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Double-blind randomized controlled study of the efficacy, safety and tolerability of eszopiclone vs placebo for the treatment of patients with post-traumatic stress disorder and insomnia

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World Journal of Psychiatry 2020年第3期10卷 21-28页

作者： Sheila m Dowd alyson K Zalta Helen J Burgess Elizabeth C Adkins Zerbrina Valdespino-Hayden mark H Pollack Department of Psychiatry and Behavioral Sciences Rush University Medical CenterChicagoIL 60601United States Department of Psychological Science University of California IrvineIrvineCA 92697United States Sleep and Circadian Research Laboratory Department of PsychiatryUniversity of MichiganAnn ArborMI 48109United States Center for Behavioral Intervention Technologies|Department of Preventive medicine Northwestern University Feinberg School of MedicineChicagoIL 60611United States Department of Psychology Montclair State UniversityMontclairNJ 07043United States

BACKGROUND Sleep disturbance is a core feature of post-traumatic stress disorder(PTSD).Given the relationship between sleep disturbance and PTSD,there has been a relative paucity of studies examining the potential therapeutic impact of using pharmacotherapy to target sleep disturbance in patients with PTSD.Eszopiclone(ESZ)is a non-benzodiazepine y-aminobutyric acid-A receptor agonist indicated for the treatment of sleep and may affect sleep in patients with PTSD.AIm To evaluate the efficacy of ESZ vs placebo(PBO)for patients with PTSD and insomnia.mETHODS The study was a 12-wk,double blind,randomized controlled trial with 3 mg of ESZ(n=13)or PBO(n=12).RESULTS Patients in both arms experienced significant improvement in PTSD symptoms as assessed by the Clinician-Administered PTSD Scale for DSm-IV(CAPS):ESZ(t11=-3.12,P=0.005)and PBO(t11=-3.5,P=0.002)and by self-report with the Short PTSD Rating Interview(ESZ t11=-3.38,P=0.003 and PBO t11=-4.48,P=0.0005).There were no significant differences between treatments on the CAPS(t22=-0.13,P=0.70)or the Short PTSD Rating Interview(t22=-0.58,P=0.56).Similarly,both treated groups improved on sleep measures as assessed by the Pittsburgh Sleep Quality Index with PTSD Addendum(PSQI)and on total sleep time(TST)and sleep latency assessed by actigraphy with no significant differences between groups(PSQI t22=-0.24,P=0.81;total sleep time t10=0.13,P=0.90 and sleep latency t10=0.68,P=0.50).There was a significant correlation between improvement in sleep and overall improvement in PTSD as measured by change scores on the PSQI and CAPS,r(8)=0.79,P=0.01 for ESZ treated subjects,but not for those treated with PBO r(9)=0.16,P=0.69.Adverse events of ESZ were consistent with the known profile of the medication including dysgeusia(30%,mild),sedation(20%,mild)and headache(20%,moderate to severe).CONCLUSION Results do not support the hypothesis of a specific positive effect of ESZ compared to PBO for measures of PTSD and associated sleep disturbance.

关键词： Trauma Sleep disturbance Hypnotic Post-traumatic stress disorder

Is cardiac mRI an effective test for arrhythmogenic right ventricular cardiomyopathy diagnosis?

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World Journal of Cardiology 2014年第7期6卷 675-681页

作者： Santhi Chellamuthu alyson m Smith Steven m Thomas Catherine Hill Peter W G Brown Abdallah Al-mohammad Department of Radiology Sheffield Teaching Hospitals NHS trustNorthern General HospitalSheffield S5 7AUUnited Kingdom alyson m Smith Abdallah Al-MohammadDepartment of CardiologySheffield Teaching Hospitals NHS TrustNorthern General HospitalSheffield S5 7AUUnited Kingdom

AIm:To evaluate the referrals with suspected arrhythmogenic right ventricular cardiomyopathy(ARVC)and compare cardiac mR(cmR)findings against clinical diagnosis.mETHODS:A retrospective analysis of 114(age range16 to 83,males 55%and females 45%)patients referred for cmR with a suspected diagnosis of ARVC between may 2006 and February 2010 was performed after obtaining institutional approval for service evaluation.Reasons for referral including clinical symptoms and family history of sudden death,electrocardiogram and echo abnormalities,cmR findings,final clinical diagnosis and information about clinical management were obtained.The results of cmR were classified as major,minor,non-specific or negative depending on both functional and tissue characterisation and the cmR results were compared against the final clinical diagnosis.RESULTS:The most common reasons for referral included arrhythmias(30%)and a family history of sudden death(20%).Of the total cohort of 114 patients:4 patients(4%)had major cmR findings for ARVC,13patients(11%)had minor cmR findings,2 patients had non-specific cmR findings relating to the right ventricle and 95 patients had a negative cmR.Of the 4 patients who had major cmR findings,3(75%)had a positive clinical diagnosis.In contrast,of the 13 patients who had minor cmR findings,only 2(15%)had a positive clinical diagnosis.Out of the 95 negative patients,clinical details were available for 81 patients and none of them had ARVC.Excluding the 14 patients with no clinical data and final diagnosis,the sensitivity of the test was 100%,specificity 87%,positive predictive value29%and the negative predictive value 100%.CONCLUSION:CmR is a useful tool for ARVC evaluation because of the high negative predictive value as the outcome has a significant impact on the clinical decision-making.

关键词： Arrhythmogenic right ventricular cardiomyopathy Cardiomyopathy Right ventricular Arrhythmias magnetic resonance imaging Diagnosis Implantable cardiac defibrillator

Re-re-treatment of hepatitis C virus: Eight patients who relapsed twice after direct-acting-antiviral drugs

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World Journal of Gastroenterology 2015年第43期21卷 12430-12438页

作者： Joshua Hartman Kian Bichoupan Neal Patel Sweta Chekuri alyson Harty Douglas Dieterich Ponni Perumalswami Andrea D Branch Department of medicine Icahn School of Medicine at the Mount Sinai Medical Center Division of Liver Disease Icahn School of Medicine at the Mount Sinai Medical Center

AIm: To determine risk factors associated with hepatitis C virus(HCV) treatment failure after direct acting antivirals in patients with complex treatment histories.mETHODS: All HCV mono-infected patients who received treatment at our institution were queried.Analysis was restricted to patients who previously failed treatment with boceprevir(BOC) or telaprevir(TVR) and started simeprevir(SmV) and sofosbuvir(SOF) ± ribavirin(RBV) between December 2013 and June 2014. Patients with human immunodeficiency virus(HIV)/HCV co-infection or patients who received a liver transplant in the past were excluded. Viral loads were recorded while on treatment and after treatment. Data collection continued until December,31 st 2014 when data analysis was initiated. Patients missing virologic outcomes data were not included in the analysis. Analysis of 35 patients who had virologic outcome data available resulted in eight patients who were viral load negative at the end of treatment with SmF/SOF but later relapsed. Data related to patient demographics,HCV infection,and treatment history was collected in order to identify risk factors shared among patients who failed treatment with SmF/SOF.RESULTS: Eight patients who were treated with the first generation HCV protease inhibitors BOC or TVR in combination with pegylated-interferon(PEG) and RBV who failed this triple therapy were subsequently retreated with an off-label all-oral regimen of SmV and SOF for 12 wk,with RBV in seven cases. Treatment was initiated before the Food and Drug Administration approved a 24-wk SmV/SOF regimen for patients with liver cirrhosis. All eight patients had an end of treatment response,but later relapsed. Eight(100%) patients were male. mean age was 56(range,49-64). Eight(100%) patients had previously failed PEG/RBV dual therapy at least once in addition to prior failure with triple therapy. Total number of times treated ranged from 3-6(mean 3.8). Eight(100%) patients were male had liver cirrhosis as determined by Fibroscan or mRI. Seven(87.5%) patients h

关键词： Hepatitis C Protease inhibitor Relapse Simeprevir

Pilot Study on the Effects of Partially Restored Riparian Plant Communities on Habitat Quality and Biodiversity along First-Order Tributaries of the Lower St. Johns River

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Journal of Water Resource and Protection 2010年第9期2卷 771-782页

作者： Anthony m. Rossi Daniel C. moon Dale Casamatta Kelly Smith Christopher Bentzien Jason mcGregor alyson Norwich Emilie Perkerson Ralph Perkerson Joanna Savinon Keith Stokes Dean Doebberfuhl 不详

The St. Johns River is one of the premiere waterways in the southeastern United States, but it is increasingly affected by anthropogenic disturbances and influences such as excessive loading of nutrients. In the current pilot project, small native plant communities (“garden sites”) were established along sections of riparian corridors of five first-order tributaries in residential-commercial areas that drain into the lower St. Johns River in north Florida. In addition, four “non-garden” (control) tributaries were monitored for comparison. Garden sites included five species native to the area;20 plants of each species on both banks (200 total plants). These sites were used to assess the ability of partially restored riparian areas to ameliorate nutrient loading and water quality and determine their impact on local biodiversity in disturbed suburban drainage systems. Partially restored sites showed a significant reduction in both NO3- and P concentrations in both soil and water samples compared to control sites. For instance, soil NO3- levels were reduced by 14% in garden sites, while water samples were 30% lower. moreover, both plant species richness and Shannon diversity (H’) were significantly higher at partially restored sites, 33 and 19% respectively, compared to control streams after two years. Garden sites also had significantly higher terrestrial and invertebrate diversity than non-restored tributaries. Intermittent patches of partially restored habitat along suburban riparian corridors may provide a practical cost-effective technique for improving ecosystem function, water quality and increasing biodiversity along these frequently disturbed lotic habitats. Trends detected in the current study may have general implications for riparian restoration and reduction of nutrient loading in these small tributaries and, ultimately, effect water quality of the lower St. Johns River basin.

关键词： Riparian Restoration Biodiversity Soil and Water Quality

Real-world cure rates for hepatitis C virus treatments that include simeprevir and/or sofosbuvir are comparable to clinical trial results

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World Journal of Virology 2017年第4期6卷 59-72页

作者： Kian Bichoupan Neeta Tandon James F Crismale Joshua Hartman David Del Bello Neal Patel Sweta Chekuri alyson Harty michel Ng Keith m Sigel meena B Bansal Priya Grewal Charissa Y Chang Jennifer Leong Gene Y Im Lawrence U Liu Joseph A Odin Nancy Bach Scott L Friedman Thomas D Schiano Ponni V Perumalswami Douglas T Dieterich Andrea D Branch Division of Liver Diseases Icahn School of Medicine at Mount Sinai Janssen Scientific Affairs LLC Division of General Internal medicine Icahn School of Medicine at Mount Sinai

AIm To assess the real-world effectiveness and cost of simeprevir(SmV), and/or sofosbuvir(SOF)-based therapy for chronic hepatitis C virus(HCV) infection.mETHODS The real-world performance of patients treated with SmV/SOF ± ribavirin(RBV), SOF/RBV, and SOF/RBV with pegylated-interferon(PEG) were analyzed in a consecutive series of 508 patients with chronic HCV infection treated at a single academic medical center. Patients with genotypes 1 through 4 were included. Rates of sustained virological response-the absence of a detectable serum HCV RNA 12 wk after the end of treatment [sustained virological response(SVR) 12]-were calculated on an intention-to-treat basis. Costs were calculated from the payer's perspective using medicare/medicaid fees and Redbook Wholesale Acquisition Costs. Patient-related factors associated with SVR12 were identified using multivariable logistic regression.RESULTS SVR 12 rates were as follows: 86%(95%CI: 80%-91%)among 178 patients on SmV/SOF ± RBV; 62%(95%CI: 55%-68%) among 234 patients on SOF/RBV; and 78%(95%CI: 68%-86%) among 96 patients on SOF/PEG/RBV. mean costs-per-SVR 12 were $174442(standard deviation: ± $18588) for SmV/SOF ± RBV; $223003(± $77946) for SOF/RBV; and $126496(± $31052) for SOF/PEG/RBV. Among patients on SmV/SOF ± RBV, SVR12 was less likely in patients previously treated with a protease inhibitor [odds ratio(OR): 0.20, 95%CI: 0.06-0.56]. Higher bilirubin(OR: 0.47, 95%CI: 0.30-0.69) reduced the likelihood of SVR12 among patients on SOF/RBV, while FIB-4 score ≥ 3.25 reduced the likelihood of SVR 12(OR: 0.18, 95%CI: 0.05-0.59) among those on SOF/PEG/RBV. CONCLUSION SVR 12 rates for SmV and/or SOF-based regimens in a diverse real-world population are comparable to those in clinical trials. Treatment failure accounts for 27% of costs.

关键词： Cirrhosis Cost Sustained virological response Protease inhibitor Polymerase inhibitor

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论剑物联网:英特尔高层专访

微型计算机 2019年第31期39卷 8-9页

作者： Brad m.Haczynski 王稚聪 alyson N.Griffin Joe D.Jensen 谢青山 Thomas Lantzsch 陈伟博英特尔公司市场营销集团副总裁兼物联网事业部英特尔公司市场营销集团英特尔公司物联网事业部英特尔物联网销售市场部中国区英特尔公司

mC:英特尔对AIoT技术、产品在制造业的前景和应用如何看待?AIoT对中国制造业的发展与改善有什么意义?英特尔对中国市场及其合作伙伴是如何培养与支持的?

关键词：制造业英特尔物联网合作伙伴发展与改善

Hepatic decompensation/serious adverse events in post-liver transplantation recipients on sofosbuvir for recurrent hepatitis C virus

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World Journal of Gastroenterology 2016年第9期22卷 2844-2854页

作者： Neal Patel Kian Bichoupan Lawrence Ku Rachana Yalamanchili alyson Harty Donald Gardenier michel Ng David motamed Viktoriya Khaitova Nancy Bach Charissa Chang Priya Grewal meena Bansal Ritu Agarwal Lawrence Liu Gene Im Jennifer Leong Leona Kim-Schluger Joseph Odin Jawad Ahmad Scott Friedman Douglas Dieterich Thomas Schiano Ponni Perumalswami Andrea Branch Division of Liver Diseases Icahn School of Medicine at Mount Sinai Recanati miller Transplant Institute Icahn School of Medicine at Mount Sinai

AIm: To determine the safety profile of new hepatitis C virus(HCV) treatments in liver transplant(LT) recipients with recurrent HCV infection.mETHODS: Forty-two patients were identified with recurrent HCV infection that underwent LT at least 12 mo prior to initiating treatment with a Sofosbuvir-based regimen during December 2013-June 2014. Cases were patients who experienced hepatic decompensation and/or serious adverse events(SAE) during or within one month of completing treatment. Controls had no evidence of hepatic decompensation and/or SAE. HIVinfected patients were excluded. Cumulative incidence of decompensation/SAE was calculated using the Kaplan meier method. Exact logistic regression analysis was used to identify factors associated with the composite outcome. RESULTS: median age of the 42 patients was 60 years [Interquartile Range(IQR): 56-65 years], 33%(14/42) were female, 21%(9/42) were Hispanic, and 9%(4/42) were Black. The median time from transplant to treatment initiation was 5.4 years(IQR: 2.1-8.8 years). Thirteen patients experienced one or more episodes of hepatic decompensation and/or SAE. Anemia requiring transfusion, the most common event, occurred in 62%(8/13) patients, while 54%(7/13) decompensated. The cumulative incidence of hepatic decompensation/SAE was 31%(95%CI: 16%-41%). Risk factors for decompensation/SAE included lower pre-treatment hemoglobin(OR = 0.61 per g/d L, 95%CI: 0.40-0.88, P mated glomerular filtration rate(OR = 0.95 per m L/min per 1.73 m^2, 95%CI: 0.90-0.99, P = 0.01), and higher baseline serum total bilirubin(OR = 2.43 per mg/d L, 95%CI: 1.17-8.65, P management of anemia remains an important clinical challenge.

关键词： Hepatitis C virus Sofosbuvir Ribavirin Anemia Hepatic decompensation Serious adverse event Liver tra