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Abraham AG, Riauka T, Hudson M, Ghosh S, Zebak S, Alba V, Vaihenberg E, Warkentin H, Tankel K, Severin D, Bedard E, Spratlin J, Mulder K, Joseph K. 18F-Fluorodeoxyglucose Positron Emission Tomography Parameters can Predict Long-Term Outcome Following Trimodality Treatment for Oesophageal Cancer. Clin Oncol (R Coll Radiol) 2023; 35:177-187. [PMID: 36402622 DOI: 10.1016/j.clon.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/06/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022]
Abstract
AIMS 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG-PET/CT) is routinely used for the pre-treatment staging of oesophageal or gastro-oesophageal junction cancers (EGEJC). The aim of this study was to identify objective 18FDG-PET/CT-derived parameters that can aid in predicting the patterns of recurrence and prognostication in patients with EGEJC. PATIENTS AND METHODS EGEJC patients referred for consideration of preoperative chemoradiation therapy were identified and clinicopathological data were collected. 18FDG-PET/CT imaging data were reviewed and correlated with treatment outcomes. Maximum standardised uptake value (SUVmax), metabolic tumour volume (MTV) and total lesion glycolysis were assessed and association with recurrence-free survival (RFS), locoregional recurrence-free survival (LR-RFS), oesophageal cancer-specific survival (ECSS) and overall survival were evaluated using receiver operating characteristic curves, as well as Cox regression and Kaplan-Meier models. RESULTS In total, 191 EGEJC patients completed trimodality treatment and 164 with 18FDG-PET/CT data were included in this analysis. At the time of analysis, 15 (9.1%), 70 (42.7%) and two (1.2%) patients were noted to have locoregional, distant and both locoregional and distant metastases, respectively. The median RFS was 30 months (9.6-50.4) and the 5-year RFS was 31.1%. The 5-year overall survival and ECSS were both noted to be 34.8%. Pre-treatment MTV25 > 28.5 cm3 (P = 0.029), MTV40 > 12.4 cm3 (P = 0.018) and MTV50 > 10.2 cm3 (P = 0.005) predicted for worse LR-RFS, ECSS and overall survival for MTV definition of voxels ≥25%, 40% and 50% of SUVmax. CONCLUSION 18FDG-PET/CT parameters MTV and total lesion glycolysis are useful prognostic tools to predict for LR-RFS, ECSS and overall survival in EGEJC. MTV had the highest accuracy in predicting clinical outcomes. The volume cut-off points we identified for different MTV thresholds predicted outcomes with significant accuracy and may potentially be used for decision making in clinical practice.
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Affiliation(s)
- A G Abraham
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - T Riauka
- Department of Nuclear Medicine, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada; Division of Medical Physics, Department of Oncology, University of Alberta, Edmonton, Canada
| | - M Hudson
- Department of Nuclear Medicine, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - S Ghosh
- Division of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - S Zebak
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - V Alba
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - E Vaihenberg
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - H Warkentin
- Division of Medical Physics, Department of Oncology, University of Alberta, Edmonton, Canada
| | - K Tankel
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - D Severin
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - E Bedard
- Department of Thoracic Surgery, Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - J Spratlin
- Division of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - K Mulder
- Division of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - K Joseph
- Division of Radiation Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.
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John VL, Gomathi N, Joseph K, Mathew D, Chandran SM, Neogi S. Plasma Functionalized CNT/Cyanate Ester Nanocomposites for Aerospace Structural Applications. ChemistrySelect 2022. [DOI: 10.1002/slct.202201260] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Varsha Lisa John
- Indian Institute of Space Science and Technology Trivandrum India
| | - N. Gomathi
- Indian Institute of Space Science and Technology Trivandrum India
| | - K. Joseph
- Indian Institute of Space Science and Technology Trivandrum India
| | - Dona Mathew
- Polymers and Special Chemicals Group Vikram Sarabhai Space Centre Trivandrum India
| | - Satheesh M Chandran
- Polymers and Special Chemicals Group Vikram Sarabhai Space Centre Trivandrum India
| | - S. Neogi
- Department of Chemical Engineering Indian Institute of Technology Kharagpur India
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Tyeku N, Apolisi I, Daniels J, Beko B, Memani B, Cengani L, Fatshe S, Gumede N, Joseph K, Mathee S, Furin J, Maugans C, Cox H, Reuter A. Pediatric delamanid treatment for children with rifampicin-resistant TB. Int J Tuberc Lung Dis 2022; 26:986-988. [PMID: 36163672 PMCID: PMC9524514 DOI: 10.5588/ijtld.22.0264] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- N Tyeku
- Médecins Sans Frontières, Khayelitsha, Cape Town, South Africa
| | - I Apolisi
- Médecins Sans Frontières, Khayelitsha, Cape Town, South Africa
| | - J Daniels
- Médecins Sans Frontières, Khayelitsha, Cape Town, South Africa
| | - B Beko
- Médecins Sans Frontières, Khayelitsha, Cape Town, South Africa
| | - B Memani
- Médecins Sans Frontières, Khayelitsha, Cape Town, South Africa
| | - L Cengani
- Department of Health, Province of the Western Cape, Cape Town, South Africa
| | - S Fatshe
- Department of Health, Province of the Western Cape, Cape Town, South Africa
| | - N Gumede
- Department of Health, Province of the Western Cape, Cape Town, South Africa
| | - K Joseph
- Department of Health, City of Cape Town, Cape Town, South Africa
| | - S Mathee
- Department of Health, Province of the Western Cape, Cape Town, South Africa
| | - J Furin
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - C Maugans
- The Sentinel Project on Pediatric Drug Resistant Tuberculosis, Boston, MA, USA
| | - H Cox
- Institute of Infectious Diseases and Molecular Medicine, Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
| | - A Reuter
- Médecins Sans Frontières, Khayelitsha, Cape Town, South Africa
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Zhang J, Joseph K, Beck J, Schnell O, Ravi VM, Heiland DH. P10.24.A A personalized BRAF mutant glioblastoma with Human2Human ex-vivo cortical cultures. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.189] [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: 11/12/2022] Open
Abstract
Abstract
Background
Glioblastoma is among the most common primary malignancy with a poor medium survival post-diagnosis. The incredible heterogeneity of glioblastoma highlights its incurable nature. Methods to overcome difficulties leaded by glioblastoma heterogeneity remain to be explored. Here we present our Human2Human personalized autografted BRAF(V600E) mutant glioblastoma model, focusing on the idea of precision. This model, with an inoculation of self-derived glioblastoma cells, can imitate the tumor growth, invasion, metabolism and microenvironmental crosstalk within its “native” microenvironment and allows us to investigate the influence of different chemotherapies on the immunosuppressive tumor microenvironment from each specific individual glioblastoma patient.
Material and Methods
Non-neoplastic cortical tissue was obtained from a BRAF(V600E) mutant glioblastoma patient during surgical operation. Tissue was sectioned and inoculated with autografted glioblastoma cells in order to establish the ex-vivo Human2Human personalized brain slice model. Slice viability and tumor growth were monitored throughout the culture period, with and without day-wise refreshed treatments of clinically proved BRAF/MEK inhibitors. Sections were fixed and stained post cultivation. Pathway proteins p-ERK, p-Akt based on BRAF signaling along with markers (TMEM119, Iba-1, CD3, CD68, GFAP and NeuN) for major cell types in the environment were stained. Single Nuclei RNA Sequencing and Spatially Resolved Transcriptomics were applied.
Results
Tumor growth quantification over the culture period revealed different tumor reaction and tolerance towards various chemotherapies. The combination of Vemurafenib + Trametinib exhibited more efficient therapy response in comparison with either Dabrafenib + Trametinib or Encorafenib + Trametinib. Immunofluorescence and immunohistochemistry based quantification referring to neurons (NeuN), astrocytes (GFAP) and microglia/macrophage cells (Iba-1) suggested no toxic effects of the drug combinations on the tumor microenvironment. BRAF pathway proteins and immune cells showed various activation patterns upon different treatment combinations on an immunofluorescence base. Single Nuclei RNA Sequencing revealed the mesenchymal differentiation of BRAF mutant glioblastoma cells. Spatially Resolved Transcriptomics characterized tumor recurrence and suggested the therapy response accurately and visually.
Conclusion
The combination of Vemurafenib + Trametinib shows strategy to this specific BRAF mutant glioblastoma patient. And therefore, this Human2Human personalized model has a potential to provide in-depth information of the spatio-temporal tumor differentiation ex-vivo, correct inter-patient bias, and model therapy response in a very short time frame to provide drug testing results for clinical decision making.
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Affiliation(s)
- J Zhang
- Microenvironment and Immunology Research Laboratory, Department of Neurosurgery, Medical Center - University of Freiburg , Freiburg im Breisgau , Germany
- Faculty of Medicine, University of Freiburg , Freiburg im Breisgau , Germany
| | - K Joseph
- Microenvironment and Immunology Research Laboratory, Department of Neurosurgery, Medical Center - University of Freiburg , Freiburg im Breisgau , Germany
- Faculty of Medicine, University of Freiburg , Freiburg im Breisgau , Germany
| | - J Beck
- Department of Neurosurgery, Medical Center - University of Freiburg , Freiburg im Breisgau , Germany
- Faculty of Medicine, University of Freiburg , Freiburg im Breisgau , Germany
| | - O Schnell
- Department of Neurosurgery, Medical Center - University of Freiburg , Freiburg im Breisgau , Germany
- Faculty of Medicine, University of Freiburg , Freiburg im Breisgau , Germany
| | - V M Ravi
- Microenvironment and Immunology Research Laboratory, Department of Neurosurgery, Medical Center - University of Freiburg , Freiburg im Breisgau , Germany
- Faculty of Medicine, University of Freiburg , Freiburg im Breisgau , Germany
| | - D H Heiland
- Microenvironment and Immunology Research Laboratory, Department of Neurosurgery, Medical Center - University of Freiburg , Freiburg im Breisgau , Germany
- Faculty of Medicine, University of Freiburg , Freiburg im Breisgau , Germany
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Ravi VM, Behringer S, Joseph K, Beck J, Schnell O, Heiland DH. P12.14.A The role of onco-metabolite (R2hydroxyglutarate) in the IDH mutant glioblastoma microenvironment. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.279] [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
Recently, we found that the reactive astrocytes in the IDH wild type glioblastoma contribute to anti-tumor immunity and support pro-oncogenic signaling. Here, we characterized the transcriptomic signature of IDH1/2-mutant glioma associated astrocytes and determined a unique inflammatory transformation, profoundly different to astrocytes in IDH wildtype glioma patients due to an onco-metabolite R-2-hydroxyglutarate using Next generation sequencing and human ex-vivo slice model.
Material and Methods
We purified and transcriptionally profiled astrocytes from 9 patients with confirmed IDH1-R132H mutation, by means of RNA-sequencing and the data were analyzed using the established pipelines. We also used spatial transcriptomics to evidently show the spatial distribution of astrocytes in IDH-mutated/wildtype glioma samples. We validated our findings using human organotypic slice model inoculated with IDH-mutant cell line or treated with oncometabolite 2-hydroxy glutarate. Additionally, LC-MS was further used to give us a chart of neurotransmitters due to altered microenvironment.
Results
Our results from RNA sequencing showed a transcriptional transformation of reactive astrocytes within the microenvironment of IDH-mutated tumors compared to wildtype glioma by means of RNA-sequencing of purified astrocytes. And, using our established human neocortical GBM model inoculated with IDH mutant tumor and R-2HG treatment, we showed that we were able to activate inflammatory transcriptional programs in astrocytes, mediated by the presence of microglia. Further, by spatially mapping the transcriptomic profiles of purified microglia, we were able to confirm that microglia also demonstrate inflammatory activation in IDH mutated glioma. This inflammatory astrocyte transformation is associated with a loss of neurotransmitter homeostasis (disrupted levels of glutamate) in the treated sections, as has been previously reported in IDH mutated tumors. Additionally, R-H2G increased neuronal spiking rate in, pointing to potential excitotoxicity.
Conclusion
Our work provides a crucial contribution towards understanding the role of R-2HG in the IDH mutant glioma microenvironment and sheds light on the significant microenvironmental differences to IDH wild-type glioma.
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Affiliation(s)
- V M Ravi
- University Clinic of Freiburg, Freiburg , Killianstrasse , Germany
| | - S Behringer
- University Clinic of Freiburg , Freiburg , Germany
| | - K Joseph
- University Clinic of Freiburg , Freiburg im Breisgau , Germany
| | - J Beck
- University Clinic of Freiburg , Baden-Württemberg - Freiburg , Germany
| | - O Schnell
- University Clinic of Freiburg , Baden-Württemberg - Freiburg , Germany
| | - D H Heiland
- University Clinic of Freiburg , Freiburg , Germany
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Abraham AG, Joseph K, Spratlin JL, Zebak S, Alba V, Iafolla M, Ghosh S, Abdelaziz Z, Lui A, Paulson K, Bedard E, Chua N, Tankel K, Koski S, Scarfe A, Severin D, Zhu X, King K, Easaw JC, Mulder KE. Does Loosening the Inclusion Criteria of the CROSS Trial Impact Outcomes in the Curative-Intent Trimodality Treatment of Oesophageal and Gastroesophageal Cancer Patients? Clin Oncol (R Coll Radiol) 2022; 34:e369-e376. [PMID: 35680509 DOI: 10.1016/j.clon.2022.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/16/2022] [Accepted: 05/13/2022] [Indexed: 11/28/2022]
Abstract
AIM To determine the efficacy of preoperative chemoradiotherapy as per the CROSS protocol for oesophageal/gastroesophageal junction cancer (OEGEJC), when expanded to patients outside of the inclusion/exclusion criteria defined in the original clinical trial. MATERIALS AND METHODS Data were collected retrospectively on 229 OEGEJC patients referred for curative-intent preoperative chemoradiotherapy. Outcomes including pathological complete response (pCR), overall survival (OS), cancer-specific survival and recurrence-free survival (RFS) of patients who met CROSS inclusion criteria (MIC) versus those who failed to meet criteria (FMIC) were determined. RESULTS In total, 42.8% of patients MIC, whereas 57.2% FMIC; 16.6% of patients did not complete definitive surgery. The MIC cohort had higher rates of pCR, when compared with the FMIC cohort (33.3% versus 20.6%, P = 0.039). The MIC cohort had a better RFS, cancer-specific survival and OS compared with the FMIC cohort (P = 0.006, P = 0.004 and P = 0.009, respectively). Age >75 years and pretreatment weight loss >10% were not associated with a poorer RFS (P = 0.541 and 0.458, respectively). Compared with stage I-III patients, stage IVa was associated with a poorer RFS (hazard ratio (HR) = 2.158; 95% confidence interval (CI) = 1.339-3.480, P = 0.001). Tumours >8 cm in length or >5 cm in width had a trend towards worse RFS (HR = 2.060; 95% CI = 0.993-4.274, P = 0.052). CONCLUSION Our study showed that the robust requirements of the CROSS trial may limit treatment for patients with potentially curable OEGEJC and can be adapted to include patients with a good performance status who are older than 75 years or have >10% pretreatment weight loss. However, the inclusion of patients with celiac nodal metastases or tumours >8 cm in length or >5 cm in width may be associated with poor outcomes.
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Affiliation(s)
- A G Abraham
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - K Joseph
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - J L Spratlin
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - S Zebak
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - V Alba
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada; University of Alberta, Edmonton, Alberta, Canada
| | - M Iafolla
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada; Department of Medical Oncology, Juravinski Cancer Center, McMaster University, Hamilton, Ontario, Canada
| | - S Ghosh
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Z Abdelaziz
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada; Department of Clinical Oncology, Cairo University, Cairo, Egypt
| | - A Lui
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - K Paulson
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - E Bedard
- Department of Thoracic Surgery, Royal Alexandra Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - N Chua
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - K Tankel
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - S Koski
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - A Scarfe
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - D Severin
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - X Zhu
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - K King
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - J C Easaw
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada
| | - K E Mulder
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.
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Joseph L, Kumar PS, Deeraj BDS, Joseph K, Jayanarayanan K, Mini KM. Modification of epoxy binder with multi walled carbon nanotubes in hybrid fiber systems used for retrofitting of concrete structures: evaluation of strength characteristics. Heliyon 2022; 8:e09609. [PMID: 35706939 PMCID: PMC9189027 DOI: 10.1016/j.heliyon.2022.e09609] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/11/2022] [Accepted: 05/26/2022] [Indexed: 11/30/2022] Open
Abstract
The rapid development in infrastructural facilities necessitates an efficient approach for the repair and retrofitting of concrete structures and, confinement method using fiber reinforced polymer is a promising one. The commonly used carbon and glass fibers for confinement poses environmental and performance issues. The present study addresses these two major aspects by considering natural fibers along with modification of epoxy binder to impart ductile behavior ie., to investigate the effectiveness of multiwalled carbon nanotubes (MWCNT) incorporated synthetic and natural fiber reinforced polymer (FRP) systems as the external confinement. MWCNT is incorporated in 0.5-1.5wt.% in epoxy nano and epoxy multiscale and there is significant enhancement in tensile and fracture properties of the composites up to 1wt.%, beyond which it declined due to agglomeration. Various strength tests were performed with sisal, basalt, carbon and hybrid sisal-basalt FRP systems with different FRP layer thickness on plain concrete cylinders. From the test results it is outlined that external confinement with MWCNT incorporated FRP improved the axial load-carrying capacity, energy absorption and ductility of concrete with respect to that of control specimens. Compared with unconfined specimens, those strengthened with MWCNT modified hybrid FRP wraps containing sisal and basalt fibers recorded increments of 114% and 87% in their load-carrying capacity and energy absorption, due to the intrinsic rigidity of hybrid fibers and epoxy modification. Furthermore, the outcomes indicate that MWCNT incorporated hybrid sisal-basalt FRP confined specimens exhibited superior properties and the low strength of natural FRP confinement compared to artificial FRP can be improved by epoxy modification. The outer jacketing resisted abrupt and catastrophic failure to a great extent.
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Affiliation(s)
- Lakshmi Joseph
- Department of Civil Engineering, Amrita School of Engineering, Amrita Vishwa Vidyapeetham, Coimbatore, India
| | - P Sarath Kumar
- Department of Chemical Engineering and Materials Science, Amrita School of Engineering, Amrita Vishwa Vidyapeetham, Coimbatore 641112, India.,Centre of Excellence in Advanced Materials and Green Technologies (CoE-AMGT), Amrita School of Engineering, Amrita Vishwa Vidyapeetham, Coimbatore 641112, India
| | - B D S Deeraj
- Department of Chemistry, Indian Institute of Space Science and Technology, Thiruvananthapuram, Kerala, India
| | - K Joseph
- Department of Chemistry, Indian Institute of Space Science and Technology, Thiruvananthapuram, Kerala, India
| | - Karingamanna Jayanarayanan
- Department of Chemical Engineering and Materials Science, Amrita School of Engineering, Amrita Vishwa Vidyapeetham, Coimbatore 641112, India.,Centre of Excellence in Advanced Materials and Green Technologies (CoE-AMGT), Amrita School of Engineering, Amrita Vishwa Vidyapeetham, Coimbatore 641112, India
| | - K M Mini
- Department of Civil Engineering, Amrita School of Engineering, Amrita Vishwa Vidyapeetham, Coimbatore, India
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Dinakaran D, Jha N, Joseph K, Walker J. Response and Toxicity Patterns Seen in Patients Treated With Combination Immunotherapy and Radiotherapy in the UNSCARRed (UNresectable Squamous Cell Carcinoma treated With Avelumab and Radical Radiotherapy) Study. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.971] [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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Joseph K, Vollmer L, Ravi VM, Beck J, Hofmann UG, Schnell O, Heiland DH. OS06.9A Diversity of cellular communication in glioblastoma. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.032] [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
Owing to recent advances in understanding of the active functional states exhibited within glioblastoma (GBM), intra-tumoral cellular signaling has moved into focus of neuro-oncological research. In our study, we aim to explore the diversity of transcellular signaling and investigate correlations to transcriptional dynamics and cellular behavior.
MATERIAL AND METHODS
Electrophysiological mapping of primary GBM cultures was performed by planar microelectrodes, in conjunction with calcium imaging in a human neocortical section based GBM model. Exposure to conditions that are physiologically present within the tumor was carried out to identify specific signaling cells of interest and signaling diversity presented as response to specific environmental conditions. Transcriptional dynamics and plasticity were examined by means of scRNA-sequencing with CRISPR based perturbation, spatial transcriptomics and deep long-read RNA-sequencing.
RESULTS
Electrophysiological profiles of primary GBM cell lines revealed highly variable network activity. Despite these different characteristics, all profiled primary cell-lines exhibited characteristics of scale-free networks, confirmed in a human neocortical GBM model. When the GBM was allowed to grow in “in-vivo” like environment, basal activity was significantly increased, owing to interactions with elements within the neural environment. Cellular signaling was directly correlated to changes in the environment, like hypoxia or glutamatergic activation, and total inhibition of electrical signaling was achieved only with a combination of both gap junction and synaptic inhibitors. Using single-cell sequencing and proteomics, we identified several genes related to synaptogenesis that plays a crucial role in network formation and consequently transcellular signaling. CRISPR based perturbation of these genes resulted in alterations in cellular morphology and decreased cellular connectivity, with electrical signaling being significantly attenuated. Single-cell sequencing of perturbed tumor cells in the GBM model revealed a loss of developmental lineages and significant reduction of cellular stress response state.
CONCLUSION
Our findings highlight the role of electrical signaling in glioblastoma. Cellular stressors induce intercellular signaling, leading to transcriptional adaptation suggesting that there exists a highly complex and powerful mechanism for dynamic transcriptional state adaptation.
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Affiliation(s)
- K Joseph
- University Medical Center, Freiburg, Freiburg, Germany
| | - L Vollmer
- University Medical Center, Freiburg, Freiburg, Germany
| | - V M Ravi
- University Medical Center, Freiburg, Freiburg, Germany
| | - J Beck
- University Medical Center, Freiburg, Freiburg, Germany
| | - U G Hofmann
- University Medical Center, Freiburg, Freiburg, Germany
| | - O Schnell
- University Medical Center, Freiburg, Freiburg, Germany
| | - D H Heiland
- University Medical Center, Freiburg, Freiburg, Germany
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Joseph K, Wong J, Abraham A, Menon A, Ghosh S, Warkentin H, Walker J, Salopek T. PH-0331 Patterns And Predictors Of Relapse In Merkel Cell Carcinoma :Results From A Population Based Study. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07304-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Biart S, Shakeshaft M, Joseph K. CNS infection with a history of recurrent epistaxis: Streptococcal meningitis as a first presentation of juvenile nasopharyngeal angiofibroma. Acute Med 2021; 20:231-233. [PMID: 34679142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
An adolescent male with a history of recurrent epistaxis presented with headache and vomiting. Investigations revealed concurrent meningitis as well as the presence of a subarachnoid haemorrhage. Subsequent imaging identified a Juvenile Nasopharyngeal Angiofibroma; a rare but important cause of meningitis that should be considered in the young adult population.
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Affiliation(s)
- S Biart
- Acute Medicine, Arrowe Park Hospital, UK
| | | | - K Joseph
- Acute Medicine, Arrowe Park Hospital, UK
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Joseph K, Vos LJ, Gabos Z, Pervez N, Chafe S, Tankel K, Warkentin H, Ghosh S, Amanie J, Powell K, Polkosnik LA, Horsman S, MacKenzie M, Sabri S, Parliament MB, Mackey J, Abdulkarim B. Skin Toxicity in Early Breast Cancer Patients Treated with Field-In-Field Breast Intensity-Modulated Radiotherapy versus Helical Inverse Breast Intensity-Modulated Radiotherapy: Results of a Phase III Randomised Controlled Trial. Clin Oncol (R Coll Radiol) 2020; 33:30-39. [PMID: 32711920 DOI: 10.1016/j.clon.2020.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/08/2020] [Accepted: 07/03/2020] [Indexed: 11/15/2022]
Abstract
AIMS Skin toxicity is a common adverse effect of breast radiotherapy. We investigated whether inverse-planned intensity-modulated radiotherapy (IMRT) would reduce the incidence of skin toxicity compared with forward field-in-field breast IMRT (FiF-IMRT) in early stage breast cancer. MATERIALS AND METHODS This phase III randomised controlled trial compared whole-breast irradiation with either FiF-IMRT or helical tomotherapy IMRT (HT-IMRT), with skin toxicity as the primary end point. Patients received 50 Gy in 25 fractions and were assessed to compare skin toxicity between treatment arms. RESULTS In total, 177 patients were available for assessment and the median follow-up was 73.1 months. Inverse IMRT achieved more homogeneous coverage than FiF-IMRT; erythema and moist desquamation were higher with FiF-IMRT compared with HT-IMRT (61% versus 34%; P < 0.001; 33% versus 11%; P < 0.001, respectively). Multivariate analysis showed large breast volume, FiF-IMRT and chemotherapy were independent factors associated with worse acute toxicity. There was no difference between treatment arms in the incidence of late toxicities. The 5-year recurrence-free survival was 96.3% for both FiF-IMRT and HT-IMRT and the 5-year overall survival was 96.3% for FiF-IMRT and 97.4% for HT-IMRT. CONCLUSIONS Our study showed significant reduction in acute skin toxicity using HT-IMRT compared with FiF-IMRT, without significant reduction in late skin toxicities. On the basis of these findings, inverse-planned IMRT could be used in routine practice for whole-breast irradiation with careful plan optimisation to achieve the required dose constraints for organs at risk.
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Affiliation(s)
- K Joseph
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - L J Vos
- Alberta Cancer Clinical Trials, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Z Gabos
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - N Pervez
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - S Chafe
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - K Tankel
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - H Warkentin
- Division of Medical Physics, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - S Ghosh
- Division of Medical Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - J Amanie
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - K Powell
- Division of Medical Physics, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - L-A Polkosnik
- Division of Medical Physics, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - S Horsman
- Division of Medical Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - M MacKenzie
- Division of Medical Physics, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - S Sabri
- Division of Experimental Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - M B Parliament
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - J Mackey
- Division of Medical Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada
| | - B Abdulkarim
- Division of Radiation Oncology, Department of Oncology, University of Alberta & Cross Cancer Institute, Edmonton, Alberta, Canada.
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Neupane D, Rijal A, Henry ME, Kallestrup P, Koirala B, Mclachlan CS, Ghimire K, Zhao D, Sharma S, Pokharel Y, Joseph K, Olsen MH, Schutte AE, Appel LJ. Mean dietary salt intake in Nepal: A population survey with 24-hour urine collections. J Clin Hypertens (Greenwich) 2020; 22:273-279. [PMID: 31967732 DOI: 10.1111/jch.13813] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 09/05/2019] [Revised: 11/25/2019] [Accepted: 12/02/2019] [Indexed: 01/17/2023]
Abstract
High salt (sodium chloride) intake raises blood pressure and increases the risk of developing hypertension, a major risk factor for cardiovascular disease. Little is known about salt intake in Nepal, and no study has estimated salt consumption from 24-hour urinary sodium excretion. Participants (n = 451) were recruited from the Community-Based Management of Non-Communicable Diseases in Nepal (COBIN) cohort in 2018. Salt intake was estimated by analyzing 24-hour urinary sodium excretion. Multivariate linear regression was used to estimate differences in salt intake. The mean (±SD) age and salt intake were 49.6 (±9.8) years and 13.3 (±4.7) g/person/d, respectively. Higher salt intake was significantly associated with male gender (β for female = -2.4; 95% CI: -3.3, -1.4) and younger age (β10 years = -1.4; 95% CI: -1.4, -0.5) and higher BMI (β = 0.1; 95% CI: 0.0, 0.2). A significant association was also found between increase in systolic blood pressure and higher salt intake (β = 0.3; 95% CI: 0.0, 0.7). While 55% reported that they consumed just the right amount of salt, 98% were consuming more than the WHO recommended salt amount (<5 g/person/d). Daily salt intake in this population was over twice the limit recommended by the WHO, suggesting a substantial need to reduce salt intake in this population. It also supports the need of global initiatives such as WHO's Global Hearts Initiative SHAKE technical package and Resolves to Save Lives for sodium reduction in low- and middle-income countries like Nepal.
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Affiliation(s)
- Dinesh Neupane
- Nepal Development Society, Bharatpur, Chitwan, Nepal.,Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Anupa Rijal
- Nepal Development Society, Bharatpur, Chitwan, Nepal.,Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Megan E Henry
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Per Kallestrup
- Department of Public Health, Center for Global Health, Aarhus University, Aarhus, Denmark
| | - Bhagawan Koirala
- Manmohan Cardiothoracic Vascular and Transplant Center, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | | | - Kamal Ghimire
- Nepal Development Society, Bharatpur, Chitwan, Nepal
| | - Di Zhao
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
| | - Shailendra Sharma
- Department of Medicine, The George Washington University, Washington, DC, USA
| | - Yashashwi Pokharel
- Saint Luke's Mid America Heart Institute, University of Missouri, Kansas City, MO, USA
| | - Kristy Joseph
- Global Noncommunicable Disease Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michael Hecht Olsen
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Aletta E Schutte
- Hypertension in Africa Research Team, South African Medical Research Council, North-West University, Potchefstroom, South Africa
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA
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Joseph K, Halvas E, Brandt L, Patro S, Rausch J, Kearney M, Coffin J, Mellors J. High-throughput sequencing of integrated HIV-1 reveals novel proviral structures. J Virus Erad 2019. [DOI: 10.1016/s2055-6640(20)30138-2] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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15
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Neupane D, Henry M, Zhao D, Kallestrup P, Koirala B, Joseph K, Olsen MH, Schutte A, Appel L. Estimation of Salt Consumption from 24-hour Urine Collection in a Nepalese Population (P18-084-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz039.p18-084-19] [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: 11/13/2022] Open
Abstract
Abstract
Objectives
High salt (sodium chloride) intake is associated with an increased risk of hypertension, which is a major risk factor for cardiovascular diseases. Current consumption of salt in Nepal is unknown. The objective of this study was to estimate average salt intake in a Nepalese population from 24-hr urine collection in a population-based survey.
Methods
Participants (n = 499) were recruited from the Community-Based Management of Non-Communicable Diseases in Nepal (COBIN) cohort in the peri-urban area of Pokhara municipality from July to December 2018. The modified version of STEPS survey of non-communicable diseases (NCD) risk factors was administered. Salt intake was estimated from a single 24-hr urine collection. Multivariate linear regression was used to estimate differences in salt intake (g) associated with a variety of factors including demographics, lifestyle, health care, and health literacy.
Results
Mean (SD) age was 50.0 (9.7) years; mean salt intake was 13.0 (4.8) g/person/d. Male gender, younger age, and higher body mass index were significantly associated with higher salt intake (Table). Although 55% of respondents thought that they consumed just the right amount of salt, 96% were consuming more than the WHO-recommended level of less than 5 g/d. Almost half of the respondents reported that they consumed processed food containing high amounts of salt. In multivariate analyses, systolic blood pressure was 0.4 mmHg (95% CI: 0.05, 0.7) higher per 1-gram increase in salt intake.
Conclusions
Daily intake of salt in this Napalese population was over twice the WHO recommended upper limit, indicating a substantial need to reduce salt across the entire population. Community-based interventions for behavior modification through health education and dietary counseling may be effective in this population where salt is added during cooking. Still, interventions targeting the marketing, availability, and labeling of processed foods is also important, as intake of processed foods was also commonplace in Nepal.
Funding Sources
PHI through financial support from Centers for Disease Control and Prevention (CDC), USA; Jayanti Memorial Trust (JMT), Nepal; Nepal Development Society (NEDS), Nepal.
Supporting Tables, Images and/or Graphs
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Affiliation(s)
| | - Megan Henry
- Johns Hopkins Bloomberg School of Public Health
| | - Di Zhao
- Johns Hopkins Bloomberg School of Public Health
| | | | | | | | | | | | - Lawrence Appel
- The Johns Hopkins Bloomberg School of Public Health, Welch Center for Epidemiology
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Ott C, Gardner S, Joseph K, Berall A, Lavigne M, Simoni E. CORRELATION OF THE BRADEN SCALE AND COMORBIDITIES WITH PRESSURE INJURY PREVALENCE IN A GERIATRIC HOSPITAL. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1827] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kolb G, Höffken H, Müller T, Havemann K, Joseph K, Lange H. Kinetics of Pulmonary Leukocyte Sequestration in Man during Hemodialysis with Different Membrane-Types. Int J Artif Organs 2018. [DOI: 10.1177/039139889001301104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although it has been suggested that pulmonary sequestration of leukocytes could account for membrane-dependent white blood cell depletion in HD, direct evidence in patients is still lacking. Therefore a study was initiated to test whether and how leukocytes distribute in the lung circulation during HD with different membranes. Thirteen patients suffering from chronic renal failure underwent lung scintigraphy during HD with cuprophane (n = 3), hemophane (n = 8) and polysulfone (n = 2) lowflux capillary dialyzers. Isolated autologous leukocytes were labelled with 99m-Technetium and reinfused before starting HD. Distribution of leukocyte related activity was registered by lung scintigraphy. In comparison to normal lung scintigraphy performed without HD, an impressive redistribution peak was demonstrated 10-20 min after the start of HD with cuprophane and also to a lesser extent with hemophane. When HD was performed with polysulfone the decrease in activity was delayed but no real redistribution was obtained. In accordance with other phenomena, such as peripheral leukopenia and changes in granulocyte oxidative metabolism, pulmonary sequestration of leukocytes takes place in man in the initial phase of HD and appears to be strongly dependent on the type of membrane. (Int J Artif Organs 1990; 13: 729-36)
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Affiliation(s)
- G. Kolb
- Department of Medicine, Division Hematology/Oncology, Baldingerstraβe, Marburg - Germany
| | - H. Höffken
- Department of Nuclear Medicine, Baldingerstraβe, Marburg - Germany
| | - T. Müller
- Division of Nephrology, Philipps-University of Marburg, Baldingerstraβe, Marburg - Germany
| | - K. Havemann
- Department of Medicine, Division Hematology/Oncology, Baldingerstraβe, Marburg - Germany
| | - K. Joseph
- Department of Nuclear Medicine, Baldingerstraβe, Marburg - Germany
| | - H. Lange
- Division of Nephrology, Philipps-University of Marburg, Baldingerstraβe, Marburg - Germany
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Habermehl A, Eisenhauer P, Joseph K, Graul EH. Anschluß und On-line-Betrieb eines Szintiscanners an einem Digitalrechner. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1635984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Das Betriebssystem BSC 1 steuert sowohl die Übernahme der Scanner-Informationen und die Eingaben vom Teletype als auch die verschiedenen Wiedergabemöglichkeiten eines Szintigramms. Bei der Aufnahme werden zunächst Patientennamen und verschiedene Scan-Parameter eingegeben. Vor Beginn des übemahmeprogramms errechnet das Programm Größen für eine möglichst optimale Ausnutzung des Speichers. Nach der Scan-Aufnahme werden Parameter für die Wiedergabeprogramme bestimmt. Danach geht der Rechner in die Warteschleife, in der er auf Wiedergabekommandos wartet. Das Betriebssystem enthält weiter Programmteile, mit denen der Inhalt des Datenspeichers als Lochstreifen ausgegeben, ein solcher Lochstreifen wieder eingelesen werden kann und Möglichkeiten zur zusätzlichen Beschriftung der Sichtgerätausgaben.
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Eisenhauer P, Habermehl A, Joseph K, Graul EH. Anschluß und On-line-Betrieb eines Szintiscanners an einem Digitalrechner. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1635977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Zur möglichst vollständigen Übernahme und Speicherung der bei der Aufnahme eines Szintigramms gewinnbaren Basis-Informationen wird ein Digitalrechner eingesetzt. Die Anlage besteht aus einem Picker Magnascanner und einem Rechner PDP 8/S als Grundeinheiten und einem Fernschreiber, einem Sichtgerät und einem x-y-Schreiber als Ausgabeeinheiten. Interface-Elektroniken dienen dazu, die Scanner-Informationen in den Rechner zu übernehmen und die Ausgabegeräte softwaremäßig vom Rechner her zu steuern. Das “Übernahme-Interface enthält ein eigenes Zählregister, Dadurch und durch die Bedienung des Interface über den Programm-Interrupt wurde erreicht, daß der Rechner während der Szintigramm-Aufnahme nur einen kleinen Prozentsatz der Zeit beansprucht wird und in der übrigen Zeit für die Auswertung der Datenmatrix oder für die Bedienung weiterer Geräte zur Verfügung steht.
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Habermehl A, Eisenhauer P, Joseph K, Graul EH. Anschluß und On-line-Betrieb eines Szintiscanners an einem Digitalrechner. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1635983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Das Betriebssystem enthält 2 Arten von Wiedergabeprogrammen: Wiedergaben am Sichtgerät und Druckausgaben. Beide werden durch ein Codewort vom Teletype aus aufgerufen.Bei dem Programm SSWE werden auf dem Sichtgerät alle Werte dargestellt, die über einer bestimmten Schwelle liegen. Diese Schwelle wird bei diesem Programm mit der Hand eingestellt, während sie bei dem Programm SASW automatisch angehoben wird und so einen Bilderzyklus liefert. Weitere Programme zeichnen die Höhenschichtlinien und liefern eine perspektivische Darstellung des Aktivitätsgebirges.Bei den Druckausgaben liefert das Programm FSWE eine Schwellendarstellung, während das Programm FVZE eine Darstellung der verschiedenen Niveaus mit verschiedenen Druckzeichen ausgibt. Ein ähnliches Programm ergibt eine Darstellung in mehrfachen Niveaugruppen. Außerdem ist in dem Betriebssystem noch ein Programm zur Druckausgabe von Höhenschichtlinien enthalten.
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Stapp J, Reinecke J, Skamel HJ, Höffken H, Benning R, Neuhaus C, Lenze H, Trautmann ME, Arnold R, Joseph K. Rezeptorszintigraphie mit 111In-Pentetreotid beiendokrinen gastroenteropankreatischenTumoren. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1632294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungDie Rezeptorszintigraphie mit 111In-Pentetreotid ist ein komplementäres bildgebendesVerfahren mit einer Sensitivität von 88%, um bei Patienten mitklinischen und biochemischen Symptomen eines endokrinen Tumors desGastrointestinaltraktes oder des Pankreas den Primärtumor und dessen Metastasen zu lokalisieren. Als Ganzkörperszintigraphie erfaßt sie jede Körperregionund stellt auch kleine Tumoren dar, die mit den übrigen bildgebendenVerfahren nicht oder nur schwer zu entdecken sind. Bei 104 Patienten mit GEP-Tumoren oder nach operativer Entfernung eines solchen Tumors erwiessich die Rezeptorszintigraphie als dem Ultraschall und der Computertomographie bei 34% in der Aussagekraftüberlegen, bei 52% als gleich und bei 14%als unterlegen.
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Dietlein M, Dressler J, Grünwald F, Joseph K, Leisner B, Moser E, Reiners C, Schicha H, Schneider P, Schober O, Rendl J. Guideline for in vivo- and in vitro procedures for thyroid diseases (version 2). Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1625307] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe version 2 of the guideline for diagnostic standards of thyroid disorders is an update of the guideline published in 1999 and describes standards of in vitro and in vivo procedures. The following statements are modified: In vitro procedures: When measurement of the TSH-receptor antibodies is indicated, the guideline recommends the use of a second generation assay (recombinant human TSH-receptor as antigen). The functional assay sensitivity for the measurement of thyroglobulin should reach a value ≤1 ng/ml. Moleculargenetic tests (RET proto-oncogen) are indicated in patients with a newly diagnosed medullary thyroid cancer and in the relatives of patients with hereditary medullary thyroid cancer. In vivo procedures: The sonographic examination should use a probe with a frequency of at least 7.5 MHz. Indications for the thyroid scintigraphy: nodule size ≥1 cm in diameter, autonomous goitre/nodule with clinical or subclinical hyperthyroidism, necessity of a differentiation between Graves’ disease and chronic lymphocytic thyroiditis, therapy control after a definitive treatment and – in individual cases – the follow-up of untreated autonomous nodules.
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Mahlstedt J, Welcke U, Joseph K. Früherkennung der thyreoidalen Autonomie durch Kombination von quantitativer Szintigrammauswertung mit einem Äquivalent des freien T4. Nuklearmedizin 2018. [DOI: 10.1055/s-0037-1620931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
ZusammenfassungAutonomes Schilddrüsengewebe (AFTT) fanden wir im Endemiegebiet bei eumetabolen Menschen sowohl in der umschriebenen (sog. autonomes Adenom) als auch in der disseminierten Form gleich häufig und in gleicher Ausprägung vor wie nach dem 40. Lebensjahr. Es ist im Endemiegebiet die häufigste Voraussetzung einer ungezügelten Hormonproduktion, die durch - meist iatrogene - Jodzufuhr ausgelöst wird. Die Verdachtsdiagnose der thyreoidalen Autonomie kann mit einer Treffsicherheit von etwa 80% schon bei euthyreoten Menschen durch gemeinsame Betrachtung des freien Thyroxin-Äquivalents (FTE) und eines durch quantitative Auswertung des Technetiumszintigrammes erhaltenen äquivalents der Jodidclearance (TcTU) gestellt werden. Der Suppressionstest liefert dann nicht nur qualitativ den Nachweis der fehlenden Regelbarkeit, sondern ermöglicht in der protrahiert-fraktionierten Form auch eine Abschätzung des Volumens autonomen Gewebes, denn der TcTU nach Suppression korreliert linear mit dem Volumen autonomen Gewebes. Da nach Jodzufuhr das FTE dem Volumen autonomen Gewebes proportional ansteigt, erscheint auch im Sinne einer groben Faustregel eine Prognose der thyreoidalen Autonomie möglich: oberhalb eines „kritischen‟ Volumens autonomen Gewebes wird mit an Sicherheit grenzender Wahrscheinlichkeit eine ausreichende Jodzufuhr genügender Dauer eine Hyperthyreose auslösen. Eine prospektive Studie an euthyreoten Patienten im Alter unter 50 Jahren mit unterschiedlichen Mengen autonomen Schilddrüsengewebes ergab, daß die Jodsalzprophylaxe in dieser Altersgruppe keine klinisch manifeste Hyperthyreose auslöst, wenn die tägliche zusätzliche Jodaufnahme 100 μg nicht übersteigt.
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Joseph K, Ahmed Y, Baker J, Antone J, Chang J. Comparing the Plan Quality of Two Commercial Treatment Planning Systems for the Single Isocenter for Multiple Targets Technique. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wang M, Hwang M, Ghosh S, Severin D, Nijjar T, Chu K, Gabos Z, Debenham B, Yee D, Tankel K, Roa W, Pearcey R, Joseph K, Danielson B, Fairchild A. Documentation of Driving Recommendations for Patients Receiving Whole Brain Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tangka FKL, Subramanian S, Hoover S, Royalty J, Joseph K, DeGroff A, Joseph D, Chattopadhyay S. Costs of promoting cancer screening: Evidence from CDC's Colorectal Cancer Control Program (CRCCP). Eval Program Plann 2017; 62:67-72. [PMID: 27989647 PMCID: PMC5840873 DOI: 10.1016/j.evalprogplan.2016.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 11/12/2016] [Accepted: 12/11/2016] [Indexed: 05/02/2023]
Abstract
The Colorectal Cancer Control Program (CRCCP) provided funding to 29 grantees to increase colorectal cancer screening. We describe the screening promotion costs of CRCCP grantees to evaluate the extent to which the program model resulted in the use of funding to support interventions recommended by the Guide to Community Preventive Services (Community Guide). We analyzed expenditures for screening promotion for the first three years of the CRCCP to assess cost per promotion strategy, and estimated the cost per person screened at the state level based on various projected increases in screening rates. All grantees engaged in small media activities and more than 90% used either client reminders, provider assessment and feedback, or patient navigation. Based on all expenditures, projected cost per eligible person screened for a 1%, 5%, and 10% increase in state-level screening proportions are $172, $34, and $17, respectively. CRCCP grantees expended the majority of their funding on Community Guide recommended screening promotion strategies but about a third was spent on other interventions. Based on this finding, future CRC programs should be provided with targeted education and information on evidence-based strategies, rather than broad based recommendations, to ensure that program funds are expended mainly on evidence-based interventions.
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Affiliation(s)
- Florence K L Tangka
- Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA.
| | - Sujha Subramanian
- RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA
| | - Sonja Hoover
- RTI International, 307 Waverley Oaks Road, Suite 101, Waltham, MA 02452, USA
| | - Janet Royalty
- Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA
| | - Kristy Joseph
- Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA
| | - Amy DeGroff
- Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA
| | - Djenaba Joseph
- Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA
| | - Sajal Chattopadhyay
- Centers for Disease Control and Prevention, 4770 Buford Highway, NE, Mailstop K-76, Atlanta, GA 30341-3717, USA
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Mathen P, McConnell Y, Yeung R, Graham D, Warkentin H, Warkentin B, Joseph K, Doll C. Chemoradiation Therapy for Anal Cancer: Analysis of 2 Radiation Techniques and Chemotherapy Regimens. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abdulkarim B, Joseph K, Vos L, Warkentin H, Gabos Z, Pervez N, Tankel K, Ghosh S, Chafe S, Parliament M. A Phase III Randomized Control Trial Comparing Skin-Sparing Helical Tomotherapy Versus 3D-Conformal Radiation Therapy in Early-Stage Breast Cancer: Acute and Late Skin Toxicity Outcomes. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mathen P, Mcintyre J, Roldan-Urgoti G, Box A, Koebel M, Chan A, Joseph K, Doll C. Mutational Spectrum of Anal Cancers From Patients Treated With Radical Chemoradiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Joseph K, Hitchcock SA, Meyer HP, Geyser MM, Becker PJ. Active myofascial trigger points in head and neck muscles of patients with chronic tension-type headache in two primary health care units in Tshwane. S Afr Fam Pract (2004) 2016. [DOI: 10.4102/safp.v58i4.5441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: The management of patients presenting with chronic tension-type headache (CTTH) can be challenging for primary health care practitioners. As with most chronic pain disorders, a multimodal management approach is frequently required. It has been postulated that myofascial pain syndrome (MPS) and its hallmark myofascial trigger points (MTrPs) found in specific muscle tissues may play a role in the chronic pain experienced by patients with CTTH. Little is known about the prevalence of MTrPs in patients with CTTH, in primary health care settings on the African continent. This study therefore aimed to investigate the prevalence of active MTrP’s in specific head and neck muscles/muscle groups in patients with CTTH.Methods: A prospective, cross-sectional and descriptive study was done in two primary health care facilities situated in Tshwane, South Africa. The sample included 97 adult patients with CTTH. Five head and neck muscles/muscle groups were examined bilaterally for active MTrPs. Outcome measures were the prevalence and distribution of active MTrPs in these patients.Results: Active MTrPs were found in 95.9% of the patients, the majority (74.2%) having four or more active MTrPs. The temporalis muscles and suboccipital muscle group exhibited the highest number of active MTrPs (prevalence 87.6% and 80.4% respectively).Conclusion: Our study suggests a strong association between MPS and CTTH in patients, presenting in the primary health care setting. This indicates the importance of a musculoskeletal assessment of neck and pericranial muscles in patients with CTTH. This can assist in determining the most appropriate treatment strategy in these patients.
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Marrero M, Joseph K, Klein E. SU-F-T-536: Contra-Lateral Breast Study for Prone Versus Supine Patients. Med Phys 2016. [DOI: 10.1118/1.4956721] [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: 11/07/2022] Open
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Joseph K, Hitchcock SA, Meyer HP, Geyser MM, Becker PJ. Active myofascial trigger points in head and neck muscles of patients with chronic tension-type headache in two primary health care units in Tshwane. S Afr Fam Pract (2004) 2016. [DOI: 10.1080/20786190.2015.1120932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Gleason B, Redd J, Kilmarx P, Sesay T, Bayor F, Mozalevskis A, Connolly A, Akpablie J, Prybylski D, Moffett D, King M, Bass M, Joseph K, Jones J, Ocen F. Establishment of an Ebola Treatment Unit and Laboratory - Bombali District, Sierra Leone, July 2014-January 2015. MMWR Morb Mortal Wkly Rep 2015; 64:1108-11. [PMID: 26447483 DOI: 10.15585/mmwr.mm6439a4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The first confirmed case of Ebola virus disease (Ebola) in Sierra Leone related to the ongoing epidemic in West Africa occurred in May 2014, and the outbreak quickly spread. To date, 8,704 Ebola cases and 3,955 Ebola deaths have been confirmed in Sierra Leone. The first Ebola treatment units (ETUs) in Sierra Leone were established in the eastern districts of Kenema and Kailahun, where the first Ebola cases were detected, and these districts were also the first to control the epidemic. By September and October 2014, districts in the western and northern provinces, including Bombali, had the highest case counts, but additional ETUs outside of the eastern province were not operational for weeks to months. Bombali became one of the most heavily affected districts in Sierra Leone, with 873 confirmed patients with Ebola during July-November 2014. The first ETU and laboratory in Bombali District were established in late November and early December 2014, respectively. T- evaluate the impact of the first ETU and laboratory becoming operational in Bombali on outbreak control, the Bombali Ebola surveillance team assessed epidemiologic indicators before and after the establishment of the first ETU and laboratory in Bombali. After the establishment of the ETU and laboratory, the interval from symptom onset to laboratory result and from specimen collection to laboratory result decreased. By providing treatment to Ebola patients and isolating contagious persons to halt ongoing community transmission, ETUs play a critical role in breaking chains of transmission and preventing uncontrolled spread of Ebola (4). Prioritizing and expediting the establishment of an ETU and laboratory by pre-positioning resources needed to provide capacity for isolation, testing, and treatment of Ebola are essential aspects of pre-outbreak planning.
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Metcalfe A, Lisonkova S, Joseph K. Temporal Changes in Small-for-Gestational Age Live Births Associated with Obstetric Intervention in the United States. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Joseph K, Mukendi Kavulu M. Peripheral neuropathies associated with HIV a clinical study in patients infected with HIV cases HIV excellence centre / University of Lubumbashi. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.1284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Howard DH, Tangka FKL, Royalty J, Dalzell LP, Miller J, O’Hara B, Joseph K, Kenney K, Guy G, Hall IJ. Erratum to: Breast cancer screening of underserved women in the USA: results from the National Breast and Cervical Cancer Early Detection Program, 1998–2012. Cancer Causes Control 2015; 26:669. [DOI: 10.1007/s10552-015-0591-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dalzell LP, Tangka FKL, Powers DS, O’Hara BJ, Holmes W, Joseph K, Royalty J. Erratum to: Data sources for identifying low-income, uninsured populations: application to public health—National Breast and Cervical Cancer Early Detection Program. Cancer Causes Control 2015; 26:711. [DOI: 10.1007/s10552-015-0597-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Dalzell LP, Tangka FKL, Powers DS, O'Hara BJ, Holmes W, Joseph K, Royalty J. Data sources for identifying low-income, uninsured populations: application to public health-National Breast and Cervical Cancer Early Detection Program. Cancer Causes Control 2015; 26:699-709. [PMID: 25916228 PMCID: PMC4732875 DOI: 10.1007/s10552-015-0571-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 03/23/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To provide information on the sources of data for estimating low-income, uninsured populations. To recommend uses of these data sources. To demonstrate the application of these data sources in the public health field, using the National Breast and Cervical Cancer Early Detection Program as an example. METHODS We describe U.S. Census Bureau data sources for identifying low-income, uninsured populations using two population surveys: the Annual Social and Economic Supplement to the Current Population Survey (CPS ASEC) and the American Community Survey (ACS), and using one model-based estimation program, the Small Area Health Insurance Estimates (SAHIE). We provide recommendations for use of these data sources, and we use CPS ASEC and SAHIE to estimate the percent of U.S. women eligible for the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). RESULTS CPS ASEC, ACS, and SAHIE are produced by the U.S. Census Bureau, and they are reliable sources for estimates of the low-income, uninsured populations in the USA. Key characteristics of these three data sources were presented to highlight the strengths of each to meet the needs of various programs at national and local levels. Recommendations are made on the use of the data sources. Based on these three data sources, estimates of NBCCEDP eligibility showed substantial variation over time at the national and state levels, and across states and counties. CONCLUSIONS Publicly funded programs that are directed toward low-income, uninsured individuals require information on their eligible populations to make decisions about program policy and resource allocation, and to monitor and evaluate the effectiveness of the programs. The U.S. Census Bureau produces three data sources (CPS ASEC, ACS, and SAHIE) for these estimates. The percent of U.S. women eligible for NBCCEDP varies over time and across states and counties. The data sources for these estimates are changing in order to measure key dimensions of the Affordable Care Act (ACA) and can provide helpful information for assessing the legislation's impact.
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Affiliation(s)
- Lucinda P Dalzell
- Social, Economic and Housing Statistics Division, 6H123, U.S. Census Bureau, 4600 Silver Hill Road, Washington, DC, 20233-8500, USA,
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Howard DH, Tangka FKL, Royalty J, Dalzell LP, Miller J, O'Hara B, Joseph K, Kenney K, Guy G, Hall IJ. Breast cancer screening of underserved women in the USA: results from the National Breast and Cervical Cancer Early Detection Program, 1998-2012. Cancer Causes Control 2015; 26:657-68. [PMID: 25779379 PMCID: PMC4748380 DOI: 10.1007/s10552-015-0553-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 03/04/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To describe the number and proportion of eligible women receiving mammograms funded by the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). METHODS Low-income, uninsured, and underinsured women aged 40-64 are eligible for mammography screening through the NBCCEDP. We used data from the NBCCEDP, the Current Population Survey, and Medical Expenditure Panel Survey to describe the number and proportion of women screened by the NBCCEDP and overall. RESULTS In 2011 and 2012, the NBCCEDP screened 549,043 women aged 40-64, an estimated 10.6 % (90 % confidence interval [CI] 10.4-10.9 %) of the eligible population. We estimate that 30.6 % (90 % CI 26.4-34.8 %) of eligible women aged 40-64 were screened outside the NBCCEDP, and 58.8 % (90 % CI 54.6-63.0 %) were not screened. The proportion of eligible women screened by the NBCCEDP varied across states, with an estimated range of 3.2 % (90 % CI 2.9-3.5 %) to 52.8 % (90 % CI 36.1-69.6 %) and a median of 13.7 % (90 % CI 11.0-16.4 %). The estimated proportion of eligible women aged 40-64 who received mammograms through the NBCCEDP was relatively constant over time, 11.1 % (90 % CI 10.2-11.9 %) in 1998-1999 and 10.6 % (90 % CI 10.4-11.9 %) in 2011-2012 (p = 0.23), even as the number of women screened increased from 343,692 to 549,043. CONCLUSIONS Although the NBCCEDP provided screening services to over a half million low-income uninsured women for mammography, it served a small percentage of those eligible. The majority of low-income, uninsured women were not screened.
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Affiliation(s)
- David H Howard
- Department of Health Policy and Management, Emory University, 1518 Clifton Road NE, Atlanta, GA, 30030, USA,
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Tangka FKL, Howard DH, Royalty J, Dalzell LP, Miller J, O'Hara BJ, Sabatino SA, Joseph K, Kenney K, Guy GP, Hall IJ. Cervical cancer screening of underserved women in the United States: results from the National Breast and Cervical Cancer Early Detection Program, 1997-2012. Cancer Causes Control 2015; 26:671-86. [PMID: 25783455 PMCID: PMC4429146 DOI: 10.1007/s10552-015-0524-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 01/08/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides breast and cervical cancer screens to low-income, uninsured, and underinsured women. We describe the number and proportion of women eligible for cervical cancer screening services and the proportion of eligible women screened over the period 1997-2012. METHODS Low-income, uninsured, and underinsured women aged 18-64 years who have not had a hysterectomy are eligible for cervical cancer screening through the NBCCEDP. We estimated the number of low-income, uninsured women using data from the US Census Bureau. We adjusted our estimates for hysterectomy status using the National Health Interview Survey and the Behavioral Risk Factor Surveillance System. We used data from the NBCCEDP to describe the number of women receiving NBCCEDP-funded screening and calculated the proportion of eligible women who received screening through the NBCCEDP at the national level (by age group, race/ethnicity) and at the state level by age group. We used the Medical Expenditure Panel Survey to estimate the proportion of NBCCEDP-eligible women who were screened outside the NBCCEDP and the proportion that are not screened. RESULTS We estimate that in 2010-2012, 705,970 women aged 18-64 years, 6.5 % (705,970 of 9.8 million) of the eligible population, received NBCCEDP-funded Pap tests. We estimate that 60.2 % of eligible women aged 18-64 years were screened outside the NBCCEDP and 33.3 % were not screened. The NBCCEDP provided 623,603 screens to women aged 40-64 years, an estimated 16.5 % of the eligible population, and 83,660 screens to women aged 18-39 years, representing an estimated 1.2 % of the eligible population. The estimated proportions of eligible women screened in each state ranged from 1.5 to 32.7 % and 5 % to 73.2 % among the 18-64 and 40-64 years age groups, respectively. Changes in the proportion of eligible women screened over the study period were nonsignificant. CONCLUSIONS Although the program provided cervical screening to over 700,000 women between 2010 and 2012, it served a small percent of those eligible. The proportion of women screened varied substantially across age groups, racial/ethnic groups, and states. Many low-income, uninsured women are not being screened.
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Affiliation(s)
- Florence K L Tangka
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, Mailstop F-76, Atlanta, GA, 30341-3717, USA,
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Tangka FKL, Howard DH, Royalty J, Dalzell LP, Miller J, O'Hara BJ, Sabatino SA, Joseph K, Kenney K, Guy GP, Hall IJ. Erratum to: Cervical cancer screening of underserved women in the United States: results from the National Breast and Cervical Cancer Early Detection Program, 1997-2012. Cancer Causes Control 2015; 26:687. [PMID: 25929885 PMCID: PMC4643590 DOI: 10.1007/s10552-015-0584-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Florence K L Tangka
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE, Mailstop F-76, Atlanta, GA, 30341-3717, USA,
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Kolb G, Fischer W, Schoenemann H, Bathke K, Höffken H, Müller T, Lange H, Joseph K, Havemann K. Effect of cuprophan, hemophan and polysulfone membranes on the oxidative metabolism, degranulation reaction, enzyme release and pulmonary sequestration of granulocytes. Contrib Nephrol 2015; 74:10-21. [PMID: 2562018 DOI: 10.1159/000417466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- G Kolb
- Department of Internal Medicine, University of Marburg, FRG
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Gidado M, Obasanya JO, Onazi J, Eneogu R, Chukwueme N, Joseph K, Useni S, Adejumo AO. TUBERCULOSIS CONTROL IN SECURITY CHALLENGED STATES OF NORTH-EAST NIGERIA. ARE THERE SIGNIFICANT IMPACT? Niger J Med 2015; 24:155-161. [PMID: 26353427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Nigeria in the past few years is faced with various security challenges in different parts of the country. The most severe in the last three years has been the crisis in northern Nigeria and specifically the north-eastern States, where three of the States have been under emergency rule for a year. Health care delivery system is usually one of the major casualties in a security challenged environment leading to unavailability or low utilization of services.The aim of this paper is to share the experience of TB services in states under emergency rule. METHODOLOGY A retrospective review of program data (reportable indicators for TB case finding,TB/HIV and treatment outcome for periods of eight years (2006-2013) comparing national data with north-east and the three states most affected by security challenges (Borno, Adamawa & Yobe). RESULTS A national positive trend on case notification for all forms of TB and smear positive, with a declined in 2011 but generally the case notification has remain low (59/100,000 in 2013 compared to estimated prevalence of 338/100,000). North east data is a negative trend for case notification and this is worse for 2 states (Borno and Yobe) while Adamawa shows and increase CNR from 2012 because of TB Reach active case, finding. Treatment success rate has a positive trend both national, north east states and in the 3 challenged states (TSR above 84%). TB/HIV indicators for north east are 81%, 75%, and 58% for HCT CPT and ART respectively, these figures has serious fluctuations within and among the three security challenged states with Borno most affected. CONCLUSIONS Insecurity can pose a challenge for TB control activities especially case finding, therefore the need for innovative approaches for case finding in areas of insecurity. Chronic infectious diseases like TB and HIV should be incorporated into emergency responses offered by organisations and agencies for internally displaced persons.
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Joseph K, Bains S, Tholanikunnel BG, Bygum A, Aabom A, Koch C, Farkas H, Varga L, Ghebrehiwet B, Kaplan AP. A novel assay to diagnose hereditary angioedema utilizing inhibition of bradykinin-forming enzymes. Allergy 2015; 70:115-9. [PMID: 25186184 DOI: 10.1111/all.12520] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Hereditary angioedema types I and II are caused by a functional deficiency of C1 inhibitor (C1-INH), leading to overproduction of bradykinin. The current functional diagnostic assays employ inhibition of activated C1s; however, an alternative, more physiologic method is desirable. METHODS ELISAs were developed using biotinylated activated factor XII (factor XIIa) or biotinylated kallikrein bound to avidin-coated plates. Incubation with plasma was followed by detection of bound C1-INH. RESULTS After standard curves were developed for quantification of C1-INH, serial dilutions of normal plasma were employed to validate the ability to detect known concentration of C1-INH in the plasma as a percent of normal. Hereditary angioedema (HAE) types I and II were then tested. The level of functional C1-INH in all HAE types I and II plasma tested was less than 40% of our normal control. This was evident regardless of whether we measured factor XIIa-C1-INH or kallikrein-C1-INH complexes, and the two assays were in close agreement. By contrast, testing the same samples utilizing the commercial method (complex ELISA, Quidel Corp.) revealed the levels of C1-INH between 0 and 57% of normal (mean, 38%), and 42 samples were considered equivocal (four controls and 38 patients). CONCLUSIONS Diagnosis of HAE types I and II can be ascertained by inhibition of enzymes of the bradykinin-forming cascade, namely factor XIIa and kallikrein. Either method yields functional C1-INH levels in patients with HAE (types I and II) that are clearly abnormal with less variance or uncertainty than the commercial method.
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Affiliation(s)
- K. Joseph
- Medical university of South Carolina; Charleston SC USA
| | - S. Bains
- Medical university of South Carolina; Charleston SC USA
| | | | - A. Bygum
- University of Southern Denmark and OPEN Odense Patient data Explorative Network; Odense University Hospital; Odense Denmark
| | - A. Aabom
- University of Southern Denmark and OPEN Odense Patient data Explorative Network; Odense University Hospital; Odense Denmark
| | - C. Koch
- University of Southern Denmark and OPEN Odense Patient data Explorative Network; Odense University Hospital; Odense Denmark
| | - H. Farkas
- 3rd Department of Internal Medicine; National Angioedema Center; Semmelweis University; Budapest Hungary
| | - L. Varga
- 3rd Department of Internal Medicine; National Angioedema Center; Semmelweis University; Budapest Hungary
| | | | - A. P. Kaplan
- Medical university of South Carolina; Charleston SC USA
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Gidado M, Obasanya JO, Onazi J, Eneogu R, Chukwueme N, Joseph K, Useni S, Adejumo AO. Tuberculosis control in security challenged states of North-East Nigeria. Are there significant impact? Niger J Med 2015. [DOI: 10.4103/1115-2613.278303] [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: 03/12/2023] Open
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Yu E, Stitt L, Vujovic O, Joseph K, Assouline A, Au J, Younus J, Perera F, Tai P. Male Breast Cancer Prognostic Factors: Similarity to Female Counterparts With Propensity Scores and Matched-Pair Analysis. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.800] [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: 11/26/2022]
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Lim K, Omidakhsh N, Hutcheon J, Lee B, Gong J, Gagnon A, Robertson J, Butler B, Delisle MF, Von Dadelzson P, Pare E, Joseph K. 141: CVS loss and complication rates: operator dependent factors. Am J Obstet Gynecol 2014. [DOI: 10.1016/j.ajog.2013.10.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Barrett J, Asztalos E, Willan A, Hannah M, Hutton E, Allen A, Armson BA, Gafni A, Joseph K, Ohlsson A, Ross S. 595: Twin Birth Study: an analysis of the predictors for a successful planned vaginal twin birth. Am J Obstet Gynecol 2014. [DOI: 10.1016/j.ajog.2013.10.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Barrett J, Asztalos E, Willan A, Mei-Dan E, Allen A, Armson BA, Gafni A, Hannah M, Hutton E, Joseph K, Ohlsson A, Ross S. 578: Twin Birth Study: neonatal and maternal outcomes in induction in twin pregnancies. Am J Obstet Gynecol 2014. [DOI: 10.1016/j.ajog.2013.10.611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pervez N, El-Gehani F, Joseph K, Dechaphunkul A, Kamal M, Pertschy D, Venner P, Ghosh S, North S. Genitourinary small-cell carcinoma: a single-institution experience. ACTA ACUST UNITED AC 2013; 20:258-64. [PMID: 24155630 DOI: 10.3747/co.20.1338] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Small-cell carcinomas (sccs) of the genitourinary (gu) tract are rare systemic diseases, and there is no standard treatment strategy for patients with this malignancy. The objectives of the present study were to report the management and outcome of patients with scc of the gu tract treated at a tertiary-care institution from 1982 to 2009. METHODS In a chart review of all patients diagnosed with scc of the gu tract between 1982 and 2009, data on demographics, clinical and pathologic characteristics, treatment, and patient outcomes were collected. RESULTS The 58 patients identified had scc in the following primary sites: urinary bladder (n = 35), prostate (n = 17), and upper urinary tract (n = 6). In 38 patients (66%), the scc was of pure histology; in the remainder, histology was mixed. Overall, 28 patients had limited-stage disease; 24 had extensive-stage disease; and staging was unknown in 6 patients. Median survival for the entire cohort was 7.5 months, with extensive-stage disease being identified as a poor prognostic factor (survival was 22.0 months for limited-stage patients and 4.1 months for extensive-stage patients, p < 0.001). Based on site, prostate patients fared worst, with a median survival of only 5.1 months. Compared with best supportive care, treatment was associated with better outcomes (median survival: 12.3 months vs. 2.3 months, p < 0.0001). CONCLUSIONS Small-cell cancer of the gu tract is an aggressive cancer, with a poor prognosis overall. Although there is no standard of care, patients should be treated using a multimodality approach analogous to that used in the treatment of small-cell lung cancer.
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Affiliation(s)
- N Pervez
- Department of Radiation Oncology, University of Alberta and Cross Cancer Institute, Edmonton, AB
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