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Fitzgerald E, Pokhvisneva I, Patel S, Yu Chan S, Peng Tan A, Chen H, Pelufo Silveira P, Meaney MJ. Microglial function interacts with the environment to affect sex-specific depression risk. Brain Behav Immun 2024; 119:597-606. [PMID: 38670238 DOI: 10.1016/j.bbi.2024.04.030] [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: 12/04/2023] [Revised: 04/02/2024] [Accepted: 04/22/2024] [Indexed: 04/28/2024] Open
Abstract
There is a two-fold higher incidence of depression in females compared to men with recent studies suggesting a role for microglia in conferring this sex-dependent depression risk. In this study we investigated the nature of this relation. Using GWAS enrichment, gene-set enrichment analysis and Mendelian randomization, we found minimal evidence for a direct relation between genes functionally related to microglia and sex-dependent genetic risk for depression. We then used expression quantitative trait loci and single nucleus RNA-sequencing resources to generate polygenic scores (PGS) representative of individual variation in microglial function in the adult (UK Biobank; N = 54753-72682) and fetal (ALSPAC; N = 1452) periods. The adult microglial PGS moderated the association between BMI (UK Biobank; beta = 0.001, 95 %CI 0.0009 to 0.003, P = 7.74E-6) and financial insecurity (UK Biobank; beta = 0.001, 95 %CI 0.005 to 0.015, P = 2E-4) with depressive symptoms in females. The fetal microglia PGS moderated the association between maternal prenatal depressive symptoms and offspring depressive symptoms at 24 years in females (ALSPAC; beta = 0.04, 95 %CI 0.004 to 0.07, P = 0.03). We found no evidence for an interaction between the microglial PGS and depression risk factors in males. Our results illustrate a role for microglial function in the conferral of sex-dependent depression risk following exposure to a depression risk factor.
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Affiliation(s)
- Eamon Fitzgerald
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Canada; Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada.
| | - Irina Pokhvisneva
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada
| | - Sachin Patel
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada
| | - Shi Yu Chan
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore
| | - Ai Peng Tan
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Diagnostic Imaging, National University Health System, Singapore; Brain - Body Initiative, Agency for Science, Technology & Research (A*STAR), Singapore
| | - Helen Chen
- Department of Psychological Medicine, KK Women's and Children's Hospital, Singapore; Duke-National University of Singapore, Singapore
| | - Patricia Pelufo Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Canada; Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael J Meaney
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Canada; Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Brain - Body Initiative, Agency for Science, Technology & Research (A*STAR), Singapore.
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2
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Stone AL, Pham A, Osmundson SS, Pedowitz A, Kingsley PJ, Marnett LJ, Patel S, Wickersham N, Sorabella LL, Bruehl S. Interactions Between Endocannabinoid and Endogenous Opioid Systems Prospectively Influence Postoperative Opioid Use in Pregnant Patients Undergoing Cesarean Delivery. J Pain 2024:104548. [PMID: 38663651 DOI: 10.1016/j.jpain.2024.104548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/09/2024] [Accepted: 04/16/2024] [Indexed: 05/08/2024]
Abstract
Both endocannabinoid (EC) and endogenous opioid systems are involved in nociceptive processing and may work together synergistically based on preclinical models. This study evaluated the interactive effects of preoperative beta-endorphin concentrations (a key analgesic endogenous opioid) in cerebrospinal fluid (CSF) and ECs (CSF and plasma 2-arachidonoylglycerol [2-AG] and plasma anandamide [AEA]) on postoperative opioid use and pain intensity in a prospective cohort of n = 112 pregnant patients undergoing scheduled cesarean delivery. Maternal blood and CSF samples were collected preoperatively for beta-endorphin and EC assays. Patients completed measures of outpatient opioid use (number of tablets used and days of use) and average pain intensity at 2 weeks postoperatively. Results of general linear model analyses controlling for maternal age, BMI at time of delivery, and race revealed significant multiplicative interactions between EC and beta-endorphin concentrations on number of opioid tablets used (based on pill count), days of opioid use, and total milligram morphine equivalents used in the 2 week follow-up period. Elevated preoperative plasma and CSF 2-AG predicted reduced outpatient opioid analgesic use particularly for patients low in CSF beta-endorphin. Similar analyses for pain intensity at 2-week follow-up indicated a significant interaction (p<.02) characterized by higher preoperative beta-endorphin concentrations being associated with lower subsequent pain only for individuals with low preoperative plasma AEA concentrations. Further exploration of interactions between EC and endogenous opioid inhibitory systems as they influence responses to opioid analgesics in other clinical pain populations may help guide development of precision pain management approaches. PERSPECTIVE: In the postoperative setting of patients undergoing cesarean delivery, elevated endocannabinoids were linked to reduced outpatient opioid analgesic use in individuals who had low endogenous opioid concentrations in cerebrospinal fluid. Further exploration of interactions between these two inhibitory systems as they impact on responses to pain management interventions appears warranted.
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Affiliation(s)
- Amanda L Stone
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amelie Pham
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Sarah S Osmundson
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alex Pedowitz
- University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Philip J Kingsley
- Department of Biochemistry, Vanderbilt University, Nashville, TN, USA; A.B. Hancock Memorial Laboratory for Cancer Research, Vanderbilt University, Nashville, TN
| | - Larry J Marnett
- Department of Biochemistry, Vanderbilt University, Nashville, TN, USA
| | - Sachin Patel
- Department of Psychiatry, Northwestern University School of Medicine, Chicago, IL, USA
| | - Nancy Wickersham
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Laura L Sorabella
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
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Weisel K, Dimopoulos MA, Beksac M, Leleu X, Richter J, Heeg B, Patel S, Majer I, McFadden I, Mikhael J. Carfilzomib, daratumumab, and dexamethasone (KdD) vs. lenalidomide-sparing pomalidomide-containing triplet regimens for relapsed/refractory multiple myeloma: an indirect treatment comparison. Leuk Lymphoma 2024; 65:481-492. [PMID: 38345269 DOI: 10.1080/10428194.2023.2300051] [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: 08/14/2023] [Accepted: 12/23/2023] [Indexed: 02/24/2024]
Abstract
Nearly all patients with multiple myeloma eventually relapse or become refractory to treatment. Lenalidomide is increasingly administered in the frontline until disease progression or intolerance to therapy, resulting in the need for highly effective, lenalidomide-sparing options. In this study, carfilzomib plus daratumumab and dexamethasone were evaluated against lenalidomide-sparing, pomalidomide-containing triplets using matching-adjusted indirect comparison in the absence of head-to-head data. The analyses utilized long-term follow-up data from the CANDOR study (NCT03158688). Treatment with carfilzomib, daratumumab, and dexamethasone resulted in significantly longer progression-free survival (hazard ratio 0.60 [95% confidence interval: 0.37, 0.88])vs. pomalidomide plus bortezomib and dexamethasone, and numerically longer progression-free survival (hazard ratio 0.77 [95% confidence interval: 0.50, 1.08]) vs. daratumumab plus pomalidomide and dexamethasone in patients with relapsed/refractory multiple myeloma and previous lenalidomide exposure, the majority of whom were lenalidomide refractory. Carfilzomib plus daratumumab and dexamethasone offers a highly effective, lenalidomide-sparing treatment option for this population.
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Affiliation(s)
- Katja Weisel
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Xavier Leleu
- CHU de Poitiers - La Miletrie, INSERM CIC 1402, Poitiers, France
| | - Joshua Richter
- Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA
| | - Bart Heeg
- Cytel Inc, Rotterdam, The Netherlands
| | | | | | | | - Joseph Mikhael
- Translational Genomics Research Institute (TGen), City of Hope Cancer Center, Phoenix, AZ, USA
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Wilson BE, Booth CM, Patel S, Berry S, Kong W, Merchant SJ. First-line Palliative Chemotherapy for Colorectal Cancer: a Population-based Analysis of Delivery and Outcomes in a Single-payer Health System. Clin Oncol (R Coll Radiol) 2024; 36:211-220. [PMID: 38199907 DOI: 10.1016/j.clon.2023.12.003] [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: 08/02/2023] [Accepted: 12/07/2023] [Indexed: 01/12/2024]
Abstract
AIMS Clinical practice guidelines recommend palliative chemotherapy for most patients with metastatic colorectal cancer. However, outcomes observed in the real world compared with patients enrolled in clinical trials have not been sufficiently described. The objective of this study was to evaluate the delivery and outcomes of first-line palliative chemotherapy administered to patients with colorectal cancer in routine clinical practice compared with clinical trials. MATERIALS AND METHODS Using linked health administrative data, we carried out a retrospective population-level cohort study on patients diagnosed with colorectal cancer in Ontario, Canada from 2010 to 2019. Patient, disease and treatment characteristics were summarised. The primary outcome was median overall survival, stratified by treatment prescribed and age. Demographics and outcomes in this real-world population were compared with those from pivotal clinical trials. A multivariable Cox regression model reporting hazard ratios and 95% confidence intervals was used to determine factors associated with survival in patients receiving systemic treatment. RESULTS We identified 70 987 patients with a new diagnosis of colorectal cancer, of which 4613 received first-line chemotherapy for unresectable locally advanced or metastatic disease and formed the study cohort. Fifty-eight per cent were male and the mean age was 63 years. Most had colon cancer (69%), at least one comorbidity (73%) and lived in an urban location (79%). Less than half (47%) had surgery after diagnosis. The most common regimen prescribed was folinic acid, 5-fluorouracil and irinotecan (FOLFIRI) with bevacizumab or epidermal growth factor receptor inhibitors (EGFRi; n = 2784, 60%). Among all treated patients, the median overall survival was 17.1 months, with survival difference by regimen [median overall survival 18.3 for FOLFIRI with bevacizumab or EGFRi, 19.6 for folinic acid, 5-fluorouracil and oxaliplatin (FOLFOX)/capecitabine, oxaliplatin (XELOX) with bevacizumab or EGFRi, 13.6 for FOLFIRI alone and 7.8 for 5-fluorouracil or capecitabine]. Patients aged >80 years were most likely to have received single-agent 5-fluorouracil or capecitabine, and had inferior overall survival compared with their younger counterparts. Compared with pivotal clinical trials, patients in the real world had inferior overall survival outcomes despite similar demographic characteristics (including age and sex). CONCLUSIONS In this real-world population-based analysis of patients receiving first-line chemotherapy for unresectable locally advanced or metastatic colorectal cancer, survival outcomes were inferior to those reported in randomised trials despite similarities in age and sex. This information can be used when counselling patients in routine practice about expected outcomes.
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Affiliation(s)
- B E Wilson
- Department of Oncology, Queen's University, Kingston, Ontario, Canada; Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - C M Booth
- Department of Oncology, Queen's University, Kingston, Ontario, Canada; Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada
| | - S Patel
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada; Department of Surgery, Queen's University, Kingston, Ontario, Canada
| | - S Berry
- Department of Oncology, Queen's University, Kingston, Ontario, Canada
| | - W Kong
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada
| | - S J Merchant
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Ontario, Canada; Department of Surgery, Queen's University, Kingston, Ontario, Canada.
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Mohajer Y, Patel S, Sangam R, Sharma V. Highly recommended programme. Br Dent J 2024; 236:507. [PMID: 38609593 DOI: 10.1038/s41415-024-7302-2] [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] [Received: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 04/14/2024]
Affiliation(s)
- Y Mohajer
- Department of Oral and Maxillofacial Surgery, Bedfordshire Hospitals NHS Trust, Luton, UK; General Dental Practice, Hitchin Dental, Hitchin, Hertfordshire, UK.
| | - S Patel
- Department of Oral and Maxillofacial Surgery, Bedfordshire Hospitals NHS Trust, Luton, UK; General Dental Practice, Hitchin Dental, Hitchin, Hertfordshire, UK.
| | - R Sangam
- General Dental Practice, Hitchin Dental, Hitchin, Hertfordshire, UK.
| | - V Sharma
- Department of Oral and Maxillofacial Surgery, Bedfordshire Hospitals NHS Trust, Luton, UK.
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Volling C, Mataseje L, Graña-Miraglia L, Hu X, Anceva-Sami S, Coleman BL, Downing M, Hota S, Jamal AJ, Johnstone J, Katz K, Leis JA, Li A, Mahesh V, Melano R, Muller M, Nayani S, Patel S, Paterson A, Pejkovska M, Ricciuto D, Sultana A, Vikulova T, Zhong Z, McGeer A, Guttman DS, Mulvey MR. Epidemiology of healthcare-associated Pseudomonas aeruginosa in intensive care units: are sink drains to blame? J Hosp Infect 2024; 148:77-86. [PMID: 38554807 DOI: 10.1016/j.jhin.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/23/2024] [Accepted: 03/04/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Pseudomonas aeruginosa (PA) is a common cause of healthcare-associated infection (PA-HAI) in the intensive care unit (ICU). AIM To describe the epidemiology of PA-HAI in ICUs in Ontario, Canada, and to identify episodes of sink-to-patient PA transmission. METHODS This was a prospective cohort study of patients in six ICUs from 2018 to 2019, with retrieval of PA clinical isolates, and PA-screening of antimicrobial-resistant organism surveillance rectal swabs, and of sink drain, air, and faucet samples. All PA isolates underwent whole-genome sequencing. PA-HAI was defined using US National Healthcare Safety Network criteria. ICU-acquired PA was defined as PA isolated from specimens obtained ≥48 h after ICU admission in those with prior negative rectal swabs. Sink-to-patient PA transmission was defined as ICU-acquired PA with close genomic relationship to isolate(s) previously recovered from sinks in a room/bedspace occupied 3-14 days prior to collection date of the relevant patient specimen. FINDINGS Over ten months, 72 PA-HAIs occurred among 60/4263 admissions. The rate of PA-HAI was 2.40 per 1000 patient-ICU-days; higher in patients who were PA-colonized on admission. PA-HAI was associated with longer stay (median: 26 vs 3 days uninfected; P < 0.001) and contributed to death in 22/60 cases (36.7%). Fifty-eight admissions with ICU-acquired PA were identified, contributing 35/72 (48.6%) PA-HAIs. Four patients with five PA-HAIs (6.9%) had closely related isolates previously recovered from their room/bedspace sinks. CONCLUSION Nearly half of PA causing HAI appeared to be acquired in ICUs, and 7% of PA-HAIs were associated with sink-to-patient transmission. Sinks may be an under-recognized reservoir for HAIs.
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Affiliation(s)
- C Volling
- Department of Microbiology, Sinai Health, Toronto, Canada.
| | - L Mataseje
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - L Graña-Miraglia
- Department of Cell & Systems Biology, University of Toronto, Toronto, Canada
| | - X Hu
- Department of Cell & Systems Biology, University of Toronto, Toronto, Canada
| | - S Anceva-Sami
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - B L Coleman
- Department of Microbiology, Sinai Health, Toronto, Canada
| | | | - S Hota
- Department of Medicine, University Health Network, Toronto, Canada
| | - A J Jamal
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - J Johnstone
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - K Katz
- Department of Medicine, North York General Hospital, Toronto, Canada
| | - J A Leis
- Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - A Li
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - V Mahesh
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - R Melano
- Pan American Health Organization, Washington, USA
| | - M Muller
- Department of Medicine, Unity Health Toronto, Toronto, Canada
| | - S Nayani
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - S Patel
- Public Health Ontario Laboratory, Toronto, Canada
| | - A Paterson
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - M Pejkovska
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - D Ricciuto
- Department of Medicine, Lakeridge Health, Oshawa, Canada
| | - A Sultana
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - T Vikulova
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - Z Zhong
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - A McGeer
- Department of Microbiology, Sinai Health, Toronto, Canada
| | - D S Guttman
- Department of Cell & Systems Biology, University of Toronto, Toronto, Canada; Centre for the Analysis of Genome Evolution and Function, Department of Cell and Systems Biology, University of Toronto, Toronto, Canada
| | - M R Mulvey
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
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Kastritis E, Ntanasis-Stathopoulos I, Theodorakakou F, Migkou M, Roussou M, Malandrakis P, Kanellias N, Eleutherakis-Papaiakovou E, Fotiou D, Spiliopoulou V, Gavriatopoulou M, Patel S, Majer I, Boukis C, Fetani A, Dimopoulos MA, Terpos E. Characteristics and Outcomes of Patients With Relapsed/Refractory Multiple Myeloma After Exposure to Lenalidomide in First Line of Therapy: A Single Center Database Review in Greece. Clin Lymphoma Myeloma Leuk 2024:S2152-2650(24)00110-1. [PMID: 38616479 DOI: 10.1016/j.clml.2024.03.003] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 02/22/2024] [Accepted: 03/06/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND The increasing use of lenalidomide (Len) in first-line (1L) therapy of multiple myeloma (MM) has led to a significant proportion of patients becoming Len-refractory following 1L treatment. However, there are limited real-world data on treatment strategies and outcomes of patients who become Len-refractory following 1L therapy. PATIENTS AND METHODS This real-world retrospective cohort study analyzed Len-refractory and non-Len-refractory patients who received 1L Len and initiated second-line (2L) therapy at a Greek MM center. The Len-exposed cohort (n = 249) included 55.4% Len-refractory patients after 1L. RESULTS Compared to non-Len-refractory patients, Len-refractory patients more frequently had high-risk cytogenetics and Revised-International Staging System-3 disease stage at diagnosis, and had shorter progression-free survival (PFS) following 1L therapy. Len-refractory versus non-Len-refractory patients more frequently received triplets (59% vs. 40%), anti-CD38 agents (20% vs. 9%) and pomalidomide (22% vs. 13%). The overall response rate was 53% for Len-refractory patients and 64% for non-Len-refractory patients in 2L therapy; median PFS was 10.7 vs. 18.3 months, respectively. Median overall survival (OS) was shorter for Len-refractory patients vs non-Len-refractory patients (23.8 vs. 53.6 months). Len refractoriness was an independent prognostic factor for both PFS and OS in Len-exposed patients. CONCLUSION In this real-world Len-exposed cohort, Len-refractory patients receiving 1L Len experienced poorer survival outcomes than non-Len-refractory patients, highlighting the unmet need in this patient population which has driven the development of novel therapies.
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Affiliation(s)
- Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece.
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Foteini Theodorakakou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Magdalini Migkou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Maria Roussou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Panagiotis Malandrakis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Nikolaos Kanellias
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | - Despina Fotiou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Vassiliki Spiliopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | | | | | | | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece
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8
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Ramos-Medina L, Rosas-Vidal LE, Patel S. Pharmacological diacylglycerol lipase inhibition impairs contextual fear extinction in mice. Psychopharmacology (Berl) 2024; 241:569-584. [PMID: 38182791 PMCID: PMC10884152 DOI: 10.1007/s00213-023-06523-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 12/21/2023] [Indexed: 01/07/2024]
Abstract
Acquisition and extinction of associative fear memories are critical for guiding adaptive behavioral responses to environmental threats, and dysregulation of these processes is thought to represent important neurobehavioral substrates of trauma and stress-related disorders including posttraumatic stress disorder (PTSD). Endogenous cannabinoid (eCB) signaling has been heavily implicated in the extinction of aversive fear memories and we have recently shown that pharmacological inhibition of 2-arachidonoylglycerol (2-AG) synthesis, a major eCB regulating synaptic suppression, impairs fear extinction in an auditory cue conditioning paradigm. Despite these data, the role of 2-AG signaling in contextual fear conditioning is not well understood. Here, we show that systemic pharmacological blockade of diacylglycerol lipase, the rate-limiting enzyme catalyzing in the synthesis of 2-AG, enhances contextual fear learning and impairs within-session extinction. In sham-conditioned mice, 2-AG synthesis inhibition causes a small increase in unconditioned freezing behavior. No effects of 2-AG synthesis inhibition were noted in the Elevated Plus Maze in mice tested after fear extinction. These data provide support for 2-AG signaling in the suppression of contextual fear learning and the expression of within-session extinction of contextual fear memories.
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Affiliation(s)
| | - Luis E Rosas-Vidal
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Sachin Patel
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
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Abu Baker D, Patel S, Charalambous P, Albuloushi N, Rodriguez J. Multi-Modal Digital Impressions For Palatal Defects. Eur J Prosthodont Restor Dent 2024; 32:75-82. [PMID: 37721541 DOI: 10.1922/ejprd_2586abubaker08] [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] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/16/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION This in-vitro study investigated limitations of intra-oral scanners (IOS) in capturing palatal defects at decreased mouth openings. The trueness and precision of composite 3D-printed models from Cone-Beam Computed Tomography (CBCT) and IOS were measured. METHODS A partially dentate palatal defect model was scanned with IOS (3M™TrueDefinition) at various simulated mouth openings. Five silicone impressions were poured in gypsum. Scans were taken using 3M™TrueDefinition; Planmeca Planscan®, n=5 each. Model was scanned on two CBCT (PlanmecaProFace®; Accuitomo170®CBCT, n=5 each). Geomagic®Control2014™ was used to create composite-models merging CBCT with IOS. Thirty composite-models were 3D-printed. Trueness and precision were measured. Pearson Correlation Coefficients measured correlation between mouth opening and data capture. Data analysed using Kruskal-Wallis, Wilcoxon rank-sum, and ANOVA. Statistical significance inferred when p⟨0.05. RESULTS Mouth openings ⟨20mm, IOS didn't capture information of soft tissue. Increased mouth opening positively correlated with increased data capture(r=0.93, p=0.001). AccuitomoCBCT and TrueDefinition IOS composite-models had the highest (trueness) and [precision](median (IQR) 0.172 mm(0.062-0.426)); [mean [SD] 0.080 mm [0.008]]. Casts had the lowest results (median (IQR) 0.289 mm(0.119-1.565));[mean [SD] 0.338 mm [0.089]](p⟨0.001). CONCLUSION Mouth opening ⟨20mm resulted in insufficient data capture by IOS for clinical applications. Composite digital models showed promising trueness and precision results.
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Affiliation(s)
- D Abu Baker
- Assistant Professor, Department of Prosthodontics, University of Jordan, Amman, Jordan
| | - S Patel
- Specialist Registrar in Restorative Dentistry, Guy's and St Thomas's Trust, NHS, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, SE1 9RT
| | - P Charalambous
- Clinical Lecturer, Bristol University, Bristol Dental School, Bristol
| | - N Albuloushi
- Registrar, King's College London, Guy's Campus, London, UK
| | - J Rodriguez
- Consultant in Restorative Dentistry, Honorary Senior Clinical Lecturer, Guy's and St Thomas's Trust, NHS, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, SE1 9RT
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Rosas-Vidal LE, Naskar S, Mayo LM, Perini I, Altemus M, Engelbrektsson H, Jagasia P, Heilig M, Patel S. PREFRONTAL CORRELATES OF FEAR GENERALIZATION DURING ENDOCANNABINOID DEPLETION. bioRxiv 2024:2024.01.30.577847. [PMID: 38352388 PMCID: PMC10862899 DOI: 10.1101/2024.01.30.577847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Maladaptive fear generalization is one of the hallmarks of trauma-related disorders. The endocannabinoid 2-arachidonoylglycerol (2-AG) is crucial for modulating anxiety, fear, and stress adaptation but its role in balancing fear discrimination versus generalization is not known. To address this, we used a combination of plasma endocannabinoid measurement and neuroimaging from a childhood maltreatment exposed and non-exposed mixed population combined with human and rodent fear conditioning models. Here we show that 2-AG levels are inversely associated with fear generalization at the behavioral level in both mice and humans. In mice, 2-AG depletion increases the proportion of neurons, and the similarity between neuronal representations, of threat-predictive and neutral stimuli within prelimbic prefrontal cortex ensembles. In humans, increased dorsolateral prefrontal cortical-amygdala resting state connectivity is inversely correlated with fear generalization. These data provide convergent cross-species evidence that 2-AG is a key regulator of fear generalization and suggest 2-AG deficiency could represent a trauma-related disorder susceptibility endophenotype.
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Affiliation(s)
- Luis E Rosas-Vidal
- Northwestern University, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL
| | - Saptarnab Naskar
- Northwestern University, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL
| | - Leah M Mayo
- Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Linköping University, Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping, Sweden
| | - Irene Perini
- Linköping University, Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping, Sweden
| | - Megan Altemus
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, Nashville, TN
| | - Hilda Engelbrektsson
- Linköping University, Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping, Sweden
| | - Puja Jagasia
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences, Nashville, TN
| | - Markus Heilig
- Linköping University, Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping, Sweden
| | - Sachin Patel
- Northwestern University, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL
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11
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Liu CH, Harrison DC, Patel S, Wilen CD, Rafferty O, Shearrow A, Ballard A, Iaia V, Ku J, Plourde BLT, McDermott R. Quasiparticle Poisoning of Superconducting Qubits from Resonant Absorption of Pair-Breaking Photons. Phys Rev Lett 2024; 132:017001. [PMID: 38242669 DOI: 10.1103/physrevlett.132.017001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 11/22/2023] [Accepted: 11/29/2023] [Indexed: 01/21/2024]
Abstract
The ideal superconductor provides a pristine environment for the delicate states of a quantum computer: because there is an energy gap to excitations, there are no spurious modes with which the qubits can interact, causing irreversible decay of the quantum state. As a practical matter, however, there exists a high density of excitations out of the superconducting ground state even at ultralow temperature; these are known as quasiparticles. Observed quasiparticle densities are of order 1 μm^{-3}, tens of orders of magnitude greater than the equilibrium density expected from theory. Nonequilibrium quasiparticles extract energy from the qubit mode and can induce dephasing. Here we show that a dominant mechanism for quasiparticle poisoning is direct absorption of high-energy photons at the qubit junction. We use a Josephson junction-based photon source to controllably dose qubit circuits with millimeter-wave radiation, and we use an interferometric quantum gate sequence to reconstruct the charge parity of the qubit. We find that the structure of the qubit itself acts as a resonant antenna for millimeter-wave radiation, providing an efficient path for photons to generate quasiparticles. A deep understanding of this physics will pave the way to realization of next-generation superconducting qubits that are robust against quasiparticle poisoning.
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Affiliation(s)
- C H Liu
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - D C Harrison
- Intelligence Community Postdoctoral Research Fellowship Program, Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - S Patel
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - C D Wilen
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - O Rafferty
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Shearrow
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - A Ballard
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - V Iaia
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - J Ku
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - B L T Plourde
- Department of Physics, Syracuse University, Syracuse, New York 13244, USA
| | - R McDermott
- Department of Physics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
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12
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Arcego DM, Buschdorf JP, O'Toole N, Wang Z, Barth B, Pokhvisneva I, Rayan NA, Patel S, de Mendonça Filho EJ, Lee P, Tan J, Koh MX, Sim CM, Parent C, de Lima RMS, Clappison A, O'Donnell KJ, Dalmaz C, Arloth J, Provençal N, Binder EB, Diorio J, Silveira PP, Meaney MJ. A Glucocorticoid-Sensitive Hippocampal Gene Network Moderates the Impact of Early-Life Adversity on Mental Health Outcomes. Biol Psychiatry 2024; 95:48-61. [PMID: 37406925 DOI: 10.1016/j.biopsych.2023.06.028] [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: 11/03/2022] [Revised: 04/15/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Early stress increases the risk for psychiatric disorders. Glucocorticoids are stress mediators that regulate transcriptional activity and morphology in the hippocampus, which is implicated in the pathophysiology of multiple psychiatric conditions. We aimed to establish the relevance of hippocampal glucocorticoid-induced transcriptional activity as a mediator of the effects of early life on later psychopathology in humans. METHODS RNA sequencing was performed with anterior and posterior hippocampal dentate gyrus from adult female macaques (n = 12/group) that were chronically treated with betamethasone (glucocorticoid receptor agonist) or vehicle. Coexpression network analysis identified a preserved gene network in the posterior hippocampal dentate gyrus that was strongly associated with glucocorticoid exposure. The single nucleotide polymorphisms in the genes in this network were used to create an expression-based polygenic score in humans. RESULTS The expression-based polygenic score significantly moderated the association between early adversity and psychotic disorders in adulthood (UK Biobank, women, n = 44,519) and on child peer relations (ALSPAC [Avon Longitudinal Study of Parents and Children], girls, n = 1666 for 9-year-olds and n = 1594 for 11-year-olds), an endophenotype for later psychosis. Analyses revealed that this network was enriched for glucocorticoid-induced epigenetic remodeling in human hippocampal cells. We also found a significant association between single nucleotide polymorphisms from the expression-based polygenic score and adult brain gray matter density. CONCLUSIONS We provide an approach for the use of transcriptomic data from animal models together with human data to study the impact of environmental influences on mental health. The results are consistent with the hypothesis that hippocampal glucocorticoid-related transcriptional activity mediates the effects of early adversity on neural mechanisms implicated in psychiatric disorders.
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Affiliation(s)
- Danusa Mar Arcego
- Douglas Research Centre, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada.
| | - Jan-Paul Buschdorf
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore
| | - Nicholas O'Toole
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Zihan Wang
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Barbara Barth
- Douglas Research Centre, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Irina Pokhvisneva
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | | | - Sachin Patel
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | | | - Patrick Lee
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore
| | - Jennifer Tan
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore
| | - Ming Xuan Koh
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore
| | - Chu Ming Sim
- Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore
| | - Carine Parent
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | | | - Andrew Clappison
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Kieran J O'Donnell
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada; Yale Child Study Center, Yale School of Medicine, Yale University, New Haven, Connecticut
| | - Carla Dalmaz
- Department of Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Janine Arloth
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany; Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Nadine Provençal
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Elisabeth B Binder
- Department Genes and Environment, Max Planck Institute of Psychiatry, Munich, Germany
| | - Josie Diorio
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada
| | - Patrícia Pelufo Silveira
- Douglas Research Centre, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Research Centre, McGill University, Montreal, Quebec, Canada; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
| | - Michael J Meaney
- Douglas Research Centre, Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Translational Neuroscience Program, Singapore Institute for Clinical Sciences, Singapore, Republic of Singapore; Brain Body Initiative, Agency for Science, Technology and Research (A∗STAR), Singapore, Republic of Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore
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Cowan B, Kvale M, Yin J, Patel S, Jorgenson E, Mostaedi R, Choquet H. Risk factors for inguinal hernia repair among US adults. Hernia 2023; 27:1507-1514. [PMID: 37947923 DOI: 10.1007/s10029-023-02913-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/08/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE To investigate demographic, clinical, and behavioral risk factors for undergoing inguinal hernia repair within a large and ethnically diverse cohort. METHODS We conducted a retrospective case-control study from 2007 to 2020 on 302,532 US individuals from a large, integrated healthcare delivery system with electronic health records, who participated in a survey of determinants of health. Participants without diagnosis or procedure record of an inguinal hernia at enrollment were included. We then assessed whether demographic (age, sex, race/ethnicity), clinical, and behavioral factors (obesity status, alcohol use, cigarette smoking and physical activity) were predictors of undergoing inguinal hernia repair using survival analyses. Risk factors showing statistical significance (P < 0.05) in the univariate models were added to a multivariate model. RESULTS We identified 7314 patients who underwent inguinal hernia repair over the study period, with a higher incidence in men (6.31%) compared to women (0.53%). In a multivariate model, a higher incidence of inguinal hernia repair was associated with non-Hispanic white race/ethnicity, older age, male sex (aHR = 13.55 [95% confidence interval 12.70-14.50]), and more vigorous physical activity (aHR = 1.24 [0.045]), and alcohol drinker status (aHR = 1.05 [1.00-1.11]); while African-American (aHR = 0.69 [0.59-0.79]), Hispanic/Latino (aHR = 0.84 [0.75-0.91]), and Asian (aHR = 0.35 [0.31-0.39]) race/ethnicity, obesity (aHR = 0.33 [0.31-0.36]) and overweight (aHR = 0.71 [0.67-0.75]) were associated with a lower incidence. The use of cigarette was significantly associated with a higher incidence of inguinal hernia repair in women (aHR 1.23 [1.09-1.40]), but not in men (aHR 0.96 [0.91-1.02]). CONCLUSION Inguinal hernia repair is positively associated with non-Hispanic white race/ethnicity, older age, male sex, increased physical activity, alcohol consumption and tobacco use (only in women); while negatively associated with obesity and overweight status. Findings from this large and ethnically diverse study may support future prediction tools to identify patients at high risk of this surgery.
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Affiliation(s)
- B Cowan
- UCSF-East Bay General Surgery, Oakland, CA, USA
| | - M Kvale
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, USA
| | - J Yin
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, USA
| | - S Patel
- UCSF-East Bay General Surgery, Oakland, CA, USA
| | - E Jorgenson
- Regeneron Genetics Center, Tarrytown, NY, USA
| | - R Mostaedi
- KPNC, Richmond Medical Center, Richmond, CA, USA
| | - H Choquet
- Division of Research, Kaiser Permanente Northern California (KPNC), Oakland, CA, USA.
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14
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Argani P, Medeiros LJ, Matoso A, Baraban E, Lotan T, Pawel BR, McKenney JK, Mehra R, Falzarano SM, Pallavajjalla A, Lin MT, Patel S, Rawwas J, Bendel AE, Gagan J, Palsgrove DN. "Oncocytoid Renal Cell Carcinomas After Neuroblastoma" Represent TSC -mutated Eosinophilic Solid and Cystic Renal Cell Carcinomas : Association With Prior Childhood Malignancy and Multifocality With Therapeutic Implications. Am J Surg Pathol 2023; 47:1335-1348. [PMID: 37522346 DOI: 10.1097/pas.0000000000002101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
The concept of oncocytoid renal cell carcinoma in patients who have survived neuroblastoma as a distinct biologic entity has been controversial since its original description in 1999. This is in part because similar oncocytoid renal cell carcinomas have been described in association with other pediatric cancers, and also because other renal cell carcinoma subtypes (such as MiT family translocation renal cell carcinoma) have been described in children who have survived neuroblastoma. We identified an index case of a child who survived medulloblastoma and developed multifocal bilateral oncocytoid renal cell carcinomas with morphology and immunophenotype compatible with eosinophilic solid and cystic renal cell carcinoma (ESC RCC) and demonstrated that both neoplasms harbored distinctive mutations in the TSC1/TSC2 genes. Remarkably, the child's remaining bilateral multifocal renal neoplasms completely responded to MTOR inhibitor therapy without need for further surgery. To confirm our hypothesis that oncocytoid renal cell carcinomas after childhood cancer represent ESC RCC, we obtained formalin-fixed paraffin-embedded tissue blocks from 2 previously published cases of oncocytoid renal cell carcinoma after neuroblastoma, confirmed that the morphology and immunophenotype was consistent with ESC RCC, and demonstrated that both cases harbored somatic TSC gene mutations. Both expressed markers previously associated with neoplasms harboring TSC gene mutations, glycoprotein nonmetastatic B, and cathepsin K. Of note, one of these patients had 2 ESC RCC which harbored distinctive TSC2 mutations, while the background kidney of the other patient had multiple small cysts lined by similar oncocytoid cells which showed loss of TSC2 protein. We then reviewed 3 of 4 cases from the original 1999 report of oncocytoid renal cell carcinomas after neuroblastoma, found that all 3 demonstrated morphology (including basophilic cytoplasmic stippling) that is characteristic of ESC RCC, showed that all 3 overexpressed glycoprotein nonmetastatic B, and showed that both cases with adequate material demonstrated loss of TSC2 protein and expressed cytokeratin 20 and cathepsin K by immunohistochemistry. In summary, "oncocytoid renal cell carcinomas after neuroblastoma" represent ESC RCC which are often multifocal in patients who have survived childhood cancer, likely representing an incompletely characterized tumor predisposition syndrome. MTOR-targeted therapy represents an effective therapeutic option for such patients to preserve functional nephrons.
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Affiliation(s)
- Pedram Argani
- Departments of Pathology
- Urology
- Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - L Jeffrey Medeiros
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston
| | - Andres Matoso
- Departments of Pathology
- Urology
- Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ezra Baraban
- Departments of Pathology
- Urology
- Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Tamara Lotan
- Departments of Pathology
- Urology
- Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Bruce R Pawel
- Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles and Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Jesse K McKenney
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH
| | - Rohit Mehra
- Department of Pathology and Michigan Center for Translational Pathology (MCTP), University of Michigan School of Medicine, Ann Arbor, MI
| | - Sara M Falzarano
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL
| | - Aparna Pallavajjalla
- Departments of Pathology
- Urology
- Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ming-Tseh Lin
- Departments of Pathology
- Urology
- Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Jawhar Rawwas
- Hematology/Oncology, Children's Minnesota, Minneapolis, MN
| | - Anne E Bendel
- Hematology/Oncology, Children's Minnesota, Minneapolis, MN
| | - Jeffrey Gagan
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Doreen N Palsgrove
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX
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15
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Patel S, Awan KH, Freitas CMT, Bhandi S, Licari FW, Patil S. Diode laser targeting red-complex bacteria in periodontitis: a systematic review. Eur Rev Med Pharmacol Sci 2023; 27:11806-11816. [PMID: 38164844 DOI: 10.26355/eurrev_202312_34779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVE This systematic review examines the effectiveness of diode laser irradiation in reducing the levels of red complex bacteria as well as periodontal parameters of pocket depth and clinical attachment level. MATERIALS AND METHODS We conducted electronic searches across databases such as Scopus, Embase, Medline, and Web of Science databases in July 2022. Randomized controlled trials that evaluated the reduction of red-complex bacteria in patients with periodontitis using diode lasers were included. The primary focus was the reduction in the microbial count of red complex bacteria, whereas probing depth and attachment level were considered secondary outcomes. Articles in languages other than English were excluded. Study quality was assessed based on the Cochrane Handbook for Systematic Reviews of Interventions and the ROB2 tool. RESULTS After searching the databases, eight independent studies were included, with a sample size of 210 subjects. The average age group of the study population was 30-60 years, and there was a lack of consensus on the antimicrobial effect of diode lasers. Out of the eight studies, four studies reported no significant difference in the levels of red complex bacteria before and after laser application. Three studies reported significantly lower levels of red complex bacteria in the intergroup comparison. One study reported that laser had no significant effect on intergroup bacterial levels. The combination of diode laser irradiation with scaling reduced the count of red complex bacteria and improved the clinical parameters, although not significantly. CONCLUSIONS Based on the limited evidence available, the adjunctive use of diode laser for scaling and root planning may provide some additional benefit in terms of reduction of red complex bacterial count and clinical parameters. Further well-designed trials and the use of objective measures are necessary before outlining universal guidelines for best practice. The adjunctive use of diode laser in non-surgical periodontal therapy may provide a reduction in the red complex microbial count and improvement in clinical parameters, decreasing the need for periodontal surgery.
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Affiliation(s)
- S Patel
- College of Graduate Studies, Roseman University of Health Sciences, South Jordan, Utah, USA.
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16
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Luján MÁ, Covey DP, Young-Morrison R, Zhang L, Kim A, Morgado F, Patel S, Bass CE, Paladini C, Cheer JF. Mobilization of endocannabinoids by midbrain dopamine neurons is required for the encoding of reward prediction. Nat Commun 2023; 14:7545. [PMID: 37985770 PMCID: PMC10662422 DOI: 10.1038/s41467-023-43131-3] [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: 01/31/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023] Open
Abstract
Brain levels of the endocannabinoid 2-arachidonoylglycerol (2-AG) shape motivated behavior and nucleus accumbens (NAc) dopamine release. However, it is not clear whether mobilization of 2-AG specifically from midbrain dopamine neurons is necessary for dopaminergic responses to external stimuli predicting forthcoming reward. Here, we use a viral-genetic strategy to prevent the expression of the 2-AG-synthesizing enzyme diacylglycerol lipase α (DGLα) from ventral tegmental area (VTA) dopamine cells in adult mice. We find that DGLα deletion from VTA dopamine neurons prevents depolarization-induced suppression of excitation (DSE), a form of 2-AG-mediated synaptic plasticity, in dopamine neurons. DGLα deletion also decreases effortful, cue-driven reward-seeking but has no effect on non-cued or low-effort operant tasks and other behaviors. Moreover, dopamine recording in the NAc reveals that deletion of DGLα impairs the transfer of accumbal dopamine signaling from a reward to its earliest predictors. These results demonstrate that 2-AG mobilization from VTA dopamine neurons is a necessary step for the generation of dopamine-based predictive associations that are required to direct and energize reward-oriented behavior.
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Affiliation(s)
- Miguel Á Luján
- Department of Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Dan P Covey
- Department of Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Neuroscience, Lovelace Biomedical Research Institute, Albuquerque, NM, USA
| | - Reana Young-Morrison
- Department of Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - LanYuan Zhang
- Department of Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Andrew Kim
- Department of Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Fiorella Morgado
- Department of Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sachin Patel
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Caroline E Bass
- Department of Pharmacology and Toxicology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Carlos Paladini
- UTSA Neuroscience Institute, University of Texas at San Antonio, San Antonio, TX, USA
| | - Joseph F Cheer
- Department of Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA.
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17
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Shah K, Ghosh J, Patel S, Chowdhuri MB, Jadeja KA, Shukla G, Macwan T, Kumar A, Dolui S, Singh K, Tanna RL, Patel KM, Dey R, Manchanda R, Ramaiya N, Kumar R, Aich S, Yadava N, Purohit S, Gupta MK, Nagora UC, Pathak SK, Atrey PK, Mayya KBK. Author Correction: Role of pinch in Argon impurity transport in ohmic discharges of Aditya-U Tokamak. Sci Rep 2023; 13:19969. [PMID: 37968383 PMCID: PMC10651834 DOI: 10.1038/s41598-023-47362-8] [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: 11/17/2023] Open
Affiliation(s)
- K Shah
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India.
| | - J Ghosh
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India.
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India.
| | - S Patel
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India
| | - M B Chowdhuri
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - K A Jadeja
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Department of Nano Science and Advanced Materials, Saurashtra University, Rajkot, 360 005, India
| | - G Shukla
- ITER-India, Institute for Plasma Research, Koteshwar, Ahmedabad, 380 005, India
| | - T Macwan
- University of California, Los Angeles, CA, 90095, USA
| | - A Kumar
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - S Dolui
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - K Singh
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - R L Tanna
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Institute of Science, Nirma University, Ahmedabad, 382 481, India
| | - K M Patel
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Dey
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Manchanda
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - N Ramaiya
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Kumar
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - S Aich
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - N Yadava
- Institute of Science, Nirma University, Ahmedabad, 382 481, India
| | - S Purohit
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - M K Gupta
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - U C Nagora
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - S K Pathak
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - P K Atrey
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - K B K Mayya
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India
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18
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Fitzgerald E, Shen M, Yong HEJ, Wang Z, Pokhvisneva I, Patel S, O'Toole N, Chan SY, Chong YS, Chen H, Gluckman PD, Chan J, Lee PKM, Meaney MJ. Hofbauer cell function in the term placenta associates with adult cardiovascular and depressive outcomes. Nat Commun 2023; 14:7120. [PMID: 37963865 PMCID: PMC10645763 DOI: 10.1038/s41467-023-42300-8] [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: 11/24/2022] [Accepted: 10/05/2023] [Indexed: 11/16/2023] Open
Abstract
Pathological placental inflammation increases the risk for several adult disorders, but these mediators are also expressed under homeostatic conditions, where their contribution to adult health outcomes is unknown. Here we define an inflammation-related expression signature, primarily expressed in Hofbauer cells of the term placenta and use expression quantitative trait loci to create a polygenic score (PGS) predictive of its expression. Using this PGS in the UK Biobank we conduct a phenome-wide association study, followed by Mendelian randomization and identify protective, sex-dependent effects of the placental module on cardiovascular and depressive outcomes. Genes differentially regulated by intra-amniotic infection and preterm birth are over-represented within the module. We also identify aspirin as a putative modulator of this inflammation-related signature. Our data support a model where disruption of placental Hofbauer cell function, due to preterm birth or prenatal infection, contributes to the increased risk of depression and cardiovascular disease observed in these individuals.
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Affiliation(s)
- Eamon Fitzgerald
- Sackler Program for Epigenetics and Psychobiology, McGill University, Montréal, Canada.
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montréal, Canada.
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, Canada.
| | - Mojun Shen
- Singapore Institute for Clinical Sciences, Agency for Science, Technology & Research, Singapore, Singapore
| | - Hannah Ee Juen Yong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology & Research, Singapore, Singapore
| | - Zihan Wang
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, Canada
| | - Irina Pokhvisneva
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, Canada
| | - Sachin Patel
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, Canada
| | - Nicholas O'Toole
- Sackler Program for Epigenetics and Psychobiology, McGill University, Montréal, Canada
- Ludmer Centre for Neuroinformatics and Mental Health, McGill University, Montréal, Canada
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, Canada
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science, Technology & Research, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology & Research, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Helen Chen
- KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology & Research, Singapore, Singapore
- The University of Auckland, Auckland, New Zealand
| | - Jerry Chan
- KK Women's and Children's Hospital, Singapore, Singapore
- Duke-National University of Singapore, Singapore, Singapore
| | - Patrick Kia Ming Lee
- Brain - Body Initiative, Agency for Science, Technology & Research, Singapore, Singapore
| | - Michael J Meaney
- Sackler Program for Epigenetics and Psychobiology, McGill University, Montréal, Canada.
- Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, Canada.
- Singapore Institute for Clinical Sciences, Agency for Science, Technology & Research, Singapore, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Brain - Body Initiative, Agency for Science, Technology & Research, Singapore, Singapore.
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Gunduz-Cinar O, Castillo LI, Xia M, Van Leer E, Brockway ET, Pollack GA, Yasmin F, Bukalo O, Limoges A, Oreizi-Esfahani S, Kondev V, Báldi R, Dong A, Harvey-White J, Cinar R, Kunos G, Li Y, Zweifel LS, Patel S, Holmes A. A cortico-amygdala neural substrate for endocannabinoid modulation of fear extinction. Neuron 2023; 111:3053-3067.e10. [PMID: 37480845 PMCID: PMC10592324 DOI: 10.1016/j.neuron.2023.06.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 08/01/2022] [Revised: 04/25/2023] [Accepted: 06/23/2023] [Indexed: 07/24/2023]
Abstract
Preclinical and clinical studies implicate endocannabinoids (eCBs) in fear extinction, but the underlying neural circuit basis of these actions is unclear. Here, we employed in vivo optogenetics, eCB biosensor imaging, ex vivo electrophysiology, and CRISPR-Cas9 gene editing in mice to examine whether basolateral amygdala (BLA)-projecting medial prefrontal cortex (mPFC) neurons represent a neural substrate for the effects of eCBs on extinction. We found that photoexcitation of mPFC axons in BLA during extinction mobilizes BLA eCBs. eCB biosensor imaging showed that eCBs exhibit a dynamic stimulus-specific pattern of activity at mPFC→BLA neurons that tracks extinction learning. Furthermore, using CRISPR-Cas9-mediated gene editing, we demonstrated that extinction memory formation involves eCB activity at cannabinoid CB1 receptors expressed at vmPFC→BLA synapses. Our findings reveal the temporal characteristics and a neural circuit basis of eCBs' effects on fear extinction and inform efforts to target the eCB system as a therapeutic approach in extinction-deficient neuropsychiatric disorders.
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Affiliation(s)
- Ozge Gunduz-Cinar
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA.
| | - Laura I Castillo
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Maya Xia
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Elise Van Leer
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Emma T Brockway
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Gabrielle A Pollack
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Farhana Yasmin
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Olena Bukalo
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Aaron Limoges
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Sarvar Oreizi-Esfahani
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Veronika Kondev
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
| | - Rita Báldi
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Ao Dong
- Peking University School of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Judy Harvey-White
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Resat Cinar
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA; Section on Fibrotic Disorders, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - George Kunos
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA
| | - Yulong Li
- Peking University School of Life Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China
| | - Larry S Zweifel
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA; Department of Pharmacology, University of Washington, Seattle, WA 98195, USA
| | - Sachin Patel
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Andrew Holmes
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA.
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20
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Morse R, Beaty B, Moon DH, Green R, Xu V, Weiss J, Sheth S, Patel S, Blumberg J, Hackman T, Lumley C, Patel S, Yarbrough W, Huff SB, Repka MC, Dagan R, Amdur RJ, Chera BS, Shen C, Chen X. Long-Term Outcomes of De-Intensified Chemoradiotherapy for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:S123-S124. [PMID: 37784319 DOI: 10.1016/j.ijrobp.2023.06.464] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To report long-term oncologic outcomes among patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) treated with definitive de-intensified chemoradiotherapy. MATERIALS/METHODS Major criteria for de-intensification were (1) AJCC 7th edition T0-T3, N0-N2c, M0 (AJCC 8th edition T0-T3, N0-N2, M0), (2) pathologically confirmed p16 positive, and (3) no or minimal/remote smoking history (non-mutated p53 if ≥30 pack-years). Treatment was 60 Gy intensity-modulated radiotherapy with first-choice concurrent cisplatin 30 mg/m2 once per week (alternative regimens permissible for cisplatin ineligible patients). Patients with T0-T2 N0-1 (AJCC 7th edition) were recommended 60 Gy radiation alone. Systemic therapy received included: cisplatin 30 mg/m2 (n = 122), cetuximab (n = 15), cisplatin 40 mg/m2 (n = 12), carboplatin/paclitaxel (n = 2), and radiation alone (n = 25). Kaplan Meier estimates for overall survival (OS), progression-free survival (PFS), locoregional control (LRC), and freedom from distant metastasis (FFDM) were calculated. Cox regression models were used for comparisons among subgroups. RESULTS A total 176 patients received de-intensified treatment (n = 153 prospective protocol, n = 23 off-protocol). Median follow-up was 52.6 months (range 5.3 - 102.0, 90.8% with minimum 2-year follow-up); 56.8% (n = 100) were never smokers and 43.2% (n = 76) former smokers; former smokers had median 9 pack-years smoking history (range 0.25 - 50) with 46% ≥10 pack-years. Outcomes were as follows: 2-year OS 99.4% and 5-year OS 91.8%; 2-year PFS 94.1% and 5-year PFS 84.3%; 2-year LRC 98.3% and 5-year LRC 95.8%; 2-year FFDM 95.8% and 5-year FFDM 93.2%. Median time to progression events were 21.1 months (range, 7.2 - 54.1) with 37.5% (6 of 16) of recurrences occurring after 24 months. Six total locoregional events occurred (five recurrences and one site of persistent disease), within the 60 Gy planning target volume. Twenty-three patients with T0-T2 N0-1 disease received radiation alone with 2-year PFS 92.9% (5-year 83.8%) and 2-year LRC 100% (5-year 95.2%). Outcomes for former smokers with ≥10 pack-years were comparable to patients with less or no smoking history (2-year PFS 94.1% vs 94.1%; 5-year PFS 90.6% vs 82.7%; HR 0.58, p = 0.38). Early results suggest similar oncologic outcomes among those treated off-protocol (median follow-up 25.6 months) with 1 of 23 patients experiencing locoregional recurrence. CONCLUSION Dose de-intensification of 60 Gy radiotherapy with weekly cisplatin results in favorable long-term tumor control in patients with HPV-associated OPSCC. De-intensified 60 Gy alone may be efficacious in carefully selected patients with T0-T2 N0-1 (AJCC 7th edition) disease. Inclusion of biologically favorable patients with more extensive former smoking history in de-intensification clinical trials may be warranted.
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Affiliation(s)
- R Morse
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - B Beaty
- Albert Einstein College of Medicine, Bronx, NY
| | - D H Moon
- University of Texas Southwestern Department of Radiation Oncology, Dallas, TX
| | - R Green
- University of North Carolina Hospitals, Chapel Hill, NC
| | - V Xu
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - J Weiss
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - S Sheth
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - S Patel
- University of North Carolina Hospitals, Chapel Hill, NC
| | | | - T Hackman
- Department of Otolaryngology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - C Lumley
- UNC School of Medicine, Chapel Hill, NC
| | - S Patel
- UNC School of Medicine, Chapel Hill, NC
| | | | - S B Huff
- University of Carolina, Chapel Hill, NC
| | - M C Repka
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - R Dagan
- University of Florida Health Proton Therapy Institute, Jacksonville, FL
| | - R J Amdur
- University of Florida Hospitals, Gainesville, FL
| | - B S Chera
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - X Chen
- Case Western Reserve University School of Medicine, Cleveland, OH
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21
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Wadi-Ramahi S, Lalonde RJ, Patel S, Conte A, Siddiqui ZA, Olson AC, Huq MSS. Failure Mode and Effects Analysis for Treatment Workflow of a Novel Ring Gantry Linac. Int J Radiat Oncol Biol Phys 2023; 117:S163. [PMID: 37784410 DOI: 10.1016/j.ijrobp.2023.06.258] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) A new ring gantry Linac machine combined with a PET ring is available in the market. It has 3 separate centers, one for laser, one for CT imaging and a 3rd for the Linac. As a first-generation machine of its kind, the workflow heavily depends on user-input. As example, it uses two separate coordinate systems, IEC for lasers and CT localization offsets and DICOM for treatment planning. The planner must manually convert between the two systems. We hypothesize that the unique design of the machine that is heavily dependent on users' input increases the potential of failure of treatment. The present work investigates failure modes for treatment delivery using the methodology of failure modes and effects analysis (FMEA) and proposes solutions to mitigate some of the failure modes (FMs). MATERIALS/METHODS A group of two radiation oncologists, two radiation therapists and three medical physicists was assembled. The process map for treatment delivery on the X1 was created and FMs were identified. Members independently graded each FM on 3 parameters, likelihood of occurrence, detectability of FM and level of severity on patient treatment. A grading scale of 1-5 was used with five representing the worst outcome in each parameter. Each member also identified the origin of each FM to be human, machine or clinical process. Mitigation solutions were proposed. RESULTS The process map of treatment delivery on X1 consists of six major processes and 24 sub-processes. A total of 27 FMs were identified, with many 19/27 (70%) caused by human errors and 7/27 (27%) caused by machine. From all responses, we tallied a median of 11 FMs (40%) that have both S≥ 4 and O or D ≥ 4. To further focus our analysis, we looked at the highest PRN scores from each member and found 7 FMs that were common. 1 FM was in "initiation of Treatment" sub-process and 6 FMs in "Treatment delivery" sub-process. Proposed solutions to these FMs were concerned with software upgrades. Examples are, allow changes in fractionation, allow dose tracking, auto calculation of couch position for various sub processes, allow DICOM image transfer and many more. The current clinical workflow that we adopted for these FMs either puts the burden on the user to confirm/verify parameters or the use of third-party software. In addition to these high-scoring FMs, we adopted changes in clinical workflow to mitigate other FMs, most of them through third-party software. CONCLUSION This study confirmed that the unique design and user-dependent machine environment, human failures are high accounting for 70% of FMs in treatment delivery alone. Our current workflow of the machine depends on direct user input to calculate/confirm certain parameters or the use of third-party software, which also depends on the user for proper completion of the task. Suggested solutions also included proposed improvement to the machine's software and user interface.
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Affiliation(s)
| | - R J Lalonde
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
| | - S Patel
- UPMC Cancer Center, Pittsburgh, PA, United States
| | - A Conte
- UPMC Shadyside Hospital, Pittsburgh, PA
| | - Z A Siddiqui
- University of Pittsburgh Medical Center, Pittsburgh, PA
| | - A C Olson
- Department of Radiation Oncology, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA
| | - M S S Huq
- Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA
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22
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Patel S, Olatunji EO, Joseph AO, Lasebikan N, Ngoma M, Ngoma TA, Nnko G, Chigbo DC, Ngwa W. An Analysis of Delays in Treatment Time for Prostate Cancer Patients in Sub-Saharan Africa. Int J Radiat Oncol Biol Phys 2023; 117:e610-e611. [PMID: 37785838 DOI: 10.1016/j.ijrobp.2023.06.1984] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Time interval from diagnosis of prostate cancer to treatment is an important predictor of survival outcomes for patients. These time intervals can be prolonged in resource-limited settings, such as those in Sub-Saharan Africa (SSA). The purpose of this project was to analyze the time interval between diagnosis and either hormonal or radiotherapy treatment for prostate cancer patients in Nigeria and Tanzania. The outcomes can inform the implementation of the recent Lancet Oncology Commission recommendations on increasing access to radiotherapy services in SSA to curb the growing cancer burden in the region. MATERIALS/METHODS Data were extracted from electronic patient records at the NSIA-LUTH Cancer Center (NLCC) in Lagos, Nigeria and at the Ocean Road Cancer Institute (ORCI) in Dar Es Salaam, Tanzania. Included patients were prostate cancer patients who received hypofractionated radiotherapy (HFRT) at ORCI between January 6 - June 16, 2022, and either HFRT or conventionally fractionated radiotherapy (CFRT) at NLCC between February 1 - July 27, 2022. Simple descriptive statistics were used to calculate the mean time interval between the patient's date of diagnosis of prostate cancer and the start of hormonal or radiotherapy treatment. RESULTS Time to hormonal therapy was collected for 23 ORCI patients and 28 NLCC patients. The mean time interval from date of diagnosis to start of hormonal therapy was 19.3 weeks for patients in Tanzania and 8.0 weeks for patients in Nigeria. Time to radiotherapy was collected for 23 ORCI patients and 50 NLCC patients. The mean time interval from date of diagnosis to start of radiotherapy was 59.13 weeks for patients in Tanzania and 48.5 weeks for patients in Nigeria. CONCLUSION Prostate cancer patients in Nigeria and Tanzania experience significant delay in receiving hormonal and radiotherapy treatment, especially when compared to wait times in well-resourced countries. For example, a recent assessment of U.S. patients in the National Cancer Database who were diagnosed with prostate cancer between 2004-2015 revealed that the mean interval from diagnosis to definitive therapy (either surgery or some form of radiotherapy) was 11.3 weeks - significantly less than the mean times documented in our study of SSA patients (Cone et al., 2020). Additionally, patients in Tanzania experienced longer treatment delays compared to patients in Nigeria, highlighting potential disparities in access to care between SSA countries. These prolonged delay times are likely to negatively impact survival and represent an intervention opportunity to alleviate the cancer crisis in SSA.
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Affiliation(s)
- S Patel
- Johns Hopkins Medicine, Baltimore, MD
| | | | | | - N Lasebikan
- University of Nigeria Teaching Hospital Enugu, Enugu, Nigeria
| | - M Ngoma
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - T A Ngoma
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - G Nnko
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - D C Chigbo
- University of Nigeria Teaching Hospital, Lagos, Nigeria
| | - W Ngwa
- John Hopkins University Hospital, Baltimore, MD
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23
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Kotecha R, McDermott MW, Chen C, Ferreira C, Hanft S, Shen C, Wanebo J, Smith K, Wardak Z, Patel T, Chamoun R, Hoang KB, Choutka O, Rodriguez A, Shah M, Brachman DG, Campbell L, Patel S. Surgically Targeted Radiation Therapy (STaRT) for Brain Metastases: Initial Experience from a Prospective Multi-Institutional Registry. Int J Radiat Oncol Biol Phys 2023; 117:e120. [PMID: 37784668 DOI: 10.1016/j.ijrobp.2023.06.908] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Resection and intraoperative brachytherapy for patients with large, operable brain metastasis allows for both relief of mass effect and the delivery of radiotherapy (RT) to the resection cavity with a favorable dosimetric profile. The objective of this study was to analyze early patterns-of-care and treatment-related toxicity outcomes for brain metastasis patients treated with surgically targeted radiation therapy (STaRT) using a novel brachytherapy carrier. MATERIALS/METHODS Patients with brain metastasis, de novo and recurrent disease, who enrolled onto a prospective multi-institutional observational study (NCT04427384) were the subject of this analysis. Patients underwent resection and immediate implantation of bioresorbable, conformable, 20 mm x 20 mm x 4 mm collagen tile brachytherapy device(s) containing four uniform-intensity Cesium-131 sources. Toxicities were categorized using the CTCAE v5.0 adverse event (AE) criteria. RESULTS From 10/2020 to 01/2023, 13 participating sites enrolled and treated 48 patients with 51 metastases (13 with de novo and 35 patients with recurrent brain metastases), and 3 patients had 2 lesions implanted at the same procedure. Median age was 61 years (range: 28-80), 52% were female, and the most common primary types were lung (56%) and breast (13%). The median maximum pre-operative dimension was 3.4 cm (range: 1.7-5.7) and median pre-operative tumor volume 13.7cm3 (range: 1.7-132). 64% had received prior RT with a median time from last RT to STaRT of 14.6 months range: 3.5-57.3). Median KPS at screening was 80 (range: 50-100), and remained stable at post op visit (80, range: 50-100), and at 3-months following treatment (80, range 50-100), respectively (p>0.05). The median time for implantation was 3 minutes (range: 0.4-30). At a median follow-up of 4 months (range: <1-18), no patient experienced a radiation-attributed AE, and only 1 attributable Gr >3 AE was noted (Gr 5 intracerebral hemorrhage deemed probably related to surgery and unrelated to the implanted device). CONCLUSION Early results from this prospective multi-center trial demonstrate the feasibility and safety of STaRT. The lack of radiation-related AE, even with short follow-up, is intriguing given the relatively large lesion size and proportion of patients treated for recurrent, previously irradiated disease. Additional follow-up will provide data on tumor control outcomes and radiation necrosis rates using this novel technique.
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Affiliation(s)
- R Kotecha
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL
| | - M W McDermott
- Department of Neurosurgery, Miami Neuroscience Institute, Baptist Health South Florida, Miami, FL
| | - C Chen
- Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, MN
| | - C Ferreira
- Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
| | - S Hanft
- Westchester Medical Center, Valhalla, NY
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - J Wanebo
- Honor Health Research Institute, Scottsdale, AZ
| | - K Smith
- Barrow Neurological Institute, Phoenix, AZ
| | - Z Wardak
- University of Texas Southwestern Medical Center, Dallas, TX
| | - T Patel
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Chamoun
- University of Kansas Medical Center, Kansas City, KS
| | - K B Hoang
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA
| | - O Choutka
- St. Alphonsus Regional Medical Center, Boise, ID
| | - A Rodriguez
- University of Arkansas for Medical Sciences, Director of Neurosurgical Oncology, Little Rock, AR
| | - M Shah
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health North Hospital, Indianapolis, IN
| | | | | | - S Patel
- GT Medical Technologies, Tempe, AZ
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24
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Affiliation(s)
- S Patel
- University Dental Hospital Manchester, Manchester, UK.
| | - J Darcey
- University Dental Hospital Manchester, Manchester, UK.
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25
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Olatunji EO, Kisukari JD, Adeneye S, Mkhize T, Patel S, Joseph AO, Studen A, Ajose A, Alabi A, Swanson W, Ngoma TA, Wijesooriya K, Avery SM, Lehmann J, Graef K, Li H, Huq S, Ngwa W, Incrocci L, Mallum AAI. Can Advanced Radiotherapy Clinical Trials be Conducted in Resources Limited Countries? Int J Radiat Oncol Biol Phys 2023; 117:e604-e605. [PMID: 37785822 DOI: 10.1016/j.ijrobp.2023.06.1972] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The Lancet Oncology Commission on Cancer in Sub-Saharan Africa (SSA) highlighted the region's increasing cancer incidence and mortality, and recommended a series of actions to address this growing crisis. One such approach recommended by the Commission to increase access to curative treatment is the use of hypofractionated radiotherapy (HFRT). Here we highlight the barriers and facilitators to launching HFRT in SSA, as identified through the HypoAfrica clinical trial. MATERIALS/METHODS HypoAfrica is a longitudinal multi-center clinical trial that was launched in late 2021 at three centers in Nigeria, Tanzania, and South Africa. The goal of HypoAfrica was to assess the feasibility of implementing HFRT for localized prostate cancer in SSA. To date, 155 of 182 subjects have been enrolled in this study. During the last year, a team of radiation oncology professionals from Africa, Europe, Australia, and USA met once every Saturday and reviewed the sites' data to identify the barriers to the implementation of HFRT and find solutions to overcome these challenges. With the intent to expand HFRT trials and practice to new SSA countries and radiotherapy centers, we also conducted an online survey to elucidate the readiness of radiotherapy centers across SSA to perform HFRT. RESULTS The major challenge identified by this team was securing high-quality data that will yield statistically significant results. Factors that contribute to quality data are: harmonization of machine and patient-specific quality assurance (QA) procedures across the centers, data quality harmonization, and challenges associated with machine maintenance. Immediate solutions implemented included introduction of low-cost QA tools for patient-specific QA measurements, ongoing training of the site's healthcare professionals, implementation of preventative maintenance for Linacs, and data centralization infrastructure. These actions have resulted in the production of a high-quality, standardized dataset. Planned longer-term solutions to HFRT challenges include implementation of ongoing training, telehealth for remote support and QA, and the creation of an Imaging and Radiation Oncology Core for Africa. The online survey indicated that 61% of respondents' institutions perform HFRT for palliative purposes, emphasizing the readiness of sites in SSA to utilize HFRT for curative purposes. CONCLUSION The study serves as a useful guide for increasing access to HFRT treatment in resource-limited settings and for conducting multicenter radiotherapy clinical trials.
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Affiliation(s)
| | - J Dachi Kisukari
- Ocean Road Cancer Institute, Dar Es Salam, United Republic of Tanzania
| | - S Adeneye
- NSIA-LUTH Cancer Center, Lagos, Nigeria
| | - T Mkhize
- Inkosi Albert Luthuli Central Hospital, Durban, South Africa
| | - S Patel
- Johns Hopkins Medicine, Baltimore, MD
| | | | - A Studen
- University of Ljubljana, Ljubljana, Slovenia
| | - A Ajose
- Lagos University Teaching Hospital, Lagos, Nigeria
| | - A Alabi
- Lagos University Teaching Hospital, Lagos, Nigeria
| | - W Swanson
- Weill Cornell Medicine, New York City, NY
| | - T A Ngoma
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - K Wijesooriya
- Department of Radiation Oncology, University of Virginia, Charlottesville, VA
| | - S M Avery
- University of Pennsylvania, Philadelphia, PA
| | - J Lehmann
- Calvary Mater Newcastle, Newcastle, Australia
| | - K Graef
- BIO Ventures for Global Health, Seattle, WA
| | - H Li
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - S Huq
- UPMC Hillman Cancer Center, Pittsburgh, PA
| | - W Ngwa
- John Hopkins University Hospital, Baltimore, MD
| | - L Incrocci
- Department of Radiotherapy, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A A I Mallum
- Inkosi Albert Luthuli Central Hospital, Durban, South Africa; University of KwaZulu Natal, Durban, South Africa
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Patel S, Olatunji EO, Mallum AAI, Benjika B, Joseph AO, Joseph S, Lasebikan N, Mahuna H, Ngoma M, Ngoma TA, Nnko G, Chigbo DC, Vorster M, Ngwa W. Expanding Radiotherapy Access in Sub-Saharan Africa: An Analysis of Travel Burdens and Patient-Related Benefits of Hypofractionation. Int J Radiat Oncol Biol Phys 2023; 117:e613. [PMID: 37785843 DOI: 10.1016/j.ijrobp.2023.06.1989] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this project was to examine the travel burdens for radiotherapy patients in Nigeria, Tanzania, and South Africa, and to assess the patient-related benefits of hypofractionated radiotherapy (HFRT) for breast and prostate cancer patients in these countries. The outcomes can inform the implementation of the recent Lancet Oncology Commission recommendations on increasing the adoption of HFRT in Sub-Saharan Africa (SSA) to enhance radiotherapy access in the region. MATERIALS/METHODS Data were extracted from electronic patient records at the NSIA-LUTH Cancer Center (NLCC) in Lagos, Nigeria and the Inkosi Albert Luthuli Central Hospital (IALCH) in Durban, South Africa, from written records at the University of Nigeria Teaching Hospital (UNTH) Oncology Center in Enugu, Nigeria, and from phone interviews at Ocean Road Cancer Institute (ORCI) in Dar Es Salaam, Tanzania. Google Maps was used to calculate the shortest driving distance between a patient's home address and their respective radiotherapy center. QGIS was used to map the straight-line distances to each center. Descriptive statistics were used to compare transportation costs, time expenditures, and lost wages when using HFRT versus conventionally fractionated radiotherapy (CFRT) for breast and prostate cancer. All transportation- and wage-related cost data were contextualized within each country's monthly adjusted net national income (MANNI) per capita, as reported by 2020 data from the World Bank. RESULTS Patients in Nigeria (n = 390) traveled a median distance of 24.0 km (interquartile range (IQR) = 238.5 km) to NLCC and 86.7 km (IQR = 87.3 km) to UNTH, patients in Tanzania (n = 23) traveled a median distance of 537.0 km (IQR = 587.5 km) to ORCI, and patients in South Africa (n = 412) traveled a median distance of 18.0 km (IQR = 15.0 km) to IALCH. Estimated transportation cost savings for breast cancer patients in Lagos and Enugu were 12,895 Naira and 7,369 Naira (20% and 11% of MANNI per capita), respectively, and for prostate cancer patients were 25,329 and 14,276 Naira (38% and 22% of MANNI per capita), respectively. Prostate cancer patients in Tanzania saved a median of 137,765 Shillings (78% of MANNI per capita) in transportation costs. Significant time expenditures - a relevant consideration for patient convenience - were also saved for ORCI patients, including a median of 80.0 hours (includes travel, treatment, and wait times). Mean transportation cost savings for patients in South Africa were 4,777 Rand (72% of MANNI per capita) for breast cancer and 9,486 Rand (143% of MANNI per capita) for prostate cancer. CONCLUSION Cancer patients in SSA travel considerable distances to access radiotherapy services. HFRT decreases patient-related costs and time expenditures, which may increase radiotherapy access and alleviate the growing burden of cancer in the region.
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Affiliation(s)
- S Patel
- Johns Hopkins Medicine, Baltimore, MD
| | | | - A A I Mallum
- University of KwaZulu-Natal, Durban, South Africa
| | - B Benjika
- ICT University USA, Yaounde, Cameroon
| | | | - S Joseph
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - N Lasebikan
- University of Nigeria Teaching Hospital Enugu, Enugu, Nigeria
| | - H Mahuna
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - M Ngoma
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - T A Ngoma
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - G Nnko
- Ocean Road Cancer Institute, Dar Es Salaam, United Republic of Tanzania
| | - D C Chigbo
- University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - M Vorster
- University of KwaZulu-Natal, Durban, South Africa
| | - W Ngwa
- John Hopkins University Hospital, Baltimore, MD
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Thawani N, Lee J, Kirsch C, Pinnaduwage D, Srivastava SP, Patel S, Sorensen SP, Jani S, Ellefson S, Vasireddy S, Riley J, Jennifer M, Diaz AZ, Gagliano R, Patel M. Implementation Science in Radiation Oncology: Case Study for Liver SBRT. Int J Radiat Oncol Biol Phys 2023; 117:e404. [PMID: 37785348 DOI: 10.1016/j.ijrobp.2023.06.1542] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The translation of research into clinical practice is challenging and implementation science is becoming as important as the trial design and development. Implementation science methodologies have been shown to reduce research-to-practice gap in other clinical settings. This is especially true for the field of Radiation Oncology where modern hypofractionated techniques, like Stereotactic Ablative Body Radiotherapy for Liver are at a high risk of over enthusiastic implementation as well as underutilization. We present the results of a multicomponent implementation methodology utilized to develop our Liver SBRT program as a model to safely translate a complex technology into clinical practice. MATERIALS/METHODS After review of literature and market research a setup was created with focus on machine requirements, immobilization devices, motion management techniques and QA techniques. Clinical tools in the form of checklists were developed for patient selection, simulation along with image fusion, target delineation, planning (conformity indices, dose constraint criteria) and treatment delivery. All patients were treated on Truebeam® after Bodyfix® immobilization with plastic wrap. Planning was completed on Eclipse TPS with dose constraints and conformity guidelines defined per the RTOG 1112 and TG 101. Clinical outcomes including clinical and imaging follow-up for tumor control and toxicity were recorded. For this report, all patients treated were reviewed and compared to published data to assess the success of the implementation methodology. RESULTS A total of 64 consecutive Patients treated with liver SBRT at Dignity Health Cancer Institute (DHCI) were eligible for the study. 58 patients treated for primary liver malignancies were included in this analysis to assess outcomes including control of disease and toxicity to compare to the published literature. Median follow up for these patients 6.5 months (4-46mnths). Median GTV volume was 38.7cc (0.1cc-2056.1 cc), median PTV volume was 159.35 cc (21.5cc-2673.5cc). Median SBRT prescription dose was 50 Gy/5 fractions (35-50 Gy). Median Liver- GTV was 1595.8 cc(770.7cc-2983.0cc). Following toxicities were noted- Grade 1- 10.3%, Grade 2 - 1.72%, Grade 3- 3.44%. No Grade 4 toxicity was noted. 1 year LC rate was 96.6%. 8.6% showed out of field liver failure and 6.9% developed distant metastasis. These results were compared to the current published literature and are shown to be comparable. CONCLUSION Strong and well thought out Implementation methodologies can ensure reproducing results in clinical practice, comparable to the controlled environment of trials. These are crucial in translation of clinical trials utilizing advanced technologies to promote the culture of safety in clinical practice of Radiation Oncology. Regular assessment and tracking of clinical outcomes can be used as Quality markers for directing care and reimbursements for future.
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Affiliation(s)
- N Thawani
- Dignity Health Cancer Institute/ CUSOM/ UACC, Phoenix, AZ
| | - J Lee
- Dignity Health Cancer Institute/ CUSOM/ UACC, Phoenix, AZ
| | - C Kirsch
- Creighton School of Medicine- Phoenix, Phoenix, AZ
| | - D Pinnaduwage
- St. Joseph's Hospital and Medical Center, Phoenix, AZ
| | | | - S Patel
- University of Arizona Cancer Center / Dignity Health Saint Joseph Hospital, Phoenix, AZ
| | - S P Sorensen
- University of Arizona Cancer Center / Dignity Health Saint Joseph Hospital, Phoenix, AZ
| | - S Jani
- University of Arizona Cancer Center / Dignity Health Saint Joseph Hospital, Phoenix, AZ
| | - S Ellefson
- Dignity Health Cancer Institute, Phoenix, AZ
| | - S Vasireddy
- University of Arizona Cancer Center, Phoenix, AZ, United States
| | - J Riley
- St. Joseph's Hospital and Medical Center, Phoenix, AZ
| | - M Jennifer
- Dignity Health cancer Institute, Phoenix, AZ
| | - A Z Diaz
- Dignity Health Cancer Institute, Phoenix, AZ
| | - R Gagliano
- Dignity Health Cancer Institute, Phoenix, AZ
| | - M Patel
- Dignity Health Cancer Institute, Phoenix, AZ
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Shah K, Ghosh J, Patel S, Chowdhuri MB, Jadeja KA, Shukla G, Macwan T, Kumar A, Dolui S, Singh K, Tanna RL, Patel KM, Dey R, Manchanda R, Ramaiya N, Kumar R, Aich S, Yadava N, Purohit S, Gupta MK, Nagora UC, Pathak SK, Atrey PK, Mayya KBK. Role of pinch in Argon impurity transport in ohmic discharges of Aditya-U Tokamak. Sci Rep 2023; 13:16087. [PMID: 37752170 PMCID: PMC10522584 DOI: 10.1038/s41598-023-42746-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
We present experimental results of the trace argon impurity puffing in the ohmic plasmas of Aditya-U tokamak performed to study the argon transport behaviour. Argon line emissions in visible and Vacuum Ultra Violet (VUV) spectral ranges arising from the plasma edge and core respectively are measured simultaneously. During the experiments, space resolved brightness profile of Ar1+ line emissions at 472.69 nm (3p44s 2P3/2-3p44p 2D3/2), 473.59 nm (3p44s 4P5/2-3p44p 4P3/2), 476.49 nm (3p44s 2P1/2-3p44p 2P3/2), 480.60 nm (3p44s 4P5/2-3p44p 4P5/2) are recorded using a high resolution visible spectrometer. Also, a VUV spectrometer has been used to simultaneously observe Ar13+ line emission at 18.79 nm (2s22p 2P3/2-2s2p2 2P3/2) and Ar14+ line emission at 22.11 nm (2s2 1S0-2s2p 1P1). The diffusivity and convective velocity of Ar are obtained by comparing the measured radial emissivity profile of Ar1+ emission and the line intensity ratio of Ar13+ and Ar14+ ions, with those simulated using the impurity transport code, STRAHL. Argon diffusivities ~ 12 m2/s and ~ 0.3 m2/s have been observed in the edge (ρ > 0.85) and core region of the Aditya-U, respectively. The diffusivity values both in the edge and core region are found to be higher than the neo-classical values suggesting that the argon impurity transport is mainly anomalous in the Aditya-U tokamak. Also, an inward pinch of ~ 10 m/s mainly driven by Ware pinch is required to match the measured and simulated data. The measured peaked profile of Ar density suggests impurity accumulation in these discharges.
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Affiliation(s)
- K Shah
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India.
| | - J Ghosh
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India.
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India.
| | - S Patel
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India
| | - M B Chowdhuri
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - K A Jadeja
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Department of Nano Science and Advanced Materials, Saurashtra University, Rajkot, 360 005, India
| | - G Shukla
- ITER-India, Institute for Plasma Research, Koteshwar, Ahmedabad, 380 005, India
| | - T Macwan
- University of California, Los Angeles, CA, 90095, USA
| | - A Kumar
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - S Dolui
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - K Singh
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - R L Tanna
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Institute of Science, Nirma University, Ahmedabad, 382 481, India
| | - K M Patel
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Dey
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Manchanda
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - N Ramaiya
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - R Kumar
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - S Aich
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - N Yadava
- Institute of Science, Nirma University, Ahmedabad, 382 481, India
| | - S Purohit
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - M K Gupta
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - U C Nagora
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - S K Pathak
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
- Homi Bhabha National Institute, Training School Complex, Anushaktinagar, Mumbai, 400 094, India
| | - P K Atrey
- Institute for Plasma Research, Bhat, Gandhinagar, 382 428, India
| | - K B K Mayya
- Department of Physics, Pandit Deendayal Energy University, Raisan, Gandhinagar, 382 007, India
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Kondev V, Najeed M, Yasmin F, Morgan A, Loomba N, Johnson K, Adank DN, Dong A, Delpire E, Li Y, Winder D, Grueter BA, Patel S. Endocannabinoid release at ventral hippocampal-amygdala synapses regulates stress-induced behavioral adaptation. Cell Rep 2023; 42:113027. [PMID: 37703881 PMCID: PMC10846613 DOI: 10.1016/j.celrep.2023.113027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/14/2023] [Accepted: 08/09/2023] [Indexed: 09/15/2023] Open
Abstract
The endocannabinoid (eCB) system is a key modulator of glutamate release within limbic neurocircuitry and thus heavily modulates stress responsivity and adaptation. The ventral hippocampus (vHPC)-basolateral amygdala (BLA) circuit has been implicated in the expression of negative affective states following stress exposure and is modulated by retrograde eCB signaling. However, the mechanisms governing eCB release and the causal relationship between vHPC-BLA eCB signaling and stress-induced behavioral adaptations are not known. Here, we utilized in vivo optogenetic- and biosensor-based approaches to determine the temporal dynamics of activity-dependent and stress-induced eCB release at vHPC-BLA synapses. Furthermore, we demonstrate that genetic deletion of cannabinoid type-1 receptors selectively at vHPC-BLA synapses decreases active stress coping and exacerbates stress-induced avoidance and anhedonia phenotypes. These data establish the in vivo determinants of eCB release at limbic synapses and demonstrate that eCB signaling within vHPC-BLA circuitry serves to counteract adverse behavioral consequences of stress.
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Affiliation(s)
- Veronika Kondev
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
| | - Mustafa Najeed
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
| | - Farhana Yasmin
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Amanda Morgan
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Niharika Loomba
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
| | - Keenan Johnson
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Danielle N Adank
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37232, USA
| | - Ao Dong
- State Key Laboratory of Membrane Biology, Peking University School of Life Sciences, Beijing, China; PKU-IDG/McGoverrn Institute for Brain Research, Beijing, China; Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Eric Delpire
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Yulong Li
- State Key Laboratory of Membrane Biology, Peking University School of Life Sciences, Beijing, China; PKU-IDG/McGoverrn Institute for Brain Research, Beijing, China; Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China; Chinese Institute for Brain Research, Beijing, China
| | - Danny Winder
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN 37232, USA; Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN 37232, USA
| | - Brad A Grueter
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Sachin Patel
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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Osman A, Patel S, Gonsalves M, Renani S, Morgan R. Vascular Interventions in Oncology. Clin Oncol (R Coll Radiol) 2023:S0936-6555(23)00311-4. [PMID: 37805354 DOI: 10.1016/j.clon.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/21/2023] [Accepted: 09/13/2023] [Indexed: 10/09/2023]
Abstract
Vascular interventions are an important and established tool in the management of the oncology patient. The goal of these procedures may be curative, palliative or adjunctive in nature. Some of the common vascular interventions used in oncology include transarterial embolisation or chemoembolisation, selective internal radiation therapy, chemosaturation, venous access lines, superior vena cava stenting and portal vein embolisation. We provide an overview of the principles, technology and approach of vascular techniques for tumour therapy in both the arterial and venous systems. Arterial interventions are currently mainly used in the management of hepatocellular carcinoma. Transarterial embolisation, chemoembolisation and selective internal radiation therapy deliver targeted catheter-delivered treatments with the aim of reducing tumour burden, controlling tumour growth or increasing survival in patients not eligible for transplantation. Chemosaturation is a regional chemotherapy technique that delivers high doses of chemotherapy directly to the liver via the hepatic artery, while reducing the risks of systemic effects. Venous interventions are more adjunctive in nature. Venous access lines are used to provide a means of delivering chemotherapy and other medications directly into the bloodstream. Superior vena cava stenting is a palliative procedure that is used to relieve symptoms of superior vena cava obstruction. Portal vein embolisation is a procedure that allows hypertrophy of a healthy portion of the liver in preparation for liver resection. Interventional radiology-led vascular interventions play an essential part of cancer management. These procedures are minimally invasive and provide a safe and effective adjunct to traditional cancer treatment methods. Appropriate work-up and discussion of each patient-specific problem in a multidisciplinary setting with interventional radiology is essential to provide optimum patient-centred care.
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Affiliation(s)
- A Osman
- St George's Hospital University Hospitals NHS Foundation Trust, London, UK.
| | - S Patel
- St George's Hospital University Hospitals NHS Foundation Trust, London, UK
| | - M Gonsalves
- St George's Hospital University Hospitals NHS Foundation Trust, London, UK
| | - S Renani
- St George's Hospital University Hospitals NHS Foundation Trust, London, UK
| | - R Morgan
- St George's Hospital University Hospitals NHS Foundation Trust, London, UK
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Patel S, Jenkins P, Zhong J, Liu W, Harborne K, Modi S, Joy C, Williams R, Haslam P. Better safe than so ray: national survey of radiation protection amongst interventional radiology trainees in the United Kingdom. Br J Radiol 2023; 96:20230071. [PMID: 37493155 PMCID: PMC10461283 DOI: 10.1259/bjr.20230071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/30/2023] [Accepted: 06/14/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE To establish the provision and use of radiation personal protective equipment (PPE) and dosimetry amongst UK interventional radiology (IR) trainees and highlight areas of improvement in order to enhance the radiation safety. METHODS A survey questionnaire was designed by members of the British Society of Interventional Radiology (BSIR) trainee committee via survey monkey and distributed to UK IR trainees via the BSIR membership mailing list, local representatives and Twitter. The survey was open from 04/01/2021 to 20/02/2021. Only IR trainees in years ST4 and above were included. RESULTS Of the 73 respondents, 62 qualified for analysis. Respondents (81% male) spent a median of 5.5 sessions (half day list) per week in the angiography suite and 58% (n=36) had difficulty finding appropriately sized lead aprons at least once a week. Overall 53% (n=33) had concerns about their radiation PPE. Furthermore 56% of trainees (n=35) experienced back pain among other symptoms attributed to wearing the lead aprons available to them. 77% (n=48) regularly wore lead glasses. For trainees requiring prescription glasses (n=22) overfit goggles were provided however 17 (77%) of these trainees felt the goggles compromised their ability to perform the procedure. Eye and finger dosimeters were used by 50% and 52% of respondents respectively. Compliance with body dosimetry was 99%. CONCLUSION Provision of radiation PPE and dose monitoring for IR trainees is suboptimal, particularly access to adequate eye protection or suitably fitting leads. Based on the findings of this survey, recommendations have been made to promote the safety and radiation awareness of IR trainees. ADVANCES IN KNOWLEDGE Radiation protection practices for IR trainees nationally are poor. Provision of suitable eye protection and well fitting lead body protection is low.
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Affiliation(s)
| | | | | | - W Liu
- University Hospitals Coventry and Warwickshire, Coventry, United Kingdom
| | - K Harborne
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | | | - C Joy
- University Hospital Southampton, Southampton, United Kingdom
| | - R Williams
- Freeman Hospital, The Newcastle Upon Tyne Hospitals NHS Foundation, London, United Kingdom
| | - P Haslam
- Freeman Hospital, The Newcastle Upon Tyne Hospitals NHS Foundation, London, United Kingdom
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Jaramillo-Ospina AM, Roman GT, Rodrigues DM, Patel S, Pokhvisneva I, Chakr VG, Levitan RD, Meaney MJ, Silveira PP. Omega-3 polygenic score protects against altered eating behavior in intrauterine growth-restricted children. Pediatr Res 2023; 94:1225-1234. [PMID: 37142650 DOI: 10.1038/s41390-023-02609-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Alterations in eating behavior are common in infants with intrauterine growth restriction (IUGR); omega-3 polyunsaturated fatty acids (PUFA) could provide protection. We hypothesized that those born IUGR with a genetic background associated with increased production of omega-3-PUFA will have more adaptive eating behaviors during childhood. METHODS IUGR/non-IUGR classified infants from MAVAN and GUSTO cohorts were included at the age of 4 and 5 years, respectively. Their parents reported child's eating behaviors using the child eating behavior questionnaire-CEBQ. Based on the GWAS on serum PUFA (Coltell 2020), three polygenic scores were calculated. RESULTS Significant interactions between IUGR and polygenic score for omega-3-PUFA on emotional overeating (β = -0.15, P = 0.049 GUSTO) and between IUGR and polygenic score for omega-6/omega-3-PUFA on desire to drink (β = 0.35, P = 0.044 MAVAN), pro-intake/anti-intake ratio (β = 0.10, P = 0.042 MAVAN), and emotional overeating (β = 0.16, P = 0.043 GUSTO) were found. Only in IUGR, a higher polygenic score for omega-3-PUFA associated with lower emotional overeating, while a higher polygenic score for omega-6/omega-3-PUFA ratio was associated with a higher desire to drink, emotional overeating, and pro-intake/anti-intake. CONCLUSION Only in IUGR, the genetic background for higher omega-3-PUFA is associated with protection against altered eating behavior, while the genetic score for a higher omega-6/omega-3-PUFA ratio is associated with altered eating behavior. IMPACT A genetic background related to a higher polygenic score for omega-3 PUFA protected infants born IUGR against eating behavior alterations, while a higher polygenic score for omega-6/omega-3 PUFA ratio increased the risk of having eating behavior alterations only in infants born IUGR, irrespective of their adiposity in childhood. Genetic individual differences modify the effect of being born IUGR on eating outcomes, increasing the vulnerability/resilience to eating disorders in IUGR group and likely contributing to their risk for developing metabolic diseases later in life.
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Affiliation(s)
| | - Gabriel T Roman
- Programa de Residência Médica em Medicina Intensiva Pediátrica, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Danitsa M Rodrigues
- Graduate Program in Neurosciences, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Sachin Patel
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Irina Pokhvisneva
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Valentina G Chakr
- Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Robert D Levitan
- Department of Psychiatry, University of Toronto and Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Michael J Meaney
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Patricia P Silveira
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada.
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
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Kondev V, Najeed M, Loomba N, Brown J, Winder DG, Grueter BA, Patel S. Synaptic and cellular endocannabinoid signaling mechanisms regulate stress-induced plasticity of nucleus accumbens somatostatin neurons. Proc Natl Acad Sci U S A 2023; 120:e2300585120. [PMID: 37590414 PMCID: PMC10450650 DOI: 10.1073/pnas.2300585120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/28/2023] [Indexed: 08/19/2023] Open
Abstract
Interneuron populations within the nucleus accumbens (NAc) orchestrate excitatory-inhibitory balance, undergo experience-dependent plasticity, and gate-motivated behavior, all biobehavioral processes heavily modulated by endogenous cannabinoid (eCB) signaling. While eCBs are well known to regulate synaptic plasticity onto NAc medium spiny neurons and modulate NAc function at the behavioral level, how eCBs regulate NAc interneuron function is less well understood. Here, we show that eCB signaling differentially regulates glutamatergic and feedforward GABAergic transmission onto NAc somatostatin-expressing interneurons (NAcSOM+) in an input-specific manner, while simultaneously increasing postsynaptic excitability of NAcSOM+ neurons, ultimately biasing toward vHPC (ventral hippocampal), and away from BLA (basolateral amygdalalar), activation of NAcSOM+ neurons. We further demonstrate that NAcSOM+ are activated by stress in vivo and undergo stress-dependent plasticity, evident as a global increase in intrinsic excitability and an increase in excitation-inhibition balance specifically at vHPC, but not BLA, inputs onto NAcSOM+ neurons. Importantly, both forms of stress-induced plasticity are dependent on eCB signaling at cannabinoid type 1 receptors. These findings reveal eCB-dependent mechanisms that sculpt afferent input and excitability of NAcSOM+ neurons and demonstrate a key role for eCB signaling in stress-induced plasticity of NAcSOM+-associated circuits.
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Affiliation(s)
- Veronika Kondev
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN37232
| | | | - Niharika Loomba
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN37232
| | - Jordan Brown
- Department of Pharmacology, Vanderbilt University, Nashville, TN37232
| | - Danny G. Winder
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN37232
- Vanderbilt Center for Addiction Research, Vanderbilt University School of Medicine, Nashville, TN27323
| | - Brad A. Grueter
- Vanderbilt Center for Addiction Research, Vanderbilt University School of Medicine, Nashville, TN27323
- Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN37232
| | - Sachin Patel
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL60611
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Yang M, Chiu J, Scartelli C, Ponzar N, Patel S, Patel A, Ferreira RB, Keyes RF, Carroll KS, Pozzi N, Hogg PJ, Smith BC, Flaumenhaft R. Sulfenylation links oxidative stress to protein disulfide isomerase oxidase activity and thrombus formation. J Thromb Haemost 2023; 21:2137-2150. [PMID: 37037379 PMCID: PMC10657653 DOI: 10.1016/j.jtha.2023.03.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 11/17/2022] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Oxidative stress contributes to thrombosis in atherosclerosis, inflammation, infection, aging, and malignancy. Oxidant-induced cysteine modifications, including sulfenylation, can act as a redox-sensitive switch that controls protein function. Protein disulfide isomerase (PDI) is a prothrombotic enzyme with exquisitely redox-sensitive active-site cysteines. OBJECTIVES We hypothesized that PDI is sulfenylated during oxidative stress, contributing to the prothrombotic potential of PDI. METHODS Biochemical and enzymatic assays using purified proteins, platelet and endothelial cell assays, and in vivo murine thrombosis studies were used to evaluate the role of oxidative stress in PDI sulfenylation and prothrombotic activity. RESULTS PDI exposure to oxidants resulted in the loss of PDI reductase activity and simultaneously promoted sulfenylated PDI generation. Following exposure to oxidants, sulfenylated PDI spontaneously converted to disulfided PDI. PDI oxidized in this manner was able to transfer disulfides to protein substrates. Inhibition of sulfenylation impaired disulfide formation by oxidants, indicating that sulfenylation is an intermediate during PDI oxidation. Agonist-induced activation of platelets and endothelium resulted in the release of sulfenylated PDI. PDI was also sulfenylated by oxidized low-density lipoprotein (oxLDL). In an in vivo model of thrombus formation, oxLDL markedly promoted platelet accumulation following an arteriolar injury. PDI oxidoreductase inhibition blocked oxLDL-mediated augmentation of thrombosis. CONCLUSION PDI sulfenylation is a critical posttranslational modification that is an intermediate during disulfide PDI formation in the setting of oxidative stress. Oxidants generated by vascular cells during activation promote PDI sulfenylation, and interference with PDI during oxidative stress impairs thrombus formation.
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Affiliation(s)
- Moua Yang
- Division of Hemostasis and Thrombosis, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
| | - Joyce Chiu
- The Centenary Institute and University of Sydney, Sydney, New South Wales, Australia
| | - Christina Scartelli
- Division of Hemostasis and Thrombosis, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Nathan Ponzar
- Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Sachin Patel
- Division of Hemostasis and Thrombosis, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Anika Patel
- Division of Hemostasis and Thrombosis, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Renan B Ferreira
- Department of Chemistry, UF Scripps Biomedical Research, Jupiter, Florida, USA
| | - Robert F Keyes
- Program in Chemical Biology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Kate S Carroll
- Department of Chemistry, UF Scripps Biomedical Research, Jupiter, Florida, USA
| | - Nicola Pozzi
- Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Philip J Hogg
- The Centenary Institute and University of Sydney, Sydney, New South Wales, Australia
| | - Brian C Smith
- Program in Chemical Biology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Department of Biochemistry, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Robert Flaumenhaft
- Division of Hemostasis and Thrombosis, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.
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Mughal Z, Patel S, Gupta KK, Metcalfe C, Beech T, Jennings C. Evaluating the perceptions of workplace-based assessments in surgical training: a systematic review. Ann R Coll Surg Engl 2023; 105:507-512. [PMID: 36374289 PMCID: PMC10313445 DOI: 10.1308/rcsann.2022.0113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION Workplace-based assessments (WBAs) are intended to maximise learning opportunities in surgical training. There is speculation as to whether mandatory assessments in this form contribute to a tick-box culture. The objective of this review was to investigate surgical trainees' attitudes towards WBAs. METHODS This systematic review of qualitative studies was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement. The literature was searched on the Medline®, Embase™, PubMed and Web of Science™ databases on 22 March 2022. RESULTS Sixteen studies were included in the review, mostly carried out on users of the Intercollegiate Surgical Curriculum Programme portfolio in the UK. Trainees felt that WBAs were educationally useful, providing opportunity for feedback, but this was overshadowed by a pressure to reach a set annual quota for WBAs and achieve high scores. Other themes included inaccurate recording of WBAs, the role of WBAs as formative or summative assessments, engagement and accessibility of trainers, and lack of time to complete WBAs. CONCLUSIONS Negative perceptions about WBAs were widespread among surgical trainees despite a recognition of their capacity to facilitate learning. This review supports the recent removal of the annual quota for WBAs in UK surgical training programmes.
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Affiliation(s)
- Z Mughal
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - S Patel
- Shrewsbury and Telford Hospital NHS Foundation Trust, UK
| | - K Kumar Gupta
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - C Metcalfe
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - T Beech
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - C Jennings
- University Hospitals Birmingham NHS Foundation Trust, UK
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Gudipalli Y, Deshpande G, Patel S, Schuller BW. Deep Modelling Strategies for Human Confidence Classification using Audio-visual Data. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083410 DOI: 10.1109/embc40787.2023.10340488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Human behavior expressions such as of confidence are time-varying entities. Both vocal and facial cues that convey the human confidence expressions keep varying throughout the duration of analysis. Although, the cues from these two modalities are not always in synchrony, they impact each other and the fused outcome as well. In this paper, we present a deep fusion technique to combine the two modalities and derive a single outcome to infer human confidence. Fused outcome improves the classification performance by capturing the temporal information from both the modalities. The analysis of time-varying nature of expressions in the conversations captured in an interview setup is also presented. We collected data from 51 speakers who participated in interview sessions. The average area under the curve (AUC) of uni-modal models using speech and facial expressions is 70.6% and 69.4%, respectively, for classifying confident videos from non-confident ones in 5-fold cross-validation analysis. Our deep fusion model improves the performance giving an average AUC of 76.8%.
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Belfrage SL, Husted M, Fraser S, Patel S, Faulkner JA. A systematic review of the effectiveness of community-based interventions aimed at improving health literacy of parents/carers of children. Perspect Public Health 2023:17579139231180746. [PMID: 37381897 DOI: 10.1177/17579139231180746] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
AIM The aim of this systematic review was to examine the effectiveness of community-based health literacy interventions in improving the health literacy of parents. METHODS A systematic review of six databases - MEDLINE, PsycINFO, CINAHL, Cochrane Library, Embase, and Education Source - was conducted to identify relevant articles. Risk of bias was assessed using version two of the Cochrane risk of bias tool for randomised controlled trials or the Cochrane collaboration risk of bias in non-randomised studies of interventions. The study findings were grouped and synthesised following the synthesis without meta-analysis framework. RESULTS Eleven community-based health literacy interventions for parents were identified. Study design included randomised controlled trials (n = 4), non-randomised studies with comparison group (n = 4), and non-randomised studies without a comparison group (n = 3). Interventions were delivered digitally, in person or a combination of the two. The risk of bias was high in over half the studies (n = 7). The main findings of the studies showed some potential for both in person and digital interventions to increase parental health literacy. Studies were heterogeneous preventing a meta-analysis. CONCLUSION Community-based, health literacy interventions have been identified as potential methods for enhancing parental health literacy. Due to the small number of included studies and their potential for bias, these results must be interpreted with caution. This study emphasises the need for additional theory and evidence-based research on the long-term effects of community interventions.
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Affiliation(s)
- S L Belfrage
- University of Winchester, Winchester SO22 4NR, UK
| | - M Husted
- University of Winchester, Winchester, UK
| | - Sds Fraser
- University of Southampton, Southampton, UK
| | - S Patel
- Southampton Children's Hospital, Southampton, UK
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Williford KM, Taylor A, Melchior JR, Yoon HJ, Sale E, Negasi MD, Adank DN, Brown JA, Bedenbaugh MN, Luchsinger JR, Centanni SW, Patel S, Calipari ES, Simerly RB, Winder DG. BNST PKCδ neurons are activated by specific aversive conditions to promote anxiety-like behavior. Neuropsychopharmacology 2023; 48:1031-1041. [PMID: 36941364 PMCID: PMC10209190 DOI: 10.1038/s41386-023-01569-5] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/13/2023] [Accepted: 03/05/2023] [Indexed: 03/22/2023]
Abstract
The bed nucleus of the stria terminalis (BNST) is a critical mediator of stress responses and anxiety-like behaviors. Neurons expressing protein kinase C delta (BNSTPKCδ) are an abundant but understudied subpopulation implicated in inhibiting feeding, but which have conflicting reports about their role in anxiety-like behaviors. We have previously shown that expression of PKCδ is dynamically regulated by stress and that BNSTPKCδ cells are recruited during bouts of active stress coping. Here, we first show that in vivo activation of this population is mildly aversive. This aversion was insensitive to prior restraint stress exposure. Further investigation revealed that unlike other BNST subpopulations, BNSTPKCδ cells do not exhibit increased cfos expression following restraint stress. Ex vivo current clamp recordings also indicate they are resistant to firing. To elucidate their afferent control, we next used rabies tracing with whole-brain imaging and channelrhodopsin-assisted circuit mapping, finding that BNSTPKCδ cells receive abundant input from affective, arousal, and sensory regions including the basolateral amygdala (BLA) paraventricular thalamus (PVT) and central amygdala PKCδ-expressing cells (CeAPKCδ). Given these findings, we used in vivo optogenetics and fiber photometry to further examine BNSTPKCδ cells in the context of stress and anxiety-like behavior. We found that BNSTPKCδ cell activity is associated with increased anxiety-like behavior in the elevated plus maze, increases following footshock, and unlike other BNST subpopulations, does not desensitize to repeated stress exposure. Taken together, we propose a model in which BNSTPKCδ cells may serve as threat detectors, integrating exteroceptive and interoceptive information to inform stress coping behaviors.
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Affiliation(s)
- Kellie M Williford
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
| | - Anne Taylor
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
| | - James R Melchior
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
| | - Hye Jean Yoon
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
| | - Eryn Sale
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
| | - Milen D Negasi
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
| | - Danielle N Adank
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
| | - Jordan A Brown
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
| | - Michelle N Bedenbaugh
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Joseph R Luchsinger
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
| | - Samuel W Centanni
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Sachin Patel
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University, Nashville, TN, USA
| | - Erin S Calipari
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University, Nashville, TN, USA
| | - Richard B Simerly
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Danny G Winder
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA.
- Vanderbilt Center for Addiction Research, Vanderbilt University, Nashville, TN, USA.
- Department of Pharmacology, Vanderbilt University, Nashville, TN, USA.
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA.
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University, Nashville, TN, USA.
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Pollard AJ, Garner S, Patel S, Jerreat M. A Retrospective Service- Evaluation of Implant Success, Survival, Periimplant Health and Prosthetic Complications in a Cohort of Head and Neck Cancer Patients. Eur J Prosthodont Restor Dent 2023; 31:92-103. [PMID: 35917210 DOI: 10.1922/ejprd_2441pollard12] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To determine the success, survival, peri-implant health and prosthetic complications in head and neck cancer patients receiving oral rehabilitation utilising dental implants between 2008 and the present day. MATERIALS AND METHODS Service evaluation. Survival Group: Retrospective review of records to determine implant survival and prosthetic complications. Success Group: Examination to determine implant success and health. RESULTS Survival Group: 260 implants in 81 individuals, median follow up 49.2 months. 89.3% implant survival at 96 months, no further failures up to 133 months. 40.9% individuals required repair or remake of prosthesis by 72 months - mostly denture re-lines. Success group: 164 implants in 48 individuals, median follow up 56 months. Peri-implant mucositis detected in 22% of fixtures (37.5% individuals); peri-implantitis in 12.8% (25% individuals); 33.3% fixtures exhibiting periimplantitis at 120 months. Previous smoking significantly associated with development of peri-implantitis (HR 2.372, p=0.032, 95CI:1.232, 93.317). Compromised survival (e.g. peri-implantitis), absolute (not in mouth) or clinical failure estimated to occur in 28.1% fixtures at 101 months, mostly due to peri-implantitis. CONCLUSIONS There is a large burden of ongoing care in this cohort, requiring interventions to improve peri-implant health and maintain complex prostheses. Oral rehabilitation and ongoing maintenance in this cohort is complex and multi-disciplinary.
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Affiliation(s)
- A J Pollard
- University of Bristol Dental Hospital, Bristol
- Musgrove Park Hospital, Taunton
- Peninsula Dental School, University of Plymouth, Plymouth
| | - S Garner
- University of Bristol Dental Hospital, Bristol
- Musgrove Park Hospital, Taunton
| | - S Patel
- Musgrove Park Hospital, Taunton
| | - M Jerreat
- Musgrove Park Hospital, Taunton
- Peninsula Dental School, University of Plymouth, Plymouth
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Winters ND, Yasmin F, Kondev V, Grueter BA, Patel S. Cannabidiol Differentially Modulates Synaptic Release and Cellular Excitability in Amygdala Subnuclei. ACS Chem Neurosci 2023. [PMID: 37163725 DOI: 10.1021/acschemneuro.2c00775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
Cannabidiol (CBD) is a non-psychoactive constituent of the Cannabis plant that has purported effectiveness in treating an array of stress-related neuropsychiatric disorders. The amygdala is a subcortical brain structure that regulates emotional behavior, and its dysfunction has been linked to numerous disorders including anxiety and posttraumatic stress disorder. Despite this, the direct effects of CBD on synaptic and cellular function in the amygdala are not known. Using electrophysiology and pharmacology, we report that CBD reduces presynaptic neurotransmitter release in the amygdala, and these effects are dependent on subnucleus and cell type. Furthermore, CBD broadly decreases cellular excitability across amygdala subnuclei. These data reveal physiological mechanisms by which CBD modulates amygdala activity and could provide insights into how CBD could affect emotional and stress-related behavioral responses.
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Affiliation(s)
- Nathan D Winters
- Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Addiction Research, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
| | - Farhana Yasmin
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, United States
| | - Veronika Kondev
- Vanderbilt Center for Addiction Research, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
- Vanderbilt Brain Institute, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
| | - Brad A Grueter
- Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Addiction Research, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
- Vanderbilt Brain Institute, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
- Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, United States
| | - Sachin Patel
- Northwestern Center for Psychiatric Neuroscience, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, United States
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Alonso MT, Torres-Vidal P, Calvo B, Rodriguez C, Delrio-Lorenzo A, Rojo-Ruiz J, Garcia-Sancho J, Patel S. Use of aequorin-based indicators for monitoring Ca 2+ in acidic organelles. Biochim Biophys Acta Mol Cell Res 2023; 1870:119481. [PMID: 37142127 DOI: 10.1016/j.bbamcr.2023.119481] [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: 03/08/2023] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 05/06/2023]
Abstract
Over the last years, there is accumulating evidence that acidic organelles can accumulate and release Ca2+ upon cell activation. Hence, reliable recording of Ca2+ dynamics in these compartments is essential for understanding the physiopathological aspects of acidic organelles. Genetically encoded Ca2+ indicators (GECIs) are valuable tools to monitor Ca2+ in specific locations, although their use in acidic compartments is challenging due to the pH sensitivity of most available fluorescent GECIs. By contrast, bioluminescent GECIs have a combination of features (marginal pH sensitivity, low background, no phototoxicity, no photobleaching, high dynamic range and tunable affinity) that render them advantageous to achieve an enhanced signal-to-noise ratio in acidic compartments. This article reviews the use of bioluminescent aequorin-based GECIs targeted to acidic compartments. A need for more measurements in highly acidic compartments is identified.
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Affiliation(s)
- M T Alonso
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain.
| | - P Torres-Vidal
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain
| | - B Calvo
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain
| | - C Rodriguez
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain
| | - A Delrio-Lorenzo
- Universidad Alfonso X el Sabio, Madrid, Avenida Universidad, 1, 28691 Villanueva de la Cañada, Madrid, Spain
| | - J Rojo-Ruiz
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain
| | - J Garcia-Sancho
- Unidad de Excelencia, Instituto de Biomedicina y Genética Molecular de Valladolid (IBGM), Universidad de Valladolid y Consejo Superior de Investigaciones Científicas (CSIC), c/ Sanz y Forés 3, 47003 Valladolid, Spain
| | - S Patel
- Department of Cell and Developmental Biology, University College London, Gower Street, London WC1E 6BT, UK
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Zou Y, Laothamatas K, Sonett J, Lemaitre P, Stanifer B, Magda G, Grewal H, Shah L, Robbins H, Patel S, Miller A, Anderson M, Costa J, D'Ovidio F, Arcasoy S, Benvenuto L. Effect of Age and Transplant Type on Survival and Hospital-Free Days in COPD Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1462] [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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Alexy T, Patel S, Rochlani Y, Saeed O, Gjelaj C, Madan S, Shin J, Maharaj V, Goldstein D, Jorde U, Vukelic S. Risk of Acute Rejection in Heart Transplant Patients Treated with M-TOR Inhibitors. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.177] [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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Patel S, Uriel N, Nguyen A, Silvia B, Wolf-Doty T, Tian W, Qu K, Pinney S. Relationship Between Absolute Quantification of Donor-Derived Cell-Free DNA and Donor-Derived Cell-Free DNA Fraction for Detection of Allograft Rejection in Heart Transplant Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1107] [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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Takahashi T, Kobayashi Y, Saeed O, Vukelic S, Jorde U, Shin J, Patel S. Optical Coherence Tomography Evaluation of Donor Transmitted Coronary Atherosclerosis and Risk of Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.170] [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: 04/05/2023] Open
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Milwidsky A, Chan M, Travin M, Gjelaj C, Saeed O, Vukelic S, Rochlani Y, Madan S, Shin J, Sims D, Murthy S, Chavez P, Jorde U, Patel S. PET-CT Defined Micro-Vascular Dysfunction and Cardiac Allograft Vasculopathy Risk Factors in Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.172] [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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47
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Balgobind A, Patel S, Varrias D, Safiriyu I, Villela MA. Left Ventricular Assist Device Therapy in “Cold and Dry” Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1639] [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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48
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Hirsch E, Nnani D, Patel S, Rochlani Y, Vukelic S, Shin J, Chavez P, Madan S, Sims D, Jorde U, Saeed O. Tolerability and Effectiveness of Intensified Statin after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.465] [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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49
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Greissman S, Laothamatas K, Costa J, D'Ovidio F, Grewal H, Lemaitre P, Magda G, Miller A, Patel S, Robbins H, Shah L, Sonnett J, Stanifer B, Arcasoy S, Benvenuto L. Comparison of Post-Transplant Survival Between Lung-Kidney and Lung Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1463] [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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50
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Teuteberg J, Pinney S, Khush K, Fei M, Yue J, Shen L, Patel S, Kanwar M, Shah P, Uriel N. A “Negative” Endomyocardial Biopsy after an Elevated Donor-Derived Cell Free DNA is Associated with Worse Survival after Heart Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1522] [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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