Summary of Study ST001091
This data is available at the NIH Common Fund's National Metabolomics Data Repository (NMDR) website, the Metabolomics Workbench, https://www.metabolomicsworkbench.org, where it has been assigned Project ID PR000730. The data can be accessed directly via it's Project DOI: 10.21228/M89X1C This work is supported by NIH grant, U2C- DK119886.
See: https://www.metabolomicsworkbench.org/about/howtocite.php
This study contains a large results data set and is not available in the mwTab file. It is only available for download via FTP as data file(s) here.
Study ID | ST001091 |
Study Title | Aspirin Metabolomics in Colorectal Cancer Chemoprevention (part 1 - Colon) |
Study Type | Untargeted high-resolution mass spectrometry profiling |
Study Summary | Substantial evidence supports the effectiveness of aspirin for cancer chemoprevention in addition to its well established role in cardiovascular protection. In recent meta-analyses of randomized controlled trials in humans, daily aspirin use reduced incidence, metastasis and mortality from several common types of cancer, especially colorectal cancer. The mechanism(s) by which aspirin exerts an anticancer benefit is uncertain; numerous effects have been described involving both cyclooxygenase-dependent and -independent pathways. The goal of this research is to elucidate the key metabolic changes that are responsible for the anticancer effects of aspirin in humans using untargeted metabolomics analysis. Metabolomics, or global metabolite profiling, is an emerging discipline that has the potential to transform the study of pharmaceutical agents. Our innovative approach will use high-resolution mass spectroscopy to detect thousands of metabolites in blood plasma and normal colon mucosa biopsies that were collected from participants in the Aspirin/Folate Polyp Prevention Study, a randomized, double-blind, placebo-controlled trial of aspirin and/or folic acid supplementation for the prevention of colorectal adenomas. Participants in the trial were assigned with equal probability to three aspirin treatment arms (placebo, 81 mg, or 325 mg daily). Over the three-year treatment period, 81 mg/day of aspirin reduced the risk of adenomas, whereas the 325 mg/day dose had less effect. The aims of the current proposal are to identify metabolomic signatures, including specific metabolites and metabolic pathways, that are associated with aspirin treatment in blood and normal colon mucosal tissue of participants after three years of randomized aspirin treatment; and then to assess the associations of these metabolic signatures with adenoma risk and whether they mediate the reductions in risk due to 81 mg/day aspirin treatment. We will prioritize metabolites for study by evaluating metabolite levels in patients from the placebo and treatment arms while controlling the false discovery rate, use correlation analysis to enhance identification of relevant metabolic modules associated with these prioritized metabolites, and apply pathway mapping with post-hoc application of ion dissociation spectroscopy to representative metabolites to confirm pathway identification. Because aspirin is a multifunctional drug that is thought to modify numerous pathways with potential roles in carcinogenesis, a global discovery-based metabolomics approach is the best way to identify its key activities. The public health significance of this work is substantial because understanding the mechanism of aspirin’s anticancer effects is key to optimizing its use and to the development of novel drugs targeting the metabolic pathways identified. |
Institute | Emory University |
Department | School of Medicine |
Laboratory | Clincal Biomarkers Laboratory |
Last Name | Uppal |
First Name | Karan |
Address | 615 Michael Street, Atlanta, GA, 30322, USA |
kuppal2@emory.edu | |
Phone | (404) 727 5027 |
Submit Date | 2018-09-05 |
Num Groups | 3 |
Total Subjects | 325 |
Num Males | 214 |
Num Females | 111 |
Study Comments | Both pooled colon tissue samples and Clinical Biomarker Laboratory pooled plasma samples were used |
Analysis Type Detail | LC-MS |
Release Date | 2019-09-23 |
Release Version | 1 |
Select appropriate tab below to view additional metadata details:
Project:
Project ID: | PR000730 |
Project DOI: | doi: 10.21228/M89X1C |
Project Title: | Aspirin Metabolomics in Colorectal Cancer Chemoprevention (part 1 - Colon) |
Project Type: | NIH/NCI R01CA188038 |
Project Summary: | Substantial evidence supports the effectiveness of aspirin for cancer chemoprevention in addition to its well established role in cardiovascular protection. In recent meta-analyses of randomized controlled trials in humans, daily aspirin use reduced incidence, metastasis and mortality from several common types of cancer, especially colorectal cancer. The mechanism(s) by which aspirin exerts an anticancer benefit is uncertain; numerous effects have been described involving both cyclooxygenase-dependent and -independent pathways. The goal of this research is to elucidate the key metabolic changes that are responsible for the anticancer effects of aspirin in humans using untargeted metabolomics analysis. Metabolomics, or global metabolite profiling, is an emerging discipline that has the potential to transform the study of pharmaceutical agents. Our innovative approach will use high-resolution mass spectroscopy to detect thousands of metabolites in blood plasma and normal colon mucosa biopsies that were collected from participants in the Aspirin/Folate Polyp Prevention Study, a randomized, double-blind, placebo-controlled trial of aspirin and/or folic acid supplementation for the prevention of colorectal adenomas. Participants in the trial were assigned with equal probability to three aspirin treatment arms (placebo, 81 mg, or 325 mg daily). Over the three-year treatment period, 81 mg/day of aspirin reduced the risk of adenomas, whereas the 325 mg/day dose had less effect. The aims of the current proposal are to identify metabolomic signatures, including specific metabolites and metabolic pathways, that are associated with aspirin treatment in blood and normal colon mucosal tissue of participants after three years of randomized aspirin treatment; and then to assess the associations of these metabolic signatures with adenoma risk and whether they mediate the reductions in risk due to 81 mg/day aspirin treatment. We will prioritize metabolites for study by evaluating metabolite levels in patients from the placebo and treatment arms while controlling the false discovery rate, use correlation analysis to enhance identification of relevant metabolic modules associated with these prioritized metabolites, and apply pathway mapping with post-hoc application of ion dissociation spectroscopy to representative metabolites to confirm pathway identification. Because aspirin is a multifunctional drug that is thought to modify numerous pathways with potential roles in carcinogenesis, a global discovery-based metabolomics approach is the best way to identify its key activities. The public health significance of this work is substantial because understanding the mechanism of aspirin’s anticancer effects is key to optimizing its use and to the development of novel drugs targeting the metabolic pathways identified. |
Institute: | Emory University |
Department: | School of Medicine |
Laboratory: | Clinical Biomarkers Laboratory |
Last Name: | Uppal |
First Name: | Karan |
Address: | 615 Michael Street, Atlanta, GA, 30322, USA |
Email: | kuppal2@emory.edu |
Phone: | (404) 727 5027 |
Funding Source: | NIH/NCI R01CA188038 |
Project Comments: | Requested embargo date: 8/1/2019 |
Contributors: | Dartmouth: Elizabeth Barry Leila Mott John Baron Christopher Amos Michael Passarelli Emory: Dean Jones Veronika Fedirko Karan Uppal Shuzhao Li Douglas Walker Yutong Jin Chunyu Ma |
Subject:
Subject ID: | SU001135 |
Subject Type: | Human |
Subject Species: | Homo sapiens |
Taxonomy ID: | 9606 |
Age Or Age Range: | 25-78 yr |
Gender: | Male and female |
Species Group: | Mammals |
Factors:
Subject type: Human; Subject species: Homo sapiens (Factor headings shown in green)
mb_sample_id | local_sample_id | Aspirin Dosage | Sample.Matrix |
---|---|---|---|
SA073638 | 40023179_2 | ASA 325 | Colon Mucosal Tissue |
SA073639 | 40023368_2 | ASA 325 | Colon Mucosal Tissue |
SA073640 | 40023269_2 | ASA 325 | Colon Mucosal Tissue |
SA073641 | 40023355_1 | ASA 325 | Colon Mucosal Tissue |
SA073642 | 40023369_1 | ASA 325 | Colon Mucosal Tissue |
SA073643 | 40023334_1 | ASA 325 | Colon Mucosal Tissue |
SA073644 | 40023364_2 | ASA 325 | Colon Mucosal Tissue |
SA073645 | 40023332_2 | ASA 325 | Colon Mucosal Tissue |
SA073646 | 40023357_2 | ASA 325 | Colon Mucosal Tissue |
SA073647 | 40023329_1 | ASA 325 | Colon Mucosal Tissue |
SA073648 | 40023293_1 | ASA 325 | Colon Mucosal Tissue |
SA073649 | 40023321_1 | ASA 325 | Colon Mucosal Tissue |
SA073650 | 40023296_1 | ASA 325 | Colon Mucosal Tissue |
SA073651 | 40023308_1 | ASA 325 | Colon Mucosal Tissue |
SA073652 | 40023303_1 | ASA 325 | Colon Mucosal Tissue |
SA073653 | 40023352_2 | ASA 325 | Colon Mucosal Tissue |
SA073654 | 40023317_1 | ASA 325 | Colon Mucosal Tissue |
SA073655 | 40023305_1 | ASA 325 | Colon Mucosal Tissue |
SA073656 | 40023315_1 | ASA 325 | Colon Mucosal Tissue |
SA073657 | 40023348_1 | ASA 325 | Colon Mucosal Tissue |
SA073658 | 40023357_1 | ASA 325 | Colon Mucosal Tissue |
SA073659 | 40023364_1 | ASA 325 | Colon Mucosal Tissue |
SA073660 | 40023203_2 | ASA 325 | Colon Mucosal Tissue |
SA073661 | 40023368_1 | ASA 325 | Colon Mucosal Tissue |
SA073662 | 40023280_2 | ASA 325 | Colon Mucosal Tissue |
SA073663 | 40023358_2 | ASA 325 | Colon Mucosal Tissue |
SA073664 | 40023351_2 | ASA 325 | Colon Mucosal Tissue |
SA073665 | 40023332_1 | ASA 325 | Colon Mucosal Tissue |
SA073666 | 40023352_1 | ASA 325 | Colon Mucosal Tissue |
SA073667 | 40023195_2 | ASA 325 | Colon Mucosal Tissue |
SA073668 | 40023351_1 | ASA 325 | Colon Mucosal Tissue |
SA073669 | 40023358_1 | ASA 325 | Colon Mucosal Tissue |
SA073670 | 40023339_1 | ASA 325 | Colon Mucosal Tissue |
SA073671 | 40023196_2 | ASA 325 | Colon Mucosal Tissue |
SA073672 | 40023185_2 | ASA 325 | Colon Mucosal Tissue |
SA073673 | 40023359_2 | ASA 325 | Colon Mucosal Tissue |
SA073674 | 40023359_1 | ASA 325 | Colon Mucosal Tissue |
SA073675 | 40023294_1 | ASA 325 | Colon Mucosal Tissue |
SA073676 | 40023324_1 | ASA 325 | Colon Mucosal Tissue |
SA073677 | 40023388_2 | ASA 325 | Colon Mucosal Tissue |
SA073678 | 40023395_2 | ASA 325 | Colon Mucosal Tissue |
SA073679 | 40023278_1 | ASA 325 | Colon Mucosal Tissue |
SA073680 | 40023216_2 | ASA 325 | Colon Mucosal Tissue |
SA073681 | 40023222_2 | ASA 325 | Colon Mucosal Tissue |
SA073682 | 40023280_1 | ASA 325 | Colon Mucosal Tissue |
SA073683 | 40023269_1 | ASA 325 | Colon Mucosal Tissue |
SA073684 | 40023238_2 | ASA 325 | Colon Mucosal Tissue |
SA073685 | 40023262_1 | ASA 325 | Colon Mucosal Tissue |
SA073686 | 40023397_2 | ASA 325 | Colon Mucosal Tissue |
SA073687 | 40023231_2 | ASA 325 | Colon Mucosal Tissue |
SA073688 | 40023406_2 | ASA 325 | Colon Mucosal Tissue |
SA073689 | 40023212_2 | ASA 325 | Colon Mucosal Tissue |
SA073690 | 40023275_1 | ASA 325 | Colon Mucosal Tissue |
SA073691 | 40023252_1 | ASA 325 | Colon Mucosal Tissue |
SA073692 | 40023260_1 | ASA 325 | Colon Mucosal Tissue |
SA073693 | 40023265_1 | ASA 325 | Colon Mucosal Tissue |
SA073694 | 40023262_2 | ASA 325 | Colon Mucosal Tissue |
SA073695 | 40023288_1 | ASA 325 | Colon Mucosal Tissue |
SA073696 | 40023394_2 | ASA 325 | Colon Mucosal Tissue |
SA073697 | 40023384_2 | ASA 325 | Colon Mucosal Tissue |
SA073698 | 40023387_2 | ASA 325 | Colon Mucosal Tissue |
SA073699 | 40023278_2 | ASA 325 | Colon Mucosal Tissue |
SA073700 | 40023331_1 | ASA 325 | Colon Mucosal Tissue |
SA073701 | 40023318_1 | ASA 325 | Colon Mucosal Tissue |
SA073702 | 40023326_1 | ASA 325 | Colon Mucosal Tissue |
SA073703 | 40023292_1 | ASA 325 | Colon Mucosal Tissue |
SA073704 | 40023277_1 | ASA 325 | Colon Mucosal Tissue |
SA073705 | 40023291_1 | ASA 325 | Colon Mucosal Tissue |
SA073706 | 40023255_1 | ASA 325 | Colon Mucosal Tissue |
SA073707 | 40023374_2 | ASA 325 | Colon Mucosal Tissue |
SA073708 | 40023391_2 | ASA 325 | Colon Mucosal Tissue |
SA073709 | 40023379_2 | ASA 325 | Colon Mucosal Tissue |
SA073710 | 40023268_1 | ASA 325 | Colon Mucosal Tissue |
SA073711 | 40023267_1 | ASA 325 | Colon Mucosal Tissue |
SA073712 | 40023398_2 | ASA 325 | Colon Mucosal Tissue |
SA073713 | 40023339_2 | ASA 325 | Colon Mucosal Tissue |
SA073714 | 40023288_2 | ASA 325 | Colon Mucosal Tissue |
SA073715 | 40023321_2 | ASA 325 | Colon Mucosal Tissue |
SA073716 | 40023457_1 | ASA 325 | Colon Mucosal Tissue |
SA073717 | 40023449_1 | ASA 325 | Colon Mucosal Tissue |
SA073718 | 40023447_1 | ASA 325 | Colon Mucosal Tissue |
SA073719 | 40023448_1 | ASA 325 | Colon Mucosal Tissue |
SA073720 | 40023192_2 | ASA 325 | Colon Mucosal Tissue |
SA073721 | 40023296_2 | ASA 325 | Colon Mucosal Tissue |
SA073722 | 40023453_1 | ASA 325 | Colon Mucosal Tissue |
SA073723 | 40023452_1 | ASA 325 | Colon Mucosal Tissue |
SA073724 | 40023434_1 | ASA 325 | Colon Mucosal Tissue |
SA073725 | 40023293_2 | ASA 325 | Colon Mucosal Tissue |
SA073726 | 40023431_1 | ASA 325 | Colon Mucosal Tissue |
SA073727 | 40023415_1 | ASA 325 | Colon Mucosal Tissue |
SA073728 | 40023190_2 | ASA 325 | Colon Mucosal Tissue |
SA073729 | 40023197_2 | ASA 325 | Colon Mucosal Tissue |
SA073730 | 40023425_1 | ASA 325 | Colon Mucosal Tissue |
SA073731 | 40023445_1 | ASA 325 | Colon Mucosal Tissue |
SA073732 | 40023417_1 | ASA 325 | Colon Mucosal Tissue |
SA073733 | 40023171_2 | ASA 325 | Colon Mucosal Tissue |
SA073734 | 40023294_2 | ASA 325 | Colon Mucosal Tissue |
SA073735 | 40023144_2 | ASA 325 | Colon Mucosal Tissue |
SA073736 | 40023160_2 | ASA 325 | Colon Mucosal Tissue |
SA073737 | 40023145_2 | ASA 325 | Colon Mucosal Tissue |
Collection:
Collection ID: | CO001129 |
Collection Summary: | Fresh frozen normal colon mucosal tissue samples were collected from participants in the Aspirin/Folate Polyp Prevention Study [1, 2] at the year three (end of treatment) colonoscopy. After the endoscope was advanced to the cecum, biopsy specimens were obtained from the mid-ascending colon (5 cm above the ileocecal valve). Immediately after the biopsies were taken, they were removed from the forceps, placed into 1.8 ml freezer tubes and immersed in liquid nitrogen or a dry ice/ethanol slurry until storage in a -70C freezer. The specimens were shipped on dry ice from the clinical centers to the Dartmouth biorepository storage facility and subsequently to the metabolomics analysis lab at Emory University. In addition, a colon tissue reference was generated using normal colon tissue removed at surgery from an anonymous donor. References 1. Baron JA, Cole BF, Sandler RS, et al. A randomized trial of aspirin to prevent colorectal adenomas. The New England journal of medicine. 2003;348(10):891-9. 2. Cole BF, Baron JA, Sandler RS, et al. Folic acid for the prevention of colorectal adenomas: a randomized clinical trial. JAMA : the journal of the American Medical Association. 2007;297(21):2351-9. |
Sample Type: | Colon mucosal tissue |
Storage Conditions: | Described in summary |
Treatment:
Treatment ID: | TR001149 |
Treatment Summary: | Samples were received frozen in aliquouts of <250uL. Prior to analysis, samples were thawed and prepared for HRM analysis using the standard protocols described in the Sample Preparation section. |
Sample Preparation:
Sampleprep ID: | SP001142 |
Sampleprep Summary: | Samples were prepared for metabolomics analysis using established methods(Johnson et al. (2010). Analyst; Go et al. (2015). Tox Sci). Prior to analysis, plasma aliquots were removed from storage at -80 degrees C and thawed on ice. Each cryotube was then vortexed briefly to ensure homogeneity, and 50 microliters was transferred to a clean microfuge tube. Immediately after, the samples were treated with 200 microliters of ice-cold LC-MS grade acetonitrile (Sigma Aldrich) containing 5 microliters of internal standard solution with eight stable isotopic chemicals selected to cover a range of chemical properties. Following addition of acetonitrile, samples were homogenized for a few seconds using an Active Motif EpiShear probe sonicator and equilibrated for 30 min on ice, upon which precipitated proteins were removed by centrifuge (14,000 rpm at 4 degrees C for 10 min). The resulting supernatant (100 microliters) was removed, added to a low volume autosampler vial and maintained at 4 degrees C until analysis (<22 h). |
Sampleprep Protocol ID: | HRM_SP_082016_01 |
Sampleprep Protocol Filename: | EmoryUniversity_HRM_sample_preparation_082016_01 |
Sampleprep Protocol Comments: | Date effective: 30 July 2016 |
Extraction Method: | 2:1 acetonitrile: sample followed by vortexing and centrifugation |
Combined analysis:
Analysis ID | AN001776 | AN001777 |
---|---|---|
Analysis type | MS | MS |
Chromatography type | HILIC | Reversed phase |
Chromatography system | Thermo Dionex Ultimate 3000 | Thermo Dionex Ultimate 3000 |
Column | Waters XBridge Amide (50 x 2.1mm,2.5um) | Thermo Higgins C18 (50 x 2.1mm,3um) |
MS Type | ESI | ESI |
MS instrument type | Orbitrap | Orbitrap |
MS instrument name | Thermo Fusion Tribrid Orbitrap | Thermo Fusion Tribrid Orbitrap |
Ion Mode | POSITIVE | NEGATIVE |
Units | Peak area | Peak area |
Chromatography:
Chromatography ID: | CH001255 |
Chromatography Summary: | The HILIC column is operated parallel to reverse phase column for simultaneous analytical separation and column flushing through the use of a dual head HPLC pump equipped with 10-port and 6-port switching valves. During operation of "HILIC separation method, the MS is operated in positive ion mode and 10" microliters of sample is injected onto the HILIC column while the reverse phase column is flushing with wash solution. Flow rate is maintained at 0.35 mL/min "until 1.5 min, increased to 0.4 mL/min at 4 min and held for 1 min. Solvent A is" "100% LC-MS grade water, solvent B is 100% LC-MS grade acetonitrile and solvent C" is 2% formic acid (v/v) in LC-MS grade water. Initial mobile phase conditions "are 22.5% A, 75% B, 2.5% C hold for 1.5 min, with linear gradient to 77.5% A," "20% B, 2.5% C at 4 min, hold for 1 min, resulting in a total analytical run time" "of 5 min. During the flushing phase (reverse phase analytical separation), the" "HILIC column is equilibrated with a wash solution of 77.5% A, 20% B, 2.5% C." |
Methods ID: | 2% formic acid in LC-MS grade water |
Methods Filename: | 20160920_posHILIC120kres5min_ESI_c18negwash.meth |
Chromatography Comments: | Triplicate injections for each chromatography mode |
Instrument Name: | Thermo Dionex Ultimate 3000 |
Column Name: | Waters XBridge Amide (50 x 2.1mm,2.5um) |
Column Temperature: | 60C |
Flow Gradient: | A= water, B= acetontrile, C= 2% formic acid in water; 22.5% A, 75% B, 2.5% C hold for 1.5 min, linear gradient to 77.5% A, 20% B, 2.5% C at 4 min, hold for 1 min |
Flow Rate: | 0.35 mL/min for 1.5 min; linear increase to 0.4 mL/min at 4 min, hold for 1 min |
Sample Injection: | 10 uL |
Solvent A: | 100% water |
Solvent B: | 100% acetonitrile |
Analytical Time: | 5 min |
Sample Loop Size: | 15 uL |
Sample Syringe Size: | 100 uL |
Chromatography Type: | HILIC |
Chromatography ID: | CH001256 |
Chromatography Summary: | The C18 column is operated parallel to the HILIC column for simultaneous analytical separation and column flushing through the use of a dual head HPLC pump equipped with 10-port and 6- port switching valves. During operation of the "C18 method, the MS is operated in negative ion mode and 10 μL of sample is" injected onto the C18 column while the HILIC column is flushing with wash "solution. Flow rate is maintained at 0.4 mL/min until 1.5 min, increased to 0.5" "mL/min at 2 min and held for 3 min. Solvent A is 100% LC-MS grade water, solvent" B is 100% LC-MS grade acetonitrile and solvent C is 10mM ammonium acetate in "LC-MS grade water. Initial mobile phase conditions are 60% A, 35% B, 5% C hold" "for 0.5 min, with linear gradient to 0% A, 95% B, 5% C at 1.5 min, hold for 3.5" "min, resulting in a total analytical run time of 5 min. During the flushing" "phase (HILIC analytical separation), the C18 column is equilibrated with a wash" "solution of 0% A, 95% B, 5% C until 2.5 min, followed by an equilibration" "solution of 60% A, 35% B, 5% C for 2.5 min." |
Methods ID: | 10mM ammonium acetate in LC-MS grade water |
Methods Filename: | 20160920_negC18120kres5min_ESI_HILICposwash.meth |
Instrument Name: | Thermo Dionex Ultimate 3000 |
Column Name: | Thermo Higgins C18 (50 x 2.1mm,3um) |
Column Temperature: | 60C |
Flow Rate: | 0.4 mL/min for 1.5 min; linear increase to 0.5 mL/min at 2 min held for 3 min |
Sample Injection: | 10 uL |
Solvent A: | 100% water |
Solvent B: | 100% acetonitrile |
Analytical Time: | 5 min |
Sample Loop Size: | 15 uL |
Sample Syringe Size: | 100 uL |
Chromatography Type: | Reversed phase |
MS:
MS ID: | MS001641 |
Analysis ID: | AN001776 |
Instrument Name: | Thermo Fusion Tribrid Orbitrap |
Instrument Type: | Orbitrap |
MS Type: | ESI |
Ion Mode: | POSITIVE |
Capillary Temperature: | 250C |
Collision Gas: | N2 |
Dry Gas Flow: | 45 |
Dry Gas Temp: | 150C |
Mass Accuracy: | < 3ppm |
Spray Voltage: | 3500 |
Activation Parameter: | 5.00E+05 |
Activation Time: | 118ms |
Interface Voltage: | S-Lens RF level= 55 |
Resolution Setting: | 120000 |
Scanning Range: | 85-1275 |
Analysis Protocol File: | EmoryUniversity_HRM_Fusion-MS_092017_v1.pdf |
MS ID: | MS001642 |
Analysis ID: | AN001777 |
Instrument Name: | Thermo Fusion Tribrid Orbitrap |
Instrument Type: | Orbitrap |
MS Type: | ESI |
Ion Mode: | NEGATIVE |
Capillary Temperature: | 250C |
Collision Gas: | N2 |
Dry Gas Flow: | 45 |
Dry Gas Temp: | 150C |
Mass Accuracy: | < 3ppm |
Spray Voltage: | -4000 |
Activation Parameter: | 5.00E+05 |
Activation Time: | 118ms |
Interface Voltage: | S-Lens RF level= 55 |
Resolution Setting: | 120000 |
Scanning Range: | 85-1275 |
Analysis Protocol File: | EmoryUniversity_HRM_Fusion-MS_092017_v1.pdf |