PubMed Health⌕ Search

Biomedical subjects

William Kelly

Publications and source records attributed to William Kelly.

7 recordsLinked to original sources
PubMed2025

A Prospective Validation of the Decipher Genomic Classifier in Men With Early Localized Prostate Cancer: The VANDAAM Study.

BACKGROUND: The emergence of genomic precision oncology has advanced personalized care for some patients with prostate cancer (PCa), while threatening to widen existing disparities due to the historically low recruitment of African American men (AAM), who have the highest disease burden. Here, we report the first prospective validation of a genomic classifier (GC) to predict rapid-onset biochemical recurrence (BCR) in AAM. METHODS: Between 2016 and 2021, this multicenter prospective validation study recruited 243 patients with low- or intermediate-risk PCa who received treatment for their disease. Patients were recruited on a 1:1 basis (AAM:White) and matched by CAPRA score. Patients who elected active surveillance were ineligible for participation. Decipher GC testing was ordered for all patients using their biopsy and/or radical prostatectomy (RP) tumor tissue. The primary outcome was to determine whether the GC could predict 2-year BCR rates-used as a surrogate for disease aggressiveness-following standard treatment. The secondary outcome evaluated the concordance between biopsy- and RP-derived GC risk scores for treatment recommendations. RESULTS: The final analytical cohort included 226 matched patients with genomic information, and 207 evaluable cases (104 AAM, 103 White) with both genomic and complete clinical outcome data. Overall, a high genomic-risk GC score was associated with a 5.25-fold increase in the odds of rapid-onset 2-year BCR compared with the low-risk group (odds ratio, 5.25 [95% CI, 1.27-21.66]; P=.021). In a subset of the surgical cohort (n=74), biopsy- and RP-derived GC scores exhibited a 77% concordance rate, defined as no reclassification in GC risk-based categories. CONCLUSIONS: This study represents the first prospective validation of GC performance in predicting early 2-year BCR in both AAM and White men. The findings provide strong evidence supporting the integration of the GC into clinical practice guidelines to improve risk stratification and management of AAM with early-stage PCa. CLINICALTRIALS: gov identifier: NCT02723734.

Aged↗
PubMed2007

Human skin-color sexual dimorphism: a test of the sexual selection hypothesis.

Applied to skin color, the sexual selection hypothesis proposes that male preference for light-skinned females explains the presence of light skin in areas of low solar radiation. According to this proposal, in areas of high solar radiation, natural selection for dark skin overrides the universal preference of males for light females. But in areas in which natural selection ceases to act, sexual selection becomes more important, and causes human populations to become light-skinned, and females to be lighter than males. The sexual selection hypothesis proposes that human sexual dimorphism of skin color should be positively correlated with distance from the equator. We tested the prediction that sexual dimorphism should increase with increasing latitude, using adult-only data sets derived from measurements with standard reflectance spectrophotometric devices. Our analysis failed to support the prediction of a positive correlation between increasing distance from the equator and increased sexual dimorphism. We found no evidence in support of the sexual selection hypothesis.

Female↗
PubMed2005

Multiple dose pharmacokinetics of caffeine administered in chewing gum to normal healthy volunteers.

UNLABELLED: The purpose of this study was to examine the pharmacokinetics of three doses of caffeine administered as Stay Alert chewing gum in a multiple dose regimen. METHODS: A double-blind, parallel randomized, four-treatment study design was employed. The treatment groups were: 50, 100 and 200 mg caffeine and placebo. Subjects were 48 (n = 12 per group), healthy, non-smoking, males and females who had abstained from caffeine ingestion for at least 20 h prior to dosing, who were randomly assigned to the treatment groups. Caffeine was administered at 2,400, 0200 and 0400 h depending on the treatment group. Blood samples were collected pre-dose and at 5, 15, 30, 45, 60, 75, 90 and 105 min after each caffeine dose. Samples were also collected at 7.5, 8.5 and 18 h after the last dose of caffeine. Plasma caffeine levels were analysed by a validated UV-HPLC method. RESULT: The mean T(max) after the third dosing ranged from 0.37 to 1.12 h. C(max) for 50, 100 and 200 mg was 2.69, 3.45 and 6.33 mg/l, respectively. AUC(inf) for 50, 100 and 200 mg group was 33.2, 46.94 and 86.94 mg/l * h, respectively. AUC(inf) values suggested a dose proportionate increase. Dose normalized C(max) and AUC(0-tau) values across doses were not significantly different, suggesting linearity was maintained after multiple doses of the Stay Alert chewing gum. There were no group related differences in elimination. CONCLUSIONS: The results suggest that caffeine administered in the gum formulation (Stay Alert chewing gum) via a multiple dosing regimen provides an effective and convenient means of maintaining effective concentrations of caffeine that would in some operational scenarios be desirable for maintaining alertness and performance in sleep deprived individuals.

Absorption↗
PubMed2004

Health promotion and health education about diabetes mellitus.

Diabetes mellitus, especially if poorly controlled, is a major contributory cause for blindness, heart attacks, amputations, strokes, kidney failure and impotence. The prevalence of diabetes is increasing globally. Fortunately there is compelling evidence from clinical trials that lifestyle modifications and education can minimise the risk of diabetes, and new treatments can reduce the burden of morbidity and mortality. We now have modified insulin, infusion pumps, dialysis, kidney and pancreas transplants, and effective therapies for reducing lipids and blood pressure. However, important as these advances are, diabetes and its complications can be prevented, or delayed, by modifying risk factors. Persons with diabetes must understand their disease and be empowered to avoid obesity, smoking and unhealthy diets, and encouraged to exercise, and control blood glucose. Good health education, health promotion and access to professional care are essential for persons with diabetes mellitus. Valuable health information is available from Diabetes UK and the Internet.

Diabetes Complications↗
PubMedDate not supplied

Pay for performance: an excellent idea that simply needs implementation.

Pay for performance cannot consist of a one-size-fits-all approach. Variation in quality and cost of care is best measured using a single "value" (quality/cost) score that is decomposed into component cost and quality for every health care encounter type. Economic incentives must be enough to focus the provider's attention on each score part. Tools exist that improve the overall "value" of health care. We need agreement on an overall pay for performance approach together with a toolbox (not an approved list) of scientifically validated tools that payers, providers, and consumers can choose to build the incentives needed for pay for performance.

Cost Control↗