The first report of the potentially harmful diatom <i>Pseudo‐nitzschia caciantha</i> from Australian coastal waters

Ajani, Penelope,Kim, Jin H.,Han, Myung Soo,Murray, Shauna A. John Wiley Sons Australia, Ltd 2016 Phycological research Vol.64 No.4

<P><B>SUMMARY</B></P><P>The diatom <I>Pseudo‐nitzschia</I> is a significant component of coastal waters worldwide and a producer of the potent neurotoxin, domoic acid. Sixteen species belonging to this genus have been reported from Australian waters, but the potentially toxic species <I>P. caciantha</I> has not been previously known from this region. Two clonal strains of <I>P. caciantha</I> were isolated from Coogee Beach, south‐east Australia, and the morphological, molecular and toxicological evidence for this species delineation were examined using light and transmission electron microscopy, phylogenetic analysis based on sequences of the second internal transcribed spacer and domoic acid production as measured by liquid chromatography–mass spectrometry. The results unambiguously confirmed that these isolates are the potentially toxic species <I>P. caciantha</I>, being only the second report of this species in the Southern Hemisphere. The potential for further hidden <I>Pseudo‐nitzschia</I> diversity in these waters is considerable.</P>

Immediate application of vacuum assisted closure dressing over free muscle flaps in the lower extremity does not compromise flap survival and results in decreased flap thickness

Harvey Chim,Yasmina Zoghbi,Ajani George Nugent,Wrood Kassira,Morad Askari,Christopher John Salgado 대한성형외과학회 2018 Archives of Plastic Surgery Vol.45 No.1

Background Free muscle flaps are a mainstay for reconstruction of distal third leg wounds and for large lower extremity wounds with exposed bone. However a major problem is the significant postoperative flap swelling, which may take months to resolve. We studied the efficacy and safety of immediate application of a vacuum assisted closure (VAC) dressing after a free muscle flap to the lower extremity. Methods Over a 19 months period, all consecutive free muscle flaps for lower extremity reconstruction at a Level I trauma center were evaluated prospectively for postoperative flap thickness, complications and flap survival. Immediate application of a VAC dressing was performed in 9 patients, while the flap was left exposed for monitoring in 8 patients. Results There was no statistically significant difference in flap survival between both cohorts. Mean flap thickness at postoperative day 5 for the VAC group was 6.4±6.4 mm, while flap thickness for the exposed flap group was 29.6±13.5 mm. Flap thickness was significantly decreased at postoperative day 5 for the VAC dressing group. Conclusions Immediate application of VAC dressing following free muscle flaps to the lower extremity does not compromise flap survival or outcomes and results in decreased flap thickness and a better aesthetic outcome.

Study Habits, Locus of Control and Self-Efficacy as Correlates of Academic Achievement among Undergraduate Students of University of Lagos, Nigeria.

Alade Oluwatomi Modupeola,Idowu Rasheed Ajani APEC국제교육협력원 2017 Asia-Pacific Cybereducation Journal Vol.13 No.2

Education is undoubtedly the greatest instrument which man has devised for his own progress. All societies have one form of education or another but the use to which it is put varies. This study investigated study habits, academic locus of control and self-efficacy as correlates of academic achievement among undergraduate students of the University of Lagos, Nigeria. A descriptive research survey was utilised for the study. The sample consisted of 524 undergraduate students selected from five faculties through proportional stratified random sampling technique. Three research questions and corresponding hypotheses were tested at .05 significant level while data were generated using standardized psychological tests which are Internal Control Index (ICI), Self-Efficacy Scale (SES), Study Habit Inventory (SHI) and Cumulative Grade point Average (CGPA) of the participants. Pearson Product Moment Correlation Coefficient Statistics was used to analyse the data. Results obtained showed a significant relationship between study habits, locus of control, self-efficacy and academic achievement among undergraduate students of the University of Lagos, Nigeria. It was recommended that parents, lecturers and the stakeholders on the campus and in the society at large should empower the undergraduate students to match both external and internal locus of control by self-efficacy, competence and effective study habits to achieve their academic goals.

Immediate application of vacuum assisted closure dressing over free muscle flaps in the lower extremity does not compromise flap survival and results in decreased flap thickness

Chim, Harvey,Zoghbi, Yasmina,Nugent, Ajani George,Kassira, Wrood,Askari, Morad,Salgado, Christopher John Korean Society of Plastic and Reconstructive Surge 2018 Archives of Plastic Surgery Vol.45 No.1

Background Free muscle flaps are a mainstay for reconstruction of distal third leg wounds and for large lower extremity wounds with exposed bone. However a major problem is the significant postoperative flap swelling, which may take months to resolve. We studied the efficacy and safety of immediate application of a vacuum assisted closure (VAC) dressing after a free muscle flap to the lower extremity. Methods Over a 19 months period, all consecutive free muscle flaps for lower extremity reconstruction at a Level I trauma center were evaluated prospectively for postoperative flap thickness, complications and flap survival. Immediate application of a VAC dressing was performed in 9 patients, while the flap was left exposed for monitoring in 8 patients. Results There was no statistically significant difference in flap survival between both cohorts. Mean flap thickness at postoperative day 5 for the VAC group was $6.4{\pm}6.4mm$, while flap thickness for the exposed flap group was $29.6{\pm}13.5mm$. Flap thickness was significantly decreased at postoperative day 5 for the VAC dressing group. Conclusions Immediate application of VAC dressing following free muscle flaps to the lower extremity does not compromise flap survival or outcomes and results in decreased flap thickness and a better aesthetic outcome.

Chrysophyllum albidum mucilage as a binding agent in paracetamol tablet formulations

Tolulope O. Ajala,Olufunke D. Akin-Ajani,Chinemerem Ihuoma-Chidi,Oluwatoyin A. Odeku 한국약제학회 2016 Journal of Pharmaceutical Investigation Vol.46 No.6

Chrysophyllum mucilage obtained from the fruit of Chrysophyllum albidum (Family Sapotaceae) has been characterised and evaluated as a binding agent in comparison with methylcellulose in paracetamol tablet formulations. Chrysophyllum mucilage was characterised using elemental and proximate analyses as well as material properties. The Heckel and Kawakita plots were used to assess the compressional properties and the tablet properties were evaluated using tensile strength, friability, disintegration and dissolution times. The results showed the presence of calcium, magnesium, potassium, sodium, manganese, iron, copper, zinc and absence of heavy metals from the mucilage. The mucilage exhibited excellent flow and swelling properties, but poor water solubility. The viscosity of chrysophyllum mucilage increased with decrease in temperature in a similar manner with methylcellulose. C. albidum mucilage when used as a binder in paracetamol tablet formulation induced faster onset of plastic deformation and higher amount of total plastic deformation than methylcellulose. The results of the tablet properties showed that the tensile strength, disintegration and dissolution times, increased with increase in binder concentration while friability decreased. Tablets containing chrysophyllum mucilage as binder also had lower tensile strength, disintegration and dissolution times but higher friability values than those containing methylcellulose. However, tablets containing chrysophyllum mucilage at low concentrations conformed to pharmacopeial standard on disintegration indicating its potential usefulness as binder for immediate release tablets. Thus, C. albidum mucilage could be used as an alternative binding agent in pharmaceutical tablets.

Formulation of floating metronidazole microspheres using cassava starch (Manihot esculenta) as polymer

Oluwatoyin A. Odeku,Aderemi A. Aderogba,Tolulope O. Ajala,Olufunke D. Akin‑Ajani,Adenike Okunlola 한국약제학회 2017 Journal of Pharmaceutical Investigation Vol.47 No.5

Floating gastroretentive microspheres have been used to prolong the gastric residence time after oral administration and improve the local effect of metronidazole in the stomach in the treatment of peptic ulcer caused by Helicobacter pylori. In the present study, cassava starch, obtained from the tubers of Manihot esculenta has been pregelatinized and used as polymer in combination with sodium alginate for the formulation of floating gastroretentive metronidazole microspheres. Metronidazole microspheres were prepared by ionic gelation method using pregelatinized cassava starch and sodium alginate at different concentrations as polymers and calcium chloride (2% w/v) as chelating agent. Sodium bicarbonate (2% w/w) was used as gas releasing agent. Microspheres were characterized using the particle size, swelling index, floating lag time (FLT), total floating time and drug release properties. Spherical discrete microspheres with size ranging from 1.52 to 2.23 mm were obtained with FLT of less than 5 min and drug entrapment efficiency of 42–60% w/w. The microsphere maintained buoyancy for over 19 h and the microspheres provided controlled release of metronidazole for up to 18 h. Drug release from the microspheres, swelling index and buoyancy depended on the concentration of cassava starch in the polymer blend. Formulations containing high concentration of cassava starch showing shorter floating lag time and faster drug release. Thus, buoyancy and rate of drug release appeared to be modulated by the concentration of cassava starch in the polymer blend. The results showed that pregelatinized cassava could be useful in the formulation of floating gastroretentive metronidazole microspheres.

Hemoglobin F level in different hemoglobin variants

Akanni E. Olufemi,Oseni B. Sola,Bamisaye E. Oluwaseyi,Raji A. Ajani,Mewoyeka O. Olusoji,Hassan R. Olubunmi 대한혈액학회 2011 Blood Research Vol.46 No.2

Background :Fetal hemoglobin (HbF) levels in different hemoglobin variants in Osogbo, Nigeria, were estimated using two principal methods of estimation using existing information for HbF concentration and distribution of various hemoglobin variants in the area, as well as diagnosed cases of thalassemia. Two hundred and sixty samples collected from HbSS, HbSC, HbAA, HbAS, and HbAC subjects were analyzed. HbF level and hemoglobin type were determined in this study. Methods :The hemoglobin type was determined using cellulose acetate electrophoresis at an alkaline pH, and HbF was determined by the acid elution and alkaline denaturation methods. Results :The mean±SD of HbF in the respective hemoglobin variants was as follows: HbSS, 2.09±1.94%; HbSC, 0.85±0.54%; HbAA, 0.69±0.46%; HbAS, 0.52±0.31%; and HbAC, 0.57±0.26%. The mean HbF level across the hemoglobin variants was statistically significant (P<0.05). Investigating the sex distribution of the HbF level in the studied population revealed a slightly higher mean HbF level in females than in their male counterparts. Conclusion :Within the study population, the HbF level was found to be highest in HbSS and lowest in HbAS. The two methods of estimating HbF are equally reliable, since there was no significant difference between the results obtained from the two methods.

Exposure-Response Analyses of Ramucirumab from Two Randomized, Phase III Trials of Second-line Treatment for Advanced Gastric or Gastroesophageal Junction Cancer

Tabernero, Josep,Ohtsu, Atsushi,Muro, Kei,Van Cutsem, Eric,Oh, Sang Cheul,Bodoky, Gyorgy,Shimada, Yasuhiro,Hironaka, Shuichi,Ajani, Jaffer A.,Tomasek, Jiri,Safran, Howard,Chandrawansa, Kumari,Hsu, Yan American Association for Cancer Research 2017 Molecular cancer therapeutics Vol.16 No.10

<P>Ramucirumab is an IgG1 monoclonal antibody specific for the vascular endothelial growth factor receptor-2. Ramucirumab, 8 mg/kg every 2 weeks, administered as monotherapy (REGARD) or in combination with paclitaxel (RAINBOW), was safe and effective in patients with previously treated advanced gastric or gastroesophageal junction (GEJ) cancer. We evaluated exposure-efficacy and exposure-safety relationships of ramucirumab from two randomized, placebo-controlled phase III trials. Sparse pharmacokinetic samples were collected, and a population pharmacokinetic analysis was conducted to predict ramucirumab minimumtrough concentration at steady state (C-min,C-ss). Kaplan-Meier methods and Cox proportional hazards models were used to evaluate the ramucirumab exposure (C-min,C-ss)-efficacy relationship to overall survival (OS) and progression-free survival (PFS). Logistic regression analyses were used to evaluate exposure-safety relationships. Analyses included 321 ramucirumab + paclitaxel and 335 placebo + paclitaxel patients from RAINBOW and 72 ramucirumab and 35 placebo patients from REGARD. Exposure-efficacy analysis showed ramucirumab C-min,C-ss was a significant predictor of OS and PFS in both trials. Higher ramucirumab exposure was associated with longer OS and PFS. In RAINBOW, grade >= 3 hypertension, leukopenia, and neutropenia, but not febrile neutropenia, significantly correlated with Cmin, ss, with increased exposure leading to increased incidence. Exploratory exposure-response analyses suggest a positive relationship between efficacy and ramucirumab exposure with manageable toxicities at exposures generated from a dose of 8 mg/kg ramucirumab given every 2 weeks for patients with advanced gastric/GEJ cancer. These findings suggest an opportunity to further optimize benefit versus risk profiles of ramucirumab treatment in patients with gastric/GEJ cancer. (C) 2017 AACR.</P>

Efficacy of Sequential Ipilimumab Monotherapy versus Best Supportive Care for Unresectable Locally Advanced/Metastatic Gastric or Gastroesophageal Junction Cancer

Bang, Yung-Jue,Cho, Jae Yong,Kim, Yeul Hong,Kim, Jin Won,Di Bartolomeo, Maria,Ajani, Jaffer A.,Yamaguchi, Kensei,Balogh, Agnes,Sanchez, Teresa,Moehler, Markus American Association for Cancer Research 2017 Clinical Cancer Research Vol.23 No.19

<P><B>Purpose:</B> Ipilimumab, a monoclonal antibody that blocks cytotoxic T-lymphocyte–associated protein-4 interactions, enhances T-cell activation and promotes tumor immunity. This phase II study evaluated the safety and efficacy of ipilimumab monotherapy versus best supportive care (BSC) among patients with advanced/metastatic gastric or gastroesophageal junction cancer who achieved at least stable disease with first-line chemotherapy.</P><P><B>Experimental Design:</B> Eligible patients were randomized to ipilimumab 10 mg/kg every 3 weeks for four doses, then 10 mg/kg every 12 weeks for up to 3 years, or BSC, which could include continuation of fluoropyrimidine until progression or toxicity. The primary endpoint was immune-related progression-free survival (irPFS); secondary endpoints included PFS by modified World Health Organization criteria and overall survival (OS).</P><P><B>Results:</B> Of 143 patients screened, 57 were randomized to each arm. irPFS with ipilimumab versus BSC was not improved [2.92 months, 95% confidence interval (CI), 1.61–5.16 vs. 4.90 months, 95% CI, 3.45–6.54, HR = 1.44; 80% CI, 1.09–1.91; <I>P</I> = 0.097], resulting in study cessation. At study closeout, which occurred 8 months after the interim analysis, the median OS durations were 12.7 months (95% CI, 10.5–18.9) and 12.1 months (95% CI, 9.3–not estimable), respectively. Grade 3/4 treatment-related adverse events occurred in 23% of ipilimumab-treated patients, in whom diarrhea (9%) and fatigue (5%) were most frequent, and in 9% of active BSC-treated patients.</P><P><B>Conclusions:</B> Although ipilimumab at 10 mg/kg was manageable, it did not improve irPFS versus BSC. However, comparable median OS of approximately 1 year and a favorable safety profile support the investigation of ipilimumab in combination with other therapies for advanced gastric cancer. <I>Clin Cancer Res; 23(19); 5671–8. ©2017 AACR</I>.</P>

Preoperative Therapy Regimen Influences the Incidence and Implication of Nodal Downstaging in Patients with Gastric Cancer

Alexander P. Stark,Mariela M. Blum,Yi-Ju Chiang,Prajnan Das,Bruce D. Minsky,Jeannelyn S. Estrella,Jaffer A. Ajani,Brian D. Badgwell,Paul Mansfield,Naruhiko Ikoma 대한위암학회 2020 Journal of gastric cancer Vol.20 No.3

Purpose: Nodal downstaging after preoperative therapy for gastric cancer has been shown to impart excellent prognosis, but this has not been validated in a national cohort. The role of neoadjuvant chemoradiation (NACR) in nodal downstaging remains unclear when compared with that of neoadjuvant chemotherapy alone (NAC). Furthermore, it is unknown whether the prognostic implications of nodal downstaging differ by preoperative regimen. Materials and Methods: Using the National Cancer Database, overall survival (OS) duration was compared among natural N0 (cN0/ypN0), downstaged N0 (cN+/ypN0), and node-positive (ypN+) gastric cancer patients treated with NACR or NAC. Factors associated with nodal downstaging were examined in a propensity score-matched cohort of cN+ patients, matched 1:1 by receipt of NACR or NAC. Results: Of 7,426 patients (natural N0 [n=1,858, 25.4%], downstaged N0 [n=1,813, 24.4%], node-positive [n=3,755, 50.4%]), 58.2% received NACR, and 41.9% received NAC. The median OS durations of downstaged N0 (5.1 years) and natural N0 (5.6 years) patients were similar to one another and longer than that of node-positive patients (2.1 years) (P<0.001). In the matched cohort of cN+ patients, more recent diagnosis (2010–2015 vs. 2004–2009) (odds ratio [OR], 2.57; P<0.001) and NACR (OR, 2.02; P<0.001) were independently associated with nodal downstaging. The 5-year OS rate of downstaged N0 patients was significantly lower after NACR (46.4%) than after NAC (57.7%) (P=0.003). Conclusions: Downstaged N0 patients have the same prognosis as natural N0 patients. Nodal downstaging occurred more frequently after NACR; however, the survival benefit of nodal downstaging after NACR may be less than that when such is achieved by NAC.