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Gupta A, Han D, Norwood SM. H-Wave ® Device Stimulation for Chronic Neck Pain: A Patient-Reported Outcome Measures (PROMs) Study. Pain Ther 2024:10.1007/s40122-024-00609-2. [PMID: 38733549 DOI: 10.1007/s40122-024-00609-2] [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: 03/21/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION Chronic neck pain (cNP) is one of the leading causes of disability worldwide, often being refractory to conventional forms of treatment. Various forms of electrical stimulation have been proposed to decrease pain and improve function. Patient-reported outcome measures (PROMs) for treatment of cNP have rarely been published. METHODS An independent retrospective statistical analysis of PROMs data for users of H-Wave® device stimulation (HWDS), prospectively collected by the device manufacturer over a 4-year period, was conducted. Final surveys for 34,192 pain management patients were filtered for pain chronicity limited to 3-24 months and device use of 22-365 days, resulting in 11,503 patients with "all diagnoses"; this number was further reduced to 1482 patients with cNP, sprain, or strain. RESULTS Neck pain was reduced by 3.13 points (0-10 pain scale), with significant (≥ 20%) relief in 86.6%. Function/activities of daily living (ADL) improved in 96.19%, while improved work performance was reported in 84.76%. Medication use decreased or stopped in 65.42% and sleep improved in 60.39%. Over 95% reported having expectations met or exceeded, service satisfaction, and confidence in device use, while no adverse events were reported. Subgroup analyses found positive benefit associations with longer duration of device use. CONCLUSION Near-equivalent outcomes were self-reported by cNP HWDS patients as for (previously published) chronic low back pain (cLBP) patients. HWDS provided effective and safe cNP relief, improvements in function and ADL, along with additional benefits including decreased medication use, better sleep, and improved work performance.
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Affiliation(s)
- Ashim Gupta
- Future Biologics, Lawrenceville, GA, 30043, USA.
- Regenerative Orthopaedics, Noida, UP, 201301, India.
| | - David Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, TX, 78249, USA
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Thom C, Livingstone K, Ottenhoff J, Han D, Martindale J, Moak J. Comparison of transvaginal ultrasound utilization between radiology and point of care ultrasound in first trimester pregnancy. Am J Emerg Med 2024; 80:143-148. [PMID: 38604108 DOI: 10.1016/j.ajem.2024.03.036] [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: 11/21/2023] [Revised: 03/12/2024] [Accepted: 03/31/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Transvaginal (TVUS) and transabdominal ultrasound (TAUS) are both utilized in the evaluation of early pregnancy patients. While many practitioners using point of care ultrasound (POCUS) will generally not pursue TVUS in cases where an intrauterine pregnancy (IUP) is visualized on TAUS, this may not be true in Radiology performed ultrasound. OBJECTIVES To evaluate for differences in transvaginal ultrasound (TVUS) utilization between Radiology performed (RP) ultrasound and point of care ultrasound (POCUS) by Emergency Department (ED) physicians in early pregnancy patients. Secondarily, to assess length of stay (LOS) differences and the impact of specialized emergency ultrasound training on TVUS utilization. METHODS This was a retrospective study at a single academic ED. Study population was all ED patients who underwent first trimester ultrasound during the one year period of March 1, 2021 to February 28, 2022. Variables evaluated were chief complaint, gestational age, LOS, TAUS and TVUS utilization, ultrasound findings, and ultrasound specialty training of the ED physician. RESULTS There were 133 cases of POCUS ultrasound and 254 cases of RP ultrasound. All cases had TAUS imaging performed. Median LOS for patients when POCUS was utilized was 207 min (IQR 151-294) and 258 min (IQR 208-328) for those only using RP ultrasound, p ≤ 0.001. In the POCUS cohort, 38% (95% CI 30%-46%) received TVUS, while 94% received TVUS in the RP cohort (95% CI 90%-96%), p ≤ 0.001. Patients seen by ED faculty with ultrasound specialty training had TVUS 53% of the time (95% CI 41%-65%), while those seen by other ED faculty had TVUS 79% (95% CI 74%-83%) of the time, p = 0.035. CONCLUSION POCUS in early pregnancy is associated with a significant reduction in TVUS usage. We suspect that POCUS users elect not to pursue TVUS after an IUP is identified on TAUS, while technicians perform protocol-based TVUS irrespective of TAUS findings. Patients seen by ultrasound trained ED physicians are less likely to receive TVUS.
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Affiliation(s)
| | | | | | - David Han
- University of Virginia Health System, USA
| | | | - James Moak
- University of Virginia Health System, USA
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Han D, Park MY, Choi J, Shin H, Behrens R, Rhim S. Evaluation of force pain thresholds to ensure collision safety in worker-robot collaborative operations. Front Robot AI 2024; 11:1374999. [PMID: 38651053 PMCID: PMC11033501 DOI: 10.3389/frobt.2024.1374999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
With the growing demand for robots in the industrial field, robot-related technologies with various functions have been introduced. One notable development is the implementation of robots that operate in collaboration with human workers to share tasks, without the need of any physical barriers such as safety fences. The realization of such collaborative operations in practice necessitates the assurance of safety if humans and robots collide. Thus, it is important to establish criteria for such collision scenarios to ensure robot safety and prevent injuries. Collision safety must be ensured in both pinching (quasi-static contact) and impact (transient contact) situations. To this end, we measured the force pain thresholds associated with impacts and evaluated the biomechanical limitations. This measurements were obtained through clinical trials involving physical collisions between human subjects and a device designed for generating impacts, and the force pain thresholds associated with transient collisions between humans and robots were analyzed. Specifically, the force pain threshold was measured at two different locations on the bodies of 37 adults aged 19-32 years, using two impactors with different shapes. The force pain threshold was compared with the results of other relevant studies. The results can help identify biomechanical limitations in a precise and reliable manner to ensure the safety of robots in collaborative applications.
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Affiliation(s)
- D. Han
- Department of Mechanical Engineering, Kyung Hee University, Yongin-si, Republic of Korea
- Robotic Systems, Fraunhofer IFF, Magdeburg, Germany
| | - M. Y. Park
- Department of Industry-Academic Cooperation Foundation, Kyung Hee University, Yongin-si, Republic of Korea
| | - J. Choi
- Safetics, Seoul, Republic of Korea
| | - H. Shin
- Safetics, Seoul, Republic of Korea
| | - R. Behrens
- Robotic Systems, Fraunhofer IFF, Magdeburg, Germany
| | - S. Rhim
- Department of Mechanical Engineering, Kyung Hee University, Yongin-si, Republic of Korea
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Dang S, Han D, Duan H, Jiang Y, Aihemaiti A, Yu N, Yu Y, Duan X. The value of T2-weighted MRI contrast ratio combined with DWI in evaluating the pathological grade of solid lung adenocarcinoma. Clin Radiol 2024; 79:279-286. [PMID: 38216369 DOI: 10.1016/j.crad.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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/30/2023] [Accepted: 12/09/2023] [Indexed: 01/14/2024]
Abstract
AIM To assess the predictive value of T2-weighted (T2W) magnetic resonance imaging (MRI) in combination with diffusion-weighted imaging (DWI) for determining the pathological grading of solid lung adenocarcinoma. MATERIALS AND METHODS The clinical and imaging data from 153 cases of solid lung adenocarcinoma (82 men, 71 women, mean age 63.2 years) confirmed at histopathology in The First Affiliated Hospital of Xi'an Jiaotong University from January 2017 to May 2022 were analysed retrospectively. Adenocarcinomas were classified into low-grade (G1 and G2) and high-grade (G3) groups following the 2020 pathological grading system proposed by the International Association for the Study of Lung Cancer. The T2-weighted contrast ratio (T2CR), calculated as the T2 signal intensity of the lung mass/nodule divided by the T2 signal intensity of the right rhomboid muscle was utilised. Two experienced radiologists reviewed the MRI images independently, measured the T2CR, and obtained apparent diffusion coefficient (ADC) values. The Mann-Whitney U-test was used to compare general characteristics (sex, age, maximum diameter), T2CR, and ADC values between the low-grade and high-grade groups. The non-parametric Kruskal-Wallis test determined differences in T2CR and ADC values among the five adenocarcinoma subtypes. Receiver characteristic curve (ROC) analysis, along with area under the curve (AUC) calculation, assessed the effectiveness of each parameter in distinguishing the pathological grade of lung adenocarcinoma. A Z-test was used to compare the AUC values. RESULTS Among the 153 patients with adenocarcinoma, 103 had low-grade adenocarcinoma, and 50 had high-grade adenocarcinoma. The agreement between T2CR and ADC observers was good (0.948 and 0.929, respectively). None of the parameters followed a normal distribution (p<0.05). The ADC value was lower in the high-grade adenocarcinoma group compared to the low-grade adenocarcinoma group (p=0.004), while the T2CR value was higher in the high-grade group (p=0.011). Statistically significant differences were observed in maximum diameter and gender between the two groups (p<0.001 and p=0.005, respectively), while no significant differences were noted in age (p=0.980). Among the five adenocarcinoma subtypes, only the lepidic and micropapillary subtypes displayed statistical differences in ADC values (p=0.047), with the remaining subtypes showing no statistical differences (p>0.05). The AUC values for distinguishing high-grade adenocarcinoma from low-grade adenocarcinoma were 0.645 for ADC and 0.627 for T2CR. Combining T2CR, ADC, sex, and maximum diameter resulted in an AUC of 0.778, sensitivity of 70%, and specificity of 75%. This combination significantly improved diagnostic efficiency compared to T2CR and ADC alone (p=0.008, z = 2.624; p=0.007, z = 2.679). CONCLUSION The MRI quantitative parameters are useful for distinguishing the pathological grades of solid lung adenocarcinoma, offering valuable insights for precise lung cancer treatment.
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Affiliation(s)
- S Dang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China; Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - D Han
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China; Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - H Duan
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China; Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - Y Jiang
- Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - A Aihemaiti
- Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - N Yu
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China; Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - Y Yu
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China; Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China; Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - X Duan
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shannxi 710061, China.
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Johnson J, Lee J, Movassaghi M, Han D, Pingle SR, Williams J, Schulster M, Gorroochurn P, Shao Y, Shah O. Comparative Analyses and Ablation Efficiency of Thulium Fiber Laser by Stone Composition. J Urol 2024; 211:445-454. [PMID: 38134235 DOI: 10.1097/ju.0000000000003833] [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: 07/29/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE There are limited data on ablation effects of thulium fiber laser (TFL) settings with varying stone composition. Similarly, little is known surrounding the photothermal effects of TFL lithotripsy regarding the chemical and structural changes after visible char formation. We aim to understand the TFL's ablative efficiency across various stone types and laser settings, while simultaneously investigating the photothermal effects of TFL lithotripsy. MATERIALS AND METHODS Human specimens of calcium oxalate monohydrate, calcium oxalate dihydrate, uric acid, struvite, cystine, carbonate apatite, and brushite stones were ablated using 13 prespecified settings with the Coloplast TFL Drive. Pre- and postablation mass, ablation time, and total energy were recorded. Qualitative ablative observations were recorded at 1-minute intervals with photographs and gross description. Samples were analyzed with Fourier-transform infrared spectroscopy pre- and postablation and electron microscopy postablation to assess the photothermal effects of TFL. RESULTS Across all settings and stone types, 0.05 J × 1000 Hz was the best numerically efficient ablation setting. When selected for more clinically relevant laser settings (ie, 10-20 W), 0.2 J × 100 Hz, short pulse was the most numerically efficient setting for calcium oxalate dihydrate, cystine, and struvite stones. Calcium oxalate monohydrate ablated with the best numerical efficiency at 0.4 J × 40 Hz, short pulse. Uric acid and carbonate apatite stones ablated with the best numerical efficiency at 0.3 J × 60 Hz, short pulse. Brushite stones ablated with the best numerical efficiency at 0.5 J × 30 Hz, short pulse. Pulse duration impacted ablation effectiveness greatly with 6/8 (75%) of inadequate ablations occurring in medium or long pulse settings. The average percent of mass lost during ablation was 57%; cystine stones averaged the highest percent mass lost at 71%. Charring was observed in 36/91 (40%) specimens. Charring was most often seen in uric acid, cystine, and brushite stones across all laser settings. Electron microscopy of char demonstrated a porous melting effect different to that of brittle fracture. Fourier-transform infrared spectroscopy of brushite char demonstrated a chemical composition change to amorphous calcium phosphate. CONCLUSIONS We describe the optimal ablation settings based on stone composition, which may guide urologists towards more stone-specific care when using thulium laser for treating renal stones (lower energy settings would be safer for ureteral stones). For patients with unknown stone composition, lasers can be preset to target common stone types or adjusted based on visual cues. We recommend using short pulse for all TFL lithotripsy of calculi and altering the settings based on visual cues and efficiency to minimize the charring, an effect which can make the stone refractory to further dusting and fragmentation.
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Affiliation(s)
- Jeffrey Johnson
- Department of Urology, Weill Cornell Medicine, New York, New York
| | - Justin Lee
- Department of Urology, Columbia University Irving Medical Center, New York, New York
| | - Miyad Movassaghi
- Department of Urology, Columbia University Irving Medical Center, New York, New York
| | - David Han
- Department of Urology, Columbia University Irving Medical Center, New York, New York
| | - Srinath-Reddi Pingle
- Department of Urology, Columbia University Irving Medical Center, New York, New York
| | - James Williams
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Michael Schulster
- Department of Urology, Columbia University Irving Medical Center, New York, New York
| | | | - Yinming Shao
- Department of Physics, Columbia University, New York, New York
| | - Ojas Shah
- Department of Urology, Columbia University Irving Medical Center, New York, New York
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Norwood SM, Han D, Gupta A. H-Wave ® Device Stimulation for Chronic Low Back Pain: A Patient-Reported Outcome Measures (PROMs) Study. Pain Ther 2024; 13:113-126. [PMID: 38180725 PMCID: PMC10796857 DOI: 10.1007/s40122-023-00570-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION Chronic low back pain (cLBP) is a problem globally, creating a tremendous economic burden. Since conventional treatments often fail, various forms of electrical stimulation have been proposed to improve function and decrease pain. Patient-reported outcome measures (PROMs) have not been adequately reported in the electrical stimulation literature. METHODS A retrospective independent statistical analysis was conducted on PROMs data for users of H-Wave® device stimulation (HWDS) collected by the device manufacturer over a period of 4 years. Final surveys for 34,192 pain management patients were filtered for pain chronicity limited to 3-24 months and device use of 22-365 days, resulting in 11,503 patients with "all diagnoses"; this number was then reduced to 2711 patients with nonspecific cLBP, sprain, or strain. RESULTS Reported pain was reduced by 3.12 points (0-10 pain scale), with significant (≥ 20%) relief in 85.28%. Function/activities of daily living (ADL) improved in 96.36%, while improved work performance was reported in 81.61%. Medication use decreased or stopped in 64.41% and sleep improved in 59.76%. Over 96% reported having expectations met or exceeded, service satisfaction, and confidence in device use, while no adverse events were reported. Subgroup analyses found positive associations with longer duration of device use, home exercise participation, and working, whereas older age and longer pain chronicity resulted in reduced benefit. Similar analysis of the larger all-diagnoses cohort demonstrated near-equivalent positive outcomes. CONCLUSION Treatment outcomes directly reported by cLBP HWDS patients demonstrated profound positive effects on function and ADL, robust improvement in pain perception, and additional benefits like decreased medication use, better sleep, and improved work performance, representing compelling new evidence of treatment efficacy.
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Affiliation(s)
| | - David Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, TX, 78249, USA
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA, 30043, USA.
- Regenerative Orthopaedics, Noida, UP, 201301, India.
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Wu D, Hailer AA, Wang S, Yuan M, Chan J, El Kurdi A, Han D, Ali H, D'Angio B, Mayer A, Rahim M, Kondo A, Klufas D, Kim E, Shain AH, Choi J, Bhutani T, Simpson G, Grekin RC, Ricardo-Gonzalez R, Purdom E, North JP, Cheng JB, Cho RJ. A single-cell atlas of IL-23 inhibition in cutaneous psoriasis distinguishes clinical response. Sci Immunol 2024; 9:eadi2848. [PMID: 38277466 DOI: 10.1126/sciimmunol.adi2848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 11/22/2023] [Indexed: 01/28/2024]
Abstract
Psoriasis vulgaris and other chronic inflammatory diseases improve markedly with therapeutic blockade of interleukin-23 (IL-23) signaling, but the genetic mechanisms underlying clinical responses remain poorly understood. Using single-cell transcriptomics, we profiled immune cells isolated from lesional psoriatic skin before and during IL-23 blockade. In clinically responsive patients, a psoriatic transcriptional signature in skin-resident memory T cells was strongly attenuated. In contrast, poorly responsive patients were distinguished by persistent activation of IL-17-producing T (T17) cells, a mechanism distinct from alternative cytokine signaling or resistance isolated to epidermal keratinocytes. Even in IL-23 blockade-responsive patients, we detected a recurring set of recalcitrant, disease-specific transcriptional abnormalities. This irreversible immunological state may necessitate ongoing IL-23 inhibition. Spatial transcriptomic analyses also suggested that successful IL-23 blockade requires dampening of >90% of IL-17-induced response in lymphocyte-adjacent keratinocytes, an unexpectedly high threshold. Collectively, our data establish a patient-level paradigm for dissecting responses to immunomodulatory treatments.
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Affiliation(s)
- David Wu
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
| | - Ashley A Hailer
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
- Dermatology Service, San Francisco Veterans Administration Health Care System, San Francisco, CA 94121, USA
| | - Sijia Wang
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
- Dermatology Service, San Francisco Veterans Administration Health Care System, San Francisco, CA 94121, USA
- Department of Dermatology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710004, China
| | - Michelle Yuan
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
| | - Jamie Chan
- Dermatopathology Service, University of California, San Francisco, San Francisco, CA 94107, USA
| | - Abdullah El Kurdi
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
| | - David Han
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
| | - Hira Ali
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
| | - Blaize D'Angio
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
| | - Aaron Mayer
- Department of Biochemistry and Molecular Genetics, American University of Beirut, Beirut, Lebanon
| | - Maha Rahim
- Enable Medicine, Menlo Park, CA 94025, USA
| | | | - Daniel Klufas
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
| | - Esther Kim
- Department of Plastic Surgery, University of California, San Francisco, San Francisco, CA 94143, USA
| | - A Hunter Shain
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
| | - Jaehyuk Choi
- Departments of Dermatology and Biochemistry and Molecular Genetics, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Tina Bhutani
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
| | - Gregory Simpson
- Department of Dermatology, University of California, Fresno, CA 93701,USA
| | - Roy C Grekin
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
| | - Roberto Ricardo-Gonzalez
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
| | - Elizabeth Purdom
- Department of Statistics, University of California, Berkeley, Berkeley, CA 94720, USA
| | - Jeffrey P North
- Dermatopathology Service, University of California, San Francisco, San Francisco, CA 94107, USA
| | - Jeffrey B Cheng
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
- Dermatology Service, San Francisco Veterans Administration Health Care System, San Francisco, CA 94121, USA
| | - Raymond J Cho
- Department of Dermatology, University of California, San Francisco, San Francisco, CA 94107, USA
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Johnson J, Gorroochurn P, Movassaghi M, Han D, Villanueva J, Schulster M, Shah O. Antimicrobial Prophylaxis for Percutaneous Nephrolithotomy: Contemporary Practice Patterns. J Endourol 2023; 37:1248-1253. [PMID: 37830181 DOI: 10.1089/end.2023.0254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
Background: Updated in 2019, the American Urological Association's (AUA) Best Practice Statement on Urologic Procedures and Antimicrobial Prophylaxis outlines prophylaxis for percutaneous nephrolithotomy (PCNL). Recent studies have challenged these recommendations. We hypothesized that endourologists do not routinely follow the AUA's statement on antibiotic use during PCNL and assessed their prescribing patterns. Methods: A 24-question survey was distributed to members of the Endourological Society. The primary outcome was adherence to the AUA's recommendations. Two multiple logistic regression analyses were performed with demographics and antibiotic preference as predictors of following the AUA. Results: A total of 51.4% of endourologists follow the AUA Best Practice Statement for antimicrobial prophylaxis of uncomplicated PCNL. No demographic data were predictive of following the AUA. 90.9% and 83.6% reported they have "never" used the first-line recommendation options of metronidazole and aztreonam, respectively. Preferred antibiotics were cephalosporins (uncomplicated 60%, complicated 52.6%), fluoroquinolones (13.3%, 7.2%), aminoglycosides (12.7%, 17.8%), penicillins (7.9%, 11.2%), carbapenems (0.6%, 0.7%), trimethoprim-sulfamethoxazole (2.4%, 5.9%), fosfomycin (0.6%, 0.7%), nitrofurantoin (2.4%, 2.6%), aztreonam (0%, 0.7%), and clindamycin (0%, 0.7%). For uncomplicated PCNL, 63.1% prescribe ≤24 hours of perioperative antibiotics. For complicated PCNL, 16.2% prescribe ≤24 hours of perioperative antibiotics, while 20.4% begin antibiotics 7 or more days prior. Conclusions: Nearly half of respondents do not follow the AUA's recommendations for antibiotic choice for PCNL. Few endourologists prescribe 7 days of preoperative antibiotics for complicated PCNL despite supporting data. Metronidazole and aztreonam are rarely used as a first-line antibiotic choice for PCNL and their roles needs to be further evaluated as first-line prophylaxis recommendations. Updates on antibiotic recommendations for PCNL are needed based on current literature, antimicrobial stewardship, and contemporary practice patterns.
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Affiliation(s)
- Jeffrey Johnson
- Department of Urology, Weill Cornell Medical Center, New York, New York, USA
| | | | - Miyad Movassaghi
- Department of Urology, Columbia University Irving Medical Center, New York, New York, USA
| | - David Han
- Department of Urology, Columbia University Irving Medical Center, New York, New York, USA
| | - Juliana Villanueva
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Michael Schulster
- Department of Urology, Columbia University Irving Medical Center, New York, New York, USA
| | - Ojas Shah
- Department of Urology, Columbia University Irving Medical Center, New York, New York, USA
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Nussbaum J, Cao X, Railkar RA, Sachs JR, Spellman DS, Luk J, Shaw CA, Cejas PJ, Citron MP, Al-Ibrahim M, Han D, Pagnussat S, Stoch SA, Lai E, Bett AJ, Espeseth AS. Evaluation of a stabilized RSV pre-fusion F mRNA vaccine: Preclinical studies and Phase 1 clinical testing in healthy adults. Vaccine 2023; 41:6488-6501. [PMID: 37777449 DOI: 10.1016/j.vaccine.2023.05.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/15/2023] [Accepted: 05/26/2023] [Indexed: 10/02/2023]
Abstract
Human respiratory syncytial virus (RSV) causes a substantial proportion of respiratory tract infections worldwide. Although RSV reinfections occur throughout life, older adults, particularly those with underlying comorbidities, are at risk for severe complications from RSV. There is no RSV vaccine available to date, and treatment of RSV in adults is largely supportive. A correlate of protection for RSV has not yet been established, but antibodies targeting the pre-fusion conformation of the RSV F glycoprotein play an important role in RSV neutralization. We previously reported a Phase 1 study of an mRNA-based vaccine (V171) expressing a pre-fusion-stabilized RSV F protein (mDS-Cav1) in healthy adults. Here, we evaluated an mRNA-based vaccine (V172) expressing a further stabilized RSV pre-fusion F protein (mVRC1). mVRC1 is a single chain version of RSV F with interprotomer disulfides in addition to the stabilizing mutations present in the mDS-Cav1 antigen. The immunogenicity of the two mRNA-based vaccines encoding mVRC1 (V172) or a sequence-optimized version of mDS-Cav1 to improve transcriptional fidelity (V171.2) were compared in RSV-naïve and RSV-experienced African green monkeys (AGMs). V172 induced higher neutralizing antibody titers than V171.2 and demonstrated protection in the AGM challenge model. We conducted a Phase 1, randomized, placebo-controlled, clinical trial of 25 μg, 100 μg, 200 μg, or 300 μg of V172 in healthy older adults (60-79 years old; N = 112) and 100 μg, 200 μg, or 300 μg of V172 in healthy younger adults (18-49 years old; N = 48). The primary clinical objectives were to evaluate the safety and tolerability of V172, and the secondary objective was to evaluate RSV serum neutralization titers. The most commonly reported solicited adverse events were injection-site pain, injection-site swelling, headache, and tiredness. V172 was generally well tolerated in older and younger adults and increased serum neutralizing antibody titers, pre-fusion F-specific competing antibody titers, and RSV F-specific T-cell responses.
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Affiliation(s)
| | - Xin Cao
- Merck & Co., Inc., Rahway, NJ, USA
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Sun LH, Shaniya N, Xu Q, Pan KJ, Bao YXM, Han D, Zhang J. [Expanding antiviral indications for chronic hepatitis B using the concept of chronic disease health management: act again!]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:1002-1003. [PMID: 37872098 DOI: 10.3760/cma.j.cn501113-20220501-00233] [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] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Affiliation(s)
- L H Sun
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Niyazi Shaniya
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Q Xu
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - K J Pan
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - Y X M Bao
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - D Han
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
| | - J Zhang
- Center for Infection-Liver Diseases, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China
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Ruan WY, Zhang YL, Zheng SG, Sun Y, Fan ZP, Song YL, Sun HC, Wang WM, Dai JW, Zhao ZJ, Zhang TT, Chen D, Pan YC, Jiang YG, Wang XD, Zheng LW, Zhu QL, He M, Xu BS, Jia ZL, Han D, Duan XH. [Expert consensus on the biobank development of oral genetic diseases and rare diseases and storage codes of related biological samples from craniofacial and oral region]. Zhonghua Kou Qiang Yi Xue Za Zhi 2023; 58:749-758. [PMID: 37550034 DOI: 10.3760/cma.j.cn112144-20230523-00210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
The biological samples of oral genetic diseases and rare diseases are extremely precious. Collecting and preserving these biological samples are helpful to elucidate the mechanisms and improve the level of diagnose and treatment of oral genetic diseases and rare diseases. The standardized construction of biobanks for oral genetic diseases and rare diseases is important for achieving these goals. At present, there is very little information on the construction of these biobanks, and the standards or suggestions for the classification and coding of biological samples from oral and maxillofacial sources, and this is not conducive to the standardization and information construction of biobanks for special oral diseases. This consensus summarizes the background, necessity, principles, and key points of constructing the biobank for oral genetic diseases and rare diseases. On the base of the group standard "Classification and Coding for Human Biomaterial" (GB/T 39768-2021) issued by the National Technical Committee for Standardization of Biological Samples, we suggest 76 new coding numbers for different of biological samples from oral and maxillofacial sources. We hope the consensus may promote the standardization, and smartization on the biobank construction as well as the overall research level of oral genetic diseases and rare diseases in China.
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Affiliation(s)
- W Y Ruan
- Clinic of Oral Rare Diseases and Genetic Diseases & Department of Oral Biology, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
| | - Y L Zhang
- Clinic of Oral Rare Diseases and Genetic Diseases & Department of Oral Biology, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
| | - S G Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y Sun
- Department of Oral Implantology, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
| | - Z P Fan
- Capital Medical University School of Stomatology & Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing 100050, China
| | - Y L Song
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - H C Sun
- Department of Oral Pathology, Hospital of Stomatology, Jilin University, Changchun 130021, China
| | - W M Wang
- Department of Oral Mucosal Diseases, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
| | - J W Dai
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Z J Zhao
- The First Outpatient Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang 110002, China
| | - T T Zhang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, China
| | - D Chen
- Department of Polyclinics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y C Pan
- Department of Orthodontics, The Affiliated Stomatological Hospital of Nanjing Medical University & Jiangsu Province Key Laboratory of Oral Diseases & Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing 210029, China
| | - Y G Jiang
- Department of Cariology & Endodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, China
| | - X D Wang
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine & College of Stomatology, Shanghai Jiao Tong University & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - L W Zheng
- Deparment of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
| | - Q L Zhu
- Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
| | - M He
- Deparment of Pediatric Dentistry, School & Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - B S Xu
- Department of Oral and Maxillofacial Surgery, Institute of Stomatological Research, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510080, China
| | - Z L Jia
- Deparment of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University & State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Chengdu 610041, China
| | - D Han
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - X H Duan
- Clinic of Oral Rare Diseases and Genetic Diseases & Department of Oral Biology, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
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12
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Ding JN, Liu HC, Yu M, Liu Y, Han D. [Measurement and analysis of the crown conical degree of maxillary incisors in patients with congenital tooth agenesis caused by different gene mutations]. Zhonghua Kou Qiang Yi Xue Za Zhi 2023; 58:821-828. [PMID: 37550043 DOI: 10.3760/cma.j.cn112144-20230328-00119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Objective: To measure the crown conical degree of the remaining maxillary incisors in patients with congenital tooth agenesis, and to analyze the influence of different gene mutations on the crown conical degree of patients. Methods: Whole exome sequencing was performed on 85 patients with congenital tooth agenesis (50 males, 35 females, median age 19 years old) who visited the Department of Prosthodontics, Peking University School and Hospital of Stomatology from January 2019 to January 2023. The pathogenic gene was identified. The width of the crowns of the maxillary central and lateral incisors at the incisal 1/3 and gingival 1/3 were measured on the panoramic radiograph, and the ratio was defined as the crown conical degree. The smaller the ratio is, the more likely is the crown to be peg shaped teeth. The control group was matched by age and gender with 85 other patients with intact maxillary permanent incisors who were treated in the Department of Prosthodontics, Peking University School and Hospital of Stomatology from January 2019 to January 2023. The conical degree of the tooth agenesis group was compared with the control group by t-test, and the differences in the crown conical degree in different gene mutation groups were compared using one-way analysis of variance, and the multiple comparisons among gene groups were carried out using the LSD method. Results: Among the 85 tooth agenesis patients, the numbers of patients in each gene mutation group were 20 in ectodysplasin A (EDA) group, 8 in ectodysplasin A receptor (EDAR) group, 15 in wingless-type MMTV integration site family, member 10A (WNT10A) group, 16 in paired box 9 (PAX9) group, 10 in Msh homeobox 1 (MSX1) group, 10 in low-density lipoprotein receptor related protein 6 (LRP6) group, and 6 in bone morphogenetic protein4 (BMP4) group. The number of missing teeth were 1-27, median number 15 among the tooth agenesis patients. There was no significant difference in the conical degree between the left and right homonymous teeth in the congenital tooth agenesis group and the control group (P>0.05). The crown conical degree of maxillary central incisor and lateral incisor in the congenital missing teeth group (0.95±0.24, 0.90±0.22) was significantly smaller than that in the control group (1.12±0.09, 1.13±0.09) (t=-8.50, P<0.001; t=-11.47, P<0.001). In WNT10A mutants, the conical degree of lateral incisors (0.89±0.18) was less than that of central incisors (1.07±0.15)(t=3.68, P<0.001). The conical degree of central incisors and lateral incisors (0.70±0.23, 0.57±0.15) of EDA mutants was significantly lower than that in patients with other gene mutations (P>0.05). Conclusions: Compared with the normal control group, the remaining maxillary central and lateral incisors of the seven gene mutation groups of patients with congenital tooth agenesis all had different degrees of conical crown. Among them, the crown conical degree of maxillary central and lateral incisors of the EDA mutation was the most severe, and the WNT10A mutation affected the maxillary lateral incisors more specifically.
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Affiliation(s)
- J N Ding
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - H C Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - M Yu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - D Han
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Kongkatong M, Ottenhoff J, Thom C, Han D. Focused Ultrasonography in Cardiac Arrest. Emerg Med Clin North Am 2023; 41:633-675. [PMID: 37391255 DOI: 10.1016/j.emc.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Rapid diagnostic tools available to the emergency physician caring for cardiac arrest patients are limited. Focused ultrasound (US), and in particular, focused echocardiography, is a useful tool in the evaluation of patients in cardiac arrest. It can help identify possible causes of cardiac arrest like tamponade and pulmonary embolism, which can guide therapy. US can also yield prognostic information, with lack of cardiac activity being highly specific for failure to achieve return of spontaneous circulation. US may also be used to aid in procedural guidance. Recently, focused transesophageal echocardiography has been used in the emergency department setting.
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Affiliation(s)
- Matthew Kongkatong
- Department of Emergency Medicine, University of Virginia Health, 1215 Lee Street, Charlottesville, VA 22908, USA.
| | - Jakob Ottenhoff
- Department of Emergency Medicine, University of Virginia Health, 1215 Lee Street, Charlottesville, VA 22908, USA
| | - Christopher Thom
- Department of Emergency Medicine, University of Virginia Health, 1215 Lee Street, Charlottesville, VA 22908, USA
| | - David Han
- Department of Emergency Medicine, University of Virginia Health, 1215 Lee Street, Charlottesville, VA 22908, USA
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Taniuchi Y, van Till JWO, Wojtkowski T, Toyoshima J, Koibuchi A, Sargent B, Han D. Single- and Multiple-dose Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of ASP1128, a Novel Peroxisome Proliferator-activated Receptor δ Modulator, in Healthy Participants. Clin Pharmacol Drug Dev 2023; 12:810-818. [PMID: 36942507 DOI: 10.1002/cpdd.1236] [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: 12/01/2022] [Accepted: 01/31/2023] [Indexed: 03/23/2023]
Abstract
Peroxisome proliferator-activated receptor δ (PPARδ) plays a central role in modulating mitochondrial function in ischemia-reperfusion injury. ASP1128, a potent and selective modulator of PPARδ, is currently under investigation for treating acute kidney injury. This randomized, first-in-human study assessed the safety, tolerability, pharmacokinetics, and pharmacodynamics of ASP1128 administered intravenously in healthy participants. Forty-nine participants received a single dose of ASP1128 0.3-10 mg (n = 37) or placebo (n = 12) and 53 received daily (7 days) doses of ASP1128 3-100 mg (n = 39) or placebo (n = 14), including a cohort aged ≥65 years (ASP1128 100 mg, n = 3; placebo, n = 2). Treatment-emergent adverse events occurred in 37.8%, 59.0%, and 33.3%-35.7% of participants in the single ASP1128, multiple ASP1128, and placebo groups, respectively. All were mild in severity, and the frequency of adverse events did not appear to be dose-related. One participant (multiple ASP1128 3 mg group) withdrew with an infusion site erythema, possibly related to study drug. Exposure was roughly dose-proportional, and elimination was generally consistent across doses (mean t½ 14.6-17.4 hours in the 10, 30, and 100 mg groups on day 7). There was little accumulation in plasma following multiple dosing; steady state was reached after ∼4 days. ASP1128 treatment led to rapid and dose-related upregulation of six fatty acid oxidation-related PPARδ target genes at ≥10 mg, which lasted >24 hours postdose. In conclusion, single and multiple intravenous doses of ASP1128 were generally well tolerated, with dose-dependent pharmacokinetics and target gene engagement in healthy participants.
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Affiliation(s)
| | | | | | | | | | - Briana Sargent
- Astellas Pharma Global Development, Inc., Northbrook, Illinois, USA
| | - David Han
- Parexel Early Phase/California Clinical Trials Medical Group, Glendale, California, USA
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Vaghefi E, Yang S, Xie L, Han D, Yap A, Schmeidel O, Marshall J, Squirrell D. A multi-centre prospective evaluation of THEIA™ to detect diabetic retinopathy (DR) and diabetic macular oedema (DMO) in the New Zealand screening program. Eye (Lond) 2023; 37:1683-1689. [PMID: 36057664 PMCID: PMC10219993 DOI: 10.1038/s41433-022-02217-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/09/2022] [Accepted: 08/12/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To validate the potential application of THEIA™ as clinical decision making assistant in a national screening program. METHODS A total of 900 patients were recruited from either an urban large eye hospital, or a semi-rural optometrist led screening provider, as they were attending their appointment as part of New Zealand Diabetic Eye Screening Programme. The de-identified images were independently graded by three senior specialists, and final results were aggregated using New Zealand grading scheme, which was then converted to referable/non-referable and Healthy/mild/more than mild/sight threatening categories. RESULTS THEIA™ managed to grade all images obtained during the study. Comparing the adjudicated images from the specialist grading team, "ground truth", with the grading by the AI platform in detecting "sight threatening" disease, at the patient level THEIA™ achieved 100% imageability, 100% [98.49-100.00%] sensitivity and [97.02-99.16%] specificity, and negative predictive value of 100%. In other words, THEIA™ did not miss any patients with "more than mild" or "sight threatening" disease. The level of agreement between the clinicians and the aggregated results was (k value: 0.9881, 0.9557, and 0.9175), and the level of agreement between THEIA™ and the aggregated labels was (k value: 0.9515). CONCLUSION This multi-centre prospective trial showed that THEIA™ did not miss referable disease when screening for diabetic retinopathy and maculopathy. It also had a very high level of granularity in reporting the disease level. As THEIA™ has been tested on a variety of cameras, operating in a range of clinics (rural/urban, ophthalmologist-led\optometrist-led), we believe that it will be a suitable addition to a public diabetic screening program.
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Affiliation(s)
- Ehsan Vaghefi
- Toku Eyes®, Auckland, New Zealand.
- School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand.
| | | | - Li Xie
- Toku Eyes®, Auckland, New Zealand
| | | | - Aaron Yap
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | - Ole Schmeidel
- Department of Diabetes, Auckland District Health Board, Auckland, New Zealand
| | - John Marshall
- Institute of Ophthalmology, University College of London, London, UK
| | - David Squirrell
- Toku Eyes®, Auckland, New Zealand
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
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Xie XJ, Chen JY, Jiang J, Duan H, Wu Y, Zhang XW, Yang SJ, Zhao W, Shen SS, Wu L, He B, Ding YY, Luo H, Liu SY, Han D. [Development and validation of prognostic nomogram for malignant pleural mesothelioma]. Zhonghua Zhong Liu Za Zhi 2023; 45:415-423. [PMID: 37188627 DOI: 10.3760/cma.j.cn12152-20211124-00871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Objective: To development the prognostic nomogram for malignant pleural mesothelioma (MPM). Methods: Two hundred and ten patients pathologically confirmed as MPM were enrolled in this retrospective study from 2007 to 2020 in the People's Hospital of Chuxiong Yi Autonomous Prefecture, the First and Third Affiliated Hospital of Kunming Medical University, and divided into training (n=112) and test (n=98) sets according to the admission time. The observation factors included demography, symptoms, history, clinical score and stage, blood cell and biochemistry, tumor markers, pathology and treatment. The Cox proportional risk model was used to analyze the prognostic factors of 112 patients in the training set. According to the results of multivariate Cox regression analysis, the prognostic prediction nomogram was established. C-Index and calibration curve were used to evaluate the model's discrimination and consistency in raining and test sets, respectively. Patients were stratified according to the median risk score of nomogram in the training set. Log rank test was performed to compare the survival differences between the high and low risk groups in the two sets. Results: The median overall survival (OS) of 210 MPM patients was 384 days (IQR=472 days), and the 6-month, 1-year, 2-year, and 3-year survival rates were 75.7%, 52.6%, 19.7%, and 13.0%, respectively. Cox multivariate regression analysis showed that residence (HR=2.127, 95% CI: 1.154-3.920), serum albumin (HR=1.583, 95% CI: 1.017-2.464), clinical stage (stage Ⅳ: HR=3.073, 95% CI: 1.366-6.910) and the chemotherapy (HR=0.476, 95% CI: 0.292-0.777) were independent prognostic factors for MPM patients. The C-index of the nomogram established based on the results of Cox multivariate regression analysis in the training and test sets were 0.662 and 0.613, respectively. Calibration curves for both the training and test sets showed moderate consistency between the predicted and actual survival probabilities of MPM patients at 6 months, 1 year, and 2 years. The low-risk group had better outcomes than the high-risk group in both training (P=0.001) and test (P=0.003) sets. Conclusion: The survival prediction nomogram established based on routine clinical indicators of MPM patients provides a reliable tool for prognostic prediction and risk stratification.
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Affiliation(s)
- X J Xie
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - J Y Chen
- Department of Radiology, the Third Affiliated Hospital of Kunming Medical University, Kunming 650106, China
| | - J Jiang
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - H Duan
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Y Wu
- Department of Radiology, Chuxiong People's Hospital, Chuxiong 675099, China
| | - X W Zhang
- Department of Radiology, Chuxiong People's Hospital, Chuxiong 675099, China
| | - S J Yang
- Department of Thoracic Surgery, Chuxiong People's Hospital, Chuxiong 675099, China
| | - W Zhao
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - S S Shen
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - L Wu
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - B He
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Y Y Ding
- Department of Radiology, the Third Affiliated Hospital of Kunming Medical University, Kunming 650106, China
| | - H Luo
- Deputy President's Office, Chuxiong People's Hospital, Chuxiong 675099, China
| | - S Y Liu
- GE Healthcare (China), Beijing 100176, China
| | - D Han
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
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Liu H, Han D, Mao Y, Vonder M, Heuvelmans M, Yi J, Ye Z, De Koning H, Oudkerk M. 108P Optimization of automatic emphysema detection in lung cancer screening dataset. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00363-5] [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: 04/03/2023]
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Mao Y, Lancaster H, Jiang B, Han D, Vonder M, Dorrius M, Yu D, Yi J, de Bock G, Oudkerk M. 107P Artificial intelligence-based volumetric classification of pulmonary nodules in Chinese baseline lung cancer screening population (NELCIN-B3). J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00362-3] [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: 04/03/2023]
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Jiang B, Han D, Heuvelmans M, van der Aalst C, De Koning H, Oudkerk M. 110P Volumetric tumor volume doubling time in lung cancer: A systematic review and meta-analysis. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00365-9] [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: 04/03/2023]
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Thom C, Han D, Vandersteenhoven P, Ottenhoff J, Kongkatong M. POINT-OF-CARE ULTRASOUND FOR GUIDANCE OF CLOSED REDUCTION OF FIFTH METACARPAL NECK (BOXER'S) FRACTURE. J Emerg Med 2023; 64:321-327. [PMID: 37019497 DOI: 10.1016/j.jemermed.2023.01.001] [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: 08/16/2022] [Revised: 12/23/2022] [Accepted: 01/06/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Ultrasound has been used previously in fracture identification, analgesia delivery, and fracture reduction for patients in the emergency department. It has not been previously described as a tool for the guidance of closed fracture reduction in fifth metacarpal neck fractures ("boxer's fractures"). CASE REPORT A 28-year-old man presented with hand pain and swelling after punching a wall. Point-of-care ultrasound revealed a significantly angulated fifth metacarpal fracture, which was confirmed with a subsequent hand x-ray study. After an ultrasound-guided ulnar nerve block, closed reduction was performed. Ultrasound was used to assess reduction and ensure improvement in bony angulation during the closed reduction attempts. Post-reduction x-ray study confirmed improved angulation and adequate alignment. Why Should an Emergency Physician Be Aware of This? Point-of-care ultrasound has previously had efficacy in fracture diagnosis and anesthesia delivery for fifth metacarpal fractures. Ultrasound can also be used at the bedside to assist in the determination of adequate fracture reduction when performing closed reduction of a boxer's fracture.
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Affiliation(s)
- Christopher Thom
- Department of Emergency Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - David Han
- Department of Emergency Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Peter Vandersteenhoven
- Department of Emergency Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Jakob Ottenhoff
- Department of Emergency Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Matthew Kongkatong
- Department of Emergency Medicine, University of Virginia Health System, Charlottesville, Virginia
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Xie L, Vaghefi E, Yang S, Han D, Marshall J, Squirrell D. Automation of Macular Degeneration Classification in the AREDS Dataset, Using a Novel Neural Network Design. Clin Ophthalmol 2023; 17:455-469. [PMID: 36755888 PMCID: PMC9901462 DOI: 10.2147/opth.s396537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/12/2023] [Indexed: 02/04/2023] Open
Abstract
Purpose To create an ensemble of Convolutional Neural Networks (CNNs), capable of detecting and stratifying the risk of progressive age-related macular degeneration (AMD) from retinal photographs. Design Retrospective cohort study. Methods Three individual CNNs are trained to accurately detect 1) advanced AMD, 2) drusen size and 3) the presence or otherwise of pigmentary abnormalities, from macular centered retinal images were developed. The CNNs were then arranged in a "cascading" architecture to calculate the Age-related Eye Disease Study (AREDS) Simplified 5-level risk Severity score (Risk Score 0 - Risk Score 4), for test images. The process was repeated creating a simplified binary "low risk" (Scores 0-2) and "high risk" (Risk Score 3-4) classification. Participants There were a total of 188,006 images, of which 118,254 images were deemed gradable, representing 4591 patients, from the AREDS1 dataset. The gradable images were split into 50%/25%/25% ratios for training, validation and test purposes. Main Outcome Measures The ability of the ensemble of CNNs using retinal images to predict an individual's risk of experiencing progression of their AMD based on the AREDS 5-step Simplified Severity Scale. Results When assessed against the 5-step Simplified Severity Scale, the results generated by the ensemble of CNN's achieved an accuracy of 80.43% (quadratic kappa 0.870). When assessed against a simplified binary (Low Risk/High Risk) classification, an accuracy of 98.08%, sensitivity of ≥85% and specificity of ≥99% was achieved. Conclusion We have created an ensemble of neural networks, trained on the AREDS 1 dataset, that is able to accurately calculate an individual's score on the AREDS 5-step Simplified Severity Scale for AMD. If the results presented were replicated, then this ensemble of CNNs could be used as a screening tool that has the potential to significantly improve health outcomes by identifying asymptomatic individuals who would benefit from AREDS2 macular supplements.
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Affiliation(s)
- Li Xie
- Toku Eyes Limited, Auckland, New Zealand
| | - Ehsan Vaghefi
- Toku Eyes Limited, Auckland, New Zealand,School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand,Correspondence: Ehsan Vaghefi, Tel +6493737599, Email
| | - Song Yang
- Toku Eyes Limited, Auckland, New Zealand
| | - David Han
- Toku Eyes Limited, Auckland, New Zealand,School of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand
| | | | - David Squirrell
- Toku Eyes Limited, Auckland, New Zealand,Department of Ophthalmology, Auckland District Health Board, Auckland, New Zealand
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Trinh A, Williamson TK, Han D, Hazlewood JE, Norwood SM, Gupta A. Clinical and Quality of Life Benefits for End-Stage Workers' Compensation Chronic Pain Claimants following H-Wave ® Device Stimulation: A Retrospective Observational Study with Mean 2-Year Follow-Up. J Clin Med 2023; 12:jcm12031148. [PMID: 36769795 PMCID: PMC9917372 DOI: 10.3390/jcm12031148] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023] Open
Abstract
Previously promising short-term H-Wave® device stimulation (HWDS) outcomes prompted this retrospective cohort study of the longer-term effects on legacy workers' compensation chronic pain claimants. A detailed chart-review of 157 consecutive claimants undergoing a 30-day HWDS trial (single pain management practice) from February 2018 to November 2019 compiled data on pain, restoration of function, quality of life (QoL), and polypharmacy reduction into a summary spreadsheet for an independent statistical analysis. Non-beneficial trials in 64 (40.8%) ended HWDS use, while 19 (12.1%) trial success charts lacked adequate data for assessing critical outcomes. Of the 74 final treatment study group charts, missing data points were removed for a statistical analysis. Pain chronicity was 7.8 years with 21.6 ± 12.2 months mean follow-up. Mean pain reduction was 35%, with 89% reporting functional improvement. Opioid consumption decreased in 48.8% of users and 41.5% completely stopped; polypharmacy decreased in 36.8% and 24.4% stopped. Zero adverse events were reported and those who still worked usually continued working. An overall positive experience occurred in 66.2% (p < 0.0001), while longer chronicity portended the risk of trial or treatment failure. Positive outcomes in reducing pain, opioid/polypharmacy, and anxiety/depression, while improving function/QoL, occurred in these challenging chronic pain injury claimants. Level of evidence: III.
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Affiliation(s)
- Alan Trinh
- Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Tyler K. Williamson
- University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX 78235, USA
| | - David Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Jeffrey E. Hazlewood
- Jeffrey E. Hazlewood, MD, PC, Physical Medicine and Rehabilitation, Lebanon, TN 37090, USA
| | - Stephen M. Norwood
- Retired Orthopaedic Surgeon, Austin, TX 78738, USA
- Correspondence: (S.M.N.); (A.G.)
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
- Regenerative Orthopaedics, Noida 201301, UP, India
- Correspondence: (S.M.N.); (A.G.)
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Blum K, Green R, Mullen P, Han D, Bowirrat A, Elman I, Floyd JB, Thanos PK, Baron D, Gold MS, Badgaiyan RD. Reward Deficiency Syndrome Solution System (RDSSS) A Genetically Driven Putative Inducer of "Dopamine Homeostasis" as a Futuristic Alternative to Enhance Rehabilitation Instead of Incarceration. Asian J Complement Altern Med 2023; 11:11-14. [PMID: 36865662 PMCID: PMC9977164 DOI: 10.53043/2347-3894.acam11003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Affiliation(s)
- Kenneth Blum
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel, Israel
- Center for Sports, Exercise, Global Mental Health, Western University Health Sciences, Pomona, CA, USA
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC, Austin, TX., USA
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Department of Psychiatry, University of Vermont School of Medicine, Burlington, VY, USA
- Department of Psychiatry, Wright University, Boonshoff School of Medicine, Dayton, OH., USA
| | - Richard Green
- Precision Translational Medicine, LLC, San Antonio, Tx, USA
| | - Paul Mullen
- School of Law, University of Southampton, Southampton, UK
| | - David Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, TX USA
| | - Abdalla Bowirrat
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Igor Elman
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - John B Floyd
- Floyd, Skeren, and Kelly, PC, Los Angeles, CA, USA
| | - Panayotis K Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, Buffalo, NY, USA
- Department of Psychology, University at Buffalo, Buffalo, NY, USA
| | - David Baron
- Center for Sports, Exercise, Global Mental Health, Western University Health Sciences, Pomona, CA, USA
| | - Mark S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Mt. Sinai University, Ichan School of Medicine, New York, NY, USA
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Han D, Bai T. Exact inference for progressively Type-I censored step-stress accelerated life test under interval monitoring. Comput Stat 2022. [DOI: 10.1007/s00180-022-01314-4] [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: 12/31/2022]
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Xing P, Yang J, Xu M, Kong Y, Wang J, Wang J, Han D, Zhang L. PD-1 Inhibitors Combined with Radiotherapy and GM-CSF, Sequentially Followed by IL-2 (PRaG 2.0) Regimen in Metastatic Tumors: A Prospective, Multicenter, Single-Arm Clinical Trial. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1630] [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: 10/31/2022]
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26
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Blum K, Han D, Bowirrat A, Downs BW, Bagchi D, Thanos PK, Baron D, Braverman ER, Dennen CA, Gupta A, Elman I, Badgaiyan RD, Llanos-Gomez L, Khalsa J, Barh D, McLaughlin T, Gold MS. Genetic Addiction Risk and Psychological Profiling Analyses for "Preaddiction" Severity Index. J Pers Med 2022; 12:1772. [PMID: 36579510 PMCID: PMC9696872 DOI: 10.3390/jpm12111772] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/15/2022] [Accepted: 10/16/2022] [Indexed: 01/01/2023] Open
Abstract
Since 1990, when our laboratory published the association of the DRD2 Taq A1 allele and severe alcoholism in JAMA, there has been an explosion of genetic candidate association studies, including genome-wide association studies (GWAS). To develop an accurate test to help identify those at risk for at least alcohol use disorder (AUD), a subset of reward deficiency syndrome (RDS), Blum's group developed the genetic addiction risk severity (GARS) test, consisting of ten genes and eleven associated risk alleles. In order to statistically validate the selection of these risk alleles measured by GARS, we applied strict analysis to studies that investigated the association of each polymorphism with AUD or AUD-related conditions, including pain and even bariatric surgery, as a predictor of severe vulnerability to unwanted addictive behaviors, published since 1990 until now. This analysis calculated the Hardy-Weinberg Equilibrium of each polymorphism in cases and controls. Pearson's χ2 test or Fisher's exact test was applied to compare the gender, genotype, and allele distribution if available. The statistical analyses found the OR, 95% CI for OR, and the post risk for 8% estimation of the population's alcoholism prevalence revealed a significant detection. Prior to these results, the United States and European patents on a ten gene panel and eleven risk alleles have been issued. In the face of the new construct of the "preaddiction" model, similar to "prediabetes", the genetic addiction risk analysis might provide one solution missing in the treatment and prevention of the neurological disorder known as RDS.
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Affiliation(s)
- Kenneth Blum
- Division of Addiction Research & Education, Center for Sports, Exercise, and Mental Health, Western University of Health Sciences, Pomona, CA 91766, USA
- Division of Nutrigenomics, The Kenneth Blum Behavioral Neurogenetic Institute, LLC, Austin, TX 78701, USA
- Institute of Psychology, ELTE Eötvös Loránd University, 1075 Budapest, Hungary
- Department of Psychiatry, University of Vermont, Burlington, VT 05405, USA
- Department of Psychiatry, Wright University Boonshoft School of Medicine, Dayton, OH 45324, USA
- Division of Nutrigenomics, Victory Nutrition International, Inc., Harleysville, PA 19329, USA
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur 721172, West Bengal, India
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - David Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Bernard William Downs
- Division of Nutrigenomics, Victory Nutrition International, Inc., Harleysville, PA 19329, USA
| | - Debasis Bagchi
- Division of Nutrigenomics, Victory Nutrition International, Inc., Harleysville, PA 19329, USA
- Department of Pharmaceutical Sciences, College of Pharmacy, Southern University, Houston, TX 77004, USA
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, State University of New York at Buffalo, Buffalo, NY 14260, USA
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY 14260, USA
| | - David Baron
- Division of Addiction Research & Education, Center for Sports, Exercise, and Mental Health, Western University of Health Sciences, Pomona, CA 91766, USA
- Division of Nutrigenomics, The Kenneth Blum Behavioral Neurogenetic Institute, LLC, Austin, TX 78701, USA
| | - Eric R. Braverman
- Division of Nutrigenomics, The Kenneth Blum Behavioral Neurogenetic Institute, LLC, Austin, TX 78701, USA
| | - Catherine A. Dennen
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA 19107, USA
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
| | - Igor Elman
- Department of Psychiatry, Harvard School of Medicine, Cambridge, MA 02115, USA
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Health Science Center, San Antonio, TX 78229, USA
- Department of Psychiatry, MT. Sinai School of Medicine, New York, NY 10003, USA
| | - Luis Llanos-Gomez
- Division of Nutrigenomics, The Kenneth Blum Behavioral Neurogenetic Institute, LLC, Austin, TX 78701, USA
| | - Jag Khalsa
- Department of Microbiology, Immunology and Tropical Medicine, School of Medicine, George Washington University, Washington, DC 20052, USA
- Medical Consequences of Drug Abuse and Infections Branch, National Institute on Drug Abuse, NIH, Bethesda, MD 20892, USA
| | - Debmalya Barh
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur 721172, West Bengal, India
- Department of Genetics, Ecology and Evolution, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
| | - Thomas McLaughlin
- Division of Nutrigenomics, The Kenneth Blum Behavioral Neurogenetic Institute, LLC, Austin, TX 78701, USA
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
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Zheng RJ, Talafu T, Deng ZR, Han D, Pan KJ, Lu XB. [Sero-epidemiological characteristics of the hepatitis D virus infection among hepatitis B virus infected-patients at a single center in Xinjiang region]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:1044-1049. [PMID: 36727249 DOI: 10.3760/cma.j.cn501113-20220406-00169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective: To investigate the sero-epidemiological characteristics of the hepatitis D virus (HDV) infection among hepatitis B virus (HBV)-infected patients in Xinjiang region. Methods: A single-center cross-sectional analysis method was used to select 264 cases of hepatitis B virus infection who were hospitalized in the Center for Infectious Diseases and Liver Diseases of the First Affiliated Hospital of Xinjiang Medical University from August 2021 to January 2022. All patients were tested for HDV Ag, HDV IgM, HDV IgG, and HDV RNA. The infection status of hepatitis D virus was analyzed by grouping according to their clinical type, HBV viral load, and HBsAg level. A paired t-test was used for data with measurement data conforming to normal distribution. A paired rank sum test was used for data that did not conform to normal distribution before and after treatment. Results: A total of 36 cases (13.64%) and 26 cases (9.85%) were positive for HDV serological markers and HDV RNA. According to clinical type grouping, the positive rates of HDV serum markers in patients with chronic hepatitis B, hepatitis B-related cirrhosis, liver cancer, and liver failure were 13.46%, 12.43%, and 20.83%, respectively, and there was no statistically significant difference among the three groups (χ2=0.86, P=0.649). The positive rates of HDV RNA were 11.54%, 8.11%, and 20.83%, respectively, and there was no statistically significant difference among the three groups (χ2=4.015, P=0.134). According to HBV viral load grouping, the positive rates of HDV serum markers among patients with viral loads <20, 20-2 000, and >2 000 IU/ml were 17.15%, 7.81%, and 6.67%, respectively, and the difference was not statistically significant among the three groups (χ2=4.846, P=0.089). The positive rates of HDV RNA were 9.47%, 10.94%, and 10%, respectively, and the difference was not statistically significant among the three groups (χ2=0.113, P=0.945). According to HBsAg level grouping, the positive rates of HDV serum markers in HBsAg<0.05, 0.05~250, and >250 IU/ml were 14.29%, 16.67%, and 10.85%, respectively, and there was no statistically significance between the three groups (χ2=1.745, P=0.418). The positive rates of HDV RNA were 4.76%, 8.77%, and 11.63%, respectively, and there was no statistically significant difference among the three groups (χ2=1.221, P=0.543). Clinical outcome, disease course, HBV DNA, serological markers of viral hepatitis, routine blood test, biochemical indicators, coagulation function, and other laboratory indicators were compared between HDV serum marker and/or nucleic acid positive and negative patients, and there was no statistically significant difference (P>0.05). Conclusion: The positive rate of HDV serological markers and HDV RNA is 13.64% and 9.85%, respectively, at a single center in the Xinjiang region, and there is still a high HDV infection rate among the HBV-infected patients with low levels of viral load and HBsAg.
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Affiliation(s)
- R J Zheng
- Infectious Diseases and Hepatology Department of the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Infectious Disease (Viral Hepatitis) Clinical Medical Research Center, Urumqi 830000, China
| | - Tangnuer Talafu
- Infectious Diseases and Hepatology Department of the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Infectious Disease (Viral Hepatitis) Clinical Medical Research Center, Urumqi 830000, China
| | - Z R Deng
- Infectious Diseases and Hepatology Department of the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Infectious Disease (Viral Hepatitis) Clinical Medical Research Center, Urumqi 830000, China
| | - D Han
- Infectious Diseases and Hepatology Department of the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Infectious Disease (Viral Hepatitis) Clinical Medical Research Center, Urumqi 830000, China
| | - K J Pan
- Infectious Diseases and Hepatology Department of the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Infectious Disease (Viral Hepatitis) Clinical Medical Research Center, Urumqi 830000, China
| | - X B Lu
- Infectious Diseases and Hepatology Department of the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Infectious Disease (Viral Hepatitis) Clinical Medical Research Center, Urumqi 830000, China
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Blum K, Han D, Gupta A, Baron D, Braverman ER, Dennen CA, Kazmi S, Llanos-Gomez L, Badgaiyan RD, Elman I, Thanos PK, Downs BW, Bagchi D, Gondre-Lewis MC, Gold MS, Bowirrat A. Statistical Validation of Risk Alleles in Genetic Addiction Risk Severity (GARS) Test: Early Identification of Risk for Alcohol Use Disorder (AUD) in 74,566 Case–Control Subjects. J Pers Med 2022; 12:jpm12091385. [PMID: 36143170 PMCID: PMC9505592 DOI: 10.3390/jpm12091385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/12/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Since 1990, when our laboratory published the association of the DRD2 Taq A1 allele and severe alcoholism in JAMA, there has been an explosion of genetic candidate association studies, including GWAS. To develop an accurate test to help identify those at risk for at least Alcohol Use Disorder (AUD), Blum’s group developed the Genetic Addiction Risk Severity (GARS) test, consisting of ten genes and eleven associated risk alleles. In order to statistically validate the selection of these risk alleles measured by GARS, we applied strict analysis to studies that investigated the association of each polymorphism with AUD or AUD-related conditions published from 1990 until 2021. This analysis calculated the Hardy–Weinberg Equilibrium of each polymorphism in cases and controls. If available, the Pearson’s χ2 test or Fisher’s exact test was applied to comparisons of the gender, genotype, and allele distribution. The statistical analyses found the OR, 95% CI for OR, and a post-risk for 8% estimation of the population’s alcoholism prevalence revealed a significant detection. The OR results showed significance for DRD2, DRD3, DRD4, DAT1, COMT, OPRM1, and 5HTT at 5%. While most of the research related to GARS is derived from our laboratory, we are encouraging more independent research to confirm our findings.
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Affiliation(s)
- Kenneth Blum
- Graduate College, Western University Health Sciences, Pomona, CA 91766, USA
- Institute of Psychology, ELTE Eötvös Loránd University, Egyetem tér 1-3, 1053 Budapest, Hungary
- The Kenneth Blum Institute on Behavior & Neurogenetics, LLC., Austin, TX 78701, USA
- Department of Psychiatry, School of Medicine, University of Vermont, Burlington, VT 05405, USA
- Dayton VA Medical Centre, Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, OH 45324, USA
- Division of Precision Nutrition, Victory Nutrition International, LLC., Lederoch, PA 19438, USA
- Correspondence:
| | - David Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, TX 78249, USA
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA
| | - David Baron
- Graduate College, Western University Health Sciences, Pomona, CA 91766, USA
| | - Eric R. Braverman
- The Kenneth Blum Institute on Behavior & Neurogenetics, LLC., Austin, TX 78701, USA
| | - Catherine A. Dennen
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA 19114, USA
| | - Shan Kazmi
- Graduate College, Western University Health Sciences, Pomona, CA 91766, USA
| | - Luis Llanos-Gomez
- The Kenneth Blum Institute on Behavior & Neurogenetics, LLC., Austin, TX 78701, USA
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA
| | - Igor Elman
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Boston, MA 02115, USA
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA 02139, USA
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, Clinical Research Institute on Addictions, University at Buffalo, Buffalo, NY 14203, USA
- Department of Psychology, University at Buffalo, Buffalo, NY 14260, USA
| | - Bill W. Downs
- Division of Precision Nutrition, Victory Nutrition International, LLC., Lederoch, PA 19438, USA
| | - Debasis Bagchi
- Division of Precision Nutrition, Victory Nutrition International, LLC., Lederoch, PA 19438, USA
- Department of Pharmaceutical Science, College of Pharmacy & Health Sciences, Texas Southern University, Houston, TX 77004, USA
| | - Marjorie C. Gondre-Lewis
- Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, Washington, DC 20059, USA
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel
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Dang S, Guo Y, Han D, Ma G, Yu N, Yang Q, Duan X, Duan H, Ren J. MRI-based radiomics analysis in differentiating solid non-small-cell from small-cell lung carcinoma: a pilot study. Clin Radiol 2022; 77:e749-e757. [PMID: 35817610 DOI: 10.1016/j.crad.2022.06.006] [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] [Received: 12/13/2021] [Revised: 04/29/2022] [Accepted: 06/01/2022] [Indexed: 12/24/2022]
Abstract
AIM To investigate the ability of a T2-weighted (W) magnetic resonance imaging (MRI)-based radiomics signature to differentiate solid non-small-cell lung carcinoma (NSCLC) from small-cell lung carcinoma (SCLC). MATERIALS AND METHODS The present retrospective study enrolled 152 eligible patients (NSCLC = 125, SCLC = 27). All patients underwent MRI using a 3 T scanner and radiomics features were extracted from T2W MRI. The least absolute shrinkage and selection operator (LASSO) logistic regression model was used to identify the optimal radiomics features for the construction of a radiomics model to differentiate solid NSCLC from SCLC. Threefold cross validation repeated 10 times was used for model training and evaluation. The conventional MRI morphology features of the lesions were also evaluated. The performance of the conventional MRI morphological features, and the radiomics signature model and nomogram model (combining radiomics signature with conventional MRI morphological features) was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS Five optimal features were chosen to build a radiomics signature. There was no significant difference in age, gender, and the largest diameter. The radiomics signature and conventional MRI morphological features (only pleural indentation and lymph node enlargement) were independent predictive factors for differentiating solid NSCLC from SCLC. The area under the ROC curves (AUCs) for MRI morphological features, and the radiomics model, and nomogram model was 0.69, 0.85, and 0.90 (ROC), respectively. CONCLUSIONS The T2W MRI-based radiomics signature is a potential non-invasive approach for distinguishing solid NSCLC from SCLC.
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Affiliation(s)
- S Dang
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - Y Guo
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - D Han
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - G Ma
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - N Yu
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China; Shaanxi University of Chinese Medicine, Xianyang, China
| | - Q Yang
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China
| | - X Duan
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, China
| | - H Duan
- Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China; Shaanxi University of Chinese Medicine, Xianyang, China.
| | - J Ren
- GE Healthcare China, Daxing District, Beijing, China
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Malhotra P, Han D, Chakravarty T, Thomson L, Dey D, Tamarappoo B, Skaf S, Rader F, Siegel R, Makkar R, Friedman J, Berman D. 487 Increased CT Angiography-Derived Extracellular Volume Fraction Predicts Less Benefit In Left Ventricular Remodeling And Ejection Fraction After Transcatheter Edge To Edge Repair For Severe Mitral Regurgitation. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Han D, Venuraju S, McElhinney P, Lin A, Tamarappoo B, Berman D, Slomka P, Lahiri A, Dey D. 520 Predictors Of Coronary Atherosclerotic Plaque Progression Assessed By Serial Coronary Ct Angiography In Patients With Diabetes: From Proceed Study. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Han D, Rozanski A, Miller R, Gransar H, Hayes S, Friedman J, Thomson L, Berman D. 604 Temporal Changes In Prognostic Outcomes Among Patients Undergoing Coronary Artery Calcium Scanning: 1998 To 2013. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bolton E, Bezecny J, Han D, Carlson J, Mengden Koon S, Berry EG. Localized myxedema histologically mimicking spindle cell lipoma. Dermatol Online J 2022; 28. [DOI: 10.5070/d328357787] [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] [Received: 06/16/2022] [Accepted: 06/16/2022] [Indexed: 11/08/2022] Open
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Rekić D, Azarov I, Knöchel J, Sokolov V, Nilsson C, Wernevik L, Han D, Rydén-Bergsten T, Ebrahimi A, Dota C, Carlsson B. AZD8233 Antisense Oligonucleotide targeting PCSK9 does not prolong QT interval AZD8233 ASO C-QT analysis. Br J Clin Pharmacol 2022; 88:4839-4844. [PMID: 35653229 DOI: 10.1111/bcp.15425] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 11/28/2022] Open
Abstract
AZD8233 is a proprotein convertase subtilisin/kexin type 9 (PCSK9) antisense oligonucleotide under development for treatment of hypercholesterolemia. A prespecified concentration-QT analysis was performed based on data from a single ascending dose study that was prospectively designed to act as a TQT study substitute. Subcutaneous single doses ranging from 4 to 120 mg were evaluated in 73 adult healthy male subjects. Time-matched 12-lead digital ECG and plasma concentrations (n=15) were measured at baseline and up to 48 hours after dose in each subject. The analysis was performed using a linear mixed effect model, where change from baseline QTc (ΔQTc) was a dependent variable and time matched AZD8233 concentration was an independent variable. The high clinical exposure scenario was defined as 1.7-fold the expected Cmax following an assumed therapeutic dose of 60 mg, which corresponds to AZD8233 plasma concentration of 1.39 μg/mL. Estimated placebo-corrected and baseline-adjusted QTcF interval (ΔΔQTcF) at this concentration was -2.2 ms (90% CI: -4.11, -0.28). Furthermore, the upper 90% ΔΔQTcF confidence interval was estimated to be below 10 ms at all observed concentrations. As the effect on ΔΔQTcF is below the threshold for regulatory concern (10 ms), it can be concluded that AZD8233 does not induce QTcF prolongation at the high clinical exposure scenario.
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Affiliation(s)
- Dinko Rekić
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | | | - Jane Knöchel
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | | | - Catarina Nilsson
- Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Linda Wernevik
- Research and Early Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - David Han
- PAREXEL, Glendale, Los Angeles, CA, USA
| | - Tina Rydén-Bergsten
- Research and Early Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Ahmad Ebrahimi
- Cardiovascular Safety Center of Excellence, Global Patient Safety, Oncology R&D, AZ, Gothenburg, Sweden
| | - Corina Dota
- Cardiovascular Safety Center of Excellence, Global Patient Safety, Oncology R&D, AZ, Gothenburg, Sweden
| | - Björn Carlsson
- Research and Early Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
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Johansson S, Han D, Hunt T, Björck K, Florica D, Gillen M, Hall J, Erlandsson F. Pharmacokinetics, pharmacodynamics, and safety of verinurad with and without allopurinol in healthy Asian, Chinese, and non-Asian participants. Pharmacol Res Perspect 2022; 10:e00929. [PMID: 35593744 PMCID: PMC9121888 DOI: 10.1002/prp2.929] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 11/10/2021] [Accepted: 12/21/2021] [Indexed: 11/06/2022] Open
Abstract
Verinurad is a selective inhibitor of uric acid transporter 1 (URAT1). Here, we assessed the safety, pharmacokinetics, and pharmacodynamics of verinurad + allopurinol and verinurad monotherapy in healthy participants. Studies 1 (NCT03836599) and 2 (NCT02608710) were randomized Phase 1 studies. In Study 1, 12 healthy Asian participants received 24 mg verinurad + 300 mg allopurinol or placebo, and 9 healthy Chinese participants received 12 mg verinurad + 300 mg allopurinol. In Study 2, 24 healthy non-Asian male participants received 12 mg verinurad. Safety analyses included assessment of adverse events (AEs). Pharmacokinetic parameters included maximum concentration (Cmax ) and area under plasma concentration-time curve (AUC) over 24 h (AUCτ ). Pharmacodynamic parameters included percentage change from baseline (day -1) in serum uric acid (sUA) and urinary uric acid (uUA). There were no serious AEs or deaths in either study. In Study 1, steady-state geometric mean (gCV%) Cmax and AUCτ values of verinurad after 7 days' dosing were 73.6 (29.0) ng/mL and 478 (18.4) ng·h/mL, respectively, in healthy Asian participants, and 42.0 (40.1) ng/mL and 264 (36.1) ng·h/mL, respectively, in healthy Chinese participants; in Study 2, gCV% values were 36.3 (36.5) ng/mL and 271 (31.0) ng·h/mL, respectively. sUA decreased and uUA excretion increased compared with baseline following verinurad + allopurinol (Study 1) or verinurad (Study 2). When accounting for dose, the steady-state pharmacokinetics of verinurad following multiple dosing were comparable between healthy Asian and Chinese participants and healthy non-Asian participants. Verinurad treatments were well tolerated, including at higher verinurad exposures than previously evaluated after repeated dosing.
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Affiliation(s)
- Susanne Johansson
- Clinical Pharmacology & Quantitative PharmacologyClinical Pharmacology & Safety SciencesAstraZeneca BioPharmaceuticals Research and Development GothenburgMölndalSweden
| | - David Han
- Parexel Early Phase Clinical Unit Los AngelesGlendaleCaliforniaUSA
| | | | - Karin Björck
- Biometrics CVRMAstraZeneca BioPharmaceuticals Research and DevelopmentGothenburgMölndalSweden
| | - Delia Florica
- Patient SafetyAstraZeneca BioPharmaceuticals Research and DevelopmentGothenburgSweden
| | - Michael Gillen
- Formerly of AstraZeneca BioPharmaceuticals Research and DevelopmentGaithersburgMarylandUSA
| | - Jesse Hall
- Formerly of Ardea Biosciences, IncSan DiegoCaliforniaUSA
| | - Fredrik Erlandsson
- CVRM Late ClinicalAstraZeneca BioPharmaceuticals Research and Development GothenburgMölndalSweden
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Blum K, Han D, Baron D, Kazmi S, Elman I, Gomez LL, Gondre -Lewis MC, Thanos PK, Braverman ER, Badgaiyan RD. Nicotinamide adenine dinucleotide (NAD+) and Enkephalinase Inhibition (IV1114589NAD) infusions significantly attenuates psychiatric burden sequalae in Substance Use Disorder (SUD) in fifty cases. CPRR 2022; 18:125-143. [DOI: 10.2174/2666082218666220527114427] [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: 11/22/2022]
Abstract
Background:
There is a shortage of clinical studies examining the efficacy of Nicotinamide Adenine Dinucleotide and Enkephalinase infusions (IV1114589NAD) in treating Substance Use Disorder (SUD).
Objective:
This study aims to provide evidence that IV1114589NAD infusions significantly attenuate substance craving behavior.
Methods:
The study cohort consisted of addicted poly-drug, mixed gender, multi-ethnic individuals resistant to standard treatment. The investigation utilized Likert-Scales to assess behavioral outcomes.
Results:
Using Wilcoxon signed-rank tests and sign tests, our team detected significant results by comparing baseline to post outcome scores after IV1114589NAD injections: craving scores (P=1.063E-9); anxiety (P=5.487E-7); and depression (P=1.763E-4). A significant reduction in cravings, anxiety, and depression followed a dose-dependent linear trend. Linear trend analyses showed a significant relationship between NAD infusions and decreasing scores for cravings (P=0.015), anxiety (P=0.003), and depression (P=8.74E-5). A urine analysis was conducted on a subset of 38 patients midway through the study to assess relapse; 100% of the urine samples analyzed failed to detect illicit substance use.
Discussion:
The opioid crisis in America has claimed close to 800,000 lives since 2004; daily deaths are estimated to stand at 127 and in 2021 100,000 deaths were due to overdose. There is an urgency to find safe, side-effect-free solutions. Current interventions, such as Naltrexone implants, are invasive and may interfere with dopamine homeostasis leading to an anti-reward phenomenon. Larger randomized double-blinded placebo-controlled studies are needed to elucidate further the significance of the results presented in this study. The current pilot study provides useful preliminary data regarding the effectiveness of IV1114589NAD infusions in SUD treatment.
Conclusion:
This pilot study provides significant evidence that NAD infusions are beneficial in the treatment of SUD. This investigation serves as a rationale to extend these findings onto future research investigating the use of NAD/NADH as a stand-alone treatment, especially in patients showing high genetic risk as measured in the Genetic Addiction Risk Severity (GARS) test. Utilizing GARS will help provide a real personalized therapeutic approach to treat Reward Deficiency Syndrome (RDS).
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Affiliation(s)
- Kenneth Blum
- The Kenneth Blum Institute of Behavioral & Neurogenetics, Austin, TX, USA
- Department of Psychology, University of Buffalo, the State University of New York, Buffalo, NY, United States
| | - David Han
- Department of Management Science and Statistics, University of Texas at San Antonio, Texas , USA
| | - David Baron
- Department of Psychology, University of Buffalo, the State University of New York, Buffalo, NY, United States
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
| | - Shan Kazmi
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
| | - Igor Elman
- Department of Management Science and Statistics, University of Texas at San Antonio, Texas , USA
| | - Luis Llanos Gomez
- The Kenneth Blum Institute of Behavioral & Neurogenetics, Austin, TX, USA
| | | | - Panyotis K Thanos
- Department of Psychology & Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, and Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, NY, USA
| | - Eric R Braverman
- Division of Clinical Neurology, PATH Foundation NY., New York, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Ichan School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Long School of Medicine, University of Texas Health Science Center, San Antonio, Texas, USA
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Sharma S, Pepin X, Cheung J, Zheng L, Wei H, Townsley D, Han D, Majewski M, Ware JA, Mann J, Munugalavadla V, Sheridan L, Patel P, Gupta A, Tomkinson H. Bioavailability of acalabrutinib suspension delivered via nasogastric tube in the presence or absence of a proton pump inhibitor in healthy subjects. Br J Clin Pharmacol 2022; 88:4573-4584. [PMID: 35466438 DOI: 10.1111/bcp.15362] [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: 04/01/2021] [Revised: 12/17/2021] [Accepted: 03/16/2022] [Indexed: 11/28/2022] Open
Abstract
AIMS Acalabrutinib, a selective Bruton tyrosine kinase inhibitor is approved for the treatment of mantle cell lymphoma and chronic lymphocytic leukemia. Many critically ill patients are unable to swallow and need oral medications to be delivered via a nasogastric (NG) tube. Furthermore, critically ill patients are typically administered proton-pump inhibitors (PPIs) to prevent stress ulcers. Concomitant administration with PPIs reduces acalabrutinib exposure and is not currently recommended. To evaluate acalabrutinib in subjects co-administered with PPIs who require NG delivery, a Phase 1, open-label, randomized, crossover, single-dose study was conducted in healthy subjects. METHODS The study assessed the relative bioavailability of an acalabrutinib suspension-in regular, degassed Coca-Cola®-administered via NG tube (Acala-NG) versus the pharmacokinetics (PK) of an acalabrutinib capsule administered orally with water. In addition, the PPI effect was evaluated by comparing the PK following Acala-NG in the presence or absence of rabeprazole. RESULTS Exposure of acalabrutinib and its active metabolite (ACP-5862) were comparable following administration of Acala-NG versus the oral capsule (Geo mean ratio, % ref [90% CI]: acalabrutinib AUCinf : 103 [93-113]; Cmax : 144 [120-173]). In addition, exposure was similar following administration of Acala-NG with and without a PPI (Geo mean ratio, % ref [90% CI]: acalabrutinib AUCinf : 105 [79-138]; Cmax : 95 [66-137]). No safety or tolerability concerns were observed, and all adverse events were mild and resolved without treatment. CONCLUSIONS Acala-NG with or without a PPI, is safe and well-tolerated without impeding bioavailability.
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Affiliation(s)
- Shringi Sharma
- Quantitative Clinical Pharmacology, AstraZeneca, South San Francisco, CA, USA
| | - Xavier Pepin
- New Modalities & Parenteral Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Macclesfield, UK
| | - Jean Cheung
- Hematology, Research and Development, AstraZeneca, South San Francisco, CA, USA
| | - Lianqing Zheng
- Late Hematology Statistics, Oncology Biometrics, AstraZeneca, South San Francisco, CA, USA
| | - Hua Wei
- Acerta Pharma (a member of the AstraZeneca Group), South San Francisco, CA, USA
| | - Danielle Townsley
- Oncology Research and Development, AstraZeneca, Gaithersburg, MD, USA
| | - David Han
- Parexel International Early Phase Clinical Unit (Los Angeles), Glendale, CA, USA
| | - Michal Majewski
- Oncology Research and Development, Clinical Operations, AstraZeneca, Toronto, Canada
| | - Joseph A Ware
- Acerta Pharma (a member of the AstraZeneca Group), South San Francisco, CA, USA
| | - James Mann
- Oral Product Development, Pharmaceutical Technology & Development, Operations, AstraZeneca, Macclesfield, UK
| | - Veerendra Munugalavadla
- Translational Medicine, Hematology, Research and Early Development, AstraZeneca, South San Francisco, CA, USA
| | - Louise Sheridan
- Product Leadership, Pharmaceutical Technology & Development, Operations, AstraZeneca, Macclesfield, UK
| | - Priti Patel
- Clinical Development Hematology, Oncology Research and Development, AstraZeneca, South San Francisco, CA, USA
| | - Ashok Gupta
- Oncology Research and Development, AstraZeneca, Gaithersburg, MD, USA
| | - Helen Tomkinson
- Clinical Pharmacology & Quantitative Pharmacology (CPQP), Clinical Pharmacology and Safety Sciences, Research and Development, AstraZeneca, Cambridge, UK
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Ha A, Wallace B, Han D, Miles C, Raup V, Badalato G, Alukal J. A Population-based Analysis of Predictors to Penile Surgical Intervention among Inpatients with Acute Priapism. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.227] [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: 10/18/2022]
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Yin W, Han D, Khudyakov P, Behrje R, Posener J, Laurenza A, Arkilo D. A phase 1 study to evaluate the safety, tolerability and pharmacokinetics of TAK‐041 in healthy participants and patients with stable schizophrenia. Br J Clin Pharmacol 2022; 88:3872-3882. [PMID: 35277995 PMCID: PMC9544063 DOI: 10.1111/bcp.15305] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Wei Yin
- Takeda Pharmaceutical Company Ltd Cambridge MA USA
| | | | | | - Rhett Behrje
- Takeda Pharmaceutical Company Ltd Cambridge MA USA
| | - Joel Posener
- Takeda Pharmaceutical Company Ltd Cambridge MA USA
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Vetten Z, Auld B, Brooks P, Robertson T, Lee-Tannock A, Yim D, Han D, Alsweiler J, Gentles T. Inter-Rater Reliability and Agreement of Fetal Echocardiography Measurements Among Investigators From Multiple Sites. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.456] [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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Shan X, Han D, Ge Y, Zhang H, Lu R. Clinical outcomes of keratinized mucosa augmentation in jaws reconstructed with fibula or iliac bone flaps. Int J Oral Maxillofac Surg 2021; 51:949-956. [PMID: 34924272 DOI: 10.1016/j.ijom.2021.11.013] [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: 05/08/2021] [Revised: 08/25/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
This prospective study was undertaken to evaluate the treatment outcomes of keratinized mucosa augmentation (KMA) on the buccal and palatal/lingual sides of implants in jaws reconstructed after oncological surgery. Forty-two implants in 12 patients whose jaws had been reconstructed with a fibula or iliac bone flap were included. KMA was performed at 3 months after implant placement; this included an apically displaced partial-thickness flap and a free gingival graft (FGG) around the implants to increase the keratinized mucosa width (KMW). Patients were followed up for at least 6 months post-surgery. KMW, shrinkage, and patient pain and discomfort measured on a visual analogue scale were analysed. A histological analysis was performed of tissue epithelium from two patients. The results showed that KMW was >2 mm on both the buccal and palatal/lingual sides during follow-up. Before surgery, histological analysis showed epithelium with no epithelial spikes; normal keratinized epithelial spikes were observed at 8 weeks after KMA. Greater KMW was observed around implants in reconstructed maxillae than around those in reconstructed mandibles (P < 0.001). Patients felt more pain at the donor site than at the recipient site during the first 3 days post-surgery. KMA with FGG was predictable in reconstructed jaws and may help maintain the long-term stability of implants.
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Affiliation(s)
- X Shan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Clinical Research Centre for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - D Han
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Y Ge
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - H Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - R Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing, PR China.
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Xu H, Han D, Wang K, Zhang T, Gao GC. LINC00174 triggers the malignant development of breast cancer by negatively regulating miR-1827 level. Eur Rev Med Pharmacol Sci 2021; 25:6447-6453. [PMID: 34787848 DOI: 10.26355/eurrev_202111_27087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Long non-coding RNAs (lncRNAs) are extensively involved in tumor development. In-depth researches on cancer-associated lncRNAs provide a theoretical basis for developing prognostic hallmarks and individualized therapeutic targets in breast cancer (BCa). This study aims to detect expression characteristics of LINC00174 in BCa and its biological role in regulating BCa cell phenotypes. PATIENTS AND METHODS LINC00174 levels in BCa and adjacent normal tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The influence of LINC00174 on pathological indicators of BCa was analyzed. In MCF-7 and MDA-MB-231 cells with LINC00174 knockdown, proliferative and migratory abilities were examined by cell counting kit-8 (CCK-8), colony formation and transwell assay, respectively. At last, molecular mechanisms of LINC00174 and its downstream gene miR-1827 in regulating BCa development were explored by Luciferase assay and rescue experiments. RESULTS LINC00174 was upregulated in BCa tissues than adjacent normal ones. High level of LINC00174 predicted advanced tumor staging, high metastasis rate and poor prognosis in BCa. Knockdown of LINC00174 attenuated proliferative and migratory abilities in BCa cells. MiR-1827 was the target gene binding LINC00174, showing a negative correlation between each other. Silence of miR-1827 abolished the regulatory effects of LINC00174 on proliferative and migratory abilities in BCa cells. CONCLUSIONS LINC00174 is upregulated in BCa samples. It is closely linked to tumor staging, metastasis and prognosis in BCa. By negatively regulating miR-1827 level, LINC00174 aggravates the malignant development of BCa.
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Affiliation(s)
- H Xu
- Jiaxing University, Jiaxing, China.
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Lin A, Van Diemen P, Motwani M, McElhinney P, Otaki Y, Han D, Kwan A, Tzolos E, Cadet S, Danad I, Driessen R, Slomka PJ, Berman DS, Dey D, Knaapen P. Machine learning from quantitative coronary computed tomography angiography predicts ischemia and impaired myocardial blood flow. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0206] [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: 11/14/2022] Open
Abstract
Abstract
Background
Atherosclerotic plaque characteristics influence the hemodynamic consequences of coronary lesions. This study sought to assess the performance of a machine learning (ML) score integrating coronary computed tomography angiography (CCTA)-based quantitative plaque features for the prediction of ischemia by invasive fractional flow reserve (FFR) and impaired myocardial blood flow (MBF) by [15O]H2O positron emission tomography (PET).
Methods
This post-hoc analysis of the PACIFIC (Prospective Comparison of Cardiac PET/CT, SPECT/CT Perfusion Imaging and CT Coronary Angiography With Invasive Coronary Angiography) trial included 208 patients with suspected coronary artery disease who underwent CCTA, [15O]H2O PET, and 3-vessel invasive FFR. Plaque quantification from CCTA was performed using semiautomated software. A boosted ensemble ML algorithm (XGBoost) trained on data from the NXT (Analysis of Coronary Blood Flow using CT Angiography: Next Steps) trial was used to develop a ML score for the prediction of per-vessel ischemia (invasive FFR ≤0.80). The performance of the ML score was evaluated in 551 vessels from the PACIFIC trial for external validation. Thereafter, we assessed the discriminative ability of the ML score for per-vessel impaired hyperemic MBF (≤2.30 mL/min/g).
Results
In total, 138 (25.0%) vessels had ischemia and 195 (35.4%) vessels had impaired hyperemic MBF. CCTA-derived quantitative percent diameter stenosis and low-density noncalcified plaque (LDNCP) volume were higher in ischemic vessels compared with non-ischemic vessels (60.8% vs. 19.9%; and 42.3 mm3 vs. 9.1 mm3; both p<0.001). The ML score demonstrated a significantly higher area under the receiver-operating characteristic curve (AUC) for predicting ischemia (0.92, 95% confidence interval [CI] 0.89–0.94) compared with visual stenosis grade (0.84, 95% CI 0.80–0.87; p<0.001). Overall, quantitative percent diameter stenosis and LDNCP volume had greatest feature importance for ML, followed by percent area stenosis, minimum luminal diameter, and contrast density drop (Figure 1). An individualized explanation of ML ischemia prediction is shown in Figure 2. When applied for impaired MBF discrimination, the ML score exhibited an AUC of 0.82 (95% CI 0.78–0.85) and was superior to visual stenosis grade (AUC 0.76, 95% CI 0.72–0.80; p=0.03).
Conclusions
An externally validated ML score integrating CCTA-based quantitative plaque features accurately predicts FFR-defined ischemia and abnormal MBF by PET, outperforming standard visual CCTA interpretation.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Heart, Lung, and Blood Institute, United States Performance of the ML scoreIndividual explanation of ML prediction
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Affiliation(s)
- A Lin
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - P Van Diemen
- VU University Medical Center, Amsterdam, Netherlands (The)
| | - M Motwani
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - P McElhinney
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - Y Otaki
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - D Han
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - A Kwan
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - E Tzolos
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - S Cadet
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - I Danad
- VU University Medical Center, Amsterdam, Netherlands (The)
| | - R Driessen
- VU University Medical Center, Amsterdam, Netherlands (The)
| | - P J Slomka
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - D S Berman
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - D Dey
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - P Knaapen
- VU University Medical Center, Amsterdam, Netherlands (The)
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Ge WX, Tan WL, Teng HY, Shen H, Han D, Xiao Y, Yin JY, Hu J. [Trajectories of body mass index Z-score and risk of high blood pressure in late adolescence in Suzhou children]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:1809-1816. [PMID: 34814616 DOI: 10.3760/cma.j.cn112338-20201130-01365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To identify age and gender standardized body mass index among children and adolescents and explore their associations with high blood pressure (HBP) in late adolescence. Methods: The current study was based on the Health Promotion Program for Children and Adolescents, school-based surveillance successively conducted from 2012 to 2019 in Suzhou, China. A total of 11 812 children and adolescents aged 16-18 years, who had ≥4 examination records during 2012-2018 and were also involved in a surveillance program in 2019, were included. Latent class growth mixture modeling was used to identify the BMI-Z trajectories in different genders, and multivariate logistic regression was used to analyze the associations between different BMI-Z trajectories and risk of HBP in late adolescence. Results: Six distinct BMI-Z trajectories were determined for both genders:thin, slightly thin,standard, declining, overweight, and obese. Compared with the regular group, the obesity group had 94.0% (OR=1.94, 95%CI: 1.43-2.63) and 107.0% (OR=2.07, 95%CI: 1.33-3.22) increased risk of developing HBP in late adolescence in boys and girls, respectively. However, a neutral association was found between the descending group and HBP in late adolescence. Conclusions: Persistent obesity in children may increase the risk of HBP in their late adolescence. If an obese child restores normal weight before late adolescence, the risk of HBP may reduce.
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Affiliation(s)
- W X Ge
- School of Public Health, Soochow University, Suzhou 215006, China
| | - W L Tan
- School of Public Health, Soochow University, Suzhou 215006, China Suzhou Municipal Health Commission, Suzhou 215000, China
| | - H Y Teng
- School of Public Health, Soochow University, Suzhou 215006, China
| | - H Shen
- Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
| | - D Han
- Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
| | - Y Xiao
- School of Public Health, Soochow University, Suzhou 215006, China
| | - J Y Yin
- School of Public Health, Soochow University, Suzhou 215006, China
| | - J Hu
- Suzhou Center for Disease Control and Prevention, Suzhou 215004, China
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Li G, Zhao Y, Jiang Y, Yang Q, Huang A, Chen Y, Han D. 777P A prospective, single-arm, open-label study of camrelizumab, apatinib and nab-paclitaxel in patients with advanced cervical cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1219] [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: 10/20/2022] Open
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Dashti S, Kadner R, Folley B, Sheehan J, Han D, Kryscio R, Carter M, Shields L, Plato B, La Rocca R, Spalding A, Yao T, Fraser J. PH-0607 Intra-arterial bevacizumab after blood-brain barrier disruption for refractory radiation necrosis. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07379-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ren S, Vishwanathan K, Cantarini M, Frewer P, Hara I, Scarfe G, Burke W, Schalkwijk S, Li Y, Han D, Goldwater R. Clinical evaluation of the potential drug-drug interactions of savolitinib: Interaction with rifampicin, itraconazole, famotidine or midazolam. Br J Clin Pharmacol 2021; 88:655-668. [PMID: 34322894 PMCID: PMC9292161 DOI: 10.1111/bcp.14994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 11/29/2022] Open
Abstract
Aims We investigated savolitinib pharmacokinetics (PK) when administered alone or in combination with rifampicin, itraconazole or famotidine, and investigated midazolam PK when administered with or without savolitinib in healthy males. Methods Savolitinib PK was evaluated before/after: rifampicin (600 mg once daily [QD] for 5 days); itraconazole (200 mg QD for 5 days); a single dose of famotidine (40 mg QD) 2 hours before savolitinib. Midazolam PK was evaluated before/after midazolam (1 mg QD) with or without savolitinib (600 mg QD). Each study enrolled 20, 16, 16 and 14 volunteers, respectively. Plasma samples were collected to determine the effect on PK. Results The geometric mean ratios (GMR, %) (90% confidence intervals [CIs]) for savolitinib alone and in combination for Cmax, AUC respectively, were 45.4 (41.4–49.9), 38.5 (34.2–43.3) in the rifampicin study (n = 18); 105.2 (87.7–126.3), 108.4 (96.3–122.1) in the itraconazole study (n = 16); and 78.8 (67.7–91.7), 87.4 (81.2–94.2) in the famotidine study (n = 16). The GMRs (90% CIs) for midazolam alone and in combination with savolitinib for Cmax, AUC respectively, were 84.1 (70.0–101.0), 96.7 (92.4–101.1) (n = 14). Savolitinib alone or in combination was well tolerated. Conclusions Co‐dosing of rifampicin significantly reduced exposure to savolitinib vs savolitinib alone; co‐dosing of itraconazole or midazolam with savolitinib had no clinically significant effect on savolitinib or midazolam PK, respectively. Co‐dosing of famotidine with savolitinib reduced exposure to savolitinib, although this was not considered clinically meaningful. No new savolitinib‐related safety findings were observed.
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Affiliation(s)
- Song Ren
- Clinical Pharmacology & Quantitative Pharmacology, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, Maryland, USA
| | - Karthick Vishwanathan
- Clinical Pharmacology & Quantitative Pharmacology, CPSS, R&D, AstraZeneca, Boston, Massachusetts, USA
| | | | - Paul Frewer
- Oncology Biometrics, Oncology R&D, AstraZeneca, Cambridge, UK
| | - Indira Hara
- Patient Safety, Oncology TA, MedImmune-AstraZeneca, Cambridge, UK
| | - Graeme Scarfe
- Drug Metabolism and Pharmacokinetics, Oncology R&D, Research & Early Development, AstraZeneca, Cambridge, UK
| | | | - Stein Schalkwijk
- Clinical Pharmacology & Quantitative Pharmacology, CPSS, R&D, AstraZeneca, Cambridge, UK
| | - Yan Li
- Integrated Bioanalysis, Clinical Pharmacology & Quantitative Pharmacology, BioPharmaceuticals R&D, AstraZeneca, Boston, Massachusetts, USA
| | - David Han
- Parexel International, Glendale, California, USA
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Le Lay JE, Du Q, Mehta MB, Bhagroo N, Hummer BT, Falloon J, Carlson G, Rosenbaum AI, Jin C, Kimko H, Tsai LF, Novick S, Cook B, Han D, Han CY, Vaisar T, Chait A, Karathanasis SK, Rhodes CJ, Hirshberg B, Damschroder MM, Hsia J, Grimsby JS. Blocking endothelial lipase with monoclonal antibody MEDI5884 durably increases high density lipoprotein in nonhuman primates and in a phase 1 trial. Sci Transl Med 2021; 13:13/590/eabb0602. [PMID: 33883272 DOI: 10.1126/scitranslmed.abb0602] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/23/2021] [Indexed: 12/14/2022]
Abstract
Cardiovascular disease (CVD) is the leading global cause of death, and treatments that further reduce CV risk remain an unmet medical need. Epidemiological studies have consistently identified low high-density lipoprotein cholesterol (HDL-C) as an independent risk factor for CVD, making HDL elevation a potential clinical target for improved CVD resolution. Endothelial lipase (EL) is a circulating enzyme that regulates HDL turnover by hydrolyzing HDL phospholipids and driving HDL particle clearance. Using MEDI5884, a first-in-class, EL-neutralizing, monoclonal antibody, we tested the hypothesis that pharmacological inhibition of EL would increase HDL-C by enhancing HDL stability. In nonhuman primates, MEDI5884 treatment resulted in lasting, dose-dependent elevations in HDL-C and circulating phospholipids, confirming the mechanism of EL action. We then showed that a favorable lipoprotein profile of elevated HDL-C and reduced low-density lipoprotein cholesterol (LDL-C) could be achieved by combining MEDI5884 with a PCSK9 inhibitor. Last, when tested in healthy human volunteers, MEDI5884 not only raised HDL-C but also increased HDL particle numbers and average HDL size while enhancing HDL functionality, reinforcing EL neutralization as a viable clinical approach aimed at reducing CV risk.
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Affiliation(s)
- John E Le Lay
- Bioscience Metabolism, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Qun Du
- Biologic Therapeutics, Antibody Discovery and Protein Engineering, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Minal B Mehta
- Bioscience Metabolism, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Nicholas Bhagroo
- Bioscience Metabolism, Research and Early Development, Cardiovascular, Renal, and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - B Timothy Hummer
- CVRM Safety, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Judith Falloon
- Clinical Development, Research and Early Development, CVRM, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Glenn Carlson
- Clinical CV, Late Stage Development, CVRM, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Anton I Rosenbaum
- Integrated Bioanalysis, Clinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, South San Francisco, CA 94080, USA
| | - ChaoYu Jin
- Clinical Immunology and Bioanalysis, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, South San Francisco, CA 94080, USA
| | - Holly Kimko
- Clinical Pharmacology and DMPK, Clinical Pharmacology and Safety Sciences, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Lan-Feng Tsai
- CVRM Biometrics, Data Sciences and AI, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Steven Novick
- Data Sciences and Quantitative Biology, Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Bill Cook
- Clinical Development, Research and Early Development, CVRM, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD 20878, USA
| | - David Han
- Parexel International, Glendale, CA 91206, USA
| | - Chang Yeop Han
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA 98915, USA
| | - Tomas Vaisar
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA 98915, USA
| | - Alan Chait
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA 98915, USA
| | - Sotirios K Karathanasis
- Research and Early Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Christopher J Rhodes
- Research and Early Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Boaz Hirshberg
- Clinical Development, Research and Early Development, CVRM, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Melissa M Damschroder
- Biologic Therapeutics, Antibody Discovery and Protein Engineering, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Judith Hsia
- Clinical Development, Research and Early Development, CVRM, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD 20878, USA
| | - Joseph S Grimsby
- Research and Early Development, Cardiovascular, Renal, and Metabolism, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, USA.
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Han D, Achenbach S, Al-Mallah M, Budoff M, Cademartiri F, Maffei E, Callister T, Chinnaiyan K, Chow B, DeLago A, Hadamitzky M, Hausleiter J, Kaufmann P, Villines T, Kim Y, Leipsic J, Feuchtner G, Cury R, Pontone G, Andreini D, Marques H, Rubinshtein R, Rubinshtein R, Chang H, Lin F, Shaw L, Min J, Berman D. Prognostic Significance Of Plaque Location In Non-obstructive Coronary Artery Disease: From The Confirm Registry. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lin A, van Diemen P, Motwani M, McElhinney P, Otaki Y, Han D, Kwan A, Tzolos E, Klein E, Kuronuma K, Grodecki K, Shou B, Cadet S, Danad I, Driessen R, Slomka P, Berman D, Dey D, Knaapen P. Machine Learning From Quantitative Coronary Computed Tomography Angiography Predicts Ischemia And Impaired Myocardial Blood Flow. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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