumococcal vaccine-naïve adults compared with a 23-valent pneumococcal vaccine (PPSV23).
Methods
Adults (n=508) ≥50 years were randomized 1:1 and received a single dose of V116 or PPSV23; randomization was stratified by age (50–64 years, 65–74 years, and ≥75 years). Adverse events (AEs) were collected following vaccination. Pneumococcal serotype-specific opsonophagocytic activity (OPA) and IgG were measured before and 30 days after vaccination (Day 30). Primary immunogenicity objectives were to assess the noninferiority of V116 to PPSV23 for the shared serotypes and the superiority of V116 to PPSV23 for the unique serotypes.
Results
There were no vaccine-related serious AEs or vaccine-related deaths. V116 met noninferiority criteria compared with PPSV23 for all shared serotypes [based on the lower bound of the 95% CIs for the estimated OPA GMT ratios (V116/PPSV23) being >0.33 at Day 30] and met superiority criteria for the unique serotypes [based on the lower bound of the 95% CIs for the estimated OPA GMT ratios (V116/PPSV23) being >1.0 at Day 30].
Conclusions
In adults ≥50 years, V116 is well tolerated with a safety profile comparable to PPSV23, elicits an immune response that is noninferior to PPSV23 for the shared serotypes and superior to PPSV23 for the unique serotypes.
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Affiliation(s)
- Tosin Omole
- Merck & Co. Inc. , Kenilworth, NJ 07033 , USA
| | - Jose Cardona
- Indago Research & Health Center Inc. , Hialeah, FL 33012 , USA
| | - Neil J Fraser
- Arcturus Healthcare PLC, Troy Internal Medicine Research Division , Troy, MI 48085 , USA
| | | | - Richard Mularski
- Kaiser Permanente Center for Health Research , Portland, OR 97227 , USA
| | | | - Nizar Daboul
- Advanced Medical Research , Maumee, OH 43537 , USA
| | - Aditi Sapre
- Merck & Co. Inc. , Kenilworth, NJ 07033 , USA
| | - Jianing Li
- Merck & Co. Inc. , Kenilworth, NJ 07033 , USA
| | | | - Weifeng Xu
- Merck & Co. Inc. , Kenilworth, NJ 07033 , USA
| | | | - Lori Hall
- Merck & Co. Inc. , Kenilworth, NJ 07033 , USA
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Schwarz TF, Hwang SJ, Ylisastigui PP, Liu CS, Takazawa K, Yono M, Ervin JE, Andrews C, Fogarty C, Eckermann T, Collete D, de Heusch M, Schrevel ND, Salaun B, Lievens M, Maréchal C, Nakanwagi P, Hulstrøm V. 96. A Candidate Respiratory Syncytial Virus (RSV) Prefusion F Protein Investigational Vaccine (RSVPreF3 OA) Is Immunogenic when Administered in Adults ≥ 60 Years of Age: Results at 6 Months after Vaccination. Open Forum Infect Dis 2022. [PMCID: PMC9751606 DOI: 10.1093/ofid/ofac492.174] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background RSV infections are frequent and can lead to respiratory complications in older adults (OA). However, there is no licensed RSV vaccine yet. Here we present immunogenicity results up to month (M) 6 after vaccination with the RSVPreF3 OA. Methods In this phase 3 multi-country ongoing study (NCT04732871), adults ≥ 60 years of age were randomized (3:1:1) to receive RSVPreF3 OA and to be followed up for 3 years. All participants received a dose of RSVPreF3 on day (D) 1. Humoral immune (HI) and cell-mediated immune (CMI) responses were measured in subsets of participants at pre-vaccination (D1), D31 and M6. HI outcomes included RSV-A and RSV-B neutralizing antibody (NAb) geometric mean titers (GMTs) and RSVPreF3-specific immunoglobulin G (IgG) antibody geometric mean concentrations (GMCs). The CMI response was assessed in terms of frequency of RSVPreF3-specific CD4+ T-cells and CD8+ T-cells expressing at least 2 activation markers including at least 1 cytokine among CD40L, 4-1BB, IL-2, TNF-α, IFN-γ, IL-13, IL-17 (polypositive T-cells). Results A total of 1653 participants received a dose of RSVPreF3 OA. Of these, 987 participants were included in the HI subset and 566 in the CMI subset at D1. The RSV-A and RSV-B GMTs and RSVPreF3-specific IgG GMCs increased between D1 and D31 followed by a decline until M6. At D31, RSV-A and RSV-B NAb GMTs were 10.5-fold and 7.8-fold higher than pre-vaccination (Figure), and RSVPreF3-specific IgG antibody GMCs was 12.2-fold higher than pre-vaccination levels. At M6, the RSV-A and RSV-B GMTs were 4.4-fold and 3.5-fold, and RSVPreF3-specific IgG antibody GMCs were 4.7-fold above pre-vaccination levels. The RSVPreF3-specific polypositive CD4+ T-cell median frequency (events/106 cells) increased from 191 (below assay quantification limit) to 1339 at D31 and declined to 666 (above assay quantification limit) by M6. No RSVPreF3-specific CD8+ T-cell response was detected after RSVPreF3 OA vaccination.
![]() Conclusion In adults ≥ 60 years of age, 1 dose of RSVPreF3 OA was shown to be immunogenic, with both high HI and specific CMI responses at D31 post-vaccination and remained 3.5–4.7 fold above pre-vaccination levels at M6. This study will continue to monitor the immunogenicity of RSVPreF3 OA up to 3 years. Funding GlaxoSmithKline Biologicals SA. Disclosures Tino F. Schwarz, Prof. Dr. MD, Biogen, Merck-Serono, Pfizer, Alexion, Bavarian Nordic, Janssen-Cilag, AstraZeneca, Biontech, MSD: Grants|GlaxoSmithKline Biologicals SA: Honoraria John E. Ervin, MD, The Alliance for Multispecialty Research – KCM: Contractual agreement for conduct of study protocol Charles Andrews, MD, GlaxoSmithKline Biologicals SA: Institutional grant|Merck and Boehringer Ingelheim: Consulting fees outside of the submitted work Delphine Collete, PhD, GlaxoSmithKline Biologicals SA: Employee|GlaxoSmithKline Biologicals SA: Stocks/Bonds Magali de Heusch, PhD, GlaxoSmithKline Biologicals SA: Employee|GlaxoSmithKline Biologicals SA: Stocks/Bonds Nathalie De Schrevel, PhD, GlaxoSmithKline Biologicals SA: Employee|GlaxoSmithKline Biologicals SA: Ownership Interest Bruno Salaun, PhD, GlaxoSmithKline Biologicals SA: Employee|GlaxoSmithKline Biologicals SA: Stocks/Bonds Marc Lievens, MSc, GlaxoSmithKline Biologicals SA: Employee|GlaxoSmithKline Biologicals SA: Stocks/Bonds Céline Maréchal, PhD, GlaxoSmithKline Biologicals SA: Employee|GlaxoSmithKline Biologicals SA: Stocks/Bonds Phoebe Nakanwagi, Master’s in Biostatistics, GlaxoSmithKline Biologicals SA: Employee Veronica Hulstrøm, PhD MD, GlaxoSmithKline Biologicals SA: Employee.
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Affiliation(s)
- Tino F Schwarz
- Klinikum Würzburg Mitte, Campus Juliusspital, Würzburg, Germany, Wuerzburg, Bayern, Germany
| | | | | | - Chiu-Shong Liu
- China Medical University Hospital, Taichung, Taichung, Taiwan
| | - Kenji Takazawa
- Medical Corporation Shinanokai Shinanozaka Clinic, Shinjuku-ku, Tokyo, Japan
| | - Makoto Yono
- Nishi-Kumamoto Hospital, Souseikai, Kumamoto, Kumamoto, Japan
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11
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Muffels C, Panday S, Andrews C, Tonkin M, Spiliotopoulos A. Simulating Groundwater Interaction with a Surface Water Network Using Connected Linear Networks. Ground Water 2022; 60:801-807. [PMID: 35452131 DOI: 10.1111/gwat.13202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/23/2022] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Abstract
Simulating the interaction of groundwater with surface water networks using traditional boundary packages available with MODFLOW-USG can be challenging for complex systems. Often several package types are required as they are typically purpose built. Moreover, these packages generally do not interact with one another which complicates accounting of groundwater discharge at different points within the system. Here, we demonstrate that the connected linear network (CLN) package of MODFLOW-USG, and advances therein in USG-Transport, can be used to simulate groundwater interaction with a complex surface water network comprised of creeks, ponds, wetlands, and springs, in a manner that is comparable with these other packages, but with additional benefits, including explicit routing of water between the features.
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Affiliation(s)
| | | | - Charles Andrews
- S.S. Papadopulos & Associates, Inc., Rockville, Maryland, 20852, USA
| | - Matthew Tonkin
- S.S. Papadopulos & Associates, Inc., Williamsfield, Illinois, USA
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12
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Abunaser M, Sabri S, O'connor A, Arora P, Andrews C. 344 A Rare Case of Meckel's Diverticulitis With a 3 Cm Enterolith. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.128] [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: 11/05/2022]
Abstract
Abstract
Meckel's diverticulum (MD) is a rare condition that affects only 2% of general population. Only 4 to 6% of those Meckel's diverticulea are symptomatic. Furthermore, having a MD containing enterolith is extremely rare, and herein we present a case of 55-year-old lady with Meckle's diverticulitis containing a 3 cm enterolith. The patient presented with symptoms mimic appendicitis; however, upon further evaluation with an enhanced abdomino-pelvic CT an MD containing enterolith was confirmed. An interval laparoscopically assisted diverticulectomy was performed and the patient recovery was un-eventful.
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Affiliation(s)
- M Abunaser
- Tameside and Glossop Integrated Care NHS Foundation Trust , Ashton-under-Lyne , United Kingdom
| | - S Sabri
- Tameside and Glossop Integrated Care NHS Foundation Trust , Ashton-under-Lyne , United Kingdom
| | - A O'connor
- Tameside and Glossop Integrated Care NHS Foundation Trust , Ashton-under-Lyne , United Kingdom
| | - P Arora
- Tameside and Glossop Integrated Care NHS Foundation Trust , Ashton-under-Lyne , United Kingdom
| | - C Andrews
- Wythenshawe Hospital, Manchester University Foundation Trust , Manchester , United Kingdom
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13
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Ballinger TJ, Djuric Z, Sardesai S, Hovey K, Andrews C, Braskey TM, Rohan TE, Saquib N, Shadyab AH, Simon M, Wactawski-Wende J, Wallace R, Kato I. Proton Pump Inhibitor Use and Obesity-Associated Cancers in the Women's Health Initiative. Cancer Epidemiol Biomarkers Prev 2022. [PMID: 35775214 DOI: 10.1158/1055-9965.epi-22-0475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Proton pump inhibitors (PPIs) inhibit fatty acid synthase (FAS), a critical enzyme in lipogenesis, energy balance, and cancer cell survival. We aimed to evaluate the association of PPI use with incidence of common obesity- related cancers in women: postmenopausal breast, colorectal, and endometrial cancers. METHODS Our study included 124,931 postmenopausal who were enrolled in the Women's Health Initiative (WHI) observational study and clinical trials, and had responded to a year 3 follow-up assessment. We examined prescription and over the counter use of PPI and/or histamine 2 receptor antagonists (H2RA) at baseline and year 3, to isolate potential effects of FAS inhibition by PPI rather than simply acid suppression. Incident cancer cases were physician-adjudicated. Cox proportional hazard regression models were used to estimate multivariable hazard ratios (HR) and 95% confidence intervals (CI) for associations between PPI and/or H2RA use and cancer incidence after year 3. RESULTS There were 7956 PPI ever users (with or without H2RA use) and 9398 H2RA only users. PPI or H2RA use was not associated with risk of breast cancer (n=9186 cases), compared to women who did not use either agent (HR 1.01, 95% CI 0.93-1.10 and HR 0.95 95% CI 0.87-1.03, respectively). The incidence of colorectal cancer (n=2280) was significantly lower in PPI users (HR 0.75, 95% CI 0.61-0.92), but not in H2RA users (HR 1.13, 95% CI 0.97-1.31). This association was strengthened with increasing duration (p=0.006) and potency (p=0.005) of PPI use and held regardless of BMI or NSAID use. PPI or H2RA use was not associated with endometrial cancer (n=1231) (HR 0.81, 95% CI 0.61-1.07 and HR 1.13, 95% CI 0.91-1.40, respectively), but showed a trend in decreased risk with increasing PPI potency (P=0.048). CONCLUSIONS Among postmenopausal women, PPI use, but not H2RA use, demonstrated an inverse, dose-responsive association with colorectal cancer incidence. This was consistent with preclinical data that FAS inhibition prevents colon cancer progression and supports further investigation of this commonly used medication as a cancer preventive agent. PPI use was not associated with incidence of breast or endometrial cancer.
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14
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Song JY, Chang CJ, Andrews C, Diez-Domingo J, Oh MD, Dagan R, Musey L, Buchwald UK, Hartzel J, Pedley A, Li J, Sterling T, Tamms G, Chiarappa JA, Lutkiewicz J, Tu Y. 930 SAFETY, TOLERABILITY AND IMMUNOGENICITY OF 15-VALENT PNEUMOCOCCAL CONJUGATE VACCINE + PPV23 12 MONTHS LATER IN HEALTHY ADULTS ≥ 50. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.003] [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: 11/15/2022] Open
Abstract
Abstract
Background
Older adults are at increased risk of pneumococcal disease (PD). V114, an investigational 15-valent Pneumococcal Conjugate Vaccine (PCV), contains all serotypes in 13-valent PCV (PCV13) plus serotypes 22F and 33F. This phase 3 trial evaluated the safety, tolerability and immunogenicity of V114 or PCV13 followed 12 months later by PPSV23 in healthy adults aged ≥50 years.
Materials/Method
652 eligible adults were randomised 1:1 to receive V114 or PCV13 followed by PPSV23 12 months later. Solicited and non-solicited adverse events (AEs) were collected after each vaccination. Serotype-specific opsonophagocytic activity (OPA) and immunoglobulin G (IgG) antibodies were measured at Day 1, Day 30, Month 12 and Month 13.
Results
The most common solicited AEs following PCV were injection-site pain, fatigue and myalgia; higher proportions of participants with solicited AEs were observed in the V114 group; however, the differences were not clinically significant, as most AEs were mild and of short duration. The most common solicited AEs following PPSV23 were injection-site pain, injection-site swelling, fatigue and myalgia; these events were comparable across both intervention groups. The proportion of participants with serious AEs were low in both groups and none reported to be vaccine related. No deaths occurred during the study. Serotype-specific OPA geometric mean titres (GMTs) and IgG geometric mean concentrations (GMCs) were comparable between the groups for all 15 serotypes 30 days post-vaccination with PPSV23. OPA GMTs and IgG GMCs were comparable between PCV groups for the 13 shared serotypes and higher in V114 than PCV13 for serotypes 22F and 33F 30 days and 12 months post-vaccination with PCV. V114 elicited an immune response that persisted for at least 12 months.
Conclusion
Sequential administration of V114 and PPSV23 is well tolerated, immunogenic and generally comparable to PCV13 followed by PPSV23 in healthy adults ≥50 years of age.
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Affiliation(s)
- J-Y Song
- Korea University College of Medicine , Seoul, South Korea
| | - C-J Chang
- National Cheng Kung University , Tainan, Taiwan
| | - C Andrews
- Diagnostics Research Group , San Antonio, Texas, USA
| | | | - M-d Oh
- Seoul National University College of Medicine , Seoul, South Korea
| | - R Dagan
- Ben-Gurion University , Beer-Sheva, Israel
| | - L Musey
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | | | - J Hartzel
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | - A Pedley
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | - J Li
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | - T Sterling
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | - G Tamms
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
| | | | | | - Y Tu
- Merck & Co., Inc. , Kenilworth, New Jersey, USA
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15
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Song JY, Chang CJ, Andrews C, Diez-Domingo J, Oh MD, Dagan R, Hartzel J, Pedley A, Li J, Sterling T, Tamms G, Chiarappa JA, Lutkiewicz J, Musey L, Tu Y, Buchwald UK. Safety, tolerability, and immunogenicity of V114, a 15-valent pneumococcal conjugate vaccine, followed by sequential PPSV23 vaccination in healthy adults aged ≥50 years: A randomized phase III trial (PNEU-PATH). Vaccine 2021; 39:6422-6436. [PMID: 34489128 DOI: 10.1016/j.vaccine.2021.08.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Streptococcus pneumoniae causes pneumococcal disease, and older adults are at an increased risk. Sequential vaccination of 13-valent pneumococcal conjugate vaccine (PCV13) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) is recommended for broad protection against pneumococcal disease in some countries. METHODS This phase III trial evaluated the safety, tolerability, and immunogenicity of sequential administration of either V114 (a 15-valent PCV containing serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F, and 33F) or PCV13, followed 12 months later by PPSV23, in healthy adults aged ≥50 years (NCT03480763). A total of 652 participants were randomized 1:1 to receive either V114 or PCV13, followed by PPSV23. RESULTS The most common solicited adverse events (AEs) following PCV vaccination included injection-site pain and fatigue. Higher proportions of participants with these events were observed in the V114 group following PCV; however, these differences were not clinically significant. Following PPSV23 vaccination, the most common solicited AEs were injection-site pain and injection-site swelling; the proportions of participants with these events were comparable between both groups. Incidence of serious AEs was low in both groups following PCV and PPSV23, and none were related to study vaccines. No deaths occurred during the study. Serum opsonophagocytic activity geometric mean titers and immunoglobulin G geometric mean concentrations were comparable between both groups for all 15 serotypes in V114 following PPSV23. Immune responses elicited by V114 persisted for at least 12 months. Immune responses at 30 days and 12 months post-vaccination with PCV were comparable between both groups for the 13 shared serotypes and higher in the V114 group for the V114-unique serotypes (22F and 33F). CONCLUSION Administration of V114 followed by PPSV23 was well tolerated and induced comparable antibody levels to PCV13 followed by PPSV23 in healthy adults aged ≥50 years.
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Affiliation(s)
| | | | | | | | - Myoung-Don Oh
- Seoul National University College of Medicine, Seoul, South Korea
| | - Ron Dagan
- Ben-Gurion University, Beer-Sheva, Israel
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16
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Flenady V, Gardener G, Ellwood D, Coory M, Weller M, Warrilow KA, Middleton PF, Wojcieszek AM, Groom KM, Boyle FM, East C, Lawford H, Callander E, Said JM, Walker SP, Mahomed K, Andrews C, Gordon A, Norman JE, Crowther C. My Baby's Movements: a stepped-wedge cluster-randomised controlled trial of a fetal movement awareness intervention to reduce stillbirths. BJOG 2021; 129:29-41. [PMID: 34555257 DOI: 10.1111/1471-0528.16944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The My Baby's Movements (MBM) trial aimed to evaluate the impact on stillbirth rates of a multifaceted awareness package (the MBM intervention). DESIGN Stepped-wedge cluster-randomised controlled trial. SETTING Twenty-seven maternity hospitals in Australia and New Zealand. POPULATION Women with a singleton pregnancy without major fetal anomaly at ≥28 weeks of gestation from August 2016 to May 2019. METHODS The MBM intervention was implemented at randomly assigned time points, with the sequential introduction of eight groups of between three and five hospitals at 4-monthly intervals. Using generalised linear mixed models, the stillbirth rate was compared in the control and the intervention periods, adjusting for calendar time, study population characteristics and hospital effects. MAIN OUTCOME MEASURES Stillbirth at ≥28 weeks of gestation. RESULTS There were 304 850 births with 290 105 births meeting the inclusion criteria: 150 053 in the control and 140 052 in the intervention periods. The stillbirth rate was lower (although not statistically significantly so) during the intervention compared with the control period (2.2/1000 versus 2.4/1000 births; aOR 1.18, 95% CI 0.93-1.50; P = 0.18). The decrease in stillbirth rate was greater across calendar time: 2.7/1000 in the first versus 2.0/1000 in the last 18 months. No increase in secondary outcomes, including obstetric intervention or adverse neonatal outcome, was evident. CONCLUSIONS The MBM intervention did not reduce stillbirths beyond the downward trend over time. As a result of low uptake, the role of the intervention remains unclear, although the downward trend across time suggests some benefit in lowering the stillbirth rate. In this study setting, an awareness of the importance of fetal movements may have reached pregnant women and clinicians prior to the implementation of the intervention. TWEETABLE ABSTRACT The My Baby's Movements intervention to raise awareness of decreased fetal movement did not significantly reduce stillbirth rates.
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Affiliation(s)
- V Flenady
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - G Gardener
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Department of Maternal Fetal Medicine, Mater Misericordiae Limited, Brisbane, Queensland, Australia
| | - D Ellwood
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Gold Coast University Hospital, Southport, Queensland, Australia.,School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - M Coory
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - M Weller
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - K A Warrilow
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - P F Middleton
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - A M Wojcieszek
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - K M Groom
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - F M Boyle
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia
| | - C East
- Judith Lumley Centre, School of Nursing & Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Hls Lawford
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - E Callander
- Monash University, Melbourne, Victoria, Australia
| | - J M Said
- University of Melbourne, Melbourne, Victoria, Australia.,Sunshine Hospital, Western Health, St Albans, Victoria, Australia
| | - S P Walker
- University of Melbourne, Melbourne, Victoria, Australia
| | - K Mahomed
- Ipswich Hospital, Ipswich, Queensland, Australia
| | - C Andrews
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - A Gordon
- Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - J E Norman
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - C Crowther
- Liggins Institute, University of Auckland, Auckland, New Zealand
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17
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James ML, Troy J, Nowacki N, Komisarow J, Swisher CB, Tucker K, Hatton K, Babi MA, Worrall BB, Andrews C, Woo D, Kranz PG, Lascola C, Maughan M, Laskowitz DT. CN-105 in Participants with Acute Supratentorial Intracerebral Hemorrhage (CATCH) Trial. Neurocrit Care 2021; 36:216-225. [PMID: 34424490 DOI: 10.1007/s12028-021-01287-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 05/21/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Endogenous apolipoprotein (apo) E mediates neuroinflammatory responses and recovery after brain injury. Exogenously administered apoE-mimetic peptides effectively penetrate the central nervous system compartment and downregulate acute inflammation. CN-105 is a novel apoE-mimetic pentapeptide with excellent evidence of functional and histological improvement in preclinical models of intracerebral hemorrhage (ICH). The CN-105 in participants with Acute supraTentorial intraCerebral Hemorrhage (CATCH) trial is a first-in-disease-state multicenter open-label trial evaluating safety and feasability of CN-105 administration in patients with acute primary supratentorial ICH. METHODS Eligible patients were aged 30-80 years, had confirmed primary supratentorial ICH, and were able to intiate CN-105 administration (1.0 mg/kg every 6 h for 72 h) within 12 h of symptom onset. A priori defined safety end points, including hematoma volume, pharmacokinetics, and 30-day neurological outcomes, were analyzed. For clinical outcomes, CATCH participants were compared 1:1 with a closely matched contemporary ICH cohort through random selection. Hematoma volumes determined from computed tomography images on days 0, 1, 2, and 5 and ordinal modified Rankin Scale score at 30 days after ICH were compared. RESULTS In 38 participants enrolled across six study sites in the United States, adverse events occurred at an expected rate without increase in hematoma expansion or neurological deterioration. CN-105 treatment had an odds ratio (95% confidence interval) of 2.69 (1.31-5.51) for lower 30-day modified Rankin Scale score, after adjustment for ICH score, sex, and race/ethnicity, as compared with a matched contemporary cohort. CONCLUSIONS CN-105 administration represents an excellent translational candidate for treatment of acute ICH because of its safety, dosing feasibility, favorable pharmacokinetics, and possible improvement in neurological recovery.
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Affiliation(s)
- Michael L James
- Department of Anesthesiology, Duke University, Durham, NC, USA. .,Department of Neurology, Duke University, Durham, NC, USA. .,Duke Clinical Research Institute, Duke University, Durham, NC, USA.
| | - Jesse Troy
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | | | | | | | - Kristi Tucker
- Department of Neurology, Wake Forest-Baptist Health, Winston-Salem, NC, USA
| | - Kevin Hatton
- Department of Anesthesiology, University of Kentucky, Lexington, KY, USA
| | - Marc A Babi
- Departments of Neurology and Neurosurgery, University of Florida, Gainesville, FL, USA
| | - Bradford B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia, Charlottesvile, VA, USA
| | - Charles Andrews
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
| | - Daniel Woo
- Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Peter G Kranz
- Department of Radiology, Duke University, Durham, NC, USA
| | | | | | - Daniel T Laskowitz
- Department of Anesthesiology, Duke University, Durham, NC, USA.,Department of Neurology, Duke University, Durham, NC, USA.,Duke Clinical Research Institute, Duke University, Durham, NC, USA.,AegisCN, LLC, Durham, NC, USA
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18
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Boutry C, Hastie A, Diez-Domingo J, Tinoco JC, Yu CJ, Andrews C, Beytout J, Caso C, Cheng HS, Cheong HJ, Choo EJ, Curiac D, Di Paolo E, Dionne M, Eckermann T, Esen M, Ferguson M, Ghesquiere W, Hwang SJ, Avelino-Silva TJ, Kosina P, Liu CS, Markkula J, Moeckesch B, Murta de Oliveira C, Park DW, Pauksens K, Pirrotta P, Plassmann G, Pretswell C, Rombo L, Salaun B, Berglund JS, Schenkenberger I, Schwarz T, Shi M, Ukkonen B, Zahaf T, Zerbini C, Schuind A, Cunningham AL. The Adjuvanted Recombinant Zoster Vaccine Confers Long-term Protection Against Herpes Zoster: Interim Results of an Extension Study of the Pivotal Phase III Clinical Trials (ZOE-50 and ZOE-70). Clin Infect Dis 2021; 74:1459-1467. [PMID: 34283213 PMCID: PMC9049256 DOI: 10.1093/cid/ciab629] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Indexed: 11/29/2022] Open
Abstract
Background This ongoing follow-up study evaluated the persistence of efficacy and immune responses for 6 additional years in adults vaccinated with the glycoprotein E (gE)-based adjuvanted recombinant zoster vaccine (RZV) at age ≥50 years in 2 pivotal efficacy trials (ZOE-50 and ZOE-70). The present interim analysis was performed after ≥2 additional years of follow-up (between 5.1 and 7.1 years [mean] post-vaccination) and includes partial data for year (Y) 8 post-vaccination. Methods Annual assessments were performed for efficacy against herpes zoster (HZ) from Y6 post-vaccination and for anti-gE antibody concentrations and gE-specific CD4[2+] T-cell (expressing ≥2 of 4 assessed activation markers) frequencies from Y5 post-vaccination. Results Of 7413 participants enrolled for the long-term efficacy assessment, 7277 (mean age at vaccination, 67.2 years), 813, and 108 were included in the cohorts evaluating efficacy, humoral immune responses, and cell-mediated immune responses, respectively. Efficacy of RZV against HZ through this interim analysis was 84.0% (95% confidence interval [CI], 75.9–89.8) from the start of this follow-up study and 90.9% (95% CI, 88.2–93.2) from vaccination in ZOE-50/70. Annual vaccine efficacy estimates were >84% for each year since vaccination and remained stable through this interim analysis. Anti-gE antibody geometric mean concentrations and median frequencies of gE-specific CD4[2+] T cells reached a plateau at approximately 6-fold above pre-vaccination levels. Conclusions Efficacy against HZ and immune responses to RZV remained high, suggesting that the clinical benefit of RZV in older adults is sustained for at least 7 years post-vaccination. Clinical Trials Registration. NCT02723773.
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Affiliation(s)
- Céline Boutry
- Aixial, an Alten Company, Chaussée de Charleroi 112, 1060 Brussels, Belgium, C/O GSK, Wavre, Belgium
| | - Andrew Hastie
- GSK, 14200 Shady Grove Road, Rockville, M, 20850 USA
| | - Javier Diez-Domingo
- FISABIO Fundación para el Fomento Investigación Sanitaria y Biomédica de la Comunitat Valenciana, Av. Cataluña 21, Valencia, Spain
| | - Juan Carlos Tinoco
- Hospital General de Durango, 5 de Febrero y Norman fuentes Zona Centro, Durango, Mexico
| | - Chong-Jen Yu
- Department of Internal Medicine, Nation Taiwan University College of Medicine and National Taiwan University Hospital, Hsin-Chu Branch, No. 2, Shengyi 1st Rd, Zhubei City, Hsinchu County Taiwan 302041, Taipei, Taiwan
| | - Charles Andrews
- Diagnostics Research Group, 4410 Medical Drive, San Antonio, Texas, USA
| | - Jean Beytout
- Service CIC, CHU Clermont-Ferrand, 7 Place Henri Dunant, 63000 Clermont-Ferrand, France
| | - Covadonga Caso
- Servicio de Prevención, Hospital Clínico San Carlos, Calle del Prof Martin Lagos, s/n, 28040 Madrid, Spain
| | - Huey-Shinn Cheng
- Linkou Chang Gung Memorial Hospital, No.5, Fuxing St., Guishan District, Taoyuan City, Taiwan
| | - Hee Jin Cheong
- Korea Univeristy Guro Hospital, 80 Guro-dong Guro-Gu, Seoul, Republic of Korea
| | - Eun Ju Choo
- SoonChunhyang University Bucheon Hospital, 1174 Jungdong, Wonmi-gu, Bucheon-si, Republic of Korea
| | - Dan Curiac
- Clinical Trial Center, SU/Sahlgrenska Universitetssjukhuset, Gröna Stråket 12, Göteborg, Sweden
| | | | - Marc Dionne
- CHU de Québec-Université Laval, 3rd floor, 2400 rue d'Estimauville, Québec City, Québec, Canada
| | - Tamara Eckermann
- Praxisgemeinschaft Heimeranplatz, Heimeranplatz 2, Bayern, Muenchen, Germany
| | - Meral Esen
- Institute of Tropical Medicine, Universitätsklinikum Tübingen, Wilhelmstr. 27, Tübingen, Germany
| | - Murdo Ferguson
- Colchester Research Group, 68 Robie Street, Truro, Nova Scotia, Canada
| | - Wayne Ghesquiere
- Division of Infectious Diseases, UBC, Island Health Authority, PerCuro Clinical Research Ltd., 305, 1120 Yates Street, Victoria, British Columbia, Canada
| | - Shinn-Jang Hwang
- Taipei Veterans General Hospital, No. 201 section 2 Shih-Pai Road, Taipei City 112, Taiwan.,National Yang Ming University School of Medicine, No. 155 section 2 Linong St, Taipei City 112, Taiwan
| | - Thiago Junqueira Avelino-Silva
- Laboratorio de Investigacao Medica em Envelhecimento (LIM-66), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 155, Sao Paulo, Brazil
| | - Pavel Kosina
- Department of Infectious Diseases, Sokolska 581, Hradec Kralove, Czechia
| | - Chiu-Shong Liu
- Occupational Medicine and Family Medicine, China Medical University Hospital, 2 Yuh-Der Road, Taichung, Taiwan
| | - Jukka Markkula
- Pori Vaccine Research Clinic, Vaccine Research Center, Tampere University, Yrjonkatu 23, Pori, Finland
| | - Beate Moeckesch
- Praxis Dr. med. Beate Moeckesch, Bahnhofstr.9, Baden-Wuerttemberg, Weinheim, Germany
| | - Cláudia Murta de Oliveira
- Ambulatório de Pesquisa Clínica, Santa Casa de Misericórdia de Belo Horizonte, Rua Piauí, 290 B, Santa Efigênia, Minas Gerais, Belo Horizonte, Brazil
| | - Dae Won Park
- Korea University Ansan Hospital, 516 Gojan1-dong, Dawon-gu, Ansan, Republic of Korea
| | - Karlis Pauksens
- Akademiska sjukhuset, Infektionskliniken, Sjukhusvägen 1, Akademiska sjukhuset, 75185 UPPSALA, Sweden
| | | | - Georg Plassmann
- UHZ Klinische Forschung, Unterstrasse 75, Essen, Nordrhein-Westfalen, Germany
| | - Carol Pretswell
- Synexus Lancashire Clinical Research Centre, 24 Eaton Avenue, Matrix Park, Buckshaw Village, Chorley, Lancashire, United Kingdom
| | - Lars Rombo
- Clinical Research Centre, Region Sormland, Eskilstuna, Sweden
| | - Bruno Salaun
- GSK, Rue de l'institut 89, 1330 Rixensart, Belgium
| | | | | | - Tino Schwarz
- Institute of Laboratory Medicine and Vaccination Centre, Klinikum Würzburg Mitte, Standort Juliusspital, Salvatorstr. 7, 97074 Würzburg, Germany
| | - Meng Shi
- GSK, 14200 Shady Grove Road, Rockville, M, 20850 USA
| | - Benita Ukkonen
- Espoo Vaccine Research Clinic, Vaccine Research Center, Tampere University, Piispansilta 11, Espoo, Finland
| | | | - Cristiano Zerbini
- Centro Paulista de Investigação Clínica, CEPIC, Rua Moreira e Costa 342, São Paulo, São Paulo, Brazil
| | - Anne Schuind
- GSK, 14200 Shady Grove Road, Rockville, M, 20850 USA
| | - Anthony L Cunningham
- The Westmead Institute for Medical Research, 176 Hawkesbury Rd., Westmead, NSW 2145, Australia.,University of Sydney, 133 Castlereagh St, Sydney, NSW 2000, Australia
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Curran D, Oostvogels L, Heineman T, Matthews S, McElhaney J, McNeil S, Diez-Domingo J, Lal H, Andrews C, Athan E, Berglund J, Campora L, de Looze F, Korhonen T, Leung E, Levin M, Volpi A, Johnson RW. Quality of Life Impact of an Adjuvanted Recombinant Zoster Vaccine in Adults Aged 50 Years and Older. J Gerontol A Biol Sci Med Sci 2020; 74:1231-1238. [PMID: 29955836 PMCID: PMC6625590 DOI: 10.1093/gerona/gly150] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Indexed: 12/30/2022] Open
Abstract
Background To determine the efficacy of an adjuvanted recombinant zoster vaccine in reducing the herpes zoster (HZ) burden of illness, HZ burden of interference with activities of daily living, and HZ impact on quality of life. Methods The assessments were integrated in two Phase III trials, ZOE-50 (NCT01165177) and ZOE-70 (NCT01165229). HZ burden of illness and HZ burden of interference with activities of daily living were assessed by the Zoster Brief Pain Inventory (ZBPI) instrument and quality of life by the EuroQol-5 Dimension (EQ-5D) utility index and the SF-36 health survey. We report the ZOE-50 results and a pooled analysis of patients aged 70 years and older from the trials combined. Results The estimated vaccine efficacy in reducing HZ burden of illness and HZ burden of interference was greater than 90% in both the ZOE-50 and the pooled ZOE-70 analysis. In confirmed HZ cases, adjuvanted recombinant zoster vaccine reduced the maximal ZBPI worst-pain score in the pooled ZOE-70 analysis (p = .032) and the maximal ZBPI average-pain scores in both the ZOE-50 (p = .049) and the pooled ZOE-70 analysis (p = .043). In breakthrough HZ cases, trends for diminished loss of quality of life compared with placebo-recipient HZ cases were observed, with differences up to 0.14 on the EQ-5D index at time points during the 4 weeks following HZ onset. Conclusions Adjuvanted recombinant zoster vaccine reduced the HZ burden of illness significantly, particularly due to its very high vaccine efficacy in preventing HZ. For breakthrough HZ cases, the results suggest that the adjuvanted recombinant zoster vaccine mitigated severity of HZ-related pain, burden of interference with activities of daily living, and recipients’ utility loss.
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Affiliation(s)
| | | | | | | | - Janet McElhaney
- Health Sciences North Research Institute, Sudbury, Ontario, Canada
| | - Shelly McNeil
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Canada
| | | | | | | | - Eugene Athan
- Department of Infectious Disease, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Johan Berglund
- Department of Medical Radiation Physics, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | | | - Ferdinandus de Looze
- AusTrials Pty Ltd, Sherwood, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Australia
| | | | | | - Myron Levin
- Department of Pediatrics.,Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
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20
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Neyens R, Donaldson C, Andrews C, Kellogg R, Spiotta A. Platelet Function Testing with a VerifyNow-Directed Personalized Antiplatelet Strategy and Associated Rates of Thromboembolic Complications After Pipeline Embolization for Complex Cerebral Aneurysms. World Neurosurg 2020; 138:e674-e682. [DOI: 10.1016/j.wneu.2020.03.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 11/29/2022]
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21
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Lancia M, Zheng C, He X, Lerner DN, Andrews C. Groundwater Complexity in Urban Catchments: Shenzhen, Southern China. Ground Water 2020; 58:470-481. [PMID: 31414476 DOI: 10.1111/gwat.12935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/05/2019] [Accepted: 08/09/2019] [Indexed: 06/10/2023]
Abstract
Groundwater interactions with surface water and sewers in an urban setting are complex, and classic hydrogeological approaches must be combined with anthropogenic elements to characterize them. The level of detail needed to understand these interactions is illustrated by the analysis of an urban subcatchment in the megacity of Shenzhen in southern China that has had a drastic urban expansion in the last 40 years. The study area is characterized by the Yanshanian granite that is widespread across southern-eastern China. The urban setting is studied using multitemporal analysis of satellite images, borehole investigations and field surveys. Given the local hydrostratigraphy, a conceptual model was developed to identify the physical and anthropogenic factors that regulate the urban groundwater system. Based on the conceptual model and the data collected from the field or compiled from the literature, the average annual effective recharge is estimated to be 290 mm/year, after the urbanization process. From rural to urban conditions, it is estimated that the effective recharge increased by 170% and sewers intercept at least 23% of the effective recharge. Groundwater captured by sewers reduces river flows and increases the required capacity and costs for waste water treatment plants.
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Affiliation(s)
- Michele Lancia
- Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
- State Environmental Protection Key Laboratory of Integrated Surface Water-Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Chunmiao Zheng
- Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
- State Environmental Protection Key Laboratory of Integrated Surface Water-Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Xin He
- Department of Water Resources, China Institute of Water Resources and Hydropower Research, Beijing, 100038, China
| | - David N Lerner
- Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
- State Environmental Protection Key Laboratory of Integrated Surface Water-Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
- Department of Civil and Structural Engineering, University of Sheffield, Sheffield, UK
| | - Charles Andrews
- Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
- State Environmental Protection Key Laboratory of Integrated Surface Water-Groundwater Pollution Control, School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, 518055, China
- S.S. Papadopulos and Associates Inc., Bethesda, MD
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22
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Wells AU, Flaherty KR, Brown KK, Inoue Y, Devaraj A, Richeldi L, Moua T, Crestani B, Wuyts WA, Stowasser S, Quaresma M, Goeldner RG, Schlenker-Herceg R, Kolb M, Aburto M, Acosta O, Andrews C, Antin-Ozerkis D, Arce G, Arias M, Avdeev S, Barczyk A, Bascom R, Bazdyrev E, Beirne P, Belloli E, Bergna M, Bergot E, Bhatt N, Blaas S, Bondue B, Bonella F, Britt E, Buch K, Burk J, Cai H, Cantin A, Castillo Villegas D, Cazaux A, Cerri S, Chaaban S, Chaudhuri N, Cottin V, Crestani B, Criner G, Dahlqvist C, Danoff S, Dematte D'Amico J, Dilling D, Elias P, Ettinger N, Falk J, Fernández Pérez E, Gamez-Dubuis A, Giessel G, Gifford A, Glassberg M, Glazer C, Golden J, Gómez Carrera L, Guiot J, Hallowell R, Hayashi H, Hetzel J, Hirani N, Homik L, Hope-Gill B, Hotchkin D, Ichikado K, Ilkovich M, Inoue Y, Izumi S, Jassem E, Jones L, Jouneau S, Kaner R, Kang J, Kawamura T, Kessler R, Kim Y, Kishi K, Kitamura H, Kolb M, Kondoh Y, Kono C, Koschel D, Kreuter M, Kulkarni T, Kus J, Lebargy F, León Jiménez A, Luo Q, Mageto Y, Maher T, Makino S, Marchand-Adam S, Marquette C, Martinez R, Martínez M, Maturana Rozas R, Miyazaki Y, Moiseev S, Molina-Molina M, Morrison L, Morrow L, Moua T, Nambiar A, Nishioka Y, Nunes H, Okamoto M, Oldham J, Otaola M, Padilla M, Park J, Patel N, Pesci A, Piotrowski W, Pitts L, Poonyagariyagorn H, Prasse A, Quadrelli S, Randerath W, Refini R, Reynaud-Gaubert M, Riviere F, Rodríguez Portal J, Rosas I, Rossman M, Safdar Z, Saito T, Sakamoto N, Salinas Fénero M, Sauleda J, Schmidt S, Scholand M, Schwartz M, Shapera S, Shlobin O, Sigal B, Silva Orellana A, Skowasch D, Song J, Stieglitz S, Stone H, Strek M, Suda T, Sugiura H, Takahashi H, Takaya H, Takeuchi T, Thavarajah K, Tolle L, Tomassetti S, Tomii K, Valenzuela C, Vancheri C, Varone F, Veeraraghavan S, Villar A, Weigt S, Wemeau L, Wuyts W, Xu Z, Yakusevich V, Yamada Y, Yamauchi H, Ziora D. Nintedanib in patients with progressive fibrosing interstitial lung diseases-subgroup analyses by interstitial lung disease diagnosis in the INBUILD trial: a randomised, double-blind, placebo-controlled, parallel-group trial. Lancet Respir Med 2020; 8:453-460. [PMID: 32145830 DOI: 10.1016/s2213-2600(20)30036-9] [Citation(s) in RCA: 263] [Impact Index Per Article: 65.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/06/2020] [Accepted: 01/16/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND The INBUILD trial investigated the efficacy and safety of nintedanib versus placebo in patients with progressive fibrosing interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF). We aimed to establish the effects of nintedanib in subgroups based on ILD diagnosis. METHODS The INBUILD trial was a randomised, double-blind, placebo-controlled, parallel group trial done at 153 sites in 15 countries. Participants had an investigator-diagnosed fibrosing ILD other than IPF, with chest imaging features of fibrosis of more than 10% extent on high resolution CT (HRCT), forced vital capacity (FVC) of 45% or more predicted, and diffusing capacity of the lung for carbon monoxide (DLco) of at least 30% and less than 80% predicted. Participants fulfilled protocol-defined criteria for ILD progression in the 24 months before screening, despite management considered appropriate in clinical practice for the individual ILD. Participants were randomly assigned 1:1 by means of a pseudo-random number generator to receive nintedanib 150 mg twice daily or placebo for at least 52 weeks. Participants, investigators, and other personnel involved in the trial and analysis were masked to treatment assignment until after database lock. In this subgroup analysis, we assessed the rate of decline in FVC (mL/year) over 52 weeks in patients who received at least one dose of nintedanib or placebo in five prespecified subgroups based on the ILD diagnoses documented by the investigators: hypersensitivity pneumonitis, autoimmune ILDs, idiopathic non-specific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, and other ILDs. The trial has been completed and is registered with ClinicalTrials.gov, number NCT02999178. FINDINGS Participants were recruited between Feb 23, 2017, and April 27, 2018. Of 663 participants who received at least one dose of nintedanib or placebo, 173 (26%) had chronic hypersensitivity pneumonitis, 170 (26%) an autoimmune ILD, 125 (19%) idiopathic non-specific interstitial pneumonia, 114 (17%) unclassifiable idiopathic interstitial pneumonia, and 81 (12%) other ILDs. The effect of nintedanib versus placebo on reducing the rate of FVC decline (mL/year) was consistent across the five subgroups by ILD diagnosis in the overall population (hypersensitivity pneumonitis 73·1 [95% CI -8·6 to 154·8]; autoimmune ILDs 104·0 [21·1 to 186·9]; idiopathic non-specific interstitial pneumonia 141·6 [46·0 to 237·2]; unclassifiable idiopathic interstitial pneumonia 68·3 [-31·4 to 168·1]; and other ILDs 197·1 [77·6 to 316·7]; p=0·41 for treatment by subgroup by time interaction). Adverse events reported in the subgroups were consistent with those reported in the overall population. INTERPRETATION The INBUILD trial was not designed or powered to provide evidence for a benefit of nintedanib in specific diagnostic subgroups. However, its results suggest that nintedanib reduces the rate of ILD progression, as measured by FVC decline, in patients who have a chronic fibrosing ILD and progressive phenotype, irrespective of the underlying ILD diagnosis. FUNDING Boehringer Ingelheim.
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Affiliation(s)
- Athol U Wells
- National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Kevin R Flaherty
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Kevin K Brown
- Department of Medicine, National Jewish Health, Denver, CO, USA
| | - Yoshikazu Inoue
- Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai City, Osaka, Japan
| | - Anand Devaraj
- Department of Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK; National Heart and Lung Institute, Imperial College, London, UK
| | - Luca Richeldi
- Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Teng Moua
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, Rochester, MN, USA
| | - Bruno Crestani
- Université de Paris, Inserm U1152, APHP, Hôpital Bichat, Centre de reference constitutif pour les maladies pulmonaires rares, Paris, France
| | - Wim A Wuyts
- Unit for Interstitial Lung Diseases, Department of Pulmonary Medicine, University Hospitals Leuven, Leuven, Belgium
| | | | - Manuel Quaresma
- Boehringer Ingelheim International, Ingelheim am Rhein, Germany
| | | | | | - Martin Kolb
- McMaster University and St Joseph's Healthcare, Hamilton, Ontario, Canada
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Willer DO, Oostvogels L, Cunningham AL, Gervais P, Gorfinkel I, Hyung Kim J, Talarico C, Wascotte V, Zahaf T, Colindres R, Schuind A, Ahonen A, Andrews C, Athan E, Avelino-Silva TJ, Barba-Gomez JF, Berglund J, Cuixart CB, Caso C, Chlibek R, Choi WS, de Looze F, Desole MG, Domingo JD, Downey JH, Eizenberg P, Esen M, Ghesquiere W, Hui DSC, Hwang SJ, Ikematsu H, Johnson RW, Korhonen T, Leung E, Levin M, de Los Santos AM, McElhaney J, McNeil S, Narejos Perez S, Pauksens K, Pellegrino A, Poder A, Barbera JP, dos Santos RR, de la Pinta MLR, Rombo L, Schwarz TF, Seppa I, Smetana J, Staniscia T, Thompson A, Tinoco JC, Toma A, Watanabe D, Weckx L, Wilfred Y. Efficacy of the adjuvanted recombinant zoster vaccine (RZV) by sex, geographic region, and geographic ancestry/ethnicity: A post-hoc analysis of the ZOE-50 and ZOE-70 randomized trials. Vaccine 2019; 37:6262-6267. [DOI: 10.1016/j.vaccine.2019.09.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 01/28/2023]
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24
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Cunningham AL, Heineman TC, Lal H, Godeaux O, Chlibek R, Hwang SJ, McElhaney JE, Vesikari T, Andrews C, Choi WS, Esen M, Ikematsu H, Choma MK, Pauksens K, Ravault S, Salaun B, Schwarz TF, Smetana J, Abeele CV, Van den Steen P, Vastiau I, Weckx LY, Levin MJ. Immune Responses to a Recombinant Glycoprotein E Herpes Zoster Vaccine in Adults Aged 50 Years or Older. J Infect Dis 2019. [PMID: 29529222 PMCID: PMC5946839 DOI: 10.1093/infdis/jiy095] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background The herpes zoster subunit vaccine (HZ/su), consisting of varicella-zoster virus glycoprotein E (gE) and AS01B Adjuvant System, was highly efficacious in preventing herpes zoster in the ZOE-50 and ZOE-70 trials. We present immunogenicity results from those trials. Methods Participants (ZOE-50: ≥50; ZOE-70: ≥70 years of age) received 2 doses of HZ/su or placebo, 2 months apart. Serum anti-gE antibodies and CD4 T cells expressing ≥2 of 4 activation markers assessed (CD42+) after stimulation with gE-peptides were measured in subcohorts for humoral (n = 3293) and cell-mediated (n = 466) immunogenicity. Results After vaccination, 97.8% of HZ/su and 2.0% of placebo recipients showed a humoral response. Geometric mean anti-gE antibody concentrations increased 39.1-fold and 8.3-fold over baseline in HZ/su recipients at 1 and 36 months post-dose 2, respectively. A gE-specific CD42+ T-cell response was shown in 93.3% of HZ/su and 0% of placebo recipients. Median CD42+ T-cell frequencies increased 24.6-fold (1 month) and 7.9-fold (36 months) over baseline in HZ/su recipients and remained ≥5.6-fold above baseline in all age groups at 36 months. The proportion of CD4 T cells expressing all 4 activation markers increased over time in all age groups. Conclusions Most HZ/su recipients developed robust immune responses persisting for 3 years following vaccination. Clinical Trials Registration NCT01165177; NCT01165229.
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Affiliation(s)
| | | | | | | | - Roman Chlibek
- Faculty of Military Health Sciences, University of Defense, Hradec Kralove, Czech Republic
| | - Shinn-Jang Hwang
- Department of Family Medicine, Taipei Veterans General Hospital, and National Yang Ming University School of Medicine, Taiwan
| | | | - Timo Vesikari
- Vaccine Research Center, University of Tampere, Finland
| | | | - Won Suk Choi
- Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul
| | - Meral Esen
- Institute of Tropical Medicine, University Clinic of Tuebingen, Germany
| | | | | | - Karlis Pauksens
- Department of Infectious Diseases, Uppsala University Hospital, Sweden
| | | | | | - Tino F Schwarz
- Central Laboratory and Vaccination Centre, Klinikum Würzburg Mitte, Standort Juliusspital, Germany
| | - Jan Smetana
- Faculty of Military Health Sciences, University of Defense, Hradec Kralove, Czech Republic
| | | | | | | | | | - Myron J Levin
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora.,Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora
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Bellon J, Chen Y, Rees R, Taghian A, Wong J, Punglia R, Shiloh R, Krishnan M, Andrews C, Isakoff S, Winer E, Tolaney S. A Prospective Phase I trial of Concurrent Cisplatin (CIS) and Radiation Therapy (RT) in Women with Stage II and III Triple-negative Breast Cancer (TNBC). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.466] [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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Kapasi R, Glatter J, Lamb CA, Acheson AG, Andrews C, Arnott ID, Barrett KJ, Bell G, Bhatnagar G, Bloom S, Brookes MJ, Brown SR, Burch N, Burman A, Crook K, Cummings JRF, Davies J, Demick A, Epstein J, Faiz O, Feakins R, Fletcher M, Garrick V, Jaffray B, Johnson M, Keetarut K, Limdi J, Meade U, Muhammed R, Murdock A, Posford N, Rowse G, Shaw I, St Clair Jones A, Taylor S, Weaver S, Younge L, Hawthorne AB. Consensus standards of healthcare for adults and children with inflammatory bowel disease in the UK. Frontline Gastroenterol 2019; 11:178-187. [PMID: 32419908 PMCID: PMC7223296 DOI: 10.1136/flgastro-2019-101260] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 05/31/2019] [Accepted: 06/04/2019] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Symptoms and clinical course during inflammatory bowel disease (IBD) vary among individuals. Personalised care is therefore essential to effective management, delivered by a strong patient-centred multidisciplinary team, working within a well-designed service. This study aimed to fully rewrite the UK Standards for the healthcare of adults and children with IBD, and to develop an IBD Service Benchmarking Tool to support current and future personalised care models. DESIGN Led by IBD UK, a national multidisciplinary alliance of patients and nominated representatives from all major stakeholders in IBD care, Standards requirements were defined by survey data collated from 689 patients and 151 healthcare professionals. Standards were drafted and refined over three rounds of modified electronic-Delphi. RESULTS Consensus was achieved for 59 Standards covering seven clinical domains; (1) design and delivery of the multidisciplinary IBD service; (2) prediagnostic referral pathways, protocols and timeframes; (3) holistic care of the newly diagnosed patient; (4) flare management to support patient empowerment, self-management and access to specialists where required; (5) surgery including appropriate expertise, preoperative information, psychological support and postoperative care; (6) inpatient medical care delivery (7) and ongoing long-term care in the outpatient department and primary care setting including shared care. Using these patient-centred Standards and informed by the IBD Quality Improvement Project (IBDQIP), this paper presents a national benchmarking framework. CONCLUSIONS The Standards and Benchmarking Tool provide a framework for healthcare providers and patients to rate the quality of their service. This will recognise excellent care, and promote quality improvement, audit and service development in IBD.
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Affiliation(s)
| | | | - Christopher A Lamb
- Newcastle University, Newcastle upon Tyne, UK,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | | | | | | | | | | | - Stuart Bloom
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Matthew James Brookes
- Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK,University of Wolverhampton, Wolverhampton, UK
| | - Steven R Brown
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Nicola Burch
- University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Andy Burman
- British Dietetic Association, Birmingham, UK
| | | | | | - Justin Davies
- Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK
| | - Anne Demick
- Ileostomy & Internal Pouch Association, Essex, UK
| | - Jenny Epstein
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Omar Faiz
- St Mark's Hospital, Harrow, UK,Imperial College London, London, UK
| | - Roger Feakins
- Barts Health NHS Trust, London, UK,Queen Mary University of London, London, UK
| | | | | | - Bruce Jaffray
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK,Great North Children's Hospital, Newcastle upon Tyne, UK
| | - Matthew Johnson
- Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK
| | - Katie Keetarut
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Jimmy Limdi
- The Pennine Acute Hospitals NHS Trust, Manchester, UK
| | - Uchu Meade
- St Mark's Hospital, Harrow, UK,University of Hertfordshire, Hatfield, UK
| | - Rafeeq Muhammed
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | | | | | | | - Ian Shaw
- Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | | | - Stuart Taylor
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Sean Weaver
- Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK
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Yao Y, Zheng C, Andrews C, He X, Zhang A, Liu J. Integration of groundwater into China's south-north water transfer strategy. Sci Total Environ 2019; 658:550-557. [PMID: 30580210 DOI: 10.1016/j.scitotenv.2018.12.185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 06/09/2023]
Abstract
Groundwater supplies fresh water for drinking and irrigation and sustains the health of ecosystems. Although the serious consequences caused by unsustainable depletion of groundwater have been widely reported, restricting pumping in exhausted aquifers requires identifying alternative water sources, determining how much water can be made accessible to avert the groundwater crisis and formulating water allocation regulations to achieve regional water sustainability. It is perceived that groundwater management needs integrated action considering environmental and socioeconomic systems; however, how a coupled socio-environmental system can be captured and quantified, and how this scientific evaluation is elicited and structured in policy making and implementation processes are still unclear. Here, we propose an integrated quantification framework and a revised policy-making procedure after examining the detailed planning for the groundwater pumping control policy as part of China's South-to-North Water Transfer Project and identifying the shortcomings of the policy. This quantification framework represents the iterative feedback loops between environmental and socioeconomic systems and provides both high-resolution and aggregated indications, that serve as instruments to evaluate the change in the water resource system and the rationality of water allocation plans through projections. Furthermore, our study demonstrates that integrated management needs the participation of scientists and the public, particularly in the discussion of formulating policy drafts among central and local stakeholders, which is helpful for sound decision making and coordination among science, policy making and practice.
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Affiliation(s)
- Yingying Yao
- Department of Earth and Environmental Science, School of Human Settlements and Civil Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Chunmiao Zheng
- Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, Southern University of Science and Technology, Shenzhen, China; State Environmental Protection Key Laboratory of Integrated Surface Water-Groundwater Pollution Control, Southern University of Science and Technology, Shenzhen, China.
| | - Charles Andrews
- Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, Southern University of Science and Technology, Shenzhen, China
| | - Xin He
- Guangdong Provincial Key Laboratory of Soil and Groundwater Pollution Control, Southern University of Science and Technology, Shenzhen, China
| | - Aijing Zhang
- Bureau of South-North Water Transfer Planning, Designing and Management, Ministry of Water Resources, Beijing, China
| | - Jie Liu
- Institute of Water Sciences, Peking University, Beijing, China
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Goel S, Spring L, Rees R, Andrews C, Tahara RK, Mayer EL, Bardia A, Winer EP, Tolaney SM. Abstract P6-18-10: A phase 1b/2 study of ribociclib plus trastuzumab for the treatment of advanced, treatment-refractory HER2-positive breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-10] [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
Introduction:
Despite the success of anti-HER2 therapy, acquired resistance usually develops in the metastatic setting. CDK4/6 pathway activity has been identified as a mediator of this resistance, and in preclinical studies the combination of CDK4/6 and HER2 blockade can be more effective than either therapy alone. We conducted a single-arm phase 1b/2 study of the CDK4/6 inhibitor ribociclib given with trastuzumab or T-DM1 to subjects with advanced, treatment-refractory HER2-positive breast cancer. The results of the trastuzumab cohort are presented below. The primary objective was to determine the clinical benefit rate (CBR) at 24 weeks, and secondary endpoints included objective response rate (ORR), progression-free survival (PFS), and adverse events.
Methods: Individuals with locally advanced or metastatic, measurable HER2-positive breast cancer were eligible. All subjects must have previously received trastuzumab, pertuzumab, and T-DM1 as (neo)adjuvant or metastatic therapy. There was no limit on the number of prior lines of treatment. Patients with previous CDK4/6 inhibitor exposure, QTcF > 450msec on EKG, or without stable brain metastases were excluded. An initial safety run-in phase (with dose-limiting toxicity (DLT) monitoring) included six subjects who received trastuzumab (8mg/kg loading then 6mg/kg IV three-weekly) and ribociclib 400mg PO daily on a continuous schedule (cycle length 21 days). The study had a two-stage design. The first stage required 20 patients, at least 6 of whom must have demonstrated clinical benefit (CR+PR+ SD>24 weeks) in order to recruit 15 more patients to the second stage. All patients with accessible disease underwent metastatic tumor biopsies at baseline and C2D1.
Results: 13 patients were enrolled (6 in the safety run-in and 7 in the expansion cohort). One patient was found to have HER2-negative disease and did not receive treatment. Patient characteristics are shown in Table 1 No DLTs were observed during the safety run-in phase, and ribociclib was thus used at 400mg po daily for the expansion cohort. Grade 3/4 toxicities were observed in 5 patients (41.7%) and included neutropenia (n=2), and fatigue, pain, and muscle weakness (all n=1). No patient demonstrated QTc prolongation >480 msec, or grade 3/4 LFTs. 1/12 patients ((8.3%); 95% CI 0.2%-38.5%) achieved stable disease>24 weeks; no objective responses were observed, and median PFS was 41.5 days. The trastuzumab portion of study was closed early due to limited clinical activity observed (the T-DM1 with ribociclib cohort remains open).
Table 1Age (median, range)50.5 (42 - 71)Number of prior lines of systemic therapy for metastatic disease (median, range)5.5 (0-14)Number with Hormone receptor-positive disease (%)8 (67 %)Number of metastatic sites (median, range)2.5 (2 - 5)
Conclusions: The combination of trastuzumab and ribociclib (400mg daily continuous schedule) is safe, with no new safety signals observed. The limited activity seen in this heavily pretreated population suggests that future efforts to incorporate CDK4/6 inhibition should be limited to a less extensively treat population.
Citation Format: Goel S, Spring L, Rees R, Andrews C, Tahara RK, Mayer EL, Bardia A, Winer EP, Tolaney SM. A phase 1b/2 study of ribociclib plus trastuzumab for the treatment of advanced, treatment-refractory HER2-positive 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 P6-18-10.
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Affiliation(s)
- S Goel
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - L Spring
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - R Rees
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - C Andrews
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - RK Tahara
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - EL Mayer
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - A Bardia
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - EP Winer
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
| | - SM Tolaney
- Dana-Farber Cancer Institute, Boston, MA; Massachusetts General Hospital, Boston, MA
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Andrews C, Mohar D, Jacobs R, Tantry S. OLOPATADINE/MOMETASONE COMBINATION NASAL SPRAY EFFECTIVELY IMPROVES SEASONAL ALLERGIC RHINITIS NASAL SYMPTOMS AND QUALITY OF LIFE. Ann Allergy Asthma Immunol 2018. [DOI: 10.1016/j.anai.2018.09.197] [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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Guerrero E, Legnick-Hall R, Andrews C. Underlying challenges of public health insurance enrollment and use among Latino adults: insights from the largest safety-net institution in Los Angeles. Public Health 2017; 152:47-50. [DOI: 10.1016/j.puhe.2017.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 03/29/2017] [Accepted: 06/02/2017] [Indexed: 11/16/2022]
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Andrews C, Mohar D, Agarwal P, Salhi Y, Tantry S. P433 Efficacy and safety of once-daily and twice-daily olopatadine/mometasone nasal spray treatment in seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2017. [DOI: 10.1016/j.anai.2017.09.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Netto K, Andrews C, Graus K, Manolas K, Neill M, Tejani S, Appleby B, Rosalie S. The effect of a return-to-play circuit on lower limb muscle activation. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.01.100] [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]
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Orchard GE, Shams M, Nwokie T, Fernando P, Bulut C, Quaye CJ, Gabriel J, Ramji Z, Georgaki A, Watt M, Cole Z, Stewart K, McTaggart V, Padayachy S, Long AM, Ogden A, Andrews C, Birchall A, Shams F, Neesam H, Haine N. A multicentre study of the precision and accuracy of the TruSlice and TruSlice Digital histological dissection devices. Br J Biomed Sci 2016; 73:163-167. [PMID: 27922431 DOI: 10.1080/09674845.2016.1233791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Five key factors enabling a good surgical grossing technique include a flat uniformly perpendicular specimen cutting face, appropriate immobilisation of the tissue specimen during grossing, good visualisation of the cutting tissue face, sharp cutting knives and the grossing knife action. TruSlice and TruSlice Digital are new innovative tools based on a guillotine configuration. The TruSlice has plastic inserts whilst the TruSlice Digital has an electronic micrometre attached: both features enable these dissection factors to be controlled. The devices were assessed in five hospitals in the UK. MATERIAL AND METHODS A total of 267 fixed tissue samples from 23 tissue types were analysed, principally the breast (n = 32) skin (30), rectum (28), colon (27) and cervix (17). Precision and accuracy were evaluated by measuring the defined thickness, and the consistency of achieving the defined thickness of tissue samples taken respectively. Both parameters were expressed as a total percentage of compliance for the cohort of samples accessed. RESULTS Overall, the mean (standard deviation) score for precision was 81 (11) % whilst the accuracy score was 82 (11) % (both p < 0.05, chi-squared test), although this varied with type of tissue. Accuracy and precision were strongly correlated (rp = 0.83, p < 0.001). CONCLUSION The TruSlice Digital devices offer an assured precision and accuracy performance which is reproducible across an assortment of tissue types. The use of a micrometre to set tissue slice thickness is innovative and should comply with laboratory accreditation requirements, alleviating concerns of how to tackle issues such as the 'measurement of uncertainty' at the grossing bench.
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Affiliation(s)
- G E Orchard
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - M Shams
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - T Nwokie
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - P Fernando
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - C Bulut
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - C J Quaye
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - J Gabriel
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - Z Ramji
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - A Georgaki
- a Viapath, St John's Institute of Dermatology , St. Thomas' Hospital , London , UK
| | - M Watt
- b Crosshouse Hospital , Kilmarnock , UK
| | - Z Cole
- b Crosshouse Hospital , Kilmarnock , UK
| | - K Stewart
- b Crosshouse Hospital , Kilmarnock , UK
| | | | - S Padayachy
- c Southampton General Hospital , Southampton , UK
| | - A M Long
- c Southampton General Hospital , Southampton , UK
| | - A Ogden
- c Southampton General Hospital , Southampton , UK
| | - C Andrews
- d Heartlands Hospital , Birmingham , UK
| | - A Birchall
- e Wythenshawe Hospital , Manchester , UK
| | - F Shams
- f Barts and the London School of Medicine, Queen Mary University of London , London , UK
| | | | - N Haine
- g CellPath Ltd. , Powys , UK
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Wadley P, Howells B, Železný J, Andrews C, Hills V, Campion RP, Novák V, Olejník K, Maccherozzi F, Dhesi SS, Martin SY, Wagner T, Wunderlich J, Freimuth F, Mokrousov Y, Kuneš J, Chauhan JS, Grzybowski MJ, Rushforth AW, Edmonds KW, Gallagher BL, Jungwirth T. Electrical switching of an antiferromagnet. Science 2016; 351:587-90. [PMID: 26841431 DOI: 10.1126/science.aab1031] [Citation(s) in RCA: 297] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 01/04/2016] [Indexed: 11/02/2022]
Abstract
Antiferromagnets are hard to control by external magnetic fields because of the alternating directions of magnetic moments on individual atoms and the resulting zero net magnetization. However, relativistic quantum mechanics allows for generating current-induced internal fields whose sign alternates with the periodicity of the antiferromagnetic lattice. Using these fields, which couple strongly to the antiferromagnetic order, we demonstrate room-temperature electrical switching between stable configurations in antiferromagnetic CuMnAs thin-film devices by applied current with magnitudes of order 10(6) ampere per square centimeter. Electrical writing is combined in our solid-state memory with electrical readout and the stored magnetic state is insensitive to and produces no external magnetic field perturbations, which illustrates the unique merits of antiferromagnets for spintronics.
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Affiliation(s)
- P Wadley
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK.
| | - B Howells
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - J Železný
- Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnická 10, 162 00 Praha 6, Czech Republic. Faculty of Mathematics and Physics, Charles University, Ke Karlovu 3, 121 16 Prague 2, Czech Republic
| | - C Andrews
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - V Hills
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - R P Campion
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - V Novák
- Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnická 10, 162 00 Praha 6, Czech Republic
| | - K Olejník
- Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnická 10, 162 00 Praha 6, Czech Republic
| | - F Maccherozzi
- Diamond Light Source, Chilton, Didcot, Oxfordshire, OX11 0DE, UK
| | - S S Dhesi
- Diamond Light Source, Chilton, Didcot, Oxfordshire, OX11 0DE, UK
| | - S Y Martin
- Hitachi Cambridge Laboratory, J. J. Thomson Avenue, Cambridge CB3 0HE, UK
| | - T Wagner
- Hitachi Cambridge Laboratory, J. J. Thomson Avenue, Cambridge CB3 0HE, UK. Department of Materials Science and Metallurgy, University of Cambridge, Cambridge CB3 0HE, UK
| | - J Wunderlich
- Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnická 10, 162 00 Praha 6, Czech Republic. Hitachi Cambridge Laboratory, J. J. Thomson Avenue, Cambridge CB3 0HE, UK
| | - F Freimuth
- Peter Grünberg Institut and Institute for Advanced Simulation, Forschungszentrum Jülich and JARA, 52425 Jülich, Germany
| | - Y Mokrousov
- Peter Grünberg Institut and Institute for Advanced Simulation, Forschungszentrum Jülich and JARA, 52425 Jülich, Germany
| | - J Kuneš
- Institute of Physics, Academy of Sciences of the Czech Republic, Na Slovance 2, 182 21 Praha 8, Czech Republic
| | - J S Chauhan
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - M J Grzybowski
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK. Institute of Physics, Polish Academy of Sciences, al. Lotnikow 32/46, PL-02-668 Warsaw, Poland
| | - A W Rushforth
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - K W Edmonds
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - B L Gallagher
- School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
| | - T Jungwirth
- Institute of Physics, Academy of Sciences of the Czech Republic, Cukrovarnická 10, 162 00 Praha 6, Czech Republic. School of Physics and Astronomy, University of Nottingham, Nottingham NG7 2RD, UK
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Abstract
Feline enteropathy-associated T-cell lymphoma (EATL) type II is characterized by infiltration of the small intestinal mucosa with small T-cells with variable epitheliotropism and is often difficult to differentiate from inflammation. Polymerase chain reaction (PCR) to assess antigen receptor rearrangements (PARR) amplifies the T- (T-cell receptor gamma, TCRG) or B-cell (immunoglobulin heavy chain, IGH) antigen receptor genes and is used to differentiate EATL from inflammation. However, PARR does not determine lymphocyte phenotype, and clonal rearrangement of either or both the TCRG or IGH genes may be detected in neoplastic T-cells. The purpose of this study was to determine the incidence of cross lineage rearrangement in feline EATL type II. Using a diagnostic algorithm combining histology, immunohistochemistry, and PARR testing, 8 of 92 cases diagnosed as EATL type II at Michigan State University between January 2013 and June 2014 showed cross lineage rearrangement (8.7%). PARR for the IGH gene facilitates the diagnosis of cases histologically highly suggestive of EATL type II in which polyclonal rearrangement of the TCRG gene is detected.
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Affiliation(s)
- C. Andrews
- Diagnostic Center for Population and Animal Health, Michigan State University, Lansing, MI, USA
- Cancer and Inflammation Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Frederick, MD, USA
| | - M. Operacz
- Diagnostic Center for Population and Animal Health, Michigan State University, Lansing, MI, USA
| | - R. Maes
- Diagnostic Center for Population and Animal Health, Michigan State University, Lansing, MI, USA
| | - M. Kiupel
- Diagnostic Center for Population and Animal Health, Michigan State University, Lansing, MI, USA
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Deloose E, Bisschops R, Holvoet L, Arts J, De Wulf D, Caenepeel P, Lannoo M, Vanuytsel T, Andrews C, Tack J. A pilot study of the effects of the somatostatin analog pasireotide in postoperative dumping syndrome. Neurogastroenterol Motil 2014; 26:803-9. [PMID: 24750284 DOI: 10.1111/nmo.12333] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 02/24/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Dumping syndrome is characterized by distinct pathophysiological features such as postprandial increase in hematocrit (HT) and pulse rate (PR) and delayed hypoglycemia (HG). Treatment is based on dietary measures and somatostatin analogs (SA), but current SAs have incomplete efficacy, possibly through limited affinity for various somatostatin receptor subtypes. We evaluated the effect of pasireotide, a novel SA with high affinity for 4/5 human somatostatin receptors, on pathophysiological events and symptoms in dumping. METHODS Randomized double-blind placebo-controlled cross-over study of nine patients (six women, 47 ± 4 years) with postoperative dumping. Baseline measurements included oral glucose tolerance testing (OGTT), abdominal ultrasound, and dumping symptom severity score (DSSS). Patients were treated for 2 weeks with placebo or pasireotide 300 μg s.c. t.i.d. with a 1-week wash-out in a randomized fashion. On day 13 and 14 of each treatment OGTT, DSSS, and solid and liquid gastric emptying (GE) were obtained. KEY RESULTS Baseline OGTT was pathological in all patients based on PR (n = 5), HT (n = 1) or HG (n = 7). Compared to placebo, pasireotide suppressed the increase in PR (17.1 ± 2.8 vs 8.2 ± 3.5 bpm; p < 0.05) and late HG (nadir glycemia 55.6 ± 4.3 vs 83.3 ± 9.5 mg/dL; p = 0.007), increased peak glycemia (294.1 ± 33.3 vs 221.0 ± 23.1 mg/dL; p = 0.001) and delayed GE of solids (t1/2 83 ± 23 vs 43 ± 9 min; p = 0.05) and liquids (t1/2 70 ± 10 vs 40 ± 4 min, p = 0.05). The differences in DSSS did not reach statistical significance. Two patients dropped out because of adverse gastrointestinal events under pasireotide. CONCLUSIONS & INFERENCES Pasireotide affects pathophysiological features of both early and late dumping syndrome.
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Affiliation(s)
- E Deloose
- TARGID, University of Leuven, Leuven, Belgium
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Qu Y, O'Connell C, F. Tarantal A, Andrews C, O'Connor S, Vallejo A, Darville T. Resistance of rhesus monkeys to homotypic challenge after Chlamydia trachoma tis genital tract infection (MPF2P.816). The Journal of Immunology 2014. [DOI: 10.4049/jimmunol.192.supp.67.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Chlamydia trachomatis is the most prevalent sexually transmitted bacterial infection for which a vaccine is needed. Here, 2 groups of 5 female rhesus monkeys were infected with either plasmid-cured attenuated CTD153 or wildtype virulent C. trachomatis D/UW-3/Cx, and then challenged with D/UW-3/Cx. Cervical infection was monitored, blood and cervical secretions were collected at intervals for T cell and antibody assays and genital tissues were harvested at wk 12 for histopathology. Results showed 3/5 monkeys infected with D/UW-3/Cx or CTD153 were resistant to challenge. However, 2/5 in each group were susceptible to challenge and 2 monkeys primarily infected with CTD153 exhibited prolonged challenge infections. No chronic genital tract pathology was observed. Serum anti-elementary body (EB) IgG was detected in all; mucosal anti-EB IgG/IgA were detected only in the 2 with prolonged infection. Bioassays showed enhanced proliferation in CD4 and CD8 central (TCM) and effector (TEM) memory compartments, and IFNγ production in response to EB at wk 4, that declined to baseline by wk 12. In vivo expansion of CD4 TCM, CD8 TEM, and NKG2A cells at wk 4 coincided with infection resolution in 8/10. T cell proliferative responses to EB were highest in monkeys with prolonged infection. Three reinfection-resistant monkeys shared Mamu-DRB1*03 and DRB1*10. Resistance to chlamydial reinfection is likely linked to MHC II and driven by chlamydial antigens minimally expressed by inactivated EBs.
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Affiliation(s)
- Yanyan Qu
- 1Pediatrics, university of pittsburgh, Pittsburgh, PA
| | - Catherine O'Connell
- 1Pediatrics, university of pittsburgh, Pittsburgh, PA
- 2Pediatrics, University of North Carolina, Chapel Hill, NC
| | | | | | - Shelby O'Connor
- 5Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI
| | - Abbe Vallejo
- 1Pediatrics, university of pittsburgh, Pittsburgh, PA
| | - Toni Darville
- 1Pediatrics, university of pittsburgh, Pittsburgh, PA
- 2Pediatrics, University of North Carolina, Chapel Hill, NC
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Ramirez D, Jacobs RL, Rather C, Carrillo A, He W, Harper N, Andrews C, Ahuja SK. Baseline Predictors Of Symptom Severity Following Exposure To House Dust Mite In An Antigen Challenge Chamber (ACC). J Allergy Clin Immunol 2014. [DOI: 10.1016/j.jaci.2013.12.789] [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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Jacobs RL, Rather C, Jimenez F, Martinez H, He W, Ramirez D, Andrews C, Ahuja SK. Validation Of Biogenics Research Chamber For Elicitation Of Symptoms To Dust Mite Antigen (Der p1). J Allergy Clin Immunol 2014. [DOI: 10.1016/j.jaci.2013.12.790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gattorno M, Obici L, Meini A, Tormey V, Abrams K, Davis N, Andrews C, Lachmann H. THU0396 Efficacy and safety of canakinumab in patients with TNF receptor associated periodic syndrome (TRAPS). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2012-eular.2361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Masson S, Lavigne S, Robitaille V, Andrews C. The XperCount, a fast and cost-effective method for the enumeration of organisms in environmental media. J Xenobiot 2013. [DOI: 10.4081/xeno.2013.s1.e10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Not available
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Lachmann HJ, Obici L, Meini A, Tormey V, Abrams K, Davis N, Andrews C, Bhansali SG, Gattorno M. OR10-006 - Canakinumab in patients with TRAPS. Pediatr Rheumatol Online J 2013. [PMCID: PMC3953131 DOI: 10.1186/1546-0096-11-s1-a189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Chawla S, Milano M, Nichols L, Dimitroff L, O'Loughlin R, Walker J, Andrews C, Nagel M, Maracle D, Mohile S. Geriatric Assessment in Radiation Oncology Clinic: A Pilot Study. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1516] [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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Shaaban S, Duzcan F, Yildirim C, Chan WM, Andrews C, Akarsu NA, Engle EC. Expanding the phenotypic spectrum of ECEL1-related congenital contracture syndromes. Clin Genet 2013; 85:562-7. [PMID: 23808592 DOI: 10.1111/cge.12224] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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: 05/10/2013] [Revised: 06/25/2013] [Accepted: 06/21/2013] [Indexed: 02/06/2023]
Abstract
Using a combination of homozygosity mapping and whole-exome sequencing (WES), we identified a novel missense c.1819G>A mutation (G607S) in the endothelin-converting enzyme-like 1 (ECEL1) gene in a consanguineous pedigree of Turkish origin presenting with a syndrome of camptodactyly, scoliosis, limited knee flexion, significant refractive errors and ophthalmoplegia. ECEL1 mutations were recently reported to cause recessive forms of distal arthrogryposis. This report expands on the molecular basis and the phenotypic spectrum of ECEL1-associated congenital contracture syndromes.
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Affiliation(s)
- S Shaaban
- Department of Neurology; F.B. Kirby Neurobiology Center; Program in Genomics; Manton Center for Orphan Disease Research, Boston Children's Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Dubai Harvard Foundation for Medical Research, Boston, MA, USA
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Hanif W, Malik W, Hassanein M, Kamal A, Geransar P, Andrews C, Azam M, Barnett AH. Treatment adherence with vildagliptin compared to sulphonylurea as add-on to metformin in Muslim patients with type 2 diabetes mellitus fasting during Ramadan. Curr Med Res Opin 2013; 29:807-11. [PMID: 23659561 DOI: 10.1185/03007995.2013.803054] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess treatment adherence to dipeptidyl peptidase-4 inhibitor vildagliptin compared with sulphonylureas (SU) in Muslim patients with type 2 diabetes mellitus who were fasting during Ramadan in the UK. RESEARCH DESIGN AND METHODS This prospective, observational cohort study was conducted in four UK centres. Patients already taking vildagliptin (50 mg twice a day) or an SU as add-on therapy to metformin were followed up for ≤16 weeks. They were asked to record all missed doses of anti-diabetes medications. RESULTS Of the 72 patients enrolled (vildagliptin, n = 30; SU, n = 41; not allocated to treatment, n = 1), 59 (81.9%) completed the study (vildagliptin, n = 23; SU, n = 36), including one patient in the SU arm who completed but failed to provide information on missed doses; all patients in the SU arm were taking gliclazide. In the vildagliptin arm one patient (4.3%) missed a total of four doses while in the SU arm 10 patients (27.8%) missed a total of 266 doses (mean [SD] number of doses missed per patient: 26.6 [16.5]). The mean (SD) proportions of doses missed during fasting were 0.2% (0.9) and 10.4% (21.7) in the vildagliptin and SU arms, respectively, with a significant mean between-group difference of -10.2% (95% CI: -19.3%, -1.1%; p = 0.0292). There were no patients in the vildagliptin arm who missed more than 20% of OAD doses compared with 19.4% in the SU arm (p = 0.0358). Of the patients receiving an SU, 15 (42%) collectively reported 34 hypoglycaemic events (HEs) and one grade 2 HE; of these, fewer were non-adherent (n = 6, 40%) than adherent (n = 9, 60%). No patients reported HEs in the vildagliptin arm. CONCLUSION During Ramadan fasting, treatment with vildagliptin resulted in better treatment adherence compared with SU in Muslim patients with type 2 diabetes mellitus. Study limitations are the sample size and the lack of diet and exercise data.
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Affiliation(s)
- W Hanif
- University of Birmingham, Birmingham, UK
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Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Erratum: Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013. [DOI: 10.1038/eye.2013.84] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013. [PMID: 23449508 DOI: 10.1038/eye.2014.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AIMS To evaluate the efficacy and safety of intravitreal ranibizumab in patients with choroidal neovascularisation secondary to pathological myopia (myopic CNV). Data are from a pre-planned, 6-month interim analysis. METHODS Phase II, open-label, single arm, multicentre, 12-month study, recruiting patients (aged ≥18 years) with active primary or recurrent subfoveal or juxtafoveal myopic CNV, with a best-corrected visual acuity (BCVA) score of 24-78 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the study eye and a diagnosis of high myopia of at least -6 dioptres. Patients received 0.5 mg ranibizumab administered intravitreally to the study eye, followed by monthly injections given as needed (based on a predefined algorithm) for up to 11 months. RESULTS At 6 months, mean BCVA improved from baseline by 12.2 letters, as did central macular thickness (in this interim analysis defined as a measure of either central subfield macular thickness or centre point macular thickness) from baseline by 108 μm in the 48 study eyes of 48 patients. Fewer patients had centre-involving intraretinal oedema (13.0% vs 91.5%), intraretinal cysts (10.9% vs 57.4%), or subretinal fluid (13.0% vs 66.0%) at 6 months than at baseline. Patients received a mean of 1.9 retreatments, were satisfied with ranibizumab treatment, and well being was maintained. No new safety signals were identified. CONCLUSIONS Results from the planned interim analysis support the role of ranibizumab in the treatment of myopic CNV, with excellent efficacy achieved with a low number of injections and few serious adverse events.
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Affiliation(s)
- A Tufail
- Moorfields Eye Hospital, London, UK.
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Tufail A, Patel PJ, Sivaprasad S, Amoaku W, Browning AC, Cole M, Gale R, George S, Lotery AJ, Majid M, McKibbin M, Menon G, Yang Y, Andrews C, Brittain C, Osborne A. Ranibizumab for the treatment of choroidal neovascularisation secondary to pathological myopia: interim analysis of the REPAIR study. Eye (Lond) 2013; 27:709-15. [PMID: 23449508 DOI: 10.1038/eye.2013.8] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
AIMS To evaluate the efficacy and safety of intravitreal ranibizumab in patients with choroidal neovascularisation secondary to pathological myopia (myopic CNV). Data are from a pre-planned, 6-month interim analysis. METHODS Phase II, open-label, single arm, multicentre, 12-month study, recruiting patients (aged ≥18 years) with active primary or recurrent subfoveal or juxtafoveal myopic CNV, with a best-corrected visual acuity (BCVA) score of 24-78 Early Treatment Diabetic Retinopathy Study (ETDRS) letters in the study eye and a diagnosis of high myopia of at least -6 dioptres. Patients received 0.5 mg ranibizumab administered intravitreally to the study eye, followed by monthly injections given as needed (based on a predefined algorithm) for up to 11 months. RESULTS At 6 months, mean BCVA improved from baseline by 12.2 letters, as did central macular thickness (in this interim analysis defined as a measure of either central subfield macular thickness or centre point macular thickness) from baseline by 108 μm in the 48 study eyes of 48 patients. Fewer patients had centre-involving intraretinal oedema (13.0% vs 91.5%), intraretinal cysts (10.9% vs 57.4%), or subretinal fluid (13.0% vs 66.0%) at 6 months than at baseline. Patients received a mean of 1.9 retreatments, were satisfied with ranibizumab treatment, and well being was maintained. No new safety signals were identified. CONCLUSIONS Results from the planned interim analysis support the role of ranibizumab in the treatment of myopic CNV, with excellent efficacy achieved with a low number of injections and few serious adverse events.
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Affiliation(s)
- A Tufail
- Moorfields Eye Hospital, London, UK.
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He W, Carrillo A, Harper N, Jimenez F, Martinez H, Ahuja S, Rather C, Ramirez D, Andrews C, Jacobs RL, Ahuja S. Exposure to Juniperus Ashei (Mt. Cedar) Pollen in a Pollen Challenge Chamber Elicits Changes in White Blood Cell Counts and Cytokines in Mountain Cedar Positive and Negative Subjects. J Allergy Clin Immunol 2013. [DOI: 10.1016/j.jaci.2012.12.843] [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: 10/27/2022]
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Harper N, Castiblanco J, Rather C, Andrews C, Ramirez D, Jacobs RL, He W, Ahuja S. RNA-Seq-Derived Whole Genome Transcriptomic Profiling Following Challenge to Mt. Cedar in a Pollen Challenge Chamber Uncover Novel Insights Into Allergic Rhinoconjunctivitis Pathogenesis. J Allergy Clin Immunol 2013. [DOI: 10.1016/j.jaci.2012.12.825] [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: 10/27/2022]
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