49 results on '"Meti N"'
Search Results
2. Phytochemical screening and GC-MS analysis of root extract of Decalepis Hamiltonii Wight & Arn.
- Author
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Chikane, D. R., Meti, N. T., and Jagtap, S.
- Published
- 2022
3. Effect of Ferulic acid and Chitosan on cell suspension cultures of Decalepis hamiltonii Wight & Arn.
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Chikane, Namdeo, A. G., and Meti, N. T.
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FERULIC acid ,CHITOSAN ,CELL culture ,CELL suspensions ,VANILLIN ,LIQUID chromatography-mass spectrometry ,PICLORAM ,BENZYLAMINOPURINE - Abstract
The article investigates the effect of ferulic acid and chitosan on cell suspension cultures of Decalepis hamiltonii Wight & Arn. The study analyzes and quantifies vanillin using liquid chromatography-mass spectrometry following ferulic acid and chitosan treatments. It observes the biomass of suspension cultures and accumulation of vanillin, callus development on murashige and skoog (MS) medium containing Picloram and benzylaminopurine (BAP), and cell suspension cultures created on MS medium.
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- 2024
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- View/download PDF
4. EP07.02-15 Longitudinal ctDNA Testing in Resected, Early Stage Non-small Cell Lung Cancers
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Feng, J., primary, Waddell, T., additional, Yasufuku, K., additional, Kelly, D., additional, Meti, N., additional, Pierre, A., additional, Keshavjee, S., additional, Yeung, J., additional, Cypel, M., additional, Donahoe, L., additional, Wakeam, E., additional, de Perrot, M., additional, Law, J., additional, Salvarrey, A., additional, Le, L.W., additional, Lister, J., additional, Cabanero, M., additional, Tsao, M.S., additional, Pipinikas, C., additional, Howarth, K., additional, and Leighl, N.B., additional
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- 2023
- Full Text
- View/download PDF
5. 1151P Evolution of biomarker testing among non-squamous/non-small cell lung cancer (NSCLC) patients (Pts) and impact on turnaround times (TAT)
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Fan, Z., primary, Tudor, R., additional, Le, L., additional, Law, J., additional, Kuang, S., additional, Meti, N., additional, Fung, A., additional, Perdrizet, K., additional, Chen, K., additional, Li, J., additional, Ghumman, N., additional, Ranich, L., additional, Wei, C., additional, Sabatani, P., additional, Tsao, M-S., additional, Leighl, N., additional, and Cabanero, M., additional
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- 2022
- Full Text
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6. EP14.01-019 Identifying Circulating DNA Methylation Patterns in Small Cell Lung Cancer Patients
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Haq, S. Ul, primary, Schmid, S., additional, Aparnathi, M.K., additional, Hueniken, K., additional, Zhan, L.J., additional, Sacdalan, D., additional, Li, J.J.N., additional, Meti, N., additional, Patel, D., additional, Cheng, D., additional, Philip, V., additional, Liu, G., additional, Bratman, S.V., additional, and Lok, B.H., additional
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- 2022
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- View/download PDF
7. VSI 434: New Sugarcane Variety Obtained Through Somaclonal Variation
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Tawar, P. N., Sawant, R. A., Sushir, K. V., Devarumath, R. M., Hapase, R. S., and Meti, N. T.
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- 2016
- Full Text
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8. A new subclass of the meromorphic harmonic γ-starlike functions
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Bostanci, Hakan and Öztürk, Meti˙n
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- 2011
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9. Zinner syndrome: A first case report from Ethiopia
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Erko Beyene, MD, Engidawork Tadele, MD, and Meti Negassa, MD
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Ethiopia ,Renal agenesis ,Seminal vesicle cyst ,Zinner syndrome ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
A triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst and ipsilateral ejaculatory duct obstruction has been called Zinner syndrome since its first description in 1914 by Zinner. It is a very rare congenital abnormality of the male genitourinary tract due to abnormal embryologic development of the Wolffian ducts. There have been several case reports from different parts of the world about the clinical and imaging findings of these anomaly. In this case report, we present the first case report of Zinner syndrome in a 28-year-old male Ethiopian patient.
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- 2023
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10. A new subclass of the meromorphic harmonic γ-starlike functions
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Meti˙n Öztürk, Hakan Bostanci, Uludağ Üniversitesi/Fen-Edebiyat Fakültesi/Matematik Anabilim Dalı., and Öztürk, Metin
- Subjects
Discrete mathematics ,Pure mathematics ,Harmonic functions ,Mathematics::Complex Variables ,Meromorphic ,Applied Mathematics ,Harmonic ,Harmonic (mathematics) ,Subclass ,Univalent ,Harmonic analysis ,Computational Mathematics ,Operator (computer programming) ,Harmonic function ,Starlike ,Starlike Functions ,Analytic Function ,Hankel Determinant ,Starlike functions ,Mathematics ,Mathematics, applied ,Meromorphic function - Abstract
Recently Bostanci and Ozturk defined a new operator M-n for meromorphic harmonic functions. They introduced new classes of meromorphic harmonic starlike functions in (U) over tilde = (z : vertical bar z vertical bar > 1) using operator M-n. In this work, we have generalized these classes to meromorphic harmonic gamma-starlike functions. Also, we have examined some properties of these classes.
- Published
- 2011
11. Pedagojik Formasyon Sertifika Programı Öğrencilerinin Pedagojik Formasyon Eğitimine İlişkin Görüşleri
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Demirtaş, Hasan and Kırbaç, Meti?N
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[No Keywords] - Abstract
Bu araştırmanın temel amacı, pedagojik formasyon sertifika programı öğrencilerinin pedagojik formasyon eğitimine yönelik görüşlerini belirlemektir. Araştırmada genel tarama modeline dayalı betimsel yöntem kullanılmıştır. Çalışma nitel araştırma desenlerinden olgubilim deseniyle yürütülmüştür. Veri toplama aracı olarak yarı yapılandırılmış görüşme formu kullanılmıştır. Yarı yapılandırılmış görüşme formunda pedagojik formasyon sertifika programı öğrencilerinin, pedagojik formasyon eğitimine yönelik görüşlerini ve beklentilerini belirlemek amacıyla cevaplayacakları 5 soru yer almıştır. Elde edilen verilerin analizinde betimsel ve içerik analizi yöntemleri kullanılmıştır. Araştırmanın çalışma grubu, amaçlı örnekleme yöntemine göre kolay ulaşılabilir durum örneklemesi tekniği ile belirlenmiş olup 145 pedagojik formasyon sertifika programı öğrencisinden oluşmaktadır. Araştırma sonucunda pedagojik formasyon sertifika programı öğrencilerinin öğretmenlik mesleğini tercih etmelerinde en sık vurgulanan etkenin "Sevmek" olduğu belirlenmiştir. Pedagojik formasyon sertifika programı öğrencilerinin en önemli olarak gördüğü dersin "Rehberlik" olduğu görülmüştür. Katılımcıların çoğu, program süresinin kısalığı, programın sıkıştırılmış olması, zaman ve şartların uygun olmaması, hocaların ve programın verimli olmaması ve derslerin uygulamaya dönük olmamasından dolayı pedagojik formasyon eğitimini yetersiz bulmuşlardır. Pedagojik formasyon sertifika programı öğrencileri, daha nitelikli bir pedagojik formasyon eğitimi alınabilmesi için programın zamanının ve şartlarının iyi ayarlanması, derslerin uygulamaya dönük olması ve halihazırda görev yapmakta olan öğretmenlerin pedagojik formasyon eğitiminden belirli zaman aralıklarıyla tekrar geçirilmeleri gerektiği konusunda önerilerde bulunmuşlardır. The main purpose of this study is to determine the views of Pedagogic Formation Certificate Program Students on pedagogic formation training. Descriptive method, based on the descriptive screening method, is utilized in the research. The research is conducted with a phenomenological design, which is one of the qualitative research designs. In the study, a semistructured interview form is used as the data collection tool. The semi-structured interview form consisted of 5 questions to determine the views and expectations of pedagogic formation training programme students about pedagogic training. Descriptive and content analysis methods are used in the analysis of the gathered data. Study group is nominated by means of the easily accessible condition sampling technique, and consisted of 145 pedagogic formation certificiate program students . In the study, it is concluded that "Loving" was the most frequently mentioned factor for pedagogic formation certificiate program students in choosing this profession. It is found that pedagogic formation certificiate program studens regard "Guidance " course as the most significant one. The majority of the participants think pedagogic training programme is inadequate because of the following reasons; short span of time for the programme, being a packed programme, inproper timing and conditions, ineffectiveness of the lecturers and programme and inefficiency of the courses since students need more practice. In order to have a more qualified training, students in this programme proposed that, the timing and conditions should be well organized, courses should include more practice and the teachers of these courses should have pedagogic training at certain intervals.
- Published
- 2015
12. OKUL ÇAĞI ÇOCUKLARINDA DEHB YAYGINLIĞI: ÖN ÇALIŞMA
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Özcan, Dr . M . Erkan, Eğri, Dr. Mücahit, KUTLU, Dr. N . Onur, Yakıncı, Dr. Ceng iz, Ber, Dr. Hamza Karabi, and Genç, Dr. Meti n
- Subjects
ADHD,yaygınlık,okul-çağı çocukları ,ADHD,prevalence,school-age children - Abstract
This study has been made to determine the prevalence ofAttention Deficit- Hyperactivity Disorder(ADHD) among school-age children living in Malatya city center. Child behavior checklist has been completed by teachers of 3002 elementary school students. Students that have been pointed as having inattention, hyperactivity, and/or impulsivity were examined clinically. Prevalence ofADHD among this population was found to be 9.5 percent. Ratio ofboys/g irls was 2.75. Key words: ADHD, prevalence, school-age children, Malatya il merkezindeki okul çağı çocuklarında Dikkat Eksikliği/Hiperaktivite Bozukluğu(DEHB)'nun yaygınlığını araştırmak üzere yapılan bu çalışmaya 3002 ilk-okul öğrencisi alınmıştır. Sınıf öğretmenlerinin anket formunda dikkat eksikliği, hu-zursuzluğu ve yerinde duramaması olduğunu belirttiği öğrencilerden %10 sistematik örnekleme yöntemiyle belirlenen 73 öğrenci klini k olarak değerlendirilmiştir. DEHB yaygınlığı örneklemimizde °% 9.5 olarak bulunmuştur. DEHB tanısı konulanlar içeri-sinde erkek/kız oranı 2.75'tir. Anahtar kelimeler: ADHD, yaygınlık, okul-çağı çocukları
- Published
- 2015
13. MALATYA DA BİRİNCİ BASAMAK SAĞLIK KURULUŞLARINDA ÇALIŞAN SAĞLIK PERSONELİNİN 'AĞIZ DİŞ SAĞLIĞINI İYİLEŞTİRMEDE FLOR KULLANIMI PROGRAMI' HAKKINDAKİ BİLGİ VE GÖRÜŞLERİ
- Author
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GENÇ, Dr. Meti N, PEHLİVAN, Dr. Erkan, GÜNEŞ, Dr. Gülsen, EĞRİ, Dr. Mücah İt, and KURÇER, Dr. M .al İ
- Subjects
Flor,çocuklar ,Fluor,children - Abstract
Objective: This study is a cross-sectional research, which has been planned in order to learn the knowledge and opinions of health professionals about the programme of fluor tablet usage wh ich is carried out by the Ministry ofHealth in 13 provinces including Malatya. Materia l- Method: The questionnaire form prepared with this aim was given to all the participants consisting of 203 physicians, nurses and midwives before an in-service education meeting done on the 15th of August, 1997. Findings: 60% of the participants gave right answer to the question related to the symptoms of fluor deficiency; 78°% of them gave rigth answer to the question related to fluor supplement methods. Only 28°% of the participants chose the fluor tablet usage as the most appropriate fluor supplement method for Türkiye. According to 66°% of the participants, the attitude of the people towards the programme was positive; on the other hand, 76°% of the participants thought that, the attitude of the health personnel was positive. Results: At the end of this study, it has been seen that, continuous in-service education and motivation of the personnel are needed Key words: Fluor, children., Amaç: Bu çalışma; Sağlık Bakanlığı tarafından Malatya ilin i de kapsayan 13 ilde yürütülen flor tableti kullanımı programı hakkında sağlık personelinin bilgi ve görüşlerini öğrenmek için yapılan kesitsel bir araştırmadır. Gereç- Yöntem:Bu amaçla hazırlanmış anket formu, 15 Ağustos 1997 tarihinde yapılan ve 203 hekim, hemşire ve ebenin katıldığı bir hizmet içi eğitim toplantısı öncesinde katılımcıların tümüne uygulanmıştır. Bulgular: Katılımcılar, flor eksikliğinin belirtileriyle ilgili soruya %60, flor uygulama biçimleri He ilgili soruya °%78 oranında doğru yanıt vermişlerdir. Katılımcılardan sadece °%28'i Türkiye için en uygun flor uygulama biçimi olarak flor tableti uygulamasını seçmiştir. Katılımcıların °%66'sına göre programa karşı halkın tutum olumlu idi; öte yandan, katılımcıların °%76'sına göre sağlık personelin in tutumu olumludur. Sonuç: Bu çalışmanın sonunda görülmüştür ki, sürekli hizmet içi eğitime ve personelin motivasyonuna ihtiyaç vardır. Anahtar kelimeler: Flor, çocuklar.
- Published
- 2015
14. BEBEKLERİMİZİ NASIL BÜYÜTÜYORUZ?
- Author
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GENÇ, Dr . Meti N and PEHLİVAN, Dr . Gülsen Güneş Dr. Erkan
- Subjects
Bebek,yalnız anne sütü ile beslenme,ek gıda dönemi ,Infant,Exclusively breastfeeding,weaning period - Abstract
This cross-sectional research has been done in order to assess the knowledge and practice about infant feeding and carrying of the mothers who applied to Malatya Mother-Child Health and Family Planning Center. The researchers interviewed with 250 mothers who applied to the Center during June and July 1996 and who have children at the age of three or under; and after the questionnaire, the mothers were educated. Mean age of the mothers was 26 and 90.8°% were at least literate. Bringing their last children up, 67.8°/o of the mothers used their knowledge. Median first breastfeeding time was two hours. One hundred and fifty three babies over one year old were fed with other type of nutrition for median nine months (median). Exclusively breastfeeding rate was 3.2% in the frstsixmonths. Eighty percent of 153 one year old babies were swaddled during the f rst 12 months and 6.5% were swaddled with soil. The mothers were asked four questions about high fever and diarrhoea. The rate of the mothers who gave true answer for all was 67.6%. As WHO recommends, mothers should be encouraged to suckle as soon as they give birth, to exclusively breast feed for the f rst 7-6 months and to continue breastfeeding for 12 months. In order to bring healthy generations up, it is an important duty for health personnel to tell the people that the practice of swaddling with or without soil is wrong, and to give information about baby care to the people everywhere. Key words: Infant, Exclusively breastfeeding, weaning period., Bu araştırma, Malatya Ana-Çocuk Sağlığı ve Aile Planlaması Merkezi' ne başvuran annelerin bebek beslenmesi ve bakımı hakkındaki bilgi ve uygulamalarını değerlendirmek amacıyla yapılmıştır. Araştırmacılar, Haziran ve Temmuz 1996' da merkeze başvuran ve 3 yaş ve daha küçük çocuğu olan 250 anneyle yüzyüze görüşerek anket uygulamış ve anket sonunda annelere eğitim vermişlerdir. Annelerin ortanca yaşı 26 olup, %90.8' si en az okuryazardır. Son çocuklarını büyütürken %67.8' i kendi bilgilerine göre davranmışlardır. İlk emzirme süresi ortanca 2 saatir. Bir yaşını tamamlamış 153 bebeğe diğer gıdalarla birlikte ortanca olarak 9 ay anne sütü verilmiştir. İlk 6 ayda su bile verilmeksizin sadece anne sütü alan bebek oranı %3. 2'dir. Yaşını tamamlamış 153 bebeğini lk 12 ayda yaklaşık 0%80' ine kundak yapılmış, °%6.5' i ise toprağa sarılmıştır. İshal ve yüksek ateşle ilgiii bilgileri ölçmek amacıyla dört soru sorulmuştur. Soruların tümüne doğru cevap veren annelerin oranı %67 . 6'dır. Dünya Sağlık Örgütü' nün önerileri doğrultusunda; bebeklerin doğar doğmaz emzirmeye başlanması, ilk 7-6 ayda yalnızca anne sütü verilmesi ve emzirmeye 12 ay devam edilmesi için anneler teşvik edilmelidir. Kundak ve toprak uygulamasının zararları ile diğer bebek bakımı konularında yapılacak eğitimlerin her ortamda gerçekleştirilmesi, sağlıklı kuşaklar yetiştirmede sağlık personeline düşen önemli bir görevdir. Anahtar kelimeler: Bebek, yalnız anne sütü ile beslenme, ek gıda dönemi.
- Published
- 2015
15. Relationship between Union Citizenship Behavior and Union Identification: A Research on Teachers
- Author
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Demirtaş, Hasan, Özer, Niyazi, Atik, Servet, and Kırbaç, Meti?N
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[No Keywords] - Abstract
Bu araştırmanın temel amacı, öğretmenlerin sendikal vatandaşlık davranışlarının düzeyini, sendikal kimlik algılarını ve her iki değişken arasındaki ilişkiyi ortaya koymaktır. Bunun yanında araştırmada öğretmenlerin sendikal vatandaşlık davranışları ile sendikal kimlik algılarının çeşitli değişkenlere göre anlamlı biçimde farklılaşıp farklılaşmadığını belirmek de amaçlanmıştır. Araştırmanın verileri 2012-2013 ve 2013-2014 eğitim-öğretim yıllarında Malatya ilinde bulunan ilkokul, ortaokul ve liselerde görev yapan araştırmaya gönüllü olarak katılan (n=617) öğretmenlerden elde edilmiştir. Araştırmada araştırmacılar tarafından Türkçe' ye uyarlamaları yapılan "Sendikal Vatandaşlık Davranışı Ölçeği" ve "Sendikal Kimlik Ölçeği" kullanılmıştır. Araştırmanın verileri çözümlenirken betimsel istatistik analizler, t testi, tek yönlü varyans analizi ve regresyon analizi yapılmıştır. Araştırma sonucunda; öğretmenlerin sendikal vatandaşlık davranışlarını orta düzeyde sergiledikleri ve sendikal kimlik algılarının da orta düzeyde olduğu bulunmuştur. Araştırmada ayrıca öğretmenlerin sendikal kimlik ve vatandaşlık davranışlarının cinsiyet, branş, mesleki kıdem ve üye olunan sendika değişkenlerine göre anlamlı farklılık gösterdiği belirlenmiştir. Korelasyon analizi sonucunda, sendikal vatandaşlık ile sendikal kimlik arasında pozitif yönde ve yüksek düzeyde bir ilişkinin olduğu, sendikal kimliğin sendikal vatandaşlık davranışlarına ilişkin varyansın %52'sini açıkladığı belirlenmiştir. The main purpose of the study was to investigate the union citizenship behaviours and union identification of teachers', and to explore the relationship between union citizenship and identification. It was also aimed to determine whether teachers' union citizenship behaviours and their identification with union differ significantly according to research variables. The data were gathered from volunteer teachers (n=617) working in primary, secondary and high schools in Malatya during 2012-2013 and 2013-2014 academic years. Adapted versions of the Union Citizenship Behaviour and Union Identification scales were administered on participating teachers. Descriptive statistics, t-test, one way analysis of variance and regression analysis were used to analyse the gathered data. Results showed that teachers' union citizenship behaviour and union identification were at moderate level. Results also indicated that teachers' union citizenship and union identification scores differed significantly in terms of gender, branch, professional seniority, and entered union variables. Correlational analysis results showed that there was a positive and strong correlation between union citizenship and union identification and union identification explained 52 % of the total variance of union citizenship scale.
- Published
- 2015
16. Somaclonal Variation an Aid for Sugarcane Improvement
- Author
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Tawar, P.N., primary, Sushir, K. V., additional, and Meti, N. T., additional
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- 2016
- Full Text
- View/download PDF
17. Amide derivatives with pyrazole carboxylic acids of 5-amino-1,3,4-thiadiazole 2-sulfonamide as new carbonic anhydrase inhibitors: Synthesis and investigation of inhibitory effects
- Author
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Bülbül, Metiˇn, primary, Kasimoğullari, Rahmiˇ, additional, and Küfreviˇoğlu, Ö. Iˇrfan, additional
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- 2008
- Full Text
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18. Local defense systems in the prepuce
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Balat, Ayşe, primary, Karakök, Meti˙n, additional, Güler, Eli˙f, additional, Uçaner, Nevzat, additional, and Ki˙bar, Yasemi˙n, additional
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- 2008
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19. Transfusion-associated graft-versus-host disease in a newborn
- Author
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Özdoğan, Tutku, primary, Meti˙n, Fazi˙let, additional, Doğu, Ayşegül, additional, Ti˙mur, Çeti˙n, additional, and Yildiz, Eli˙f, additional
- Published
- 2007
- Full Text
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20. Tumor thickness as a predictor of cervical lymph node metastasis in squamous cell carcinoma of the lower lip
- Author
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ÖNERCI?, METI?N, YILMAZ, TANER, and GEDI?KOGLU, GÖKHAN
- Abstract
Tumor thickness is a relatively new prognostic factor that has been investigated for lower lip cancer. This study was performed in 27 patients, 13 of whom had histopathologically confirmed cervical metastasis, to investigate whether tumor thickness could be used as a predictor of cervical lymph node metastasis. The mean tumor thickness of those cases with neck metastasis was 5.60 mm (SD = 2.24), and the mean thickness of cases without neck metastasis was 3.79 mm (SD = 1.68). The difference between tumor thicknesses of both groups was found to be statistically significant (P< 0.05). The tumor thickness of 5 mm was determined as a cutoff point, above which the cervical lymph node metastasis rate was significantly increased. As a conclusion, tumor thickness is an objective histopathologic factor that is easily reproducible; it significantly influences cervical lymph node metastasis in lower lip cancer, and it may be used in the assessment of prognosis. (Otolaryngol Head Neck Surg 2000;122:139-42.)
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- 2000
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21. Polystyrene Suspension Polymerization: The Effect of Polymerization Parameters on Particle Size and Distribution
- Author
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Erbay, Erol, Bi˙lgi˙ç, Tüli˙n, Karali, Meti˙n, and Savasçi, Ö. Tunç
- Abstract
Effects of polymerization parameters are studied to better understand interactions between parameters in stirred-tank polymerization reactors and to derive a regression model correlating polymer particle size and particle-size distribution with agitator speed, agitator diameter, tricalcium phosphate, dodecyl benzene sodium sulfonate concentrations, and mass cycle period. The derived equations give way to prediction of the polymerization conditions in order to obtain desired particle size and particle-size distributions which covers particle sizes between 0.3 and 5 mm. The roles of some other parameters and limiting agitation parameters are also investigated.
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- 1992
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22. Universal Genetic Testing for Newly Diagnosed Invasive Breast Cancer.
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Rezoug Z, Totten SP, Szlachtycz D, Atayan A, Mohler K, Albert S, Feng L, Lemieux Anglin B, Shen Z, Jimenez D, Hamel N, Meti N, Esfahani K, Boileau JF, Prakash I, Basik M, Meterissian S, Tremblay F, Fleiszer D, Anderson D, Chong G, Wong SM, and Foulkes WD
- Subjects
- Humans, Female, Middle Aged, Cross-Sectional Studies, Adult, Aged, Fanconi Anemia Complementation Group N Protein genetics, Genetic Counseling statistics & numerical data, BRCA1 Protein genetics, BRCA2 Protein genetics, Breast Neoplasms genetics, Breast Neoplasms diagnosis, Genetic Testing methods, Genetic Testing statistics & numerical data, Genetic Predisposition to Disease
- Abstract
Importance: Between 5% and 10% of breast cancer cases are associated with an inherited germline pathogenic or likely pathogenic variant (GPV) in a breast cancer susceptibility gene (BCSG), which could alter local and systemic therapy recommendations. Traditional genetic testing criteria misses a proportion of these cases., Objective: To evaluate the prevalence and clinicopathological associations of GPVs in 2 groups of BCSGs among an ethnically diverse cohort of women with newly diagnosed breast cancer., Design, Setting, and Participants: This cross-sectional study, conducted at 3 Montreal hospitals between September 2019 and April 2022, offered universal genetic counseling and testing to all women with a first diagnosis of invasive breast cancer. Women were offered an obligatory primary panel of BRCA1, BRCA2, and PALB2 (B1B2P2) and an optional secondary panel of 14 additional BCSGs. Eligible participants were women 18 years of age or older who received a diagnosis of a first primary invasive breast cancer not more than 6 months before the time of referral to the study. Data were analyzed from November 2023 to June 2024., Results: Of 1017 referred patients, 805 were eligible and offered genetic counseling and testing, and 729 of those 805 (90.6%) consented to be tested. The median age at breast cancer diagnosis was 53 years (range, 23-91 years), and 65.4% were White and of European ancestry. Fifty-four GPVs were identified in 53 patients (7.3%), including 39 patients (5.3%) with B1B2P2 and 15 patients (2.1%) with 6 of the 14 secondary panel BCSGs (ATM, BARD1, BRIP1, CHEK2, RAD51D, and STK11). On multivariable analysis, clinical factors independently associated with B1B2P2-positive status included being younger than 40 years of age at diagnosis (odds ratio [OR], 6.83; 95% CI, 2.22-20.90), triple-negative breast cancer (OR, 3.19; 95% CI, 1.20-8.43), high grade disease (OR, 1.68; 95% CI, 1.05-2.70), and family history of ovarian cancer (OR, 9.75; 95% CI, 2.65-35.85). Of 39 B1B2P2-positive patients, 13 (33.3%) were eligible for poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitors., Conclusions and Relevance: In this cross-sectional universal genetic testing study of women with newly diagnosed invasive breast cancer, the prevalence of GPVs was 7.3%, with 5.3% of patients testing positive for B1B2P2. Among B1B2P2-women women, one-third were eligible for PARP inhibitors.
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- 2024
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23. Identifying Novel Germline Mutations and Copy Number Variations in Patients With SCLC.
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Ul Haq S, Downs G, Zhan LJ, Schmid S, Patel D, Sacdalan D, Li JJN, Cheng D, Meti N, Philip V, Kim RH, Liu G, Bratman SV, Sabatini PJB, and Lok BH
- Abstract
Introduction: SCLC has traditionally been considered to arise from toxic exposure factors, such as smoking. Recent evidence has revealed that germline mutations may also affect the development of SCLC; however, these alterations remain understudied. We sought to identify novel germline mutations in SCLC including germline copy number variations (CNVs) in our cohort of patients., Methods: We designed a custom hybrid-capture gene panel to evaluate germline alterations in 192 cancer-predisposition and frequently mutated genes in SCLC. We applied this panel to germline analysis of a treatment-naive cohort of 67 patients with SCLC at our institution. Subsequently, we annotated the variants using the American College of Medical Genetics criteria and further classified variants of uncertain significance using a set of in silico tools, including DeepMind AlphaMissense, MutationTaster, SIFT, and Polyphen2., Results: We identified American College of Medical Genetics pathogenic or likely pathogenic alterations in seven of 67 patients. Five (71%) were novel alterations ( BCORL1 , FANCC , ATR , and BBC3 ) and a novel CNV ( SLFN11 ) with two (29%) previously described mutations ( CHEK1 and BRIP1 ). We also identified 191 variants of uncertain significance in 60 of 67 patients, of which, depending on the in silico tool, 5% to 14% were predicted to be pathogenic. Patients with SCLC with the seven pathogenic alterations were observed to have a numerically longer overall survival (hazard ratio = 0.50) and progression-free survival (hazard ratio = 0.45) though not statistically significant compared with the remaining cohort., Conclusions: Our study identifies novel germline alterations, including a CNV, and provides additional evidence that germline factors could be important contributing factors to the development of SCLC., Competing Interests: Dr. Bratman is an inventor on patents related to cell-free DNA mutation and methylation analysis technologies that have been licensed to Roche and AdelaBio, respectively, and is co-founder of, has ownership in, and serves in a leadership role at AdelaBio. Dr. Liu reports receiving grants and personal fees from AstraZeneca and Takeda; grants from Boehringer Ingelheim; and personal fees from Hoffman-La Roche, Merck, Bristol-Myers Squibb, and Pfizer outside of the submitted work. Dr. Lok reports receiving grants from 10.13039/100004319Pfizer and grants, personal fees, and nonfinancial support from 10.13039/100004325AstraZeneca outside the submitted work. The remaining authors declare no conflict of interest., (© 2024 The Authors.)
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- 2024
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24. Clinical variables associated with immune checkpoint inhibitor outcomes in patients with metastatic urothelial carcinoma: a multicentre retrospective cohort study.
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Labidi S, Meti N, Barua R, Li M, Riromar J, Jiang DM, Fallah-Rad N, Sridhar SS, Del Rincon SV, Pezo RC, Ferrario C, Cheng S, Sacher AG, and Rose AAN
- Subjects
- Humans, Canada, Immune Checkpoint Inhibitors therapeutic use, Retrospective Studies, Carcinoma, Transitional Cell, Urinary Bladder Neoplasms, Liver Neoplasms
- Abstract
Objectives: Immune checkpoint inhibitors (ICIs) are indicated for metastatic urothelial cancer (mUC), but predictive and prognostic factors are lacking. We investigated clinical variables associated with ICI outcomes., Methods: We performed a multicentre retrospective cohort study of 135 patients who received ICI for mUC, 2016-2021, at three Canadian centres. Clinical characteristics, body mass index (BMI), metastatic sites, neutrophil-to-lymphocyte ratio (NLR), response and survival were abstracted from chart review., Results: We identified 135 patients and 62% had received ICI as a second-line or later treatment for mUC. A BMI ≥25 was significantly correlated to a higher overall response rate (ORR) (45.4% vs 16.3%, p value=0.020). Patients with BMI ≥30 experienced longer median overall survival (OS) of 24.8 vs 14.4 for 25≤BMI<30 and 8.5 months for BMI <25 (p value=0.012). The ORR was lower in the presence of bone metastases (16% vs 41%, p value=0.006) and liver metastases (16% vs 39%, p value=0.013). Metastatic lymph nodes were correlated with higher ORR (40% vs 20%, p value=0.032). The median OS for bone metastases was 7.3 versus 18 months (p value <0.001). Patients with liver metastases had a median OS of 8.6 versus 15 months (p value=0.006). No difference for lymph nodes metastases (13.5 vs 12.7 months, p value=0.175) was found. NLR ≥4 had worse OS (8.2 vs 17.7 months, p value=0.0001). In multivariate analysis, BMI ≥30, bone metastases, NLR ≥4, performance status ≥2 and line of ICI ≥2 were independent factors for OS., Conclusions: Our data identified BMI and bone metastases as novel clinical biomarkers that were independently associated with ICI outcomes in mUC. External and prospective validation are warranted., Competing Interests: Competing interests: Nicholas Meti—Honoraria: Takeda, Novartis. Consulting: Takeda, Seagen, AstraZeneca, Pfizer. Srikala S Sridhar—Consulting: Astellas, AstraZeneca, Bayer, Bicycle Therapeutics, BMS, Eisai, EMD Serono, Gilead, Ipsen, Janssen, Merck, Pfizer, Seagen; Research funding (Institution): Janssen, Seagen, EMD Serono. Rossanna C Pezo—Honoraria: Pfizer, Novartis, BMS, Merck, Sanofi, Gilead, AstraZeneca; Research funding (Institution): Merck, Novartis, Pfizer, Taiho, Jazz Pharmaceuticals, ZymeWorks, AstraZeneca. Cristiano Ferrario—Honoraria: Pfizer, Bayer, Novartis, Roche, Bayer, Knight therapeutics, AstraZeneca, Merck, Astellas Pharma; Consulting—Merck, Novartis, AstraZeneca, Roche; Research funding (Institution): Merck, Novartis, Pfizer, Lilly, ZymeWorks, AstraZeneca, Janssen Oncology, Bayer, Astellas Pharma, Roche, Sanofi, Seattle Genetics, Semonix Pharmaceuticals, Bicycle Therapeutics, Immunomedics. Susanna Cheng—Consulting: AstraZeneca, Merck. April A N Rose—Consulting: EMD Serono, Advanced accelerator applications/Novartis; Research funding (Personal): Canadian Institutes of Health Research CIHR, Canadian Cancer Society, Conquer Cancer Foundation, Jewish General Hospital Foundation, TransMedTech Institute, Canada Foundation of Innovation; Research Funding (Institution): AstraZeneca, Merck, Pfizer, Seattle Genetics; Employment: Family member Merck. Soumaya Labidi, Mengqi Li, Sonia V Del Rincon, Reeta Barua, Jamila Riromar, Di Maria Jiang, Nazanin Fallah-Rad, Adrian G Sacher: no competing interests., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
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- 2024
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25. Recommended first-line management of asymptomatic brain metastases from EGFR mutant and ALK positive non-small cell lung cancer varies significantly according to specialty: an international survey of clinical practice.
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Fong CH, Meti N, Kruser T, Weiss J, Liu ZA, Takami H, Narita Y, de Moraes FY, Dasgupta A, Ong CK, Yang JCH, Lee JH, Kosyak N, Pavlakis N, Kongkham P, Doherty M, Leighl NB, and Shultz DB
- Abstract
Background: The role for radiotherapy or surgery in the upfront management of brain metastases (BrM) in epidermal growth factor receptor mutant ( EGFR m) or anaplastic lymphoma kinase translocation positive ( ALK +) non-small cell lung cancer (NSCLC) is uncertain because of a lack of prospective evidence supporting tyrosine kinase inhibitor (TKI) monotherapy. Further understanding of practice heterogeneity is necessary to guide collaborative efforts in establishing guideline recommendations., Methods: We conducted an international survey among medical (MO), clinical (CO), and radiation oncologists (RO), as well as neurosurgeons (NS), of treatment recommendations for asymptomatic BrM (in non-eloquent regions) EGFRm or ALK+ NSCLC patients according to specific clinical scenarios. We grouped and compared treatment recommendations according to specialty. Responses were summarized using counts and percentages and analyzed using the Fisher exact test., Results: A total of 449 surveys were included in the final analysis: 48 CO, 85 MO, 60 NS, and 256 RO. MO and CO were significantly more likely than RO and NS to recommend first-line TKI monotherapy, regardless of the number and/or size of asymptomatic BrM (in non-eloquent regions). Radiotherapy in addition to TKI as first-line management was preferred by all specialties for patients with ≥4 BrM. NS recommended surgical resection more often than other specialties for BrM measuring >2 cm., Conclusions: Recommendations for the management of BrM from EGFRm or ALK+ NSCLC vary significantly according to oncology sub-specialties. Development of multidisciplinary guidelines and further research on establishing optimal treatment strategies is warranted., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-697/coif). NM serves on the advisory boards of Pfizer, Novartis, and Seagen. NM reports honoraria from Takeda Oncology and Astra Zeneca. FYM reports consulting fees from Elekta, and honoraria from Astra Zeneca and IASLC; grants and contracts from CTAQ Queen’s University. JCHY reports participation in advisory board with Amgen, Astra Zeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Eli Lilly, Merck, Novartis, Ono Pharmaceuticals, Pfizer, Roche/Genentech, Takeda, Yuhan Pharmaceuticals, JNJ, Puma Technology, Gilead, and GSK; grant support with Astra Zeneca. JHL reports participation in advisory boards with Novartis, Takeda, Eli Lilly, and Astra Zeneca; consulting fees from Pfizer, and payments or honoraria from Bayer, Pfizer, Daiichi-Sankyo, Novartis and Boehringer Ingelheim. NP reports research support from Pfizer, Bayer, and Roche; Honoraria from Boehringer Ingelheim, Pfizer, Roche, Takeda, Pieere-Faber; Advisory board participation from Boehringer Ingelheim, MSD, Astra Zeneca, Merck, Bristol Meyers Squibb, Pfizer, Roche, Takeda, AllVascular, Beigene, Novartis. PK reports financial compensation from Medexus Pharmaceuticals Canada. MD reports consulting fees from Roche, Astra Zeneca, Takeda, Eisai, and Merck; honoraria from Roche and Astra Zeneca. NBL reports research support from Amgen, Array, Astra Zeneca, Bayer, Eli Lilly, EMD Serono, Pfizer, Roche, Guardant Health, Takeda; Honoraria from Amgen, Astra Zeneca, BMS, Janssen, MSD, Novartis, Pfizer, Roche, Sanofi, and Takeda. The other authors have no conflicts of interest to declare., (2023 Journal of Thoracic Disease. All rights reserved.)
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- 2023
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26. Three-year disease-free survival in randomized trials of neoadjuvant chemotherapy and HER2-targeted therapy in breast cancer: A meta-analysis.
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Mittal A, Tamimi F, Molto C, Meti N, Al-Showbaki L, Wilson BE, and Amir E
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- Humans, Female, Disease-Free Survival, Trastuzumab therapeutic use, Neoadjuvant Therapy, Treatment Outcome, Randomized Controlled Trials as Topic, Receptor, ErbB-2, Ado-Trastuzumab Emtansine therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Chemotherapy, Adjuvant, Breast Neoplasms pathology
- Abstract
Background: Outcomes for breast cancer patients with residual disease (RD) after neoadjuvant chemotherapy (NACT) and HER2-targeted therapy may be better than anticipated leading to a smaller absolute benefit of adjuvant trastuzumab emtansine (T-DM1). Therefore, accurate estimates of 3-year disease-free survival (DFS) can aid in treatment planning., Methods: We reviewed randomized trials of NACT and HER2-targeted therapy in breast cancer (excluding T-DM1) and calculated mean 3-year DFS weighted by study sample size. Meta-regression comprising linear regression weighted by sample size (mixed-effects) was performed to explore associations between 3-year DFS and year of accrual and trial-level patient, disease, and treatment factors. Data were reported quantitatively irrespective of statistical significance., Results: Eleven studies (N = 3581) were included in the primary analysis. The mean 3-year DFS for patients with RD was 79.7% (95% CI 77.4-80.9). This was higher for trials completing accrual after 2010 [83% (95% CI 79.3-86.3)] and for those receiving dual HER2 targeted therapy [83.4% (95% CI 79.2-87.7]. Better outcomes for ER positivity, later accrual and dual Her-2 targeted therapy were confirmed in meta-regression. Negative quantitative significance was observed for larger clinical tumor size and nodal involvement., Conclusions: The 3-year DFS for patients with RD has improved over time possibly due to dual HER2 targeted therapy. This will reduce the absolute benefit of adjuvant T-DM1 in this group of patients., Competing Interests: Conflict of Interest Statement E. Amir: Honoraria from Sandoz, Novartis, and Exact Sciences outside the submitted work. All remaining authors have declared no conflicts of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)
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- 2023
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27. Cell-free DNA methylation-defined prognostic subgroups in small-cell lung cancer identified by leukocyte methylation subtraction.
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Ul Haq S, Schmid S, Aparnathi MK, Hueniken K, Zhan LJ, Sacdalan D, Li JJN, Meti N, Patel D, Cheng D, Philip V, Tsao MS, Cabanero M, de Carvalho D, Liu G, Bratman SV, and Lok BH
- Abstract
Small-cell lung cancer (SCLC) methylome is understudied. Here, we comprehensively profile SCLC using cell-free methylated DNA immunoprecipitation followed by sequencing (cfMeDIP-seq). Cell-free DNA (cfDNA) from plasma of 74 patients with SCLC pre-treatment and from 20 non-cancer participants, genomic DNA (gDNA) from peripheral blood leukocytes from the same 74 patients, and 7 accompanying circulating tumor cell-derived xenografts (CDXs) underwent cfMeDIP-seq. Peripheral blood leukocyte methylation (PRIME) subtraction to improve tumor specificity. SCLC cfDNA methylation is distinct from non-cancer but correlates with CDX tumor methylation. PRIME and k-means consensus identified two methylome clusters with prognostic associations that related to axon guidance, neuroactive ligand-receptor interaction, pluripotency of stem cells, and differentially methylated at long noncoding RNA and other repeats features. We comprehensively profiled the SCLC methylome in a large patient cohort and identified methylome clusters with prognostic associations. Our work demonstrates the potential of liquid biopsies in examining SCLC biology encoded in the methylome., Competing Interests: S.S. reports grants from AstraZeneca, BMS, Janssen, Von Tobel foundation, Fill the Gap, and has served on all institutional advisory board for BMS, AstraZeneca, MSD. N.M. reports personal fees from Takeda Oncology, Pfizer, and Novartis, outside of the submitted work. M.-S.T. reports research grant from Bayer and AstraZeneca, outside the submitted work, and personal fees from AstraZeneca, Amgen, BMS, Daiichi-Sankyo and Lilly, outside the submitted work. D. de Carvalho received research funds from Pfizer and is co-founder and shareholder of Adela Inc. S.V.B. is inventor on patents related to cell-free DNA mutation and methylation analysis technologies that have been licensed to Roche and Adela, respectively, and is co-founder of, has ownership in, and serves in a leadership role at Adela. G.L. reports grants and personal fees from AstraZeneca and Takeda; grants from Boehringer Ingelheim; and personal fees from Hoffman La Roche, Merck, Bristol Myers Squibb, and Pfizer outside the submitted work. B.H.L. reports grants from Pfizer; and grants, personal fees, and non-financial support from AstraZeneca outside the submitted work., (© 2022 The Author(s).)
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- 2022
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28. Prognostic Value of Programmed Death Ligand-1 Expression in Solid Tumors Irrespective of Immunotherapy Exposure: A Systematic Review and Meta-Analysis.
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Saleh RR, Scott JL, Meti N, Perlon D, Fazelzad R, Ocana A, and Amir E
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- Humans, Immunotherapy methods, Ligands, Prognosis, B7-H1 Antigen genetics, B7-H1 Antigen metabolism, Neoplasms genetics, Neoplasms therapy
- Abstract
Background: The programmed cell death-1/programmed cell death ligand-1 (PD-L1) pathway, which plays a crucial role in cancer immune surveillance, is the target of several approved immunotherapeutic agents and is used as a predictive biomarker in some solid tumors. However, its use as a prognostic marker (i.e., regardless of therapy used) is not established clearly with available data demonstrating inconsistent prognostic impact of PD-L1 expression in solid tumors., Methods: We conducted a systematic literature search of electronic databases and identified publications exploring the effect of PD-L1 expression on overall survival and/or disease-free survival. Hazard ratios were pooled in a meta-analysis using generic inverse-variance and random-effects modeling. We used the Deeks method to explore subgroup differences based on disease site, stage of disease, and method of PD-L1 quantification., Results: One hundred and eighty-six studies met the inclusion criteria. Programmed cell death ligand-1 expression was associated with worse overall survival (hazard ratio 1.33, 95% confidence interval 1.26-1.39; p < 0.001). There was significant heterogeneity between disease sites (subgroup p = 0.002) with pancreatic, hepatocellular, and genitourinary cancers associated with the highest magnitude of adverse outcomes. Programmed cell death ligand-1 was also associated with worse overall disease-free survival (hazard ratio 1.19, 95% confidence interval 1.09-1.30; p < 0.001). Stage of disease did not significantly affect the results (subgroup p = 0.52), nor did the method of quantification via immunohistochemistry or messenger RNA (subgroup p = 0.70)., Conclusions: High expression of PD-L1 is associated with worse survival in solid tumors albeit with significant heterogeneity among tumor types. The effect is consistent in early-stage and metastatic disease and is not sensitive to method of PD-L1 quantification. These data can provide additional information for the counseling of patients with cancer about prognosis., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
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- 2022
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29. Delivery of Virtual Care in Oncology: Province-Wide Interprofessional Consensus Statements Using a Modified Delphi Process.
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Cheung MC, Franco BB, Meti N, Thawer A, Tahmasebi H, Shankar A, Loblaw A, Wright FC, Fox C, Peek N, Sim V, and Singh S
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- Consensus, Delphi Technique, Humans, SARS-CoV-2, COVID-19, Pandemics
- Abstract
Virtual cancer care (i.e., teleoncology) was rapidly adopted during the COVID-19 pandemic to meet the needs of patients with cancer. However, there is a paucity of guidance for clinicians regarding virtual cancer care. We sought to develop consensus-based statements to guide the optimal provision of virtual care for clinicians caring for patients with cancer, using a modified Delphi consensus process with a 29-member panel consisting of an interprofessional group of clinicians caring for patients with cancer and patient representatives. The consensus process consisted of two rounds and one synchronous final consensus meeting. At the end of the modified Delphi process, 62 of 62 statements achieved consensus. Fifty-seven statements reached consensus in the first round of the process. Concerns regarding the ability to convey difficult news virtually and maintaining similar standards as in-person care without disproportionate strain on clinicians and patients were addressed in the consensus process. We achieved interprofessional consensus on virtual cancer care practices. Further research examining the impact of virtual cancer care on person-centred and clinical outcomes are needed to inform practices during the COVID-19 pandemic and beyond.
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- 2021
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30. Genomic sequencing to inform therapy in advanced pancreatic cancer: A systematic review and meta-analysis of prospective studies.
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Meti N, Kelly D, Allen MJ, Lanys A, Fazelzad R, Ramjeesingh R, Zogopoulos G, Notta F, Knox JJ, Amir E, Gallinger S, O'Kane G, and Grant RC
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- Humans, Neoplasm Staging, Patient Selection, Genetic Therapy methods, Molecular Targeted Therapy methods, Pancreatic Neoplasms genetics, Pancreatic Neoplasms pathology, Pancreatic Neoplasms therapy, Sequence Analysis, DNA methods, Targeted Gene Repair methods
- Abstract
Purpose: Current guidelines recommend somatic genomic sequencing for patients with advanced pancreatic cancer to identify targetable alterations amenable to targeted therapy. The benefit of somatic genomic sequencing in pancreatic cancer remains unclear. This study aims to assess the evidence supporting genomic sequencing to inform treatment selection for patients with advanced pancreatic cancer., Methods: A systematic review identified prospective studies of exocrine pancreatic cancer patients published before August 2020 which conducted genomic sequencing to inform treatment selection. Outcomes of interest included the proportion of patients with targetable alterations, the proportion that received targeted treatments, and the impact of targeted treatments on overall survival. Meta-analysis for proportions and hazard ratios was performed using Dersimonian and Laird random effect models., Results: 19 studies (representing 2048 pancreatic cancer patients) were included. Sequencing methodologies, definitions of targetable alterations, and approaches treatment selection varied across studies and were incompletely reported. 590 of 1382 sequenced patients harboured a targetable alteration (random effects meta-analysis estimate of the proportion 0.46, 95% confidence interval 0.32-0.61). The proportion of patients with targetable alterations was highly heterogenous between studies (I
2 93%, P < 0.001). 91 of 1390 patients received a matched therapy based on their targetable alterations (random effects meta-analysis estimate of the proportion 0.12, 95% CI 0.06-0.23). One observational study reported an overall survival benefit of matched therapy., Conclusions: Genomic sequencing frequently identifies targetable alterations in pancreatic cancers. Further research is required to standardize the definitions of targetable alterations, the approach to treatment matching, and quantify the benefit of targeted therapy., (Copyright © 2021 Elsevier Ltd. All rights reserved.)- Published
- 2021
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31. Platinum-based chemotherapy in early-stage triple negative breast cancer: A meta-analysis.
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Saleh RR, Nadler MB, Desnoyers A, Meti N, Fazelzad R, and Amir E
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- Female, Humans, Neoplasm Staging, Organoplatinum Compounds administration & dosage, Randomized Controlled Trials as Topic, Triple Negative Breast Neoplasms pathology, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Triple Negative Breast Neoplasms drug therapy
- Abstract
Purpose: The addition of platinum agents to anthracycline and taxane-based chemotherapy in early-stage triple negative breast cancer (TNBC) patients improves pathological complete response (pCR). Long-term outcomes, such as disease-free survival (DFS) and overall survival (OS), have not been well-established., Methods: A systematic literature review identified studies using platinum-based treatment in TNBC patients in the neoadjuvant or adjuvant setting with reportable long-term outcomes. Hazard ratios (HR) from collected data were pooled in a meta-analysis using generic inverse-variance and random effects modeling. Subgroup analyses were conducted based on treatment setting and study design., Results: Fourteen studies comprising 3518 patients met the inclusion criteria. Median follow up was 56.2 months. All studies reported DFS and 9 studies (64%) reported OS. DFS was significantly better in platinum-based treatment (HR 0.71, 95% confidence interval (CI) 0.56-0.89; p = 0.03). However, OS was no different (HR 0.98, 95% CI 0.75-1.27; p = 0.87). There was a non-significant difference between platinum exposure in the adjuvant compared to neoadjuvant setting for both DFS (HR 0.75 vs 0.62, p = 0.43) and for OS (HR 0.90 vs 1.10, p = 0.58). The addition of platinum was associated with more thrombocytopenia and all-grade neuropathy and non-significant increases in neutropenia and grade 3-4 neuropathy., Conclusions: Platinum-based treatment improves DFS but not OS. The reporting of toxicity was suboptimal, but in general adding platinum increased toxicity. The discordant effect of platinum-based treatment on DFS and OS suggest the potential development of platinum resistance and worse outcomes after recurrence. Platinum-based chemotherapy cannot be recommended in unselected patients with early TNBC., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
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- 2021
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32. Cancer Treatment During COVID-19: A Qualitative Analysis of Patient-Perceived Risks and Experiences with Virtual Care.
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Lesley GC, Tahmasebi H, Meti N, Wright FC, Thawer A, Cheung M, and Singh S
- Abstract
During the COVID-19 pandemic, most cancer centers shifted from in-person to virtual cancer care to curb community spread and ensure care continuity. This qualitative descriptive study aimed to understand cancer patient-perceived risks related to COVID-19 and cancer treatment, as well as the patient-perceived and experienced value of virtual care. From June to August 2020, focus groups were conducted with patients under active management or observation for a diagnosed malignancy in Toronto, Canada. A thematic analysis of six focus groups found that most participants worried more about treatment delays than they did about COVID-19 infection. Despite some concern about COVID-19 exposure in the hospital, care delays contributed to increased anxiety among participants who already subscribed to strict safety measures in their everyday lives. Most participants accepted virtual care for some appointment types; however, preference for in-person care was found to sustain the humanistic and therapeutic aspects of cancer care that many participants valued. Nuances in the appropriateness and adequacy of virtual cancer care still need exploration. Preserving the humanistic aspects of care is of paramount importance., Competing Interests: Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)
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- 2021
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33. Quality of patient-reported outcomes in oncology clinical trials using immune checkpoint inhibitors: A systematic review.
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Malone E, Barua R, Meti N, Li X, Fazelzad R, and Hansen AR
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- Analysis of Variance, Carcinoma, Renal Cell therapy, Clinical Trials, Phase II as Topic, Clinical Trials, Phase III as Topic, Humans, Kidney Neoplasms therapy, Linear Models, Lung Neoplasms therapy, Melanoma therapy, Quality of Life, Immune Checkpoint Inhibitors therapeutic use, Neoplasms therapy, Patient Reported Outcome Measures
- Abstract
Background: There are limited data regarding the quality of patient-reported outcome (PRO) data in immune checkpoint inhibitor (ICI) clinical trial publications., Methods: A systematic search of citations from various databases was conducted to identify prospective clinical trials involving ICI in advanced tumors from 2003 to 2020. A 30-point score was adapted from the CONSORT PRO extension statement to assess adherence to CONSORT PRO reporting. Linear regression was used to identify factors associated with quality reporting., Results: After the review of 8058 articles, 33 trials were included with ICIs as either monotherapy (91%) or part of a combination regimen (9%). The median score was 23.5 points (range 15-29). In the majority of cases (82%), PROs were reported in a separate publication from the original study. Most of the trials were conducted in the metastatic setting and predominantly in melanoma, lung, and renal cell carcinoma (RCC) (73%). Univariate analysis revealed that trials with greater than 250 patients were associated with a higher score. The score was more likely to be lower in disease sites other than melanoma, lung, and RCC and was higher in the KEYNOTE than in the CHECKMATE trial series. There was no significant correlation between the score and whether a trial met its primary end-point or if the trial improved or worsened the quality of life. In the multivariate analysis, the number of patients enrolled to the trial, disease site, and trial series remained significant., Conclusions: The quality of reporting of PROs in ICI phase II and III clinical trials is heterogeneous across various cancer sites. As PRO data are increasingly used to counsel patients and complement clinical decision making, innovative and collaborative efforts are required to improve the reporting of these essential data., (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
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- 2021
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34. Claudin-2 promotes colorectal cancer liver metastasis and is a biomarker of the replacement type growth pattern.
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Tabariès S, Annis MG, Lazaris A, Petrillo SK, Huxham J, Abdellatif A, Palmieri V, Chabot J, Johnson RM, Van Laere S, Verhoef C, Hachem Y, Yumeen S, Meti N, Omeroglu A, Altinel G, Gao ZH, Yu ASL, Grünhagen DJ, Vermeulen P, Metrakos P, and Siegel PM
- Subjects
- Animals, Biomarkers, Tumor antagonists & inhibitors, Biomarkers, Tumor genetics, Cell Adhesion genetics, Cell Adhesion physiology, Claudins antagonists & inhibitors, Claudins genetics, Colorectal Neoplasms genetics, Colorectal Neoplasms physiopathology, Female, Gene Expression Regulation, Neoplastic, Gene Knockout Techniques, HT29 Cells, Hepatocytes pathology, Heterografts, Humans, Liver Neoplasms genetics, Liver Neoplasms physiopathology, Lung Neoplasms genetics, Lung Neoplasms physiopathology, Lung Neoplasms secondary, Mice, Mice, SCID, PDZ Domains genetics, Prognosis, RNA, Messenger genetics, RNA, Messenger metabolism, Biomarkers, Tumor physiology, Claudins physiology, Colorectal Neoplasms secondary, Liver Neoplasms pathology
- Abstract
Claudin-2 promotes breast cancer liver metastasis by enabling seeding and early cancer cell survival. We now demonstrate that Claudin-2 is functionally required for colorectal cancer liver metastasis and that Claudin-2 expression in primary colorectal cancers is associated with poor overall and liver metastasis-free survival. We have examined the role of Claudin-2, and other claudin family members, as potential prognostic biomarkers of the desmoplastic and replacement histopathological growth pattern associated with colorectal cancer liver metastases. Immunohistochemical analysis revealed higher Claudin-2 levels in replacement type metastases when compared to those with desmoplastic features. In contrast, Claudin-8 was highly expressed in desmoplastic colorectal cancer liver metastases. Similar observations were made following immunohistochemical staining of patient-derived xenografts (PDXs) that we have established, which faithfully retain the histopathology of desmoplastic or replacement type colorectal cancer liver metastases. We provide evidence that Claudin-2 status in patient-derived extracellular vesicles may serve as a relevant prognostic biomarker to predict whether colorectal cancer patients have developed replacement type liver metastases. Such a biomarker will be a valuable tool in designing optimal treatment strategies to better manage patients with colorectal cancer liver metastases.
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- 2021
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35. Reply to A. Pfob et al.
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Meti N, Sadeghi-Naini A, and Tran WT
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- Contrast Media, Female, Humans, Machine Learning, Breast Neoplasms, Neoadjuvant Therapy
- Abstract
Competing Interests: Ali Sadeghi-NainiResearch Funding: ElektaPatents, Royalties, Other Intellectual Property: I have two patents on application of quantitative ultrasound imaging for tissue characterization and therapy response monitoringNo other potential conflicts of interest were reported.
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- 2021
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36. A review and comparison of breast tumor cell nuclei segmentation performances using deep convolutional neural networks.
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Lagree A, Mohebpour M, Meti N, Saednia K, Lu FI, Slodkowska E, Gandhi S, Rakovitch E, Shenfield A, Sadeghi-Naini A, and Tran WT
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- Humans, Female, Deep Learning, Image Processing, Computer-Assisted methods, Breast Neoplasms pathology, Breast Neoplasms diagnostic imaging, Cell Nucleus, Neural Networks, Computer
- Abstract
Breast cancer is currently the second most common cause of cancer-related death in women. Presently, the clinical benchmark in cancer diagnosis is tissue biopsy examination. However, the manual process of histopathological analysis is laborious, time-consuming, and limited by the quality of the specimen and the experience of the pathologist. This study's objective was to determine if deep convolutional neural networks can be trained, with transfer learning, on a set of histopathological images independent of breast tissue to segment tumor nuclei of the breast. Various deep convolutional neural networks were evaluated for the study, including U-Net, Mask R-CNN, and a novel network (GB U-Net). The networks were trained on a set of Hematoxylin and Eosin (H&E)-stained images of eight diverse types of tissues. GB U-Net demonstrated superior performance in segmenting sites of invasive diseases (AJI = 0.53, mAP = 0.39 & AJI = 0.54, mAP = 0.38), validated on two hold-out datasets exclusively containing breast tissue images of approximately 7,582 annotated cells. The results of the networks, trained on images independent of breast tissue, demonstrated that tumor nuclei of the breast could be accurately segmented.
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- 2021
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37. Computational Radiology in Breast Cancer Screening and Diagnosis Using Artificial Intelligence.
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Tran WT, Sadeghi-Naini A, Lu FI, Gandhi S, Meti N, Brackstone M, Rakovitch E, and Curpen B
- Subjects
- Breast diagnostic imaging, Female, Humans, Artificial Intelligence, Breast Neoplasms diagnostic imaging, Image Interpretation, Computer-Assisted methods, Mammography methods, Radiographic Image Interpretation, Computer-Assisted methods, Ultrasonography, Mammary methods
- Abstract
Breast cancer screening has been shown to significantly reduce mortality in women. The increased utilization of screening examinations has led to growing demands for rapid and accurate diagnostic reporting. In modern breast imaging centers, full-field digital mammography (FFDM) has replaced traditional analog mammography, and this has opened new opportunities for developing computational frameworks to automate detection and diagnosis. Artificial intelligence (AI), and its subdomain of deep learning, is showing promising results and improvements on diagnostic accuracy, compared to previous computer-based methods, known as computer-aided detection and diagnosis.In this commentary, we review the current status of computational radiology, with a focus on deep neural networks used in breast cancer screening and diagnosis. Recent studies are developing a new generation of computer-aided detection and diagnosis systems, as well as leveraging AI-driven tools to efficiently interpret digital mammograms, and breast tomosynthesis imaging. The use of AI in computational radiology necessitates transparency and rigorous testing. However, the overall impact of AI to radiology workflows will potentially yield more efficient and standardized processes as well as improve the level of care to patients with high diagnostic accuracy.
- Published
- 2021
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38. SARS-CoV-2 Testing for Asymptomatic Patients with Cancer Prior and during Treatment: A Single Centre Experience.
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Meti N, Tahmasebi H, Leahey A, Boudreau A, Thawer A, Stewart J, Reason P, Albright K, Leis JA, Katz K, Cheung MC, and Singh S
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- Adult, Aged, Aged, 80 and over, Cancer Care Facilities, Female, Humans, Male, Middle Aged, Neoplasms drug therapy, Ontario, Asymptomatic Infections, COVID-19 diagnosis, COVID-19 Testing, Neoplasms virology, SARS-CoV-2
- Abstract
Patients with cancer are more vulnerable to severe COVID-19. As a result, routine SARS-CoV-2 testing of asymptomatic patients with cancer is recommended prior to treatment. However, there is limited evidence of its clinical usefulness. The objective of this study is to evaluate the value of routine testing of asymptomatic patients with cancer. Asymptomatic patients with cancer attending Odette Cancer Centre (Toronto, ON, Canada) were tested for SARS-CoV-2 prior to and during treatment cycles. Results were compared to positivity rates of SARS-CoV-2 locally and provincially. All 890 asymptomatic patients tested negative. Positivity rates in the province were 1.5%, in hospital were 1.0%, and among OCC's symptomatic cancer patients were 0% over the study period. Given our findings and the low SARS-CoV-2 community positivity rates, we recommend a dynamic testing model of asymptomatic patients that triggers testing during increasing community positivity rates of SARS-CoV-2.
- Published
- 2021
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39. Machine Learning Frameworks to Predict Neoadjuvant Chemotherapy Response in Breast Cancer Using Clinical and Pathological Features.
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Meti N, Saednia K, Lagree A, Tabbarah S, Mohebpour M, Kiss A, Lu FI, Slodkowska E, Gandhi S, Jerzak KJ, Fleshner L, Law E, Sadeghi-Naini A, and Tran WT
- Subjects
- Bayes Theorem, Breast, Female, Humans, Breast Neoplasms therapy, Machine Learning, Neoadjuvant Therapy
- Abstract
Purpose: Neoadjuvant chemotherapy (NAC) is used to treat locally advanced breast cancer (LABC) and high-risk early breast cancer (BC). Pathological complete response (pCR) has prognostic value depending on BC subtype. Rates of pCR, however, can be variable. Predictive modeling is desirable to help identify patients early who may have suboptimal NAC response. Here, we test and compare the predictive performances of machine learning (ML) prediction models to a standard statistical model, using clinical and pathological data., Methods: Clinical and pathological variables were collected in 431 patients, including tumor size, patient demographics, histological characteristics, molecular status, and staging information. A standard multivariable logistic regression (MLR) was developed and compared with five ML models: k-nearest neighbor classifier, random forest (RF) classifier, naive Bayes algorithm, support vector machine, and multilayer perceptron model. Model performances were measured using a receiver operating characteristic (ROC) analysis and statistically compared., Results: MLR predictors of NAC response included: estrogen receptor (ER) status, human epidermal growth factor-2 (HER2) status, tumor size, and Nottingham grade. The strongest MLR predictors of pCR included HER2+ versus HER2- BC (odds ratio [OR], 0.13; 95% CI, 0.07 to 0.23; P < .001) and Nottingham grade G3 versus G1-2 (G1-2: OR, 0.36; 95% CI, 0.20 to 0.65; P < .001). The area under the curve (AUC) for the MLR was AUC = 0.64. Among the various ML models, an RF classifier performed best, with an AUC = 0.88, sensitivity of 70.7%, and specificity of 84.6%, and included the following variables: menopausal status, ER status, HER2 status, Nottingham grade, tumor size, nodal status, and presence of inflammatory BC., Conclusion: Modeling performances varied between standard versus ML classification methods. RF ML classifiers demonstrated the best predictive performance among all models.
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- 2021
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40. Associations between safety, tolerability, and toxicity and the reporting of health-related quality of life in phase III randomized trials in common solid tumors.
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Saleh RR, Meti N, Ribnikar D, Goldvaser H, Ocana A, Templeton AJ, Seruga B, and Amir E
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- Antineoplastic Agents adverse effects, Clinical Trials, Phase III as Topic, Humans, Neoplasms diagnosis, Neoplasms mortality, Randomized Controlled Trials as Topic, Research Design, Risk Assessment, Risk Factors, Treatment Outcome, Antineoplastic Agents therapeutic use, Neoplasms drug therapy, Patient Reported Outcome Measures, Quality of Life
- Abstract
Background: Anti-cancer drugs are approved typically on the basis of efficacy and safety as evaluated in phase III randomized trials (RCTs). Health-related quality of life (HRQoL) is a direct measure of patient benefit, but is under-reported. Here we explore associations with reporting of HRQoL data in phase III RCTs in common solid tumors., Methods: We searched ClinicalTrials.gov to identify phase III RCTs evaluating new drugs in adults with advanced cancers that completed accrual between January 2005 and October 2016. Data on HRQoL, safety, and tolerability comprising treatment-related death, treatment discontinuation and commonly reported grade 3 or 4 adverse events (AEs) were extracted. Associations between these measures and reporting of HRQoL data were explored using logistic regression., Results: Of 377 phase III RCTs identified initially, 143 studies were analysed and comprised 55% positive trials and 90% industry sponsored trials. HRQoL was listed as an endpoint in 59% trials; and of these, only 65% reported HRQoL data. There were higher odds of reporting HRQoL data for positive trials (OR 2.05, P = .04) and trials published in journals with higher impact factor (OR 1.35, P = .01). Reporting of HRQoL was not associated with treatment-related death (OR 1.25, P = .40) or treatment discontinuation (OR 1.12, P = .61), but was positively associated with dyspnea and dermatological adverse events., Conclusions: HRQoL is reported in only two-thirds of RCTs that describe collecting such data. Reporting of HRQoL is associated with positive trial outcome and higher journal impact factor, but not associated with overall safety and tolerability of anti-cancer drugs., (© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
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- 2020
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41. Refractory Autoimmune Hemolytic Anemia and Pure Red Cell Aplasia Secondary to Immunotherapy Requiring Prolonged Immunosuppression.
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Hall M, Meti N, Liontos L, Cheung MC, and Gandhi S
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- Humans, Immunologic Factors, Immunosuppression Therapy adverse effects, Immunotherapy, Anemia, Hemolytic, Autoimmune therapy, Red-Cell Aplasia, Pure chemically induced, Red-Cell Aplasia, Pure therapy
- Published
- 2020
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42. Virtual Cancer Care During and Beyond the COVID-19 Pandemic: We Need to Get It Right.
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Meti N, Rossos PG, Cheung MC, and Singh S
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- COVID-19, Humans, SARS-CoV-2, Betacoronavirus, Coronavirus Infections, Pandemics, Pneumonia, Viral epidemiology
- Published
- 2020
- Full Text
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43. Adverse events associated with immune checkpoint inhibitor treatment for cancer.
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Esfahani K, Meti N, Miller WH Jr, and Hudson M
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- Antineoplastic Agents, Immunological immunology, Antineoplastic Agents, Immunological therapeutic use, CTLA-4 Antigen immunology, Cell Cycle Checkpoints drug effects, Cell Cycle Checkpoints immunology, Humans, Immune System Diseases drug therapy, Immune System Diseases therapy, Neoplasms immunology, Programmed Cell Death 1 Receptor immunology, Antineoplastic Agents, Immunological adverse effects, CTLA-4 Antigen antagonists & inhibitors, Immune System Diseases chemically induced, Neoplasms drug therapy, Programmed Cell Death 1 Receptor antagonists & inhibitors
- Abstract
Competing Interests: Competing interests: Marie Hudson reports receiving a grant from Bristol-Myers Squibb, outside the submitted work. Khashayar Esfahani reports receiving speaker’s fees from Bristol-Myers Squibb, outside the submitted work. Wilson Miller reports receiving grants from Bristol-Myers Squibb, Merck, Roche, Novartis, AstraZeneca, Amgen, Bayer, MedImmune and GlaxoSmithKline, outside the submitted work, as well as personal fees from Bristol-Myers Squibb, Merck, Roche, Novartis, Amgen and GlaxoSmithKline. No other competing interests were declared.
- Published
- 2019
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44. Refractory Neutropenia Secondary to Dual Immune Checkpoint Inhibitors That Required Second-Line Immunosuppression.
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Meti N, Petrogiannis-Haliotis T, and Esfahani K
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- Hepatitis drug therapy, Humans, Male, Melanoma drug therapy, Middle Aged, Antineoplastic Agents, Immunological adverse effects, Immunologic Factors therapeutic use, Ipilimumab adverse effects, Mycophenolic Acid therapeutic use, Neutropenia chemically induced, Neutropenia drug therapy, Nivolumab adverse effects
- Published
- 2018
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45. The Role of Immune Checkpoint Inhibitors in Classical Hodgkin Lymphoma.
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Meti N, Esfahani K, and Johnson NA
- Abstract
Hodgkin Lymphoma (HL) is a unique disease entity both in its pathology and the young patient population that it primarily affects. Although cure rates are high, survivorship can be linked with significant recent long-term morbidity associated with both chemotherapy and radiotherapy. The most significant advances have been with the use of the anti-CD30-drug conjugated antibody brentuximab vedotin (BV) and inhibitors of program death 1 (PD-1). HL is genetically wired to up-regulate program death ligand 1 (PD-L1) in >95% of cases, creating a state of so-called “T cell exhaustion”, which can be reversed with immune checkpoint-inhibitor blockade. The overall and complete response rates to PD-1 inhibitors in patients with relapsed or refractory HL are 70% and 20%, respectively, with a long median duration of response of ~16 months. In fact, PD-1 inhibitors can benefit a wide spectrum of relapsed HL patients, including some who have “progressive disease” by strict response criteria. We review the biology of HL, with a focus on the immune micro-environment and mechanisms of immune evasion. We also provide the rationale supporting the use of PD-1 inhibitors in HL and highlight some of the challenges of monitoring disease response in patients treated with this immunotherapy.
- Published
- 2018
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46. Mesocortical Dopamine Phenotypes in Mice Lacking the Sonic Hedgehog Receptor Cdon.
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Verwey M, Grant A, Meti N, Adye-White L, Torres-Berrío A, Rioux V, Lévesque M, Charron F, and Flores C
- Subjects
- Amphetamine pharmacology, Animals, Animals, Newborn, Cell Adhesion Molecules genetics, Central Nervous System Stimulants pharmacology, Dopamine metabolism, Dopaminergic Neurons drug effects, Dopaminergic Neurons pathology, Female, Male, Mice, Inbred C57BL, Mice, Knockout, Motor Activity physiology, Neural Stem Cells metabolism, Neural Stem Cells pathology, Neurogenesis physiology, Pars Compacta drug effects, Pars Compacta growth & development, Pars Compacta pathology, Phenotype, Prefrontal Cortex drug effects, Prefrontal Cortex growth & development, Prefrontal Cortex pathology, Sensory Gating physiology, Tyrosine 3-Monooxygenase metabolism, Ventral Tegmental Area drug effects, Ventral Tegmental Area growth & development, Ventral Tegmental Area pathology, Cell Adhesion Molecules deficiency, Dopaminergic Neurons metabolism, Pars Compacta metabolism, Prefrontal Cortex metabolism, Ventral Tegmental Area metabolism
- Abstract
Motivated behaviors and many psychopathologies typically involve changes in dopamine release from the projections of the ventral tegmental area (VTA) and/or the substantia nigra pars compacta (SNc). The morphogen Sonic Hedgehog (Shh) specifies fates of midbrain dopamine neurons, but VTA-specific effects of Shh signaling are also being uncovered. In this study, we assessed the role of the Shh receptor Cdon in the development of VTA and SNc dopamine neurons. We find that Cdon is expressed in the proliferating progenitor zone of the embryonic ventral midbrain and that the number of proliferating cells in this region is increased in mouse Cdon(-/-) embryos. Consistent with a role of Shh in the regulation of neuronal proliferation in this region, we find that the number of tyrosine hydroxylase (TH)-positive neurons is increased in the VTA of Cdon(-/-) mice at birth and that this effect endures into adulthood. In contrast, the number of TH-positive neurons in the SNc is not altered in Cdon(-/-) mice at either age. Moreover, adult Cdon(-/-) mice have a greater number of medial prefrontal cortex (mPFC) dopamine presynaptic sites, and increased baseline concentrations of dopamine and dopamine metabolites selectively in this region. Finally, consistent with increased dopamine function in the mPFC, we find that adult Cdon(-/-) mice fail to exhibit behavioral plasticity upon repeated amphetamine treatment. Based on these data, we suggest that Cdon plays an important role encoding the diversity of dopamine neurons in the midbrain, influencing both the development of the mesocortical dopamine pathway and behavioral outputs that involve this neural circuitry.
- Published
- 2016
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47. Optimal fluoroscopic viewing angles of left-sided heart structures in patients with aortic stenosis and mitral regurgitation based on multislice computed tomography.
- Author
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Spaziano M, Thériault-Lauzier P, Meti N, Vaquerizo B, Blanke P, Deli-Hussein J, Chetrit M, Galatos C, Buithieu J, Lange R, Martucci G, Leipsic J, and Piazza N
- Subjects
- Aged, Aged, 80 and over, Anatomic Landmarks, Aortic Valve Stenosis therapy, Cardiac Catheterization, Diagnosis, Differential, Female, Fluoroscopy, Humans, Male, Middle Aged, Mitral Valve Insufficiency therapy, Observer Variation, Predictive Value of Tests, Reproducibility of Results, Retrospective Studies, Severity of Illness Index, Aortic Valve diagnostic imaging, Aortic Valve Stenosis diagnostic imaging, Atrial Appendage diagnostic imaging, Atrial Septum diagnostic imaging, Mitral Valve diagnostic imaging, Mitral Valve Insufficiency diagnostic imaging, Multidetector Computed Tomography
- Abstract
Background: Transcatheter interventions are currently undertaken using "generic" fluoroscopic viewing angles. However, the position and orientation of heart structures may vary across patients and disease-specific remodeling processes., Objective: This study uses multislice computed tomography to determine optimal fluoroscopic viewing angles of the aortic and mitral annuli, the left atrial appendage and the atrial septum. We explored differences between patients with severe aortic stenosis (AS) and severe mitral regurgitation (MR)., Methods and Results: The multislice computed tomographies of 28 patients with severe aortic stenosis (AS) and 32 patients with severe functional mitral regurgitation (MR) were analyzed. For each patient, we evaluated the optimal fluoroscopic viewing angles of the aortic and mitral annuli (en face, maximal and minimal diameters, aortic root with right, left and non coronary sinus in center), left atrial appendage orifice (en face, maximal and minimal diameters), and atrial septum (fossa ovalis) en face. The TAVR implantation view with right coronary sinus in center was LAO 9 - CRA 0 in the AS group and LAO 6 - CAU 5 in the MR group (p = NS). AS and MR patients differed significantly with respect to the fluoroscopic angulation of the aortic annulus en face (8.3°), the aortic annulus maximal (17.7°) and minimal (18.5°) diameters, the mitral annulus aorto-mural diameter (11.3°), and the left atrial appendage orifice en face (11.1°) (all p-values<0.05)., Conclusion: Optimal fluoroscopic viewing angles of left-sided structures vary considerably between patients. Multislice computed tomography is a valuable tool to determine the most procedurally relevant angulations, with the potential to optimize procedural safety, efficacy and duration., (Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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48. Incessant atrioventricular nodal reentrant tachycardia with tachycardia-induced cardiomyopathy, biventricular thrombosis, and pulmonary emboli.
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Meti N, Mongeon FP, Guerra PG, O'Meara E, and Khairy P
- Published
- 2016
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49. Canadian Surgery Forum.
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Atlas H, Safa N, Denis R, Garneau P, Moustarah F, Marceau S, Lebel S, Biertho L, Hould F, Marceau P, Biron S, Anvari M, Sharma A, Goldsmith CH, Lacobellis G, Cadeddu M, Misra M, Taylor V, Tarride J, Hubert E, Tiboni M, Hong D, Wiebe S, Klassen D, Bonjer J, Lawlor D, Plowman J, Ransom T, Vallis M, Ellsmere J, Graham PJ, Kaban GK, Vizhul A, Birch DW, Menezes AC, Shi X, Karmali S, Seth R, MacKenzie L, Kus A, Bell J, Carrier M, Atkins H, Boushey R, Auer R, Croome KP, Yamashita M, Aarts MA, Okrainec A, Glicksman A, Pearsall E, Pitzul K, Huang H, McLeod RS, Sarkhosh K, Robertson M, Boctor D, Lam V, Sigalet D, Johner A, Faulds J, Wiseman SM, Pemberton J, Gordon ML, Prashad C, Rambaran M, Cameron B, Neville A, Sarosi GA Jr, Wei Y, Gibbs JO, Reda DJ, McCarthy M Jr, Fitzgibbons RJ Jr, Barkun JST, Fenech DS, Forbes S, Pearsall E, Chung J, Glickman A, Victor JC, Nathens A, McLeod RS, Fitzmaurice GJ, Mone F, Brown R, Cranley B, Conlon EF, Todd RAJ, O'Donnell ME, Tran TT, Kaneva PA, Finch LE, Fried GM, Mayo NE, Feldman LS, VanHouwellingen L, Vogt KN, Stewart TC, Williamson J, Parry N, DeRose G, Gray D, Harriman S, Rodych N, Hayes P, Moser M, Jamal MH, Doi S, Rousseau M, Snell L, Meterissian S, Zolfaghari S, Friedlich MS, Kurashima Y, Al-Sabah S, Kaneva PA, Feldman LS, Fried GM, Vassiliou MC, Tran TT, Kaneva PA, Mayo NE, Fried GM, Feldman LS, Pearsall E, Sheth U, Fenech D, McKenzie M, Victor JC, McLeod RS, Ghaderi I, Vaillancourt M, Sroka G, Kaneva PA, Vassiliou MC, Seagull FJ, Sutton E, Godinez C, George I, Park A, Choy I, Okrainec A, Brintzenhoff R, Prabhu A, Heniford BT, Stefanidis D, Fried GM, Feldman LS, Igric A, Vogt KN, Girotti M, Parry NG, Vinden C, Kim SHH, Zhang NN, Russo JJ, El-Salfiti IK, Kowalczuk M, Rajaee AN, Bal M, Gill MS, Lysecki PJ, Hoogenes J, Dath D, Nassar AK, Reid S, Mohaisen KN, Winch J, Omar D, Hanna WC, Mulder DS, El-Hilali MM, Khwaja KA, Jamal MH, Rayment J, Doi SA, Megueditchian A, Meterissian S, Tso D, Langer M, Blair G, Butterworth S, Vaillancourt M, Vassiliou MC, Bergman S, Fried GM, Kaneva PA, Feldman LS, Davenport E, Haggar F, Trottier D, Huynh H, Soto C, Shamji FM, Seely A, Sundaresan S, Pagliarello G, Tadros S, Yelle JD, Maziak D, Moloo H, Poulin EC, Mamazza J, Knowlton LM, Chackungal S, MacQueen KA, Anvari M, Allen C, Goldsmith C, Ghaderi I, Madani A, de Gara C, Schlachta CM, Zakrison TL, Tee MC, Chan S, Nguyen V, Yang J, Holmes D, Levine D, Bugis S, Wiseman SM, Sandhu L, Zhai J, Kennedy ED, Baxter NN, Gagliardi AR, Urbach DR, Wei AC, Sabalbal M, McAlister VC, Balayla J, Bergman S, Feldman LS, Ghitulescu G, Fraser SA, Daigle R, Urquart R, Cox M, Grunfeld E, Porter G, Hallet J, Labidi S, Clairoux A, Gagné JP, Gill RS, Manouchehri N, Liu JQ, Lee TF, Bigam DL, Cheung PY, Van Koughnett JA, Colquhoun PH, Gordon ML, Cornacchi S, Farrokhyar F, Hodgson N, Porter G, Quan ML, Wright F, Lovrics P, Datta I, Brar SS, Ball CG, Heine JA, Rothwell B, Crozier M, Ting H, Boone D, O'Regan N, Brown C, Bandrauk N, Hapgood J, Hogan M, McDonald LA, Da'as S, Sorensen PHB, Berman JN, Ameer A, Jamal M, Aljiffry M, Doi S, Hasanain M, Chaudhury P, Metrakos P, Tchervenkov J, Lapierre S, Mohammad W, Balaa N, Akil M, Mimeault R, Fairfull-Smith R, Teague BD, Butler MS, Garneau PY, Sample CB, Kapoor A, Cadeddu MO, Anvari M, Hanna WC, Jamal MH, Nguyen L, Fraser SA, Kwan K, Wallis CJD, Jones S, Fraser T, Masterso J, Blair G, Duffy D, Roberts DJ, Kirkpatrick AW, Datta I, Feliciano DV, Kortbeek JB, Laupland KB, Ball CG, Haggar F, Davenport E, Moloo H, Mamazza J, Manouchehri N, Bigam D, Churchill T, Joynt C, Cheung PY, Al-Sairafi R, Sample CB, Paquette F, Fraser SA, Feldman LS, Fried GM, Weissglas I, Ghitulescu G, Meterissian S, Bergman S, Al-Dohayan A, Al-Naami M, Bamehriz F, Madkhali A, Hallet J, LeBlanc M, Gilbert A, Daigle C, Tien G, Atkins MS, Zheng B, Tanin H, Swindells C, Meneghetti A, Panton ONM, Qayumi AK, Chhiv M, Drolet S, Sirois-Giguère É, Gilbert A, Doyle JD, Sheth U, Huang H, Pearsall E, McLeod RS, Nathens AB, Suri RR, Vora P, Kirby JM, Chan K, Smith S, Ruo L, Faryniuk A, Hochman D, Ball CG, Kirkpatrick AW, Broderick TJ, Williams DR, Kholdebarin R, Helewa R, Bracken J, Zabolotny B, Hochman D, Merchant S, Hameed M, Melck A, McGuire AL, Wilson C, Mercer D, Sharma B, Orzech N, Grantcharov T, Johner A, Taylor DC, Buczkowski AK, Chung SW, Lumb KJ, Trejos AL, Ward CDW, Naish MD, Patel RV, Schlachta CM, Davenport E, Haggar F, Moloo H, Boushey RP, Poulin EC, Mamazza J, Graybiel KM, Fernandes VT, Hoogenes J, Dath D, Mohammad W, Trottier D, Nadolny K, Poulin EC, Mamazza J, Balaa F, Diederichs B, Turner S, de Gara C, Ghitulescu GA, Filip I, Bergman S, Fraser S, Finley RJ, Mayo J, Clifton J, Yee J, Evans K, MacWilliams A, Lam S, English J, Finley C, Jacks L, Darling G, Hanna WC, Sudarshan M, Roberge D, David M, Waschke KA, Mayrand S, Ferri LE, Coughlin S, Emmerton-Coughlin H, Malthaner R, Grover HS, Basi S, Chiasson P, Basi S, Irshad K, Emmerton-Coughlin HMA, Vogt KN, Malthaner RA, Spicer JD, McDonald B, Perera R, Rousseau MC, Chan CHF, Hsu RYC, Giannias B, Ferri LE, Ahmed S, Birnbaum AE, Berz D, Fontaine JP, Dipetrillo TA, Ready NE, Ng T, Alhussaini A, Oberoi M, Threader J, Villeneuve J, Gilbert S, Shamji FM, Sundaresan S, Maziak D, Seely A, Rammohan KS, Hunt I, Chuck A, Gazala S, Valji A, Stewart K, Bedard ELR, Plourde M, Fortin D, Arab A, Inculet RI, Malthaner RA, Bharadwaj SC, Hamin T, Tan LA, Unruh HW, Srinathan SK, McGuire AL, Petsikas D, Reid K, Hopman W, Levine P, Rousseau M, Spicer J, Ferri LE, Ashrafi AS, Bond RJ, Ong SR, Ahmadi SY, Partington SL, Graham AJ, Owen S, Kelly EJ, Gelfand G, Grondin SC, McFadden SD, Paolucci EO, Weeks SG, Davis PJ, Molinari M, Topp T, Walsh MJ, Simoneau E, Hassanain M, Cabrera T, Chaudhury P, Dumitra S, Aljiffry M, Feteih I, Leduc S, Rivera J, Jamal M, Valenti D, Metrakos P, Elgadi K, Cherniak W, Chan D, Wei AC, Gallinger S, Mohammad W, Mimeault R, Fairfull-Smith R, Auer R, Balaa F, Kwan J, Hassanain M, Chaudhury P, Dey C, Gadahadh R, Salman A, Simoneau E, Meti N, Aljiffry M, Jamal M, Cabrera T, Bouganim N, Kavan P, Alcindor T, Valenti D, Metrakos P, Brar B, Sutherland F, Bégin A, Bourdonnais D, Lapointe R, Plasse M, Létourneau R, Roy A, Dagenais M, Vandenbroucke-Menu F, Bégin A, Bourdonnais D, Lapointe R, Plasse M, Létourneau R, Dagenais M, Roy A, Vandenbroucke-Menu F, Bégin A, Ismail S, Vandenbroucke-Menu F, Létourneau R, Plasse M, Roy A, Dagenais M, Lapointe R, Greco EF, Nanji S, Shah SA, Wei AC, Greig PD, Gallinger S, Cleary SP, Al-Adra DP, Anderson C, Nanji S, Ryan P, Guindi M, Selvarajah S, Greig P, McGilvray I, Taylor B, Wei A, Moulton C, Cleary SP, Gallinger S, Sandroussi C, Brace C, Kennedy E, Baxter N, Gallinger S, Wei AC, Yamashita T, Leslie K, McLean SR, Karsanji D, Dixon E, Sutherland FR, Bathe OF, Suri RR, Marcaccio MJ, Ruo L, Jamal MH, Simoneau E, Khalil JA, Hassanain M, Chaudhury P, Tchervenkov J, Metrakos P, Doi SA, Barkun JS, Barnett C, Marcaccio MJ, Hankinson JJ, Ruo L, Alawashez A, Ellsmere J, Neville A, Boutros M, Barkun J, Wiebe ME, Sandhu L, Takata JL, Kennedy ED, Baxter NN, Gagliardi AR, Urbach DR, Wei AC, Chan G, Kocha W, Reid R, Wall W, Quan D, Lovrics P, Hodgson N, Ghola G, Franic S, Goldsmith C, McCready D, Cornacchi S, Garnett A, Reedijk M, Scheer AS, McSparron JI, Schulman AR, Tuorto S, Gonen M, Gonsalves J, Fong Y, Auer RAC, Francescutti V, Coates A, Thabane L, Goldsmith CH, Levine M, Simunovic M, Richardson DP, Porter G, Johnson PM, Leon-Carlyle M, Schmocker S, O'Connor BI, Victor JC, Baxter NN, Smith AJ, McLeod RS, Kennedy ED, Chan CHF, Arabzadeh A, DeMarte L, Spicer JD, Turbide C, Brodt P, Beauchemin N, Ferri LE, Zih F, Panzarella T, Hummel C, Petronis J, McCart A, Swallow C, Mathieson A, Ridgway PF, Ko YJ, Smith AJ, Gieni M, Dickson L, Sne N, Avram R, Farrokhyar F, Smith M, Giacomantonio C, Hoskin D, Doyon C, Martin G, Patocskai E, Brar SS, Wright F, Okrainec A, Smith AJ, Bischof DA, Maier B, Fitch M, Wright FC, Baliski CR, Kluftinger A, MacLeod M, Kwong S, Racz JM, Fortin A, Latosinsky S, Messenger DE, Kirsch R, McLeod RS, Aslani N, Heidary B, Prabhu KL, Raval M, Phang PT, Brow C, Richardson DP, Porter G, Johnson PM, Moloo H, Haggar F, Duhaime S, Hutton B, Grimshaw J, Coyle D, Poulin EC, Mamazza J, Boushey RP, Paun BC, Shaheen AAM, Dixon E, Maclean AR, Buie WD, Moustarah F, Talarico J, Zink J, Gatmaitan P, Schauer P, Chand B, Brethauer S, Martel G, Duhaime S, Ramsay CR, Barkun JS, Ferguson DA, Boushey RP, Palter VN, MacRae HM, Grantcharov TP, Messenger DE, Victor JC, O'Connor BI, MacRae HM, McLeod RS, Al-Sabah S, Feldman LS, Charlebois P, Stein B, Kaneva PA, Fried GM, Liberman AS, Borowiec AM, Karmal S, Apriasz I, Mysliwiec B, Hussain N, Ott M, Reynolds R, Lum A, Williams LJ, Morash R, Shin S, Smylie J, Moloo H, Auer R, Poulin EC, Mamazza J, Watters J, Fung-Kee-Fung M, Boushey RP, Pelletier JS, de Gara CJ, White J, Ghosh S, Schiller D, Drolet S, Paolucci EO, Heine J, Buie WD, Maclean AR, Barnes A, Liang S, Auer R, Moloo H, Mamazza J, Poulin EC, Boushey RP, Klevan AE, Dalvi AA, Ramsay JA, Stephen WJ, Nhan C, Driman DK, Raby M, Smith AJ, Hunter A, Srigley J, McLeod RS, Zolfaghari S, Auer R, Moloo H, Mamazza J, Friedlich M, Poulin EC, Stern HS, Boushey RP, Scheer AS, Boushey RP, Liang S, Doucette S, O'Connor AM, and Moher D
- Published
- 2010
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