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Bhandarkar AR, Bhandarkar S, Babovic-Vuksanovic D, Raghunathan A, Schwartz J, Spinner RJ. Precision oncology in neurofibromatosis type 1: quantification of differential sensitivity to selumetinib in plexiform neurofibromas using single-cell RNA sequencing. J Neurooncol 2024:10.1007/s11060-024-04711-5. [PMID: 38739187 DOI: 10.1007/s11060-024-04711-5] [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: 03/31/2024] [Accepted: 05/04/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE Selumetinib is an FDA-approved targeted therapy for plexiform neurofibromas in neurofibromatosis type 1(NF1) with durable response rates seen in most, but not all patients. In this proof-of-concept study, we demonstrate single-cell RNA sequencing(scRNAseq) as a technique for quantifying drug response to selumetinib at the single cell level. METHODS scRNAseq data from neurofibroma biopsies was obtained from a public genomics repository. Schwann cell populations were identified through standard clustering techniques and single-cell selumetinib sensitivity was quantified on a scale of 0(resistant) to 1(sensitive) based on the expression pattern of a 500 gene selumetinib sensitivity signature from the BeyondCell sensitivity library. RESULTS A total of seven plexiform neurofibromas were included in our final analysis. The median absolute number of Schwann cells across samples was 658 cells (IQR: 1,029 cells, Q1-Q3: 135 cells to 1,163 cells). There was a statistically significant difference in selumetinib sensitivity profiles across samples (p < 0.001). The tumor with the highest median selumetinib sensitivity score had a median selumetinib sensitivity score of 0.64(IQR: 0.14, Q1-Q3: 0.59-0.70, n = 112 cells) and the tumor with the lowest median selumetinib sensitivity score had a median score of 0.37 (IQR: 0.21, Q1-Q3: 0.27-0.48, n = 1,034 cells). CONCLUSIONS scRNAseq of plexiform neurofibroma biopsies reveals differential susceptibilities to selumetinib on a single cell level. These findings may explain the partial responses seen in clinical trials of selumetinib for NF1 and demonstrate the value of collecting scRNAseq data for future NF1 trials.
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Affiliation(s)
| | - Shaan Bhandarkar
- Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Dusica Babovic-Vuksanovic
- Division of Pediatric Genetics, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Aditya Raghunathan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Jonathan Schwartz
- Department of Pediatric Hematology/Oncology, Section of Neuro-Oncology, Mayo Clinic, Rochester, MN, USA
| | - Robert J Spinner
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.
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2
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Schwartz J, Di ZW, Jiang Y, Manassa J, Pietryga J, Qian Y, Cho MG, Rowell JL, Zheng H, Robinson RD, Gu J, Kirilin A, Rozeveld S, Ercius P, Fessler JA, Xu T, Scott M, Hovden R. Imaging 3D chemistry at 1 nm resolution with fused multi-modal electron tomography. Nat Commun 2024; 15:3555. [PMID: 38670945 PMCID: PMC11053043 DOI: 10.1038/s41467-024-47558-0] [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: 12/14/2023] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
Measuring the three-dimensional (3D) distribution of chemistry in nanoscale matter is a longstanding challenge for metrological science. The inelastic scattering events required for 3D chemical imaging are too rare, requiring high beam exposure that destroys the specimen before an experiment is completed. Even larger doses are required to achieve high resolution. Thus, chemical mapping in 3D has been unachievable except at lower resolution with the most radiation-hard materials. Here, high-resolution 3D chemical imaging is achieved near or below one-nanometer resolution in an Au-Fe3O4 metamaterial within an organic ligand matrix, Co3O4-Mn3O4 core-shell nanocrystals, and ZnS-Cu0.64S0.36 nanomaterial using fused multi-modal electron tomography. Multi-modal data fusion enables high-resolution chemical tomography often with 99% less dose by linking information encoded within both elastic (HAADF) and inelastic (EDX/EELS) signals. We thus demonstrate that sub-nanometer 3D resolution of chemistry is measurable for a broad class of geometrically and compositionally complex materials.
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Affiliation(s)
- Jonathan Schwartz
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Zichao Wendy Di
- Mathematics and Computer Science Division, Argonne National Laboratory, Lemont, IL, USA
| | - Yi Jiang
- Advanced Photon Source Facility, Argonne National Laboratory, Lemont, IL, USA
| | - Jason Manassa
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Jacob Pietryga
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Material Science and Engineering, Northwestern University, Evanston, IL, USA
| | - Yiwen Qian
- Department of Materials Science and Engineering, University of California at Berkeley, Berkeley, CA, USA
| | - Min Gee Cho
- Department of Materials Science and Engineering, University of California at Berkeley, Berkeley, CA, USA
- National Center for Electron Microscopy, Molecular Foundry, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Jonathan L Rowell
- Department of Chemistry and Chemical Biology, Cornell University, Ithaca, NY, USA
| | - Huihuo Zheng
- Argonne Leadership Computing Facility, Argonne National Laboratory, Lemont, IL, USA
| | - Richard D Robinson
- Department of Material Science and Engineering, Cornell University, Ithaca, NY, USA
- Kavli Institute at Cornell for Nanoscale Science, Cornell University, Ithaca, NY, USA
| | - Junsi Gu
- Dow Chemical Co., Collegeville, PA, USA
| | | | | | - Peter Ercius
- National Center for Electron Microscopy, Molecular Foundry, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Jeffrey A Fessler
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, USA
| | - Ting Xu
- Department of Materials Science and Engineering, University of California at Berkeley, Berkeley, CA, USA
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Mary Scott
- Department of Materials Science and Engineering, University of California at Berkeley, Berkeley, CA, USA.
- National Center for Electron Microscopy, Molecular Foundry, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
| | - Robert Hovden
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA.
- Applied Physics Program, University of Michigan, Ann Arbor, MI, USA.
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Hamid N, Aman E, Bae R, Scherer M, Smith TWR, Schwartz J, Rinaldi M, Singh G, Sorajja P. 3D Navigation and Intraprocedural Intracardiac Echocardiography Imaging for Tricuspid Transcatheter Edge-to-Edge Repair. JACC Cardiovasc Imaging 2024; 17:441-447. [PMID: 38569794 DOI: 10.1016/j.jcmg.2024.02.005] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Nadira Hamid
- Minneapolis Heart Institute, Minneapolis, Minnesota, USA.
| | - Edris Aman
- University of California Davis Medical Center, Sacramento, California, USA
| | - Richard Bae
- Minneapolis Heart Institute, Minneapolis, Minnesota, USA
| | - Markus Scherer
- Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Thomas W R Smith
- University of California Davis Medical Center, Sacramento, California, USA
| | | | | | - Gagan Singh
- University of California Davis Medical Center, Sacramento, California, USA
| | - Paul Sorajja
- Minneapolis Heart Institute, Minneapolis, Minnesota, USA
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4
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Schallenburger M, Schwartz J, Batzler YN, Meier S, Küppers R, Tenge T, Doll A, Kremeike K, Wetzchewald D, Neukirchen M. Handling the desire to die- evaluation of an elective course for medical students. BMC Med Educ 2024; 24:279. [PMID: 38494509 PMCID: PMC10946106 DOI: 10.1186/s12909-024-05269-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/06/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND The desire to die can occur in palliative care patients with a prevalence of up to 22%. Not every desire to die is accompanied by a pressure to act, but usually by a burden that can arise from various factors. To address this burden appropriately, health care workers should be trained. Based on an evaluated course on handling the desire to die, an elective course for medical students was developed and evaluated. In order to identify the impact of the elective course's content, a comparison of attitudes towards assisted dying with two other participant groups was conducted. Therefore, three questions from the evaluation of the elective course were used. METHOD Online evaluation of the elective and questions addressing attitude were assessed using a five-point Likert scale. The specific outcome-based assessment was determined using the Comparative Self-Assessment Gain. The main participant group (group 1) were students who took the elective. The additional survey on attitudes towards assisted dying included undergraduate medical students who had taken compulsory palliative care courses (group 2) and physicians who had taken an introductory course in intensive care or emergency medicine (group 3). RESULTS Group 1 (n = 13, response rate rr = 86.7%) was very satisfied with the blended learning format (100%) and the course itself (100%). They were able to deepen their knowledge (81.0%) and train skills (71.2%) through the course. In the additional surveys, there were 37 students in group 2 (rr = 66.1%) and 258 physicians in group 3 (rr = 73.6%). Willingness to assist with or accompany the various options for assisted dying varied according to the type of assistance. Among the participants, it can be summarised that the highest willingness was shown by the students of group 2 followed by the physicians of group 3 and the students of group 1. CONCLUSIONS A course on handling the desire to die of palliative patients can deepen knowledge and train communication skills and thus support self-confidence. Dealing with the background of the desire to die, knowledge about assisted dying, but also one's own attitudes and responsibilities can influence the attitude towards assisted dying.
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Affiliation(s)
- M Schallenburger
- Interdisciplinary Centre for Palliative Medicine, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany
- Centre of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Germany
| | - J Schwartz
- Interdisciplinary Centre for Palliative Medicine, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany
- Centre of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Germany
| | - Yann-Nicolas Batzler
- Interdisciplinary Centre for Palliative Medicine, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany.
- Centre of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Germany.
| | - St Meier
- Department of Anaesthesiology, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany
| | - R Küppers
- Department of Anaesthesiology, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Th Tenge
- Department of Anaesthesiology, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany
| | - A Doll
- Centre of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Germany
- Centre for Palliative Medicine, University Cologne, University Hospital Cologne, Cologne, Germany
| | - K Kremeike
- Centre of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Germany
- Centre for Palliative Medicine, University Cologne, University Hospital Cologne, Cologne, Germany
| | - D Wetzchewald
- Institute for Emergency Medicine, University Witten/Herdecke, Arnsberg, Germany
| | - M Neukirchen
- Interdisciplinary Centre for Palliative Medicine, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany
- Centre of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Germany
- Department of Anaesthesiology, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany
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van Opbergen CJ, Narayanan B, Sacramento CB, Stiles KM, Mishra V, Frenk E, Ricks D, Chen G, Zhang M, Yarabe P, Schwartz J, Delmar M, Herzog CD, Cerrone M. AAV-Mediated Delivery of Plakophilin-2a Arrests Progression of Arrhythmogenic Right Ventricular Cardiomyopathy in Murine Hearts: Preclinical Evidence Supporting Gene Therapy in Humans. Circ Genom Precis Med 2024; 17:e004305. [PMID: 38288614 PMCID: PMC10923105 DOI: 10.1161/circgen.123.004305] [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] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/30/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND Pathogenic variants in PKP2 (plakophilin-2) cause arrhythmogenic right ventricular cardiomyopathy, a disease characterized by life-threatening arrhythmias and progressive cardiomyopathy leading to heart failure. No effective medical therapy is available to prevent or arrest the disease. We tested the hypothesis that adeno-associated virus vector-mediated delivery of the human PKP2 gene to an adult mammalian heart deficient in PKP2 can arrest disease progression and significantly prolong survival. METHODS Experiments were performed using a PKP2-cKO (cardiac-specific, tamoxifen-activated PKP2 knockout murine model). The potential therapeutic, adeno-associated virus vector of serotype rh.74 (AAVrh.74)-PKP2a (PKP2 variant A; RP-A601) is a recombinant AAVrh.74 gene therapy viral vector encoding the human PKP2 variant A. AAVrh.74-PKP2a was delivered to adult mice by a single tail vein injection either before or after tamoxifen-activated PKP2-cKO. PKP2 expression was confirmed by molecular and histopathologic analyses. Cardiac function and disease progression were monitored by survival analyses, echocardiography, and electrocardiography. RESULTS Consistent with prior findings, loss of PKP2 expression caused 100% mortality within 50 days after tamoxifen injection. In contrast, AAVrh.74-PKP2a-mediated PKP2a expression resulted in 100% survival for >5 months (at study termination). Echocardiographic analysis revealed that AAVrh.74-PKP2a prevented right ventricle dilation, arrested left ventricle functional decline, and mitigated arrhythmia burden. Molecular and histological analyses showed AAVrh.74-PKP2a-mediated transgene mRNA and protein expression and appropriate PKP2 localization at the cardiomyocyte intercalated disc. Importantly, the therapeutic benefit was shown in mice receiving AAVrh.74-PKP2a after disease onset. CONCLUSIONS These preclinical data demonstrate the potential for AAVrh.74-PKP2a (RP-A601) as a therapeutic for PKP2-related arrhythmogenic right ventricular cardiomyopathy in both early and more advanced stages of the disease.
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Affiliation(s)
| | | | | | | | | | | | | | - Grace Chen
- The Leon Charney Division of Cardiology, New York Univ Grossmann School of Medicine, New York, NY
| | - Mingliang Zhang
- The Leon Charney Division of Cardiology, New York Univ Grossmann School of Medicine, New York, NY
| | | | | | - Mario Delmar
- The Leon Charney Division of Cardiology, New York Univ Grossmann School of Medicine, New York, NY
| | | | - Marina Cerrone
- The Leon Charney Division of Cardiology, New York Univ Grossmann School of Medicine, New York, NY
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Favrel P, Dubos MP, Bernay B, Pasquier J, Schwartz J, Lefranc B, Mouret L, Rivière G, Leprince J, Bondon A. Structural and functional characterization of an egg-laying hormone signaling system in a lophotrochozoan - The pacific oyster (Crassostrea gigas). Gen Comp Endocrinol 2024; 346:114417. [PMID: 38030018 DOI: 10.1016/j.ygcen.2023.114417] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/30/2023] [Accepted: 11/26/2023] [Indexed: 12/01/2023]
Abstract
The egg-laying hormones (ELHs) of gastropod mollusks were characterized more than forty years ago. Yet, they have remained little explored in other mollusks. To gain insights into the functionality of the ELH signaling system in a bivalve mollusk - the oyster Crassostrea gigas, this study investigates the processing of its ELH precursor (Cragi-ELH) by mass spectrometry. Some of the ELH mature peptides identified in this study were subsequently investigated by nuclear magnetic resonance and shown to adopt an extended alpha-helix structure in a micellar medium mimicking the plasma membrane. To further characterize the ELH signaling system in C. gigas, a G protein-coupled receptor phylogenetically related to ecdysozoan diuretic hormone DH44 and corticotropin-releasing hormone (CRH) receptors named Cragi-ELHR was also characterized functionally and shown to be specifically activated by the two predicted mature ELH peptides and their N-terminal fragments. Both Cragi-ELH and Cragi-ELHR encoding genes were mostly expressed in the visceral ganglia (VG). Cragi-ELH expression was significantly increased in the VG of both fully mature male and female oysters at the spawning stage. When the oysters were submitted to a nutritional or hyposaline stress, no change in the expression of the ligand or receptor genes was recorded, except for Cragi-ELHR only during a mild acclimation episode to brackish water. These results suggest a role of Cragi-ELH signaling in the regulation of reproduction but not in mediating the stress response in our experimental conditions.
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Affiliation(s)
- P Favrel
- Université Caen Normandie, Normandie Univ, Sorbonne Universités, MNHN, UPMC, UA, CNRS 7208, IRD 207, Biologie des Organismes et Ecosystèmes Aquatiques (BOREA), CS14032, Esplanade de la Paix, 14032 Caen, Cedex 5, France.
| | - M P Dubos
- Université Caen Normandie, Normandie Univ, Sorbonne Universités, MNHN, UPMC, UA, CNRS 7208, IRD 207, Biologie des Organismes et Ecosystèmes Aquatiques (BOREA), CS14032, Esplanade de la Paix, 14032 Caen, Cedex 5, France
| | - B Bernay
- Université Caen Normandie, Normandie Univ, US EMERODE, PROTEOGEN Core Facility, Esplanade de la Paix, 14032 Caen, cedex 05, France
| | - J Pasquier
- Université Caen Normandie, Normandie Univ, Sorbonne Universités, MNHN, UPMC, UA, CNRS 7208, IRD 207, Biologie des Organismes et Ecosystèmes Aquatiques (BOREA), CS14032, Esplanade de la Paix, 14032 Caen, Cedex 5, France
| | - J Schwartz
- Université Caen Normandie, Normandie Univ, Sorbonne Universités, MNHN, UPMC, UA, CNRS 7208, IRD 207, Biologie des Organismes et Ecosystèmes Aquatiques (BOREA), CS14032, Esplanade de la Paix, 14032 Caen, Cedex 5, France
| | - B Lefranc
- Université Rouen Normandie, INSERM, Normandie Univ, NorDic UMR1239, Laboratoire de Différenciation et Communication Neuroendocrine, Endocrine et Germinale, F-76000 Rouen, France
| | - L Mouret
- Univ Rennes, CNRS, ISCR-UMR 6226, F-35000 Rennes, France
| | - G Rivière
- Université Caen Normandie, Normandie Univ, Sorbonne Universités, MNHN, UPMC, UA, CNRS 7208, IRD 207, Biologie des Organismes et Ecosystèmes Aquatiques (BOREA), CS14032, Esplanade de la Paix, 14032 Caen, Cedex 5, France
| | - J Leprince
- Université Rouen Normandie, INSERM, Normandie Univ, NorDic UMR1239, Laboratoire de Différenciation et Communication Neuroendocrine, Endocrine et Germinale, F-76000 Rouen, France
| | - A Bondon
- Univ Rennes, CNRS, ISCR-UMR 6226, F-35000 Rennes, France
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Ragni MV, Callis J, Daoud N, Hu B, Manuel M, Santos J, Schwartz J, Friedman KD, Kouides P, Kuriakose P, Leavitt AD, Lim MY, Machin N, Recht M, Chrisentery-Singleton T. Observational cohort study of long-term outcomes of liver transplantation in haemophilia. Haemophilia 2024; 30:87-97. [PMID: 38111071 DOI: 10.1111/hae.14910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/23/2023] [Accepted: 11/27/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION Gene therapy is now a reality for individuals with haemophilia, yet little is known regarding the quality-of-life impact of factor correction. As few data exist, and recognizing the analogy to liver transplantation (OLTX), we identified OLTX+ and OLTX- men in the ATHNdataset to compare post-OLTX factor VIII and IX on quality of life (QoL) by Haem-A-QoL and PROMIS-29. METHODS OLTX- were matched to OLTX+ by age, race, and haemophilia type and severity. Deidentified demographic data, including post-transplant factor levels, genotype and target joint disease were analysed by descriptive statistics. Haem-A-Qol and PROMIS-29 were compared in OLTX+ and OLTX- by student's t-test and univariate regression models. RESULTS Of 86 people with haemophilia A (HA) or haemophilia B (HB) cared for at 10 haemophilia treatment centers (HTCs), 21 (24.4%) OLTX+ and 65 (75.6%) OLTX- were identified. OLTX+ and OLTX- had a similar frequency of target joint disease (p = .806), HA genotypes, null versus non-null (p = .696), and HIV infection (p = .316). At a median 9.2 years post-OLTX, median FVIII, .63 IU/mL [IQR 0.52-0.97] and FIX, .91 IU/mL [IQR .63-1.32], Haem-A-QoL, PROMIS-29, and HOT scores were comparable. Severe HA/HB had lower post-OLTX 'dealing with haemophilia' scores (p = .022) and higher 'sports and leisure' (p = .010) and 'view of yourself' scores (p = .024) than OLTX+ non-severe participants. Non-caucasian OLTX+ had significantly lower scores in sports and leisure (p = .042), future expectations (p = .021) and total score (p = .010). CONCLUSION Nine years after OLTX, QoL is comparable to OLTX-, but significantly better in OLTX+ with severe than non-severe disease and in caucasians than non-caucasians.
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Affiliation(s)
- Margaret V Ragni
- Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh Medical Center, and Hemophilia Center of Western PA, Pittsburgh, Pennsylvania, USA
| | - Jessica Callis
- American Thrombosis Hemostasis Network, Rochester, New York, USA
| | - Nabil Daoud
- American Thrombosis Hemostasis Network, Rochester, New York, USA
| | - Brian Hu
- American Thrombosis Hemostasis Network, Rochester, New York, USA
| | - Matthew Manuel
- American Thrombosis Hemostasis Network, Rochester, New York, USA
| | - Jarren Santos
- American Thrombosis Hemostasis Network, Rochester, New York, USA
| | | | | | - Peter Kouides
- Mary M. Gooley Hemophilia Center, Rochester, New York, USA
| | - Philip Kuriakose
- Henry Ford Health System Bleeding and Thrombosis Center, Detroit, Michigan, USA
| | - Andrew D Leavitt
- San Francisco Hemophilia Treatment Center, University of California, San Francisco, California, USA
| | - Ming Y Lim
- Utah Center for Bleeding and Clotting Disorders, Salt Lake City, Utah, USA
| | - Nicoletta Machin
- Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh Medical Center, and Hemophilia Center of Western PA, Pittsburgh, Pennsylvania, USA
| | - Michael Recht
- American Thrombosis Hemostasis Network, Rochester, New York, USA
- Yale University Medical Center, New Haven, Connecticut, USA
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Venneti S, Kawakibi AR, Ji S, Waszak SM, Sweha SR, Mota M, Pun M, Deogharkar A, Chung C, Tarapore RS, Ramage S, Chi A, Wen PY, Arrillaga-Romany I, Batchelor TT, Butowski NA, Sumrall A, Shonka N, Harrison RA, de Groot J, Mehta M, Hall MD, Daghistani D, Cloughesy TF, Ellingson BM, Beccaria K, Varlet P, Kim MM, Umemura Y, Garton H, Franson A, Schwartz J, Jain R, Kachman M, Baum H, Burant CF, Mottl SL, Cartaxo RT, John V, Messinger D, Qin T, Peterson E, Sajjakulnukit P, Ravi K, Waugh A, Walling D, Ding Y, Xia Z, Schwendeman A, Hawes D, Yang F, Judkins AR, Wahl D, Lyssiotis CA, de la Nava D, Alonso MM, Eze A, Spitzer J, Schmidt SV, Duchatel RJ, Dun MD, Cain JE, Jiang L, Stopka SA, Baquer G, Regan MS, Filbin MG, Agar NY, Zhao L, Kumar-Sinha C, Mody R, Chinnaiyan A, Kurokawa R, Pratt D, Yadav VN, Grill J, Kline C, Mueller S, Resnick A, Nazarian J, Allen JE, Odia Y, Gardner SL, Koschmann C. Clinical Efficacy of ONC201 in H3K27M-Mutant Diffuse Midline Gliomas Is Driven by Disruption of Integrated Metabolic and Epigenetic Pathways. Cancer Discov 2023; 13:2370-2393. [PMID: 37584601 PMCID: PMC10618742 DOI: 10.1158/2159-8290.cd-23-0131] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/30/2023] [Accepted: 08/10/2023] [Indexed: 08/17/2023]
Abstract
Patients with H3K27M-mutant diffuse midline glioma (DMG) have no proven effective therapies. ONC201 has recently demonstrated efficacy in these patients, but the mechanism behind this finding remains unknown. We assessed clinical outcomes, tumor sequencing, and tissue/cerebrospinal fluid (CSF) correlate samples from patients treated in two completed multisite clinical studies. Patients treated with ONC201 following initial radiation but prior to recurrence demonstrated a median overall survival of 21.7 months, whereas those treated after recurrence had a median overall survival of 9.3 months. Radiographic response was associated with increased expression of key tricarboxylic acid cycle-related genes in baseline tumor sequencing. ONC201 treatment increased 2-hydroxyglutarate levels in cultured H3K27M-DMG cells and patient CSF samples. This corresponded with increases in repressive H3K27me3 in vitro and in human tumors accompanied by epigenetic downregulation of cell cycle regulation and neuroglial differentiation genes. Overall, ONC201 demonstrates efficacy in H3K27M-DMG by disrupting integrated metabolic and epigenetic pathways and reversing pathognomonic H3K27me3 reduction. SIGNIFICANCE The clinical, radiographic, and molecular analyses included in this study demonstrate the efficacy of ONC201 in H3K27M-mutant DMG and support ONC201 as the first monotherapy to improve outcomes in H3K27M-mutant DMG beyond radiation. Mechanistically, ONC201 disrupts integrated metabolic and epigenetic pathways and reverses pathognomonic H3K27me3 reduction. This article is featured in Selected Articles from This Issue, p. 2293.
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Affiliation(s)
| | | | - Sunjong Ji
- University of Michigan, Ann Arbor, Michigan
| | - Sebastian M. Waszak
- University of California, San Francisco, San Francisco, California
- Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo and Oslo University Hospital, Oslo, Norway
- Laboratory of Computational Neuro-Oncology, Swiss Institute for Experimental Cancer Research, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Stefan R. Sweha
- University of Michigan, Ann Arbor, Michigan
- Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | | | | | - Chan Chung
- University of Michigan, Ann Arbor, Michigan
- Department of New Biology, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Republic of Korea
| | | | | | | | - Patrick Y. Wen
- Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts
| | | | | | | | | | | | | | - John de Groot
- University of California, San Francisco, San Francisco, California
| | | | | | | | | | | | - Kevin Beccaria
- Department of Neurosurgery, Necker Sick Children's University Hospital and Paris Descartes University, Paris, France
| | - Pascale Varlet
- Department of Neuropathology, Sainte-Anne Hospital and Paris Descartes University, Paris, France
| | | | | | | | | | | | | | | | - Heidi Baum
- University of Michigan, Ann Arbor, Michigan
| | | | - Sophie L. Mottl
- Centre for Molecular Medicine Norway (NCMM), Nordic EMBL Partnership, University of Oslo and Oslo University Hospital, Oslo, Norway
| | | | | | | | | | | | | | | | | | | | - Yujie Ding
- University of Michigan, Ann Arbor, Michigan
| | - Ziyun Xia
- University of Michigan, Ann Arbor, Michigan
| | | | - Debra Hawes
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Fusheng Yang
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Alexander R. Judkins
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California
| | | | | | - Daniel de la Nava
- Health Research Institute of Navarra (IdiSNA), Pamplona, Spain
- Solid Tumor Program, Cima Universidad de Navarra, Pamplona, Spain
- Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain
| | - Marta M. Alonso
- Health Research Institute of Navarra (IdiSNA), Pamplona, Spain
- Solid Tumor Program, Cima Universidad de Navarra, Pamplona, Spain
- Department of Pediatrics, Clínica Universidad de Navarra, Pamplona, Spain
| | - Augustine Eze
- Center for Genetic Medicine Research, Children's National Hospital, Washington, DC
| | - Jasper Spitzer
- Institute of Innate Immunity, AG Immunogenomics, University Hospital Bonn, Bonn, Germany
- Institute of Clinical Chemistry and Clinical Pharmacology, AG Immunmonitoring and Genomics, University Hospital Bonn, Bonn, Germany
| | - Susanne V. Schmidt
- Institute of Innate Immunity, AG Immunogenomics, University Hospital Bonn, Bonn, Germany
- Institute of Clinical Chemistry and Clinical Pharmacology, AG Immunmonitoring and Genomics, University Hospital Bonn, Bonn, Germany
| | - Ryan J. Duchatel
- Cancer Signalling Research Group, School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Precision Medicine Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Paediatric Program, Mark Hughes Foundation Centre for Brain Cancer Research, College of Health, Medicine, and Wellbeing, Callaghan, NSW, Australia
| | - Matthew D. Dun
- Cancer Signalling Research Group, School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
- Precision Medicine Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Paediatric Program, Mark Hughes Foundation Centre for Brain Cancer Research, College of Health, Medicine, and Wellbeing, Callaghan, NSW, Australia
| | - Jason E. Cain
- Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Molecular and Translational Sciences, Monash University, Clayton, VIC, Australia
| | - Li Jiang
- Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorder Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Sylwia A. Stopka
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gerard Baquer
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael S. Regan
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mariella G. Filbin
- Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorder Center, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Nathalie Y.R. Agar
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Lili Zhao
- University of Michigan, Ann Arbor, Michigan
| | | | - Rajen Mody
- University of Michigan, Ann Arbor, Michigan
| | | | - Ryo Kurokawa
- University of Michigan, Ann Arbor, Michigan
- The University of Tokyo, Tokyo, Japan
| | - Drew Pratt
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Viveka N. Yadav
- Department of Pediatrics at Children's Mercy Research Institute, Kansas City, Missouri
| | - Jacques Grill
- Department of Pediatric and Adolescent Oncology and INSERM Unit 981, Gustave Roussy and University Paris-Saclay, Villejuif, France
| | - Cassie Kline
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sabine Mueller
- University of California, San Francisco, San Francisco, California
- Department of Oncology, Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Adam Resnick
- Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Javad Nazarian
- Department of Pediatrics, Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
- Research Center for Genetic Medicine, Children's National Hospital, Washington, DC
- George Washington University School of Medicine and Health Sciences, Washington, DC
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Cardenas MC, Hamel B, Weckwerth J, Potter D, Bofill-Garcia AM, Schwartz J, Hassan S, Gonzalez M, Storm AC. An Unusual Presentation of Pediatric Gastrointestinal Stromal Tumor. J Pediatr Gastroenterol Nutr 2023; 77:e69. [PMID: 37434284 DOI: 10.1097/mpg.0000000000003888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Affiliation(s)
- Maria Camila Cardenas
- From the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Benjamin Hamel
- From the Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Jody Weckwerth
- the Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Dean Potter
- the Division of Pediatric Surgery, Department of Surgery, Mayo Clinic, Rochester, MN
| | | | - Jonathan Schwartz
- the Division of Pediatric Hematology Oncology, Mayo Clinic, Rochester, MN
| | - Sara Hassan
- the Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Michelle Gonzalez
- the Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
| | - Andrew C Storm
- the Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN
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10
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Millsaps W, Schwartz J, Di ZW, Jiang Y, Hovden R. Autonomous Electron Tomography Reconstruction with Machine Learning. Microsc Microanal 2023; 29:1650-1657. [PMID: 37639314 DOI: 10.1093/micmic/ozad083] [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] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/15/2023] [Accepted: 07/29/2023] [Indexed: 08/29/2023]
Abstract
Modern electron tomography has progressed to higher resolution at lower doses by leveraging compressed sensing (CS) methods that minimize total variation (TV). However, these sparsity-emphasized reconstruction algorithms introduce tunable parameters that greatly influence the reconstruction quality. Here, Pareto front analysis shows that high-quality tomograms are reproducibly achieved when TV minimization is heavily weighted. However, in excess, CS tomography creates overly smoothed three-dimensional (3D) reconstructions. Adding momentum to the gradient descent during reconstruction reduces the risk of over-smoothing and better ensures that CS is well behaved. For simulated data, the tedious process of tomography parameter selection is efficiently solved using Bayesian optimization with Gaussian processes. In combination, Bayesian optimization with momentum-based CS greatly reduces the required compute time-an 80% reduction was observed for the 3D reconstruction of SrTiO3 nanocubes. Automated parameter selection is necessary for large-scale tomographic simulations that enable the 3D characterization of a wider range of inorganic and biological materials.
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Affiliation(s)
- William Millsaps
- Department of Nuclear Engineering & Radiological Sciences, University of Michigan, 2300 Hayward St, Ann Arbor, MI 48109, USA
| | - Jonathan Schwartz
- Department of Materials Science and Engineering, University of Michigan, 2300 Hayward St, Ann Arbor, MI 48109, USA
| | - Zichao Wendy Di
- Mathematics and Computer Science Division, Argonne National Laboratory, 9700 S. Cass Ave, Lemont, IL 60439, USA
| | - Yi Jiang
- Advanced Photon Source Facility, Argonne National Laboratory, 9700 S. Cass Ave, Lemont, IL 60439, USA
| | - Robert Hovden
- Department of Materials Science and Engineering, University of Michigan, 2300 Hayward St, Ann Arbor, MI 48109, USA
- Applied Physics Program, University of Michigan, 2300 Hayward St, Ann Arbor, MI 48109, USA
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11
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Nizar R, Cazacu S, Xiang C, Krasner M, Barbiro-Michaely E, Gerber D, Schwartz J, Fried I, Yuval S, Brodie A, Kazimirsky G, Amos N, Unger R, Brown S, Rogers L, Penning DH, Brodie C. Propofol Inhibits Glioma Stem Cell Growth and Migration and Their Interaction with Microglia via BDNF-AS and Extracellular Vesicles. Cells 2023; 12:1921. [PMID: 37566001 PMCID: PMC10417602 DOI: 10.3390/cells12151921] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 04/24/2023] [Revised: 07/10/2023] [Accepted: 07/15/2023] [Indexed: 08/12/2023] Open
Abstract
Glioblastoma (GBM) is the most common and aggressive primary brain tumor. GBM contains a small subpopulation of glioma stem cells (GSCs) that are implicated in treatment resistance, tumor infiltration, and recurrence, and are thereby considered important therapeutic targets. Recent clinical studies have suggested that the choice of general anesthetic (GA), particularly propofol, during tumor resection, affects subsequent tumor response to treatments and patient prognosis. In this study, we investigated the molecular mechanisms underlying propofol's anti-tumor effects on GSCs and their interaction with microglia cells. Propofol exerted a dose-dependent inhibitory effect on the self-renewal, expression of mesenchymal markers, and migration of GSCs and sensitized them to both temozolomide (TMZ) and radiation. At higher concentrations, propofol induced a large degree of cell death, as demonstrated using microfluid chip technology. Propofol increased the expression of the lncRNA BDNF-AS, which acts as a tumor suppressor in GBM, and silencing of this lncRNA partially abrogated propofol's effects. Propofol also inhibited the pro-tumorigenic GSC-microglia crosstalk via extracellular vesicles (EVs) and delivery of BDNF-AS. In conclusion, propofol exerted anti-tumor effects on GSCs, sensitized these cells to radiation and TMZ, and inhibited their pro-tumorigenic interactions with microglia via transfer of BDNF-AS by EVs.
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Affiliation(s)
- Rephael Nizar
- The Mina and Everard Goodman Faculty of Life Sciences, Institute of Nanotechnology and Advanced Materials (BINA), Bar-Ilan University, Ramat-Gan 52900, Israel; (R.N.); (M.K.); (E.B.-M.); (D.G.); (J.S.); (G.K.); (N.A.); (R.U.)
| | - Simona Cazacu
- Davidson Laboratory of Cell Signaling and Tumorigenesis, Hermelin Brain Tumor Center, Department of Neurosurgery, Henry Ford Health, Detroit, MI 48202, USA; (S.C.); (C.X.); (D.H.P.)
| | - Cunli Xiang
- Davidson Laboratory of Cell Signaling and Tumorigenesis, Hermelin Brain Tumor Center, Department of Neurosurgery, Henry Ford Health, Detroit, MI 48202, USA; (S.C.); (C.X.); (D.H.P.)
| | - Matan Krasner
- The Mina and Everard Goodman Faculty of Life Sciences, Institute of Nanotechnology and Advanced Materials (BINA), Bar-Ilan University, Ramat-Gan 52900, Israel; (R.N.); (M.K.); (E.B.-M.); (D.G.); (J.S.); (G.K.); (N.A.); (R.U.)
| | - Efrat Barbiro-Michaely
- The Mina and Everard Goodman Faculty of Life Sciences, Institute of Nanotechnology and Advanced Materials (BINA), Bar-Ilan University, Ramat-Gan 52900, Israel; (R.N.); (M.K.); (E.B.-M.); (D.G.); (J.S.); (G.K.); (N.A.); (R.U.)
| | - Doron Gerber
- The Mina and Everard Goodman Faculty of Life Sciences, Institute of Nanotechnology and Advanced Materials (BINA), Bar-Ilan University, Ramat-Gan 52900, Israel; (R.N.); (M.K.); (E.B.-M.); (D.G.); (J.S.); (G.K.); (N.A.); (R.U.)
| | - Jonathan Schwartz
- The Mina and Everard Goodman Faculty of Life Sciences, Institute of Nanotechnology and Advanced Materials (BINA), Bar-Ilan University, Ramat-Gan 52900, Israel; (R.N.); (M.K.); (E.B.-M.); (D.G.); (J.S.); (G.K.); (N.A.); (R.U.)
| | - Iris Fried
- Pediatric Hematology Oncology Unit, Shaare Zedek Hospital, Jerusalem 9103102, Israel; (I.F.); (S.Y.)
| | - Shira Yuval
- Pediatric Hematology Oncology Unit, Shaare Zedek Hospital, Jerusalem 9103102, Israel; (I.F.); (S.Y.)
| | | | - Gila Kazimirsky
- The Mina and Everard Goodman Faculty of Life Sciences, Institute of Nanotechnology and Advanced Materials (BINA), Bar-Ilan University, Ramat-Gan 52900, Israel; (R.N.); (M.K.); (E.B.-M.); (D.G.); (J.S.); (G.K.); (N.A.); (R.U.)
| | - Naama Amos
- The Mina and Everard Goodman Faculty of Life Sciences, Institute of Nanotechnology and Advanced Materials (BINA), Bar-Ilan University, Ramat-Gan 52900, Israel; (R.N.); (M.K.); (E.B.-M.); (D.G.); (J.S.); (G.K.); (N.A.); (R.U.)
| | - Ron Unger
- The Mina and Everard Goodman Faculty of Life Sciences, Institute of Nanotechnology and Advanced Materials (BINA), Bar-Ilan University, Ramat-Gan 52900, Israel; (R.N.); (M.K.); (E.B.-M.); (D.G.); (J.S.); (G.K.); (N.A.); (R.U.)
| | - Stephen Brown
- Radiation Oncology, Henry Ford Health, Detroit, MI 48202, USA;
| | - Lisa Rogers
- Department of Neurosurgery, Henry Ford Health, Detroit, MI 48202, USA;
| | - Donald H. Penning
- Davidson Laboratory of Cell Signaling and Tumorigenesis, Hermelin Brain Tumor Center, Department of Neurosurgery, Henry Ford Health, Detroit, MI 48202, USA; (S.C.); (C.X.); (D.H.P.)
- Anesthesiology, Pain Management & Perioperative Medicine, Henry Ford Health, Detroit, MI 48202, USA
| | - Chaya Brodie
- The Mina and Everard Goodman Faculty of Life Sciences, Institute of Nanotechnology and Advanced Materials (BINA), Bar-Ilan University, Ramat-Gan 52900, Israel; (R.N.); (M.K.); (E.B.-M.); (D.G.); (J.S.); (G.K.); (N.A.); (R.U.)
- Davidson Laboratory of Cell Signaling and Tumorigenesis, Hermelin Brain Tumor Center, Department of Neurosurgery, Henry Ford Health, Detroit, MI 48202, USA; (S.C.); (C.X.); (D.H.P.)
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12
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Schwartz J, Di ZW, Jiang Y, Cho MG, Qian Y, Gu J, Rozeveld S, Ercius P, Fessler JA, Xu T, Scott M, Hovden R. Measuring 3D Chemistry at 1 nm Resolution with Fused Multi-Modal Electron Tomography. Microsc Microanal 2023; 29:1394-1395. [PMID: 37613713 DOI: 10.1093/micmic/ozad067.717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Affiliation(s)
- Jonathan Schwartz
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Zichao Wendy Di
- Mathematics and Computer Science Division, Argonne National Laboratory, Lemont, IL, United States
| | - Yi Jiang
- Advanced Photon Source, Argonne National Laboratory, Lemont, IL, United States
| | - Min Gee Cho
- Department of Materials Science and Engineering, University of California at Berkeley, Berkeley, CA, United States
- National Center for Electron Microscopy, Lawrence Berkeley National Laboratory, Berkeley, CA, United States
| | - Yiwen Qian
- Department of Materials Science and Engineering, University of California at Berkeley, Berkeley, CA, United States
| | - Junsi Gu
- Dow Chemical Co., Midland, MI, United States
| | | | - Peter Ercius
- National Center for Electron Microscopy, Lawrence Berkeley National Laboratory, Berkeley, CA, United States
| | - Jeffrey A Fessler
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, United States
| | - Ting Xu
- Department of Materials Science and Engineering, University of California at Berkeley, Berkeley, CA, United States
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, CA, United States
| | - Mary Scott
- Department of Materials Science and Engineering, University of California at Berkeley, Berkeley, CA, United States
- National Center for Electron Microscopy, Lawrence Berkeley National Laboratory, Berkeley, CA, United States
| | - Robert Hovden
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, United States
- Applied Physics Program, University of Michigan, Ann Arbor, MI, United States
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13
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Manassa J, Schwartz J, Jiang Y, Zheng H, Fessler JA, Wendy Di Z, Hovden R. Dose Requirements for Fused Multi-Modal Electron Tomography. Microsc Microanal 2023; 29:1968-1969. [PMID: 37612919 DOI: 10.1093/micmic/ozad067.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Affiliation(s)
- Jason Manassa
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Jonathan Schwartz
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Yi Jiang
- Advanced Photon Source Facility, Argonne National Laboratory, Lemont, IL, United States
| | - Huihuo Zheng
- Argonne Leadership Computing Facility, Argonne National Laboratory, Lemont, IL, United States
| | - Jeffrey A Fessler
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, United States
| | - Zichao Wendy Di
- Mathematics and Computer Science Division, Argonne National Laboratory, Lemont, IL, United States
| | - Robert Hovden
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, United States
- Applied Physics Program, University of Michigan, Ann Arbor, MI, United States
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14
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Kumar P, Xu W, Schwartz J, Hovden R, Kotov N. Hierarchically Assembled Bowtie-Shaped Hybrid Metamaterials with a Chirality Continuum. Microsc Microanal 2023; 29:1243-1245. [PMID: 37613677 DOI: 10.1093/micmic/ozad067.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Affiliation(s)
- Prashant Kumar
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, United States
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States
| | - Wenqian Xu
- X-ray Science Division, Advanced Photon Source, Argonne National Laboratory, Lemont, IL, United States
| | - Jonathan Schwartz
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Robert Hovden
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Nicholas Kotov
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, United States
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States
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15
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Agarwal N, Sung SH, Schwartz J, Schnitzer N, Xi Z, Hung J, Baggari IE, Kourkoutis LF, Qi L, Van der Ven A, Hovden R. Native Intercalant Order in TaS2 Achieved Through in situ Thermal Heating. Microsc Microanal 2023; 29:1583-1584. [PMID: 37613854 DOI: 10.1093/micmic/ozad067.814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Affiliation(s)
- Nishkarsh Agarwal
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Suk Hyun Sung
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Jonathan Schwartz
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Noah Schnitzer
- Department of Materials Science and Engineering, Cornell University, Ithaca, New York, USA
| | - Zhucong Xi
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Juihung Hung
- Materials Department and Materials Research Laboratory, U.C. Santa Barbara, California, USA
| | | | - Lena F Kourkoutis
- Kavli Institute at Cornell, Cornell University, Ithaca, New York, USA
- School of Applied and Engineering Physics, Cornell University, Ithaca, New York, USA
| | - Liang Qi
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Anton Van der Ven
- Materials Department and Materials Research Laboratory, U.C. Santa Barbara, California, USA
| | - Robert Hovden
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, Michigan, USA
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16
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Millsaps W, Schwartz J, Di ZW, Jiang Y, Hovden R. Autonomous Electron Tomography Reconstruction Using Bayesian Optimization. Microsc Microanal 2023; 29:1915-1916. [PMID: 37612960 DOI: 10.1093/micmic/ozad067.989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Affiliation(s)
- William Millsaps
- Department of Nuclear Engineering Radiological Sciences, University of Michigan, Ann Arbor, MI, United States
| | - Jonathan Schwartz
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Zichao Wendy Di
- Mathematics and Computer Science Division, Argonne National Laboratory, Lemont, IL, United States
| | - Yi Jiang
- Advanced Photon Source Facility, Argonne National Laboratory, Lemont, IL, United States
| | - Robert Hovden
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, United States
- Applied Physics Program, University of Michigan, Ann Arbor, MI, United States
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17
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Zywiciel J, Thomas A, Verm R, Schwartz J, Mangukia C. Indication for CABG Preceding Lung Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1043] [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: 04/05/2023] Open
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18
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Hibbert B, Zahr F, Simard T, Labinaz M, Nazer B, Sorajja P, Eckman P, Pineda AM, Missov E, Mahmud E, Schwartz J, Gupta B, Wiley M, Sauer A, Jorde U, Latib A, Kahwash R, Lilly S, Chang L, Gafoor S, Chaudhry SP, Hermiller J, Aldaia L, Koulogiannis K, Gray WA. Left Atrial to Coronary Sinus Shunting for Treatment of Symptomatic Heart Failure. JACC Cardiovasc Interv 2023:S1936-8798(23)00571-X. [PMID: 36989271 DOI: 10.1016/j.jcin.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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Heart failure (HF) is associated with both mortality and a significant decline in health status. Inter-atrial shunting is increasingly being investigated as a novel therapeutic option. OBJECTIVES The ALT FLOW Early Feasibility Study was designed to evaluate the safety of the Edwards left atrial to coronary sinus APTURETM Transcatheter Shunt System in patients with symptomatic HF. METHODS 18 centers enrolled patients with symptomatic HF with a pulmonary capillary wedge pressure (PCWP) >15mmHg at rest or 25mmHg during exercise. RESULTS Between May 2018 and September 2022, 87 patients underwent attempted APTURETM shunt implantation. Mean age was 71 years, and 53% were male. At baseline mean LVEF was 59% with 90% of the patients being NYHA III. Device success was achieved in 78 (90%) of patients with no device occlusions or associated adverse events identified after implantation. The primary safety outcome occurred in only 2 (2.3%) patients at 30 days. At 6 months health status improved: 68% of participants achieved NYHA I-II status, with a 23-point improvement (p<0.0001, 95% CI [17, 29]) in the Kansas City Cardiomyopathy Questionnaire overall summary score. Also at 6 months, 20-watt exercise pulmonary capillary wedge pressure was -7mmHg lower (p<0.0001, 95% CI [-11, -4]) without change in right atrial pressure or other right heart function indices. CONCLUSIONS In this single-arm experience, the APTURETM Transcatheter Shunt System in patients with symptomatic HF was observed to be safe and resulted in reduction in PCWP and clinically meaningful improvements in HF symptoms and quality of life indices.
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Affiliation(s)
- Benjamin Hibbert
- CAPITAL Research, Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Firas Zahr
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon
| | - Trevor Simard
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Marino Labinaz
- CAPITAL Research, Department of Medicine, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada
| | - Babak Nazer
- Division of Cardiology, University of Washington, Seattle, Washington
| | - Paul Sorajja
- Department of Cardiology, Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Peter Eckman
- Department of Cardiology, Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Andres M Pineda
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida
| | - Emil Missov
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida
| | - Ehtisham Mahmud
- Division of Cardiovascular Medicine, University of California San Diego, San Diego, California
| | - Jonathan Schwartz
- Sanger Heart & Vascular Institute, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina
| | - Bhanu Gupta
- Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Mark Wiley
- Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Andrew Sauer
- Saint Luke's Mid America Heart Institute, Kansas City, Missouri
| | - Ulrich Jorde
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, New York
| | - Azeem Latib
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, New York
| | - Rami Kahwash
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio
| | - Scott Lilly
- Division of Cardiovascular Medicine, The Ohio State University, Columbus, Ohio
| | - Lee Chang
- Swedish Heart and Vascular, Seattle, Washington
| | - Sameer Gafoor
- Swedish Heart and Vascular, Seattle, Washington; Cardiovascular Center Frankfurt, Frankfurt, Germany
| | - Sunit-Preet Chaudhry
- Department of Cardiology, Ascension St Vincent Heart Center of Indiana, Indianapolis, Indiana
| | - James Hermiller
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey
| | - Lillian Aldaia
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey
| | - Konstantinos Koulogiannis
- Department of Cardiovascular Medicine, Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown, New Jersey
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Ross L, Ohrenstein O, Rama-Krishnan A, Rinaldi MJ, Skipper E, Hill T, Schwartz J, Frederick JR, Shah C, Downey WE. EQUITY OPPORTUNITIES IN THE SEVERE AORTIC STENOSIS CARE PATHWAY. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)02445-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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20
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Kumar P, Vo T, Cha M, Visheratina A, Kim JY, Xu W, Schwartz J, Simon A, Katz D, Nicu VP, Marino E, Choi WJ, Veksler M, Chen S, Murray C, Hovden R, Glotzer S, Kotov NA. Photonically active bowtie nanoassemblies with chirality continuum. Nature 2023; 615:418-424. [PMID: 36922612 DOI: 10.1038/s41586-023-05733-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 01/16/2023] [Indexed: 03/17/2023]
Abstract
Chirality is a geometrical property described by continuous mathematical functions1-5. However, in chemical disciplines, chirality is often treated as a binary left or right characteristic of molecules rather than a continuity of chiral shapes. Although they are theoretically possible, a family of stable chemical structures with similar shapes and progressively tuneable chirality is yet unknown. Here we show that nanostructured microparticles with an anisotropic bowtie shape display chirality continuum and can be made with widely tuneable twist angle, pitch, width, thickness and length. The self-limited assembly of the bowties enables high synthetic reproducibility, size monodispersity and computational predictability of their geometries for different assembly conditions6. The bowtie nanoassemblies show several strong circular dichroism peaks originating from absorptive and scattering phenomena. Unlike classical chiral molecules, these particles show a continuum of chirality measures2 that correlate exponentially with the spectral positions of the circular dichroism peaks. Bowtie particles with variable polarization rotation were used to print photonically active metasurfaces with spectrally tuneable positive or negative polarization signatures for light detection and ranging (LIDAR) devices.
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Affiliation(s)
- Prashant Kumar
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - Thi Vo
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - Minjeong Cha
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - Anastasia Visheratina
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - Ji-Young Kim
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - Wenqian Xu
- X-ray Science Division, Advanced Photon Source, Argonne National Laboratory, Lemont, IL, USA
| | - Jonathan Schwartz
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Alexander Simon
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Katz
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
| | | | - Emanuele Marino
- Department of Chemistry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Physics and Chemistry, University of Palermo, Palermo, Italy
| | - Won Jin Choi
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA
| | - Michael Veksler
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Si Chen
- X-ray Science Division, Advanced Photon Source, Argonne National Laboratory, Lemont, IL, USA
| | - Christopher Murray
- Department of Chemistry, University of Pennsylvania, Philadelphia, PA, USA
| | - Robert Hovden
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Sharon Glotzer
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA.
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA.
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA.
| | - Nicholas A Kotov
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI, USA.
- Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA.
- Department of Materials Science and Engineering, University of Michigan, Ann Arbor, MI, USA.
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21
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Czechowicz A, Sevilla J, Booth C, Agarwal R, Zubicaray J, Río P, Navarro S, Chetty K, O’Toole G, Xu-Bayford J, Ancliff P, Sebastián E, Choi G, Zeini M, Nicoletti E, Wagner JE, Rao G, Thrasher AJ, Schwartz J, Roncarolo MG, Bueren J. Lentiviral-Mediated Gene Therapy for Patients with Fanconi Anemia [Group A]: Updated Results from Global RP-L102 Clinical Trials. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00182-3] [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: 02/07/2023]
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22
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Rabinowitz Y, Ravona-Springer R, Heymann A, Moshier E, Berman Y, Schwartz J, Sano M, Aisenberg D, Schnaider-Beeri M. Physical Activity Is Associated with Slower Cognitive Decline in Older Adults with Type 2 Diabetes. J Prev Alzheimers Dis 2023; 10:497-502. [PMID: 37357290 DOI: 10.14283/jpad.2023.26] [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: 12/25/2023]
Abstract
BACKGROUND Physical activity is associated with slower cognitive decline in old age. Type 2 diabetes (T2d) is a risk factor for dementia and cognitive decline. Physical activity protects against several T2d complications. Yet, little is known about the contribution of physical activity to cognitive health among the elderly with T2d. OBJECTIVES To examine the association between physical activity and cognitive decline in older adults with T2d. DESIGN This is a prospective longitudinal study using data from the Israel Diabetes and Cognitive Decline (IDCD) study. SETTING ICDC study (N=1,213), is a population-based cohort of adults over the age of 65, diagnosed with type 2 diabetes, who were cognitively normal at baseline and followed up every 18 months. PARTICIPANTS Participants with at least one follow-up assessment who were in the same physical activity group consistently and had complete demographic data. MEASUREMENTS Physical activity was measured using Minnesota Leisure Time Activity Questionnaire, cognitive functioning was measured using a broad neuropsychological assessment measuring Executive Functioning, Attention/Working Memory, Semantic Categorization and Episodic Memory. RESULTS Participants were classified into physical activity groups based on self-reported physical activity at baseline and all follow ups: "active" - participation in recreational physical activity (n=286); "non-active"- the only physical activity was walking from place to place (n=93) and "sedentary" (n=19). Linear mixed effects models were applied to adjust for key demographic and cardiovascular risk factors. Participants were 72.4 (SD 4.6) years old, had 13.3 (SD 3.6) years of education, and 163 (41%) were female. In the fully adjusted model, compared to the non-active group the active group had significantly slower rate of decline in Global Cognition (p=0.005), Executive Functioning (p=.014), and Attention/Working Memory (p=.01). There were no significant group differences for Semantic Categorization (p=.17) and Episodic Memory (p=.88). CONCLUSIONS Among initially cognitively normal and independent older adults with T2d, a physically active lifestyle was associated with a slower rate of cognitive decline. Future research should examine whether promoting physical activity may prevent or delay onset of dementia in this high-risk population.
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Affiliation(s)
- Y Rabinowitz
- Yaacov Rabinowitz, Israel, Akiva 22, Ra'anana, Israel, 972-54-5421240, , ORCID ID: https://orcid.org/0000-0003-2642-7304
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23
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Mohamad J, Sarig O, Beattie P, Malovitski K, Assaf S, O’Toole E, Schwartz J, Evans H, Samuelov L, Sprecher E. 261 A novel skin phenotype resulting from heterozygous deletion of six keratin genes. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.273] [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: 11/19/2022]
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24
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Kawakibi AR, Tarapore R, Gardner S, Chi A, Kurz S, Wen PY, Arrillaga-Romany I, Batchelor T, Butowski N, Sumrall A, Shonka N, Harrison R, DeGroot J, Mehta M, Odia Y, Hall M, Daghistani D, Cloughesy T, Ellingson B, Kim M, Umemura Y, Garton H, Franson A, Schwartz J, Li S, Cartaxo R, Ravi K, Cantor E, Cummings J, Paul A, Walling D, Dun M, Cain J, Li J, Filbin M, Zhao L, Kumar-Sinha C, Mody R, Chinnaiyan A, Kurokawa R, Pratt D, Venneti S, Grill J, Kline C, Mueller S, Resnick AC, Nazarian J, Waszak S, Allen JE, Koschmann C. CTNI-61. CLINICAL EFFICACY AND PREDICTIVE BIOMARKERS OF ONC201 IN H3K27M-MUTANT DIFFUSE MIDLINE GLIOMA. Neuro Oncol 2022. [PMCID: PMC9660897 DOI: 10.1093/neuonc/noac209.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Patients with H3K27M-mutated diffuse midline glioma (DMG) have no proven effective therapies beyond radiation. ONC201, a DRD2 antagonist and mitochondrial ClpP agonist, has shown promise in this population. Clinical and genetic variables associated with ONC201 response in H3K27M-mutant DMG continue to be investigated. A combined clinical and genetic study evaluated patients with H3K27M-DMG treated with single-agent ONC201 at the established phase 2 dose. Clinical outcomes of patients treated on two recently completed multi-site clinical studies (NCT03416530 and NCT03134131, n = 75) were compared with historical control data from patients with confirmed H3K27M-DMG (n = 391 total, n = 119 recurrent). Patients treated with ONC201 monotherapy following initial radiation, but prior to recurrence, demonstrated a median overall survival (OS) of 25.6 months from diagnosis and recurrent patients demonstrated a median OS of 16.2 months from recurrence, both of these more than doubling historical outcomes. Using a Cox model to correct for age, gender and tumor location, OS of ONC201-treated patients with H3K27M-mutant tumors remained significantly better than non-ONC201-treated historical controls (p = 0.0001). A survival and radiographic analysis based on tumor location, revealed stronger responses in thalamic patients. In patients with thalamic tumors treated after initial radiation (n = 16), median OS was not reached with median follow up of 22.1 months (historical control median OS of 12.5 months, n = 83, p = 0.0001). Significant correlations were found between baseline cerebral blood flow (CBF) on perfusion imaging and OS (Pearson’s r = 0.75, p = 0.003) and between nrCBF and PFS (r = 0.77, p = 0.002). Baseline tumor sequencing from treated patients (n = 20) demonstrates EGFR mutation (n = 3) and high EGFR expression as a marker of resistance and improved response in tumors with MAPK-pathway alterations (n = 5). In conclusion, ONC201 demonstrates unprecedented clinical and radiographic efficacy in H3K27M-mutant DMG with outcomes enriched in patients with thalamic tumors, treatment prior to recurrence, MAPK-pathway alterations, and patients with relatively high CBF.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Nicholas Butowski
- Department of Neurological Surgery, University of California San Francisco , San Francisco, CA , USA
| | - Ashley Sumrall
- Atrium Health Levine Cancer Institute, , Charlotte, NC , USA
| | | | - Rebecca Harrison
- Dept Neuro-Oncology, University of Texas MD Anderson Cancer Center , Houston, TX , USA
| | - John DeGroot
- University of Texas MD Anderson Cancer Center , Houston , USA
| | | | | | - Matthew Hall
- Miami Cancer Institute, Baptist Health South Florida , Miami , USA
| | | | | | | | | | | | | | - Andrea Franson
- C. S. Mott Children's Hospital, University of Michigan , Ann Arbor, MI , USA
| | | | | | | | | | | | | | | | | | - Matthew Dun
- Cancer Signalling Research Group, School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle , Callaghan, NSW , Australia
| | - Jason Cain
- Hudson Institute of Medical Research , Clayton, VIC , Australia
| | - Jiang Li
- Dana-Farber Boston Children’s Cancer and Blood Disorders Center , Boston , USA
| | - Mariella Filbin
- Dana-Farber Boston Children’s Cancer and Blood Disorders Center , Boston , USA
| | | | | | - Rajen Mody
- University of Michigan , Ann Arbor , USA
| | | | | | - Drew Pratt
- Center for Cancer Research, National Cancer Institute , Bethesda , USA
| | | | - Jacques Grill
- Gustave Roussy and University Paris-Saclay , Villejuif , USA
| | - Cassie Kline
- Children's Hospital of Philadelphia , Philadelphia , USA
| | - Sabine Mueller
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco , San Francisco, CA , USA
| | - Adam C Resnick
- Children's Hospital of Philadelphia , Philadelphia , USA
| | - Javad Nazarian
- Department of Oncology, Children’s Research Center, University Children’s Hospital Zurich, Zurich, Switzerland , Zurich , Switzerland
| | | | | | - Carl Koschmann
- Department of Pediatrics, Michigan Medicine , Ann Arbor, MI , USA
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Sanderson H, Bolton S, Schwartz J. PROLONGED BLOOD HYPEREOSINOPHILIA AND EOSINOPHILIC ENTEROCOLITIS FROM PINWORM INFECTION ASSOCIATED WITH IGA AND IGE DEFICIENCY. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.807] [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: 11/11/2022]
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26
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Liu W, Guo X, Schwartz J, Xie H, Dhale NU, Sung SH, Kondusamy ALN, Wang X, Zhao H, Berman D, Hovden R, Zhao L, Lv B. A Three-Stage Magnetic Phase Transition Revealed in Ultrahigh-Quality van der Waals Bulk Magnet CrSBr. ACS Nano 2022; 16:15917-15926. [PMID: 36149801 DOI: 10.1021/acsnano.2c02896] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
van der Waals (vdW) magnets are receiving ever-growing attention nowadays due to their significance in both fundamental research on low-dimensional magnetism and potential applications in spintronic devices. The high crystalline quality of vdW magnets is the key to maintaining intrinsic magnetic and electronic properties, especially when exfoliated down to the two-dimensional limit. Here, ultrahigh-quality air-stable vdW CrSBr crystals are synthesized using the direct solid-vapor synthesis method. The high single crystallinity and spatial homogeneity have been thoroughly evidenced at length scales from submm to atomic resolution by X-ray diffraction, second harmonic generation, and scanning transmission electron microscopy. More importantly, specific heat measurements of ultrahigh-quality CrSBr crystals show three thermodynamic anomalies at 185, 156, and 132 K, revealing a stage-by-stage development of the magnetic order upon cooling, which is also corroborated with the magnetization and transport results. Our ultrahigh-quality CrSBr can further be exfoliated down to monolayers and bilayers easily, providing the building blocks of heterostructures for spintronic and magneto-optoelectronic applications.
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Affiliation(s)
- Wenhao Liu
- Department of Physics, The University of Texas at Dallas, Richardson, Texas 75080, United States
| | - Xiaoyu Guo
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Jonathan Schwartz
- Department of Material Science and Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Hongchao Xie
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Nikhil Uday Dhale
- Department of Physics, The University of Texas at Dallas, Richardson, Texas 75080, United States
| | - Suk Hyun Sung
- Department of Material Science and Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
| | | | - Xiqu Wang
- Department of Chemistry, University of Houston, Houston, Texas 77004, United States
| | - Haonan Zhao
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Diana Berman
- Department of Materials Science and Engineering, University of North Texas, Denton, Texas 76203, United States
| | - Robert Hovden
- Department of Material Science and Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States
- Applied Physics Program, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Liuyan Zhao
- Department of Physics, University of Michigan, Ann Arbor, Michigan 48109, United States
| | - Bing Lv
- Department of Physics, The University of Texas at Dallas, Richardson, Texas 75080, United States
- Department of Materials Science and Engineering, The University of Texas at Dallas, Richardson, Texas 75080 United States
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27
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Khan RA, Ramachandra N, Bontu S, Mehanni M, Schwartz J, Bakhos M, Tuchek M, Perez-Tamayo RA, Leya F, Lewis B, Lopez JJ, Sanagala T. Tricuspid regurgitation worsening after transcatheter or surgical aortic valve replacement. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2095] [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
Tricuspid regurgitation (TR) often occurs concomitantly with severe aortic stenosis. Post-operative worsening of tricuspid regurgitation has been observed after surgical and transcatheter aortic valve replacement (SAVR, TAVR) [1,2].
Purpose
Pre-procedural severe tricuspid regurgitation has been shown to be a predictor of all-cause mortality in patients undergoing transcatheter aortic valve replacement (TAVR) [3,4]. However, little is known about the incidence of worsening tricuspid regurgitation after SAVR and TAVR and the impact on post-procedural outcomes. This study aims to evaluate, characterize and compare the incidence of worsening TR after TAVR and SAVR.
Methods
Retrospective single-center study of patients undergoing Transcatheter and Surgical Aortic Valve Replacement for severe aortic stenosis between 2014 and 2020. Incidence of tricuspid regurgitation was noted on echocardiogram at baseline and 1 year after TAVR or SAVR. This study enrolled 430 patients in the TAVR group and 237 patients in the SAVR group. The SAVR group only included patients who underwent isolated SAVR without any other valve intervention. Patients with severe TR at baseline were excluded from the study. Progression of TR severity was defined as deterioration by at least 1 grade of severity compared to baseline on echocardiography. Multivariable logistic regression analysis was performed to identify associations with worsening TR.
Results
Mean age of TAVR patients was higher than the SAVR patients (79±9 vs 68±12 years, p<0.0001). TAVR patients also had a significantly higher EuroSCORE than the SAVR patients (8.0±7 vs 3.5±4, p<0.0001). TAVR group was more likely to have atrial fibrillation than the SAVR group (34% vs 24%, p=0.006). Baseline right ventricular dysfunction and right ventricular enlargement were significantly higher in the TAVR group compared to the SAVR group [9% vs 4%, (p=0.009) and 10% vs 6%, (p=0.04), respectively]. Progression of TR severity occurred in 21.8% (94/430) of TAVR patients and 31.2% (74/237) of SAVR patients. Majority of these patients progressed from absent TR to mild TR [13.2% (57) in TAVR group vs 19.8% (47) in SAVR group (p=0.02)]. 6.3% (27) of patients in the TAVR group and 8.8% (21) of patients in the SAVR group had mild to moderate worsening of TR (p=0.22). 1.63% (7) in the TAVR group and 2.1% (5) in the SAVR group had progression from moderate to severe TR (p=0.65). On multivariable analysis, SAVR (Odds ratio, 2.46 [CI, 1.6–3.7]) and age (Odds ratio, 1.03 [CI, 1.03–1.05]) were associated with worsening TR severity.
Conclusions
In this retrospective observational study, SAVR and age were found to be associated with worsening tricuspid regurgitation. Majority of these patients progressed from absent TR to mild TR after SAVR. Further studies are necessary to determine long term outcomes of worsening tricuspid regurgitation after TAVR and SAVR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R A Khan
- Loyola University Medical Center , Chicago , United States of America
| | - N Ramachandra
- Loyola University Medical Center , Chicago , United States of America
| | - S Bontu
- Loyola University Medical Center , Chicago , United States of America
| | - M Mehanni
- Loyola University Medical Center , Chicago , United States of America
| | - J Schwartz
- Loyola University Medical Center , Chicago , United States of America
| | - M Bakhos
- Loyola University Medical Center , Chicago , United States of America
| | - M Tuchek
- Loyola University Medical Center , Chicago , United States of America
| | - R A Perez-Tamayo
- Loyola University Medical Center , Chicago , United States of America
| | - F Leya
- Loyola University Medical Center , Chicago , United States of America
| | - B Lewis
- Loyola University Medical Center , Chicago , United States of America
| | - J J Lopez
- Loyola University Medical Center , Chicago , United States of America
| | - T Sanagala
- Loyola University Medical Center , Chicago , United States of America
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28
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Halimi F, Sabouret P, Huberman JP, Cohen S, Ouazana L, Hoffman O, Assouline S, Guedj-Meynier D, Schwartz J, Weiss P, Lafont C, Lellouche N. Atrial fibrillation diagnosis by a systematic 14-day continuous ECG-Holter in patients with high cardiovascular risk and clinical palpitation: the prospective AFTER study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.404] [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: 11/13/2022] Open
Abstract
Abstract
Background
Atrial Fibrillation (AF) is asymptomatic in 20–30% of cases. New technologic tools for continuous ECG monitoring have been developed to detect and potentially treat AF in specific population with high cardiovascular risk.
Purpose
We aimed to evaluate the prevalence and the management of AF diagnosed in patients with no previous documented AF but with a high cardiovascular risk and clinical palpitation undergoing systematic 14-day continuous ECG-Holter monitoring and associated characteristics.
Methods
Patients were prospectively enrolled from December 2019 to December 2021 in this multicentered study, sponsored by the French National College of Cardiology. Patients needed to meet the following criteria: CHA2DS2VASc score ≥3 in women >2 in men associated with clinical palpitation without previous documented arrhythmia, particularly AF. Exclusion criteria were: previous documented AF, participation to another study that could interfere with the current study, pregnancy, previous skin intolerance to ECG-Holter electrodes. Included patients underwent a 14-day monitoring Holter-ECG to detect cardiac arrhythmia, particularly AF. Patients' characteristics, type of arrythmias and management of detected AF were described.
Results
Among the 336 included patients, 39% were men, median age was 73 [64.5–78] years, 71.5% had hypertension and 46.5% had a previous history of stroke. AF was detected in 14% of patients, among which 23.4% in the first 24 hours monitoring. In univariate analyses, older age (p=0.045) was significantly associated with AF, and a trend was observed regarding male gender (p=0.067) and less antiplatelet therapy (p=0.058). Patients with diagnosed AF had a prescription of anticoagulation therapy in 90% of cases consisting in apixaban and rivaroxaban for 72% and 28% respectively. Antiarrhythmic drugs were administered in 90% of AF patients and 13% underwent AF ablation.
Conclusions
The systematic AF screening of selected patients based on CHA2DS2VASc score ≥3 in women >2 in men associated with palpitations allows to diagnose AF in 14% of the population with a 14-day continuous ECG-Holter. This strategy seems efficient as it induced the prescription of anticoagulation and antiarrhythmic therapy in 90% of individuals.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): NATIONAL COLLEGE OF FRENCH CARDIOLOGISTS
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Affiliation(s)
- F Halimi
- Private Hopital of Parly II, Rythmology , Le Chesnay , France
| | - P Sabouret
- Hospital Pitie-Salpetriere , Paris , France
| | - J P Huberman
- National College of French Cardiologists, Cardiology , Paris , France
| | - S Cohen
- National College of French Cardiologists, Cardiology , Paris , France
| | - L Ouazana
- National College of French Cardiologists, Cardiology , Paris , France
| | - O Hoffman
- National College of French Cardiologists, Cardiology , Paris , France
| | - S Assouline
- National College of French Cardiologists, Cardiology , Paris , France
| | - D Guedj-Meynier
- National College of French Cardiologists, Cardiology , Paris , France
| | - J Schwartz
- National College of French Cardiologists, Cardiology , Paris , France
| | - P Weiss
- National College of French Cardiologists, Cardiology , Paris , France
| | - C Lafont
- University Hospital Henri Mondor, Public Health , Creteil , France
| | - N Lellouche
- University Hospital Henri Mondor, Rythmology Department , Creteil , France
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29
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Rechberger J, Khatua S, Campian J, Sarkaria J, Schwartz J, Daniels D, Schrecengost R. LOCL-07 LOCO-REGIONAL INFUSION OF GB-13 (IL13.E13K-PE4E) AS A POTENTIALLY PROMISING TREATMENT FOR RECURRENT HIGH-GRADE GLIOMA. Neurooncol Adv 2022. [PMCID: PMC9354186 DOI: 10.1093/noajnl/vdac078.049] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION High grade gliomas (HGG) are devastating diseases with largely unchanged survival outcomes despite decades of research. Recent studies suggest the interleukin 13 receptor subunit alpha 2 (IL-13Rα2) is selectively upregulated in up to 80% of HGG, including glioblastoma (GBM) and diffuse midline gliomas (DMG) harboring H3K27 alterations. Immunotoxins targeting IL-13Rα2 have been demonstrated as safe and have shown some benefit for patients with HGG in previous phase I/II and III clinical trials. We hypothesized that by using GB-13 (IL13.E13K-PE4E), a novel peptide-toxin that binds IL-13Rα2 with high specificity and possesses a Pseudomonas exotoxin moiety, we would enhance the anti-tumor effects of this immunotherapy for HGG in vitro and in vivo while decreasing off-target toxicity. METHODS We examined the pharmacological effects of GB-13 in multiple patient-derived cell lines and rodent models of HGG. GBM and DMG lines were used to confirm IL-13Rα2 expression and sensitivity towards GB-13. Tumor naïve rats were evaluated for toxicity, and orthotopic PDX mice were used to monitor tumor size and survival following loco-regional infusion of GB-13. RESULTS GB-13 induced a potent cytotoxic response strongly predicated on IL-13Rα2 expression in vitro. No treatment-related adverse effects were noted after 7-day continuous intracranial infusion of GB-13 in tumor naïve rats. Further, in IL-13Rα2-upregulated orthotopic PDX mice, direct intratumoral administration of GB-13 via convection-enhanced delivery abrogated tumor growth and prolonged survival. CONCLUSIONS Given these promising results as well as the critical need for novel therapies in CNS malignancies, we are progressing to human trials using GB-13 targeting recurrent HGG. Ongoing safety studies in tumor-bearing animals will be able to define dose levels for the initial adult study-arm and the following pediatric study-arm. In this Phase 1 clinical trial, we hypothesize that loco-regional infusion of GB-13 will safely enhance tumor clearance by causing selective killing of IL-13Rα2-upregulated HGG cells.
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Zanwar S, Abeykoon JP, Dasari S, Ravindran A, Young JR, Acosta-Medina AA, Rech KL, Schwartz J, Mangold A, Rosenthal A, Bennani NN, Shah MV, Morlote D, Goyal G, Go RS. Clinical and therapeutic implications of BRAF fusions in histiocytic disorders. Blood Cancer J 2022; 12:97. [PMID: 35764604 PMCID: PMC9240055 DOI: 10.1038/s41408-022-00693-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 11/18/2022] Open
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Shatara M, Abu-Arja MH, MacDonald S, Reiners S, Gorsi H, Govender D, Dholaria H, Nagabushan S, Schwartz J, Foo JC, Rajagopal R, Perkins S, Bartels U, Zaghloul MS, Abdelhaleem NA, El-ayadi M, Abdelbaki MS. GCT-05. Multi-institutional analysis of treatment modalities in metastatic germinoma in children. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac079.199] [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: 11/14/2022] Open
Abstract
Abstract
BACKGROUND: Primary intracranial germ cell tumors (GCTs) are rare heterogeneous tumors, with germinoma accounting for two-thirds of cases. Neoadjuvant chemotherapy with response-based reduced radiotherapy dose and field has become the standard management of localized CNS germinomas, however, treatment of primary metastatic disease has remained controversial. Furthermore, there is limited published research on the use of neoadjuvant chemotherapy in primary metastatic germinoma. METHODS: We performed a retrospective multi-institutional data collection and analysis of patients diagnosed with metastatic germinoma since 2000 to assess the overall survival (OS) and event-free survival (EFS) of the different treatment modalities administered. RESULTS: We identified 78 patients with germinoma, in two tertiary care centers, of which nine patients (11.5%; eight males) had metastatic disease. The median age at presentation was 13.3 years. All patients had a biopsy at presentation confirming the diagnosis. Three patients had positive CSF cytology (M1). Six patients received craniospinal irradiation (CSI) with boost to primary and metastatic sites, of which five patients received total CSI dose of 24 Gy, while the dose was unknown for one patient. One patient required one cycle of chemotherapy prior to CSI due to worsening visual changes, which subsequently resolved. One patient received two cycles followed by whole ventricular irradiation (WVI) of 23.4 Gy with a boost to the primary bed. One patient received WVI without neoadjuvant chemotherapy. One patient developed anoxic brain injury and only received chemotherapy. He died of recurrent progressive disease 15 months post-diagnosis. The median follow-up time was 77.5 months (range 15-130.5 months), with an OS of 88.9%. Further multi-institutional data collection and analysis is underway and will be presented at the meeting. CONCLUSION: We anticipate our results may elucidate the role of neoadjuvant chemotherapy in the treatment of metastatic germinoma, and whether when combined with lower CSI doses did not compromise EFS/OS.
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Affiliation(s)
- Margaret Shatara
- The Division of Hematology and Oncology, St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis , Missouri , USA
| | - Mohammad H Abu-Arja
- The Division of Hematology/Oncology, Department of Pediatrics, Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine , Houston, Texas , USA
| | - Shannon MacDonald
- The Department of Radiation Oncology, Francis H Burr Proton Therapy Center, Massachusetts General Hospital , Boston, Massachusetts , USA
| | - Stephanie Reiners
- The Division of Hematology and Oncology, St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis , Missouri , USA
| | - Hamza Gorsi
- The Division of Hematology and Oncology, Children’s Hospital of Michigan, Central Michigan University , Detroit, Michigan , USA
| | - Dinisha Govender
- The Department of Oncology, Cancer Center for Children, The Children’s Hospital at Westmead , Westmead, NSW , Australia
| | - Hetal Dholaria
- The Department of Hematology, Oncology and Bone Marrow Transplant, Perth Children’s Hospital , Perth, WA , Australia
| | - Sumanth Nagabushan
- Kids Cancer Centre, Sydney Children's Hospital and University of New South Wales , Randwick, NSW , Australia
| | - Jonathan Schwartz
- The Department of Hematology and Oncology, Brain Tumor Program, Mayo Clinic , Rochester, Minnesota , USA
| | - Jen Chun Foo
- Division of Hematology-Oncology, Department of Pediatrics, University Malaya Medical Center , Kuala Lumpur , Malaysia
| | - Revathi Rajagopal
- Division of Hematology-Oncology, Department of Pediatrics, University Malaya Medical Center , Kuala Lumpur , Malaysia
| | - Stephanie Perkins
- The Department of Radiation Oncology, Washington University School of Medicine, St. Louis , Missouri , USA
| | - Ute Bartels
- Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children , Toronto, Ontario , Canada
| | - Mohamed S Zaghloul
- The Department of Radiation Oncology, NCI, Cairo University and Children’s Cancer Hospital Egypt 57357 , Cairo , Egypt
| | - Nada A Abdelhaleem
- The Department of Clinical Research, Children’s Cancer Hospital Egypt 57357 , Cairo , Egypt
| | - Moatasem El-ayadi
- The Department of Pediatric Oncology, NCI, Cairo University and Children’s Cancer Hospital Egypt 57357 , Cairo , Egypt
| | - Mohamed S Abdelbaki
- The Division of Hematology and Oncology, St. Louis Children’s Hospital, Washington University School of Medicine, St. Louis , Missouri , USA
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Cunningham D, Schwartz J, Guerin J, Johnson D, Khatua S, Laack N, Ahmed S, Silvera VM, Brinkmann D, Pafundi D, Keating G, Raghunathan A, Giannini C, Daniels D, Mahajan A. EPCT-04. Stereotactic biopsy split-course radiation therapy for diffuse midline glioma of the pons (SPORT-DMG): Early phase II enrolling clinical trial. Neuro Oncol 2022. [PMCID: PMC9164655 DOI: 10.1093/neuonc/noac079.132] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Diffuse midline glioma (DMG) of the pons remains the leading cause of death among pediatric patients with brain tumors, despite numerous attempts to intensify treatment. While standard treatment includes 54Gy in 30 fractions of radiation over six weeks of time, nearly all patients progress within the treatment field, and many experience symptomatic radionecrosis with steroid dependence. Symptom improvement typically begins after 20Gy to the tumor. Both hypofractionation and reirradiation after recurrence have been found to be safe for patients with DMG. Our study aims to enroll patients with newly diagnosed pontine DMG aged >1 year (no maximum age), and collect molecular information about DMG via stereotactic biopsy, followed by a short 2 week course of 25Gy in 10 fractions of radiation, with volumes guided by MRI with tractography reconstruction and FDOPA PET radiotracer uptake. Patients are followed closely and can complete the 25Gy in 10 fraction radiation course up to 3 times total for meeting radiographic and clinical progression criteria. Our primary endpoint is to estimate the time to progression from diagnosis to after receiving the second 25Gy course, and to compare this to the historical 7 month standard from diagnosis to progression after one 54Gy course. We aim to improve the time interval where patients are asymptomatic at home while minimizing time receiving daily treatments. Other endpoints will include the patient quality of life, caregiver quality of life, PFS intervals after each course, overall survival, and toxicity.
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Maxwell A, Mendoza H, Sellitti M, Camacho J, Deipolyi A, Ziv E, Sofocleous C, Yarmohammadi H, Maybody M, Humm J, Schwartz J, Juluru K, Dunphy M, Boas F. Abstract No. 26 Optimizing Y-90 particle density improves outcomes after radioembolization. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.107] [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] Open
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Shah CD, Rinaldi MJ, Schwartz J, Holshouser JW, Hill T, Jain M, Hatfield M, Ziegler J, Smith T. SAFETY AND CRITERIA FOR PERCUTANEOUS LEFT ATRIAL APPENDAGE OCCLUSION SAME DAY DISCHARGE. J Am Coll Cardiol 2022. [PMCID: PMC9584783 DOI: 10.1016/s0735-1097(22)01654-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Bausewein C, Hodiamont F, Berges N, Ullrich A, Gerlach C, Oechsle K, Pauli B, Weber J, Stiel S, Schneider N, Krumm N, Rolke R, Gebel C, Jansky M, Nauck F, Wedding U, van Oorschot B, Roch C, Werner L, Fischer M, Schallenburger M, Reuters MC, Schwartz J, Neukirchen M, Gülay A, Maus K, Jaspers B, Radbruch L, Heckel M, Klinger I, Ostgathe C, Kriesen U, Junghanß C, Lehmann E, Gesell D, Gauder S, Boehlke C, Becker G, Pralong A, Strupp J, Leisse C, Schloesser K, Voltz R, Jung N, Simon ST. National strategy for palliative care of severely ill and dying people and their relatives in pandemics (PallPan) in Germany - study protocol of a mixed-methods project. BMC Palliat Care 2022; 21:10. [PMID: 35027041 PMCID: PMC8756412 DOI: 10.1186/s12904-021-00898-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 12/17/2021] [Indexed: 12/15/2022] Open
Abstract
Background In the SARS-CoV-2 pandemic, general and specialist Palliative Care (PC) plays an essential role in health care, contributing to symptom control, psycho-social support, and providing support in complex decision making. Numbers of COVID-19 related deaths have recently increased demanding more palliative care input. Also, the pandemic impacts on palliative care for non-COVID-19 patients. Strategies on the care for seriously ill and dying people in pandemic times are lacking. Therefore, the program ‘Palliative care in Pandemics’ (PallPan) aims to develop and consent a national pandemic plan for the care of seriously ill and dying adults and their informal carers in pandemics including (a) guidance for generalist and specialist palliative care of patients with and without SARS-CoV-2 infections on the micro, meso and macro level, (b) collection and development of information material for an online platform, and (c) identification of variables and research questions on palliative care in pandemics for the national pandemic cohort network (NAPKON). Methods Mixed-methods project including ten work packages conducting (online) surveys and qualitative interviews to explore and describe i) experiences and burden of patients (with/without SARS-CoV-2 infection) and their relatives, ii) experiences, challenges and potential solutions of health care professionals, stakeholders and decision makers during the SARS-CoV-2 pandemic. The work package results inform the development of a consensus-based guidance. In addition, best practice examples and relevant literature will be collected and variables for data collection identified. Discussion For a future “pandemic preparedness” national and international recommendations and concepts for the care of severely ill and dying people are necessary considering both generalist and specialist palliative care in the home care and inpatient setting. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00898-w.
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Thyson T, Schallenburger M, Scherg A, Leister A, Schwartz J, Neukirchen M. Communication in the face of death and dying - how does the encounter with death influence the patient management competence of medical students? An outcome-evaluation. BMC Med Educ 2022; 22:25. [PMID: 35012542 PMCID: PMC8744229 DOI: 10.1186/s12909-021-03060-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/30/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND INFORMATION As part of an elective course, the Interdisciplinary Centre for Palliative Medicine at Duesseldorf University Hospital offers medical students the opportunity to personally meet and talk to a seriously ill patient on one or more occasions. The future physicians are provided with an opportunity to broaden their professional competence, i.e. their knowledge and skills in patient-centred communication at the end of life, and enhance their personal competence, for example in how to professionally handle their own emotions. A topical e-learning module helps the students to prepare for the meetings, and writing a reflection paper forms the basis for the concluding reflection seminar. OBJECTIVES The study's objective is a global and outcome-based evaluation of the elective blended-learning course that provides real-world patient interaction. The outcome-based evaluation or outcome assessment aims to objectively evaluate changes identified in knowledge, skills and attitude among the participants of the elective-course. Furthermore, the evaluation aims to answer the question of whether changes especially in attitude (social skills and self-competence) should be expected after the students have met with severely ill or dying patients. METHOD On two questionnaires specifically developed for this survey the students were able to provide a global rating of the elective course and describe their learning gains in palliative care. The students' learning gains were measured by means of 14 items reflecting the specific educational objectives of the offered elective course. Using the German school grading system as a rating scale, the students assessed their learning progress by retrospectively evaluating their skills before and after completion of the elective course (Comparative Self-Assessment, CSA). RESULTS In the time from April 2018 till March 2020, 62 students participated in the evaluation. Overall, learning progress among students could be observed across all areas of competence, and in 50% of all retrospective self-assessment items the learning gains were ≥ 50%. The highest learning gain (63.6%) was observed in the students' ability to meet a severely ill patient without fear. The lowest learning gain was observed when students had to confront and accept their own mortality. CONCLUSIONS The offered elective course supports students in achieving social and self-competence development goals. According to the obtained results, contact with real-world patients helps mould the students' attitude.
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Affiliation(s)
- T Thyson
- Interdisciplinary Centre of Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany.
- University Hospital Duesseldorf, Interdisciplinary Centre for Palliative Medicine, Moorenstr. 5, 40225, Duesseldorf, Germany.
| | - M Schallenburger
- Interdisciplinary Centre of Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany.
- University Hospital Duesseldorf, Interdisciplinary Centre for Palliative Medicine, Moorenstr. 5, 40225, Duesseldorf, Germany.
| | - A Scherg
- Interdisciplinary Centre of Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany
| | - A Leister
- Interdisciplinary Centre of Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany
| | - J Schwartz
- Interdisciplinary Centre of Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany
| | - M Neukirchen
- Interdisciplinary Centre of Palliative Care, University Hospital, Heinrich Heine University, Duesseldorf, Germany
- Department of Anaesthesiology, University Hospital, Heinrich Heine University, Duesseldorf, Germany
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Dominici F, Zanobetti A, Schwartz J, Braun D, Sabath B, Wu X. Assessing Adverse Health Effects of Long-Term Exposure to Low Levels of Ambient Air Pollution: Implementation of Causal Inference Methods. Res Rep Health Eff Inst 2022; 2022:1-56. [PMID: 36193708 PMCID: PMC9530797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
This report provides a final summary of the principal findings and key conclusions of a study supported by an HEI grant aimed at "Assessing Adverse Health Effects of Long-Term Exposure to Low Levels of Ambient Air Pollution." It is the second and final report on this topic. The study was designed to advance four critical areas of inquiry and methods development. First, it focused on predicting short- and long-term exposures to ambient fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) at high spatial resolution (1 km × 1 km) for the continental United States over the period 2000-2016 and linking these predictions to health data. Second, it developed new causal inference methods for estimating exposure-response (ER) curves (ERCs) and adjusting for measured confounders. Third, it applied these methods to claims data from Medicare and Medicaid beneficiaries to estimate health effects associated with short- and long-term exposure to low levels of ambient air pollution. Finally, it developed pipelines for reproducible research, including approaches for data sharing, record linkage, and statistical software. Our HEI-funded work has supported an extensive portfolio of analyses and the development of statistical methods that can be used to robustly understand the health effects of short- and long-term exposure to low levels of ambient air pollution. Our Phase 1 report (Dominici et al. 2019) provided a high-level overview of our statistical methods, data analysis, and key findings, grouped into the following five areas: (1) exposure prediction, (2) epidemiological studies of ambient exposures to air pollution at low levels, (3) sensitivity analysis, (4) methodological contributions in causal inference, and (5) an open access research data platform. The current, final report includes a comprehensive overview of the entire research project. Considering our (1) massive study population, (2) numerous sensitivity analyses, and (3) transparent assessment of covariate balance indicating the quality of causal inference for simulating randomized experiments, we conclude that conditionally on the required assumptions for causal inference, our results collectively indicate that long-term PM2.5 exposure is likely to be causally related to mortality. This conclusion assumes that the causal inference assumptions hold and, more specifically, that we accounted adequately for confounding bias. We explored various modeling approaches, conducted extensive sensitivity analyses, and found that our results were robust across approaches and models. This work relied on publicly available data, and we have provided code that allows for reproducibility of our analyses. Our work provides comprehensive evidence of associations between exposures to PM2.5, NO2, and O3 and various health outcomes. In the current report, we report more specific results on the causal link between long-term exposure to PM2.5 and mortality, even at PM2.5 levels below or equal to 12 μg/m3, and mortality among Medicare beneficiaries (ages 65 and older). This work relies on newly developed causal inference methods for continuous exposure. For the period 2000-2016, we found that all statistical approaches led to consistent results: a 10-μg/m3 decrease in PM2.5 led to a statistically significant decrease in mortality rate ranging between 6% and 7% (= 1 - 1/hazard ratio [HR]) (HR estimates 1.06 [95% CI, 1.05 to 1.08] to 1.08 [95% CI, 1.07 to 1.09]). The estimated HRs were larger when studying the cohort of Medicare beneficiaries that were always exposed to PM2.5 levels lower than 12 μg/m3 (1.23 [95% CI, 1.18 to 1.28] to 1.37 [95% CI, 1.34 to 1.40]). Comparing the results from multiple and single pollutant models, we found that adjusting for the other two pollutants slightly attenuated the causal effects of PM2.5 and slightly elevated the causal effects of NO2 exposure on all-cause mortality. The results for O3 remained almost unchanged. We found evidence of a harmful causal relationship between mortality and long-term PM2.5 exposures adjusted for NO2 and O3 across the range of annual averages between 2.77 and 17.16 μg/m3 (included >98% of observations) in the entire cohort of Medicare beneficiaries across the continental United States from 2000 to 2016. Our results are consistent with recent epidemiological studies reporting a strong association between long-term exposure to PM2.5 and adverse health outcomes at low exposure levels. Importantly, the curve was almost linear at exposure levels lower than the current national standards, indicating aggravated harmful effects at exposure levels even below these standards. There is, in general, a harmful causal impact of long-term NO2 exposures to mortality adjusted for PM2.5 and O3 across the range of annual averages between 3.4 and 80 ppb (included >98% of observations). Yet within low levels (annual mean ≤53 ppb) below the current national standards, the causal impacts of NO2 exposures on all-cause mortality are nonlinear with statistical uncertainty. The ERCs of long-term O3 exposures on all-cause mortality adjusted for PM2.5 and NO2 are almost flat below 45 ppb, which shows no statistically significant effect. Yet we observed an increased hazard when the O3 exposures were higher than 45 ppb, and the HR was approximately 1.10 when comparing Medicare beneficiaries with annual mean O3 exposures of 50 ppb versus those with 30 ppb. institutions, including those that support the Health Effects Institute; therefore, it may not reflect the views or policies of these parties, and no endorsement by them should be inferred. A list of abbreviations and other terms appears at the end of this volume.
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Affiliation(s)
- F Dominici
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - A Zanobetti
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - J Schwartz
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - D Braun
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - B Sabath
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - X Wu
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Caskey M, Vora A, Mahoney P, Schwartz J, Keller A, Sodhi N, Allen K, Eisenberg R, Watson D. TCT-143 Transfemoral Versus Alternative Access for Transcatheter Aortic Valve Replacement With Evolut Platform. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.993] [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: 10/20/2022]
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Pavlovsky M, Peled A, Sarig O, Astman N, Malki L, Meijers O, Schwartz J, Hansen D, Sprecher E, Samuelov L. 166 Co-existence of pachyonychia congenita and hidradenitis suppurativa: more than a coincidence. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.170] [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]
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Bukhari A, Knowles W, Schwartz J, Lindberg T, Hough H, Reagan J, Wagaman L, Young K, Harward J, Feeney K, Weinstein J. Systematic Review of Evidence-Based Strategies to Enhance Weight Management Programming. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.08.067] [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]
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Chwallek D, Schweda A, Neukirchen M, Hense J, Schwartz J, Mallmann B, Teufel M, Schuler M, Tewes M. [PARPACT: Paramedic Palliative Care Test : Validation of a questionnaire to assess palliative care knowledge and self-efficacy expectations of paramedics]. Schmerz 2021; 36:333-341. [PMID: 34586511 PMCID: PMC9512857 DOI: 10.1007/s00482-021-00587-w] [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] [Accepted: 07/26/2021] [Indexed: 11/24/2022]
Abstract
Hintergrund Angesichts der Vielzahl von Palliativpatienten, die vom Rettungsdienst versorgt werden, spielen Aus- und Weiterbildung in palliativmedizinischen Themen eine immer größere Rolle. Zur Verbesserung der Entscheidungsfindung in Rettungssituationen wurde in vielen Städten ein Palliativ- bzw. Notfallausweis eingeführt. Ziel der Arbeit Um den Erfolg von Bildungsmaßnahmen und den Effekt des Palliativ- bzw. Notfallausweises zu überprüfen, wurde ein Fragebogen zur Ermittlung von palliativem Wissen und palliativer Selbstwirksamkeitserwartung im Rettungsdienst entwickelt und validiert. Material und Methoden Die Entwicklung und Inhaltsvalidierung erfolgte mithilfe eines Delphi-Prozesses. Zur Konstruktvalidierung wurde die Faktorenanalyse genutzt. Die Kriteriumsvalidität wurde anhand von 22 speziell in Palliative Care geschulten Pflegekräften überprüft. Die Reliabilität wurde mittels Cronbachs α als Maß der internen Konsistenz ermittelt. Ergebnisse 291 von 750 Rettungsdienstmitarbeitern nahmen an der freiwilligen Befragung teil. Nach Abschluss des Delphi-Prozesses bestand Konsens, dass die wichtigen Themen Schmerz, Dyspnoe, Sedierung, Sterbebegleitung, Sterbehilfe und rechtliche Aspekte im Fragebogen abgedeckt sind. Das Ergebnis der Faktorenanalyse sprach für eine 6‑Faktoren-Lösung. Bei der Kriteriumsvalidierung zeigte sich ein signifikanter Unterschied im palliativen Wissen zwischen den Palliative-Care-Pflegekräften (MRang 289,73) und den Rettungsdienstmitarbeitern (MRang 146,97, U = 281.000, r = 0,40, p < 0,001). Cronbachs α lag für die Wissensfragen bei 0,70 und für die Subskala der palliativen Selbstwirksamkeitserwartung bei 0,82. Diskussion Mit dem Paramedic Palliative Care Test (PARPACT) liegt ein validiertes Messinstrument zur Überprüfung von Bildungsmaßnahmen im Rettungsdienst vor.
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Affiliation(s)
- D Chwallek
- Westdeutsches Tumorzentrum, Innere Klinik (Tumorforschung), Universitätsklinikum Essen, 45122, Essen, Deutschland
| | - A Schweda
- Klinik für Psychosomatische Medizin und Psychotherapie, LVR-Klinikum Essen, Universität Duisburg-Essen, 45147, Essen, Deutschland
| | - M Neukirchen
- Klinik für Anästhesiologie, Interdisziplinäres Zentrum für Palliativmedizin, CIO Düsseldorf, Universitätsklinikum Düsseldorf, Heinrich Heine Universität, 40225, Düsseldorf, Deutschland
| | - J Hense
- Westdeutsches Tumorzentrum, Innere Klinik (Tumorforschung), Universitätsklinikum Essen, 45122, Essen, Deutschland
| | - J Schwartz
- Klinik für Anästhesiologie, Interdisziplinäres Zentrum für Palliativmedizin, CIO Düsseldorf, Universitätsklinikum Düsseldorf, Heinrich Heine Universität, 40225, Düsseldorf, Deutschland
| | - B Mallmann
- Universitätsklinikum Essen, 45122, Essen, Deutschland
| | - M Teufel
- Klinik für Psychosomatische Medizin und Psychotherapie, LVR-Klinikum Essen, Universität Duisburg-Essen, 45147, Essen, Deutschland
| | - M Schuler
- Westdeutsches Tumorzentrum, Innere Klinik (Tumorforschung), Universitätsklinikum Essen, 45122, Essen, Deutschland.,Partnerstandort Universitätsklinikum Essen, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Essen, Deutschland
| | - Mitra Tewes
- Westdeutsches Tumorzentrum, Innere Klinik (Tumorforschung), Universitätsklinikum Essen, 45122, Essen, Deutschland.
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42
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Sevilla J, Navarro S, Rio P, Sánchez-Domínguez R, Zubicaray J, Gálvez E, Merino E, Sebastián E, Azqueta C, Casado JA, Segovia JC, Alberquilla O, Bogliolo M, Román-Rodríguez FJ, Giménez Y, Larcher L, Salgado R, Pujol RM, Hladun R, Castillo A, Soulier J, Querol S, Fernández J, Schwartz J, García de Andoín N, López R, Catalá A, Surralles J, Díaz-de-Heredia C, Bueren JA. Improved collection of hematopoietic stem cells and progenitors from Fanconi anemia patients for gene therapy purposes. Mol Ther Methods Clin Dev 2021; 22:66-75. [PMID: 34485595 PMCID: PMC8390450 DOI: 10.1016/j.omtm.2021.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/04/2021] [Indexed: 12/29/2022]
Abstract
Difficulties in the collection of hematopoietic stem and progenitor cells (HSPCs) from Fanconi anemia (FA) patients have limited the gene therapy in this disease. We have investigated (ClinicalTrials.gov, NCT02931071) the safety and efficacy of filgrastim and plerixafor for mobilization of HSPCs and collection by leukapheresis in FA patients. Nine of eleven enrolled patients mobilized beyond the threshold level of 5 CD34+ cells/μL required to initiate apheresis. A median of 21.8 CD34+ cells/μL was reached at the peak of mobilization. Significantly, the oldest patients (15 and 16 years old) were the only ones who did not reach that threshold. A median of 4.27 million CD34+ cells/kg was collected in 2 or 3 aphereses. These numbers were markedly decreased to 1.1 million CD34+ cells/kg after immunoselection, probably because of weak expression of the CD34 antigen. However, these numbers were sufficient to facilitate the engraftment of corrected HSPCs in non-conditioned patients. No procedure-associated serious adverse events were observed. Mobilization of CD34+ cells correlated with younger age, higher leukocyte counts and hemoglobin values, lower mean corpuscular volume, and higher proportion of CD34+ cells in bone marrow (BM). All these values offer crucial information for the enrollment of FA patients for gene therapy protocols.
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Affiliation(s)
- Julián Sevilla
- Servicio Hematología y Oncología Pediátrica, Fundación Investigación Biomédica, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain
| | - Susana Navarro
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Hematopoietic Innovative Therapies Division, Centro de investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 40, 28040 Madrid, Spain.,Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - Paula Rio
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Hematopoietic Innovative Therapies Division, Centro de investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 40, 28040 Madrid, Spain.,Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - Rebeca Sánchez-Domínguez
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Hematopoietic Innovative Therapies Division, Centro de investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 40, 28040 Madrid, Spain.,Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - Josune Zubicaray
- Servicio Hematología y Oncología Pediátrica, Fundación Investigación Biomédica, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain
| | - Eva Gálvez
- Servicio Hematología y Oncología Pediátrica, Fundación Investigación Biomédica, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain
| | - Eva Merino
- Servicio Hematología y Oncología Pediátrica, Fundación Investigación Biomédica, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain
| | - Elena Sebastián
- Servicio Hematología y Oncología Pediátrica, Fundación Investigación Biomédica, Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain
| | - Carmen Azqueta
- Banc de Sang i Teixits de Catalunya, 08005 Barcelona, Spain
| | - José A Casado
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Hematopoietic Innovative Therapies Division, Centro de investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 40, 28040 Madrid, Spain.,Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - José C Segovia
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Hematopoietic Innovative Therapies Division, Centro de investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 40, 28040 Madrid, Spain.,Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - Omaira Alberquilla
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Hematopoietic Innovative Therapies Division, Centro de investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 40, 28040 Madrid, Spain.,Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - Massimo Bogliolo
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Servicio de Genética e Institut de Reserca, IIB-Sant Pau, Hospital Sant Pau, 08041 Barcelona, Spain.,Departmento de Genética y Microbiología, Universitat Autónoma de Barcelona, 08193 Barcelona, Spain
| | - Francisco J Román-Rodríguez
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Hematopoietic Innovative Therapies Division, Centro de investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 40, 28040 Madrid, Spain.,Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - Yari Giménez
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Hematopoietic Innovative Therapies Division, Centro de investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 40, 28040 Madrid, Spain.,Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - Lise Larcher
- Université de Paris, Institut de Recherche Saint-Louis, 75010 Paris, France
| | - Rocío Salgado
- Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
| | - Roser M Pujol
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Servicio de Genética e Institut de Reserca, IIB-Sant Pau, Hospital Sant Pau, 08041 Barcelona, Spain.,Departmento de Genética y Microbiología, Universitat Autónoma de Barcelona, 08193 Barcelona, Spain
| | - Raquel Hladun
- Servicio de Oncología y Hematología Pediátrica, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Ana Castillo
- Análisis Clínicos Hospital Infantil Universitario Niño Jesús, 28009 Madrid, Spain
| | - Jean Soulier
- Université de Paris, Institut de Recherche Saint-Louis, 75010 Paris, France
| | - Sergi Querol
- Banc de Sang i Teixits de Catalunya, 08005 Barcelona, Spain
| | | | | | | | | | - Albert Catalá
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Department of Hematology/Oncology, Hospital Sant Joan de Déu, 08950 Barcelona, Spain.,Institut de Recerca Pediàtrica Sant Joan de Déu, Barcelona, Spain
| | - Jordi Surralles
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Servicio de Genética e Institut de Reserca, IIB-Sant Pau, Hospital Sant Pau, 08041 Barcelona, Spain.,Departmento de Genética y Microbiología, Universitat Autónoma de Barcelona, 08193 Barcelona, Spain
| | - Cristina Díaz-de-Heredia
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Servicio de Oncología y Hematología Pediátrica, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d'Hebron, 08035 Barcelona, Spain
| | - Juan A Bueren
- Centro de Investigación Biomédica en Red de Enfermedades Raras, 28029 Madrid, Spain.,Hematopoietic Innovative Therapies Division, Centro de investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Avenida Complutense 40, 28040 Madrid, Spain.,Instituto de Investigaciones Sanitarias Fundación Jiménez Díaz (IIS-FJD), 28040 Madrid, Spain
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43
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Benson JC, Trejo-Lopez J, Bach SE, Schwartz J, Kaufmann TJ, Eckel L, Guerin J. Hypothalamic Pilomyxoid Astrocytoma in a Child with Lipodystrophy. AJNR Am J Neuroradiol 2021; 42:1370-1374. [PMID: 33958332 PMCID: PMC8367624 DOI: 10.3174/ajnr.a7136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/16/2021] [Indexed: 11/07/2022]
Abstract
Pilomyxoid astrocytoma is a rare form of pediatric CNS malignancy first classified in 2007 by the World Health Organization. The tumors are similar to pilocytic astrocytomas, sharing both some imaging and histologic traits. However, pilomyxoid astrocytomas portend a more ominous prognosis, with more aggressive local tendencies and a greater proclivity for leptomeningeal spread. Although tissue sampling is ultimately required to differentiate pilocytic astrocytomas and pilomyxoid astrocytomas, some imaging features can be used to suggest a pilomyxoid astrocytoma, including homogeneous enhancement, leptomeningeal seeding, and lack of intratumoral cysts. In this article, a case of a hypothalamic pilomyxoid astrocytoma is described, in which the presenting disorder was profound generalized lipodystrophy. The aforementioned imaging characteristics of pilomyxoid astrocytomas are reviewed, as are the pathologic features of such tumors, including their angiocentric cellular arrangement and myxoid background.
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Affiliation(s)
- J C Benson
- Department of Radiology (J.C.B., T.J.K., L.E., J.G.), Mayo Clinic, Rochester, Minnesota
| | - J Trejo-Lopez
- Department of Laboratory Medicine and Pathology (J.T.-L.), Mayo Clinic, Rochester, Minnesota
| | - S E Bach
- Department of Laboratory Medicine and Pathology (S.E.B.), OSF Healthcare, Peoria, Illinois
| | - J Schwartz
- Departments of Pediatric and Adolescent Medicine (J.S.), Mayo Clinic, Rochester, Minnesota
| | - T J Kaufmann
- Department of Radiology (J.C.B., T.J.K., L.E., J.G.), Mayo Clinic, Rochester, Minnesota
| | - L Eckel
- Department of Radiology (J.C.B., T.J.K., L.E., J.G.), Mayo Clinic, Rochester, Minnesota
| | - J Guerin
- Department of Radiology (J.C.B., T.J.K., L.E., J.G.), Mayo Clinic, Rochester, Minnesota
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44
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Vicedo-Cabrera AM, Scovronick N, Sera F, Royé D, Schneider R, Tobias A, Astrom C, Guo Y, Honda Y, Hondula DM, Abrutzky R, Tong S, de Sousa Zanotti Stagliorio Coelho M, Saldiva PHN, Lavigne E, Correa PM, Ortega NV, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Indermitte E, Jaakkola JJK, Ryti N, Pascal M, Schneider A, Katsouyanni K, Samoli E, Mayvaneh F, Entezari A, Goodman P, Zeka A, Michelozzi P, de’Donato F, Hashizume M, Alahmad B, Diaz MH, De La Cruz Valencia C, Overcenco A, Houthuijs D, Ameling C, Rao S, Ruscio FD, Carrasco-Escobar G, Seposo X, Silva S, Madureira J, Holobaca IH, Fratianni S, Acquaotta F, Kim H, Lee W, Iniguez C, Forsberg B, Ragettli MS, Guo YLL, Chen BY, Li S, Armstrong B, Aleman A, Zanobetti A, Schwartz J, Dang TN, Dung DV, Gillett N, Haines A, Mengel M, Huber V, Gasparrini A. The burden of heat-related mortality attributable to recent human-induced climate change. Nat Clim Chang 2021; 11:492-500. [PMID: 34221128 PMCID: PMC7611104 DOI: 10.1038/s41558-021-01058-x] [Citation(s) in RCA: 196] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/20/2021] [Indexed: 05/19/2023]
Abstract
Climate change affects human health; however, there have been no large-scale, systematic efforts to quantify the heat-related human health impacts that have already occurred due to climate change. Here, we use empirical data from 732 locations in 43 countries to estimate the mortality burdens associated with the additional heat exposure that has resulted from recent human-induced warming, during the period 1991-2018. Across all study countries, we find that 37.0% (range 20.5-76.3%) of warm-season heat-related deaths can be attributed to anthropogenic climate change and that increased mortality is evident on every continent. Burdens varied geographically but were of the order of dozens to hundreds of deaths per year in many locations. Our findings support the urgent need for more ambitious mitigation and adaptation strategies to minimize the public health impacts of climate change.
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Affiliation(s)
- A. M. Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - N. Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - F. Sera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Department of Statistics, Computer Science and Applications ‘G. Parenti’, University of Florence, Florence, Italy
| | - D. Royé
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - R. Schneider
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Φ-Lab, European Space Agency (ESA-ESRIN), Frascati, Italy
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- European Centre for Medium-Range Weather Forecast (ECMWF), Reading, UK
| | - A. Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - C. Astrom
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Y. Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Y. Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - D. M. Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| | - R. Abrutzky
- Facultad de Ciencias Sociales, Instituto de Investigaciones Gino Germani, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - S. Tong
- Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | | | | | - E. Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - P. Matus Correa
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - N. Valdes Ortega
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - H. Kan
- School of Public Health, Fudan University, Shanghai, China
| | - S. Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - J. Kyselý
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - A. Urban
- Institute of Atmospheric Physics of the Czech Academy of Sciences, Prague, Czech Republic
- Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - H. Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - E. Indermitte
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - J. J. K. Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
- Finnish Meteorological Institute, Helsinki, Finland
| | - N. Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - M. Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | - A. Schneider
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - K. Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- MRC-PHE Centre for Environment and Health, Environmental Research Group, School of Public Health, Imperial College London, London, UK
| | - E. Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - F. Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - A. Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar, Iran
| | - P. Goodman
- School of Physics, Technological University Dublin, Dublin, Ireland
| | - A. Zeka
- Institute for Environment, Health and Societies, Brunel University London, London, UK
| | - P. Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - F. de’Donato
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - M. Hashizume
- Department of Global Health Policy, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - B. Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - M. Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - C. De La Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - A. Overcenco
- Laboratory of Management in Science and Public Health, National Agency for Public Health of the Ministry of Health, Chisinau, Republic of Moldova
| | - D. Houthuijs
- Centre for Sustainability and Environmental Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - C. Ameling
- Centre for Sustainability and Environmental Health, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - S. Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - F. Di Ruscio
- Norwegian Institute of Public Health, Oslo, Norway
| | - G. Carrasco-Escobar
- Health Innovation Laboratory, Institute of Tropical Medicine ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - X. Seposo
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - S. Silva
- Department of Epidemiology, Instituto Nacional de Saúde Dr Ricardo Jorge, Lisbon, Portugal
| | - J. Madureira
- Department of Enviromental Health, Instituto Nacional de Saúde Dr Ricardo Jorge, Porto, Portugal
- EPIUnit—Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - I. H. Holobaca
- Faculty of Geography, Babes-Bolay University, Cluj-Napoca, Romania
| | - S. Fratianni
- Department of Earth Sciences, University of Torino, Turin, Italy
| | - F. Acquaotta
- Department of Earth Sciences, University of Torino, Turin, Italy
| | - H. Kim
- Graduate School of Public Health & Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - W. Lee
- Graduate School of Public Health & Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - C. Iniguez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Statistics and Computational Research, Universitat de Valencia, Valencia, Spain
| | - B. Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - M. S. Ragettli
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Y. L. L. Guo
- Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan,Taiwan
| | - B. Y. Chen
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan,Taiwan
| | - S. Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - B. Armstrong
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - A. Aleman
- Department of Preventive Medicine, School of Medicine, University of the Republic, Montevideo, Uruguay
| | - A. Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - J. Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - T. N. Dang
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - D. V. Dung
- Department of Environmental Health, Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - N. Gillett
- Canadian Centre for Climate Modelling and Analysis, Environment and Climate Change Canada, Victoria, British Colombia, Canada
| | - A. Haines
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Φ-Lab, European Space Agency (ESA-ESRIN), Frascati, Italy
| | - M. Mengel
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - V. Huber
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
- Department of Physical, Chemical and Natural Systems, Universidad Pablo de Olavide, Seville, Spain
| | - A. Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- The Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London, UK
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45
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Rinaldi MJ, Swayampakala K, Scherer M, Schwartz J, Kelly N. TRANSCATHETER EDGE TO EDGE MITRAL VALVE REPAIR (TEER) PROCEDURAL COMPLEXITY TOOL AND VALIDATION. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02557-2] [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: 10/21/2022]
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46
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Tenge T, Schlieper D, Schallenburger M, Meier S, Schwartz J, Neukirchen M. [Palliative care in patients with left ventricular assist devices: systematic review]. Anaesthesist 2021; 70:1044-1050. [PMID: 33931802 PMCID: PMC8639546 DOI: 10.1007/s00101-021-00967-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 11/25/2022]
Abstract
Hintergrund Bei terminal herzinsuffizienten Patienten gewinnt die Implantation von Linksherzunterstützungssystemen (LVAD) als Therapieoption zunehmend an Bedeutung. Diese Systeme werden als Überbrückung bis zu einer Herztransplantation (BTT) oder als definitive Therapie (DT) eingesetzt. Sie können die Lebensqualität verbessern und die Lebenszeit verlängern. Trotzdem bleibt die Prognose besonders bei DT oder bei Wechsel von BTT zu DT mit Blick auf die Lebenszeit und auftretende Komplikationen ungünstig. Bisher ist ungeklärt, ob eine LVAD-Implantation eine Indikation für eine frühzeitige Integration von Palliativmedizin darstellt. Ziel der Arbeit Erfassung der aktuellen Studienlage über den Einfluss einer palliativmedizinischen Behandlung bei LVAD-Patienten. Material und Methoden Im Mai 2020 wurde eine systematische Literaturrecherche in 6 verschiedenen Datenbanken durchgeführt. Ergebnisse Von den 491 Treffern der Literaturrecherche wurden 21 Arbeiten in diese Übersichtsarbeit eingeschlossen. Durch die frühzeitige Integration der Palliativmedizin vor LVAD-Implantation erhöhte sich die Anzahl der Patienten mit vorausschauender Versorgungsplanung und Vorsorgeinstrumenten. Außerdem zeigte sich ein positiver Einfluss auf das familiäre Umfeld, das Symptommanagement und die Umstände des Versterbens. Es gibt verschiedene Formate für die Integration palliativmedizinischer Konzepte in die LVAD-Therapie. Diskussion Die frühzeitige und kontinuierliche Einbindung der Palliativmedizin im Verlauf einer LVAD-Therapie kann die Behandlungsqualität verbessern. Die Ausarbeitung von spezifischen Handlungsempfehlungen ist in Abhängigkeit vom Therapieziel (BTT oder DT) sinnvoll. Empfohlen werden Schulungen für Palliativmediziner und LVAD-Spezialisten.
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Affiliation(s)
- T Tenge
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - D Schlieper
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - M Schallenburger
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - S Meier
- Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Deutschland.
| | - J Schwartz
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - M Neukirchen
- Interdisziplinäres Zentrum für Palliativmedizin, Universitätsklinikum Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Deutschland.,Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf, Deutschland
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Samuelov L, Sarig O, Adir N, Pavlovsky M, Smith FJ, Schwartz J, Hansen CD, Sprecher E. Identification of clinically useful predictive genetic variants in pachyonychia congenita. Clin Exp Dermatol 2021; 46:867-873. [PMID: 33486795 DOI: 10.1111/ced.14569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/19/2020] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Pachyonychia congenita (PC) refers to a group of autosomal dominant disorders caused by mutations in five keratin genes (KRT16,KRT6A,KRT17,KRT6B or KRT6C). Current disease classification is based on the gene harbouring disease-causing variants. AIMS We harnessed the International Pachyonychia Congenita Research Registry (IPCRR) containing both clinical and molecular data on patients with PC worldwide, to identify genetic variants predicting disease severity. METHODS We ascertained 815 individuals harbouring keratin mutations registered in the IPCRR. We looked for statistically significant associations between genetic variants and clinical manifestations in a subgroup of patients carrying mutations found in at least 10% of the cohort. Data were analysed using χ2 and Kruskal-Wallis tests. RESULTS We identified five mutations occurring in at least 10% of the patients registered in the IPCRR. The KRT16 p.L132P mutation was significantly associated with younger age of onset, presence of palmar keratoderma oral leucokeratosis and a higher number of involved nails. By contrast, the KRT16 p.N125S and p.R127C mutations resulted in a milder phenotype featuring a decreased number of involved nails and older age of onset. Patients carrying the p.N125S mutation were less likely to develop palmar keratoderma while p.R127C was associated with an older age of palmoplantar keratoderma onset. Moreover, the KRT17 p.L99P mutation resulted in an increased number of involved fingernails and patients demonstrating 20-nail dystrophy, while the opposite findings were observed with KRT17 p.N92S mutation. CONCLUSIONS We have identified novel and clinically useful genetic predictive variants in the largest cohort of patients with PC described to date.
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Affiliation(s)
- L Samuelov
- Division of Dermatology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - O Sarig
- Division of Dermatology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - N Adir
- Schulich Faculty of Chemistry, Technion-Israel Institute of Technology, Haifa, Israel
| | - M Pavlovsky
- Division of Dermatology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - F J Smith
- Pachyonychia Congenita Project, Holladay, UT, USA
| | - J Schwartz
- Pachyonychia Congenita Project, Holladay, UT, USA
| | - C D Hansen
- Pachyonychia Congenita Project, Holladay, UT, USA.,Department of Dermatology, University of Utah, Salt Lake City, UT, USA
| | - E Sprecher
- Division of Dermatology, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Siada RG, Lu VM, Schwartz J, Daniels DJ. Recurring pediatric anaplastic ependymoma with rare peritoneal carcinomatosis: a case report and hypothesis of mechanism. Childs Nerv Syst 2021; 37:1021-1024. [PMID: 32681369 DOI: 10.1007/s00381-020-04814-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/13/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although recurrent anaplastic ependymoma in pediatric patients is not uncommon, recurrent disease leading to widespread metastases to the peritoneum is extremely rare. CASE REPORT We present a case of an 18-month old male who initially presented with posterior fossa anaplastic ependymoma, who then proceeded to present 1 year later with spinal recurrence, and then 2 years after that with widespread disease involving the intracranial ventricular system and peritoneum. CONCLUSION We posit that surgical interventions to treat primary and recurrent presentations in combination with a conduit to the peritoneum via a ventriculoperitoneal shunt contributed to the mechanisms of this complex case.
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Affiliation(s)
- Ruby G Siada
- Department of Pediatric Oncology, Mayo Clinic Children's Center, 200 First St. SW, Rochester, MN, USA
| | - Victor M Lu
- Department of Neurologic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. .,Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL, 33136, USA.
| | - Jonathan Schwartz
- Department of Pediatric Oncology, Mayo Clinic Children's Center, 200 First St. SW, Rochester, MN, USA
| | - David J Daniels
- Department of Pediatric Oncology, Mayo Clinic Children's Center, 200 First St. SW, Rochester, MN, USA. .,Department of Neurologic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.
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Ganmore I, Elkayam I, Ravona-Springer R, Lin HM, Liu X, Plotnik M, Buchman AS, Berman Y, Schwartz J, Sano M, Heymann A, Beeri MS. Deterioration in Motor Function Over Time in Older Adults With Type 2 Diabetes is Associated with Accelerated Cognitive Decline. Endocr Pract 2021; 26:1143-1152. [PMID: 33471716 DOI: 10.4158/ep-2020-0289] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Received: 05/13/2020] [Accepted: 06/07/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Type 2 diabetes (T2D) is associated with motor impairments and a higher dementia risk. The relationships of motor decline with cognitive decline in T2D older adults has rarely been studied. Using data from the Israel Diabetes and Cognitive Decline study (N = 892), we examined associations of decline in motor function with cognitive decline over a 54-month period. METHODS Motor function measures were strength (handgrip) and gait speed (time to walk 3 m). Participants completed a neuropsychologic battery of 13 tests transformed into z-scores, summarized into 4 cognitive domains: episodic memory, attention/working memory, executive functions, and language/semantic categorization. The average of the 4 domains' z-scores defined global cognition. Motor and cognitive functions were assessed in 18-months intervals. A random coefficients model delineated longitudinal relationships of cognitive decline with baseline and change from baseline in motor function, adjusting for sociodemographic, cardiovascular, and T2D-related covariates. RESULTS Slower baseline gait speed levels were significantly associated with more rapid decline in global cognition (P = .004), language/semantic categorization (P = .006) and episodic memory (P = .029). Greater decline over time in gait speed was associated with an accelerated rate of decline in global cognition (P = .050), attention/working memory (P = .047) and language/semantic categorization (P<.001). Baseline strength levels were not associated with cognitive decline but the rate of declining strength was associated with an accelerated decline in executive functions (P = .025) and language/semantic categorization (P = .006). CONCLUSION In T2D older adults, the rate of decline in motor function, beyond baseline levels, was associated with accelerated cognitive decline, suggesting that cognitive and motor decline share common neuropathologic mechanisms in T2D.
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Affiliation(s)
- Ithamar Ganmore
- From the Joseph Sagol Neuroscience Center, Sheba Medical Center, Israel
| | - Isak Elkayam
- the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Ramit Ravona-Springer
- From the Joseph Sagol Neuroscience Center, Sheba Medical Center, Israel; the Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Hung-Mo Lin
- the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York
| | - Xiaoyu Liu
- the Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York
| | - Meir Plotnik
- the Center for Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel
| | - Aron S Buchman
- the Rush Alzheimer's Disease Center, Rush University, Illinois
| | - Yuval Berman
- From the Joseph Sagol Neuroscience Center, Sheba Medical Center, Israel
| | - Jonathan Schwartz
- From the Joseph Sagol Neuroscience Center, Sheba Medical Center, Israel
| | - Mary Sano
- the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York
| | - Anthony Heymann
- the Sackler Faculty of Medicine, Tel Aviv University, Israel; the Maccabi Health Services, Israel
| | - Michal Schnaider Beeri
- From the Joseph Sagol Neuroscience Center, Sheba Medical Center, Israel; the Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York.
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Pargaonkar V, Kimura T, Kameda R, Tanaka S, Yamada R, Schwartz J, Perl L, Rogers I, Honda Y, Fitzgerald P, Schnittger I, Tremmel J. Invasive assessment of myocardial bridging in patients with angina and no obstructive coronary artery disease. EUROINTERVENTION 2021; 16:1070-1078. [PMID: 33074153 PMCID: PMC9725037 DOI: 10.4244/eij-d-20-00779] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 11/23/2022]
Abstract
AIMS Angina and no obstructive coronary artery disease (ANOCA) is common. A potential cause of angina in this patient population is a myocardial bridge (MB). We aimed to study the anatomical and haemodynamic characteristics of an MB in patients with ANOCA. METHODS AND RESULTS Using intravascular ultrasound (IVUS), we identified 184 MBs in 154 patients. We evaluated MB length, arterial compression, and halo thickness. MB muscle index (MMI) was defined as MB length×halo thickness. Haemodynamic testing of the MB was performed using an intracoronary pressure/Doppler flow wire at rest and during dobutamine stress. We defined an abnormal diastolic fractional flow reserve (dFFR) as ≤0.76 during stress. The median MB length was 22.9 mm, arterial compression 30.9%, and halo thickness 0.5 mm. The median MMI was 12.1. Endothelial and microvascular dysfunction were present in 85.4% and 22.1%, respectively. At peak dobutamine stress, 94.2% of patients had a dFFR ≤0.76 within and/or distal to the MB. MMI was associated with an abnormal dFFR. CONCLUSIONS In select patients with ANOCA who have an MB by IVUS, the majority have evidence of a haemodynamically significant dFFR during dobutamine stress, suggesting the MB as being a cause of their angina. A comprehensive invasive assessment of such patients during coronary angiography provides important diagnostic information that can guide management.
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Affiliation(s)
- Vedant Pargaonkar
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Takumi Kimura
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Ryo Kameda
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Shigemitsu Tanaka
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Ryotaro Yamada
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Jonathan Schwartz
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Leor Perl
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Ian Rogers
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Yasuhiro Honda
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Peter Fitzgerald
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Ingela Schnittger
- Division of Cardiovascular Medicine, Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Jennifer Tremmel
- 300 Pasteur Drive, Room H2103, Stanford, CA 94305-5218, USA. E-mail:
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