26
|
Moya B, Huang C, Kjarsgaard M, Martín-Arriscado C, Nair P. Exhaled Breath Temperature Is Not Helpful for Identifying Cellular Bronchitis in Severe Asthma. J Investig Allergol Clin Immunol 2023; 33:314-316. [PMID: 36193746 DOI: 10.18176/jiaci.0862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
|
27
|
Carter-Searjeant S, Fairclough SM, Haigh SJ, Zou Y, Curry RJ, Taylor PN, Huang C, Fleck R, Machado P, Kirkland AI, Green MA. Nanoscale LiZnN - Luminescent Half-Heusler Quantum Dots. ACS APPLIED OPTICAL MATERIALS 2023; 1:1169-1173. [PMID: 37384133 PMCID: PMC10294247 DOI: 10.1021/acsaom.3c00065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 06/30/2023]
Abstract
Colloidal semiconductor quantum dots are a well-established technology, with numerous materials available either commercially or through the vast body of literature. The prevalent materials are cadmium-based and are unlikely to find general acceptance in most applications. While the III-V family of materials is a likely substitute, issues remain about its long-term suitability, and other earth-abundant materials are being explored. In this report, we highlight a nanoscale half-Heusler semiconductor, LiZnN, composed of readily available elements as a potential alternative system to luminescent II-VI and III-V nanoparticle quantum dots.
Collapse
|
28
|
Wang YK, Huang C. [Establishment and clinical practice of the global diagnostic and theraputic concept of dental esthetic restoration]. ZHONGHUA KOU QIANG YI XUE ZA ZHI = ZHONGHUA KOUQIANG YIXUE ZAZHI = CHINESE JOURNAL OF STOMATOLOGY 2023; 58:393-397. [PMID: 37082840 DOI: 10.3760/cma.j.cn112144-20230213-00043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Dental esthetic restoration covers from facial esthetics to dental esthetics, from the realization of macroscopic to microscopic esthetic restoration goals. As an esthetic restorative dentist, he has to face and solve the increasingly high diagnosis and treatment needs of patients, the increasingly standardized needs of the dental industry, and the need for oral health to become an important part of the Healthy China strategy. Dentists engaged in esthetic restoration field should establish a concept and practice system of global esthetic restoration centered on esthetic diagnosis, interdisciplinary esthetic restoration as a means, and characterized by fine microscopic restoration. Dental esthetic restoration dentists should be the designer of esthetic restoration plans and treatment plans, as well as the implementers of the final esthetic effect. Dentists should accurately grasp the global diagnosis concept and practice system of esthetic restoration, and provide standardized and high-quality oral diagnosis and treatment services for more patients.
Collapse
|
29
|
Huang C, Zhang W, Chen X, Xu X, Qiu J, Pan Z. Fibrinogen is an independent preoperative predictor of hospital length of stay among patients undergoing coronary artery bypass grafting. J Cardiothorac Surg 2023; 18:112. [PMID: 37029421 PMCID: PMC10082530 DOI: 10.1186/s13019-023-02238-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/02/2023] [Indexed: 04/09/2023] Open
Abstract
OBJECTIVE This study aims to examine the impact of preoperative fibrinogen concentration on the short-term outcomes and hospital length of stay (LOS) of patients undergoing Coronary Artery Bypass Grafting (CABG). METHODS Between January 2010 and June 2022, a retrospective analysis comprised 633 patients who sequentially received isolated, primary CABG. These patients were categorized into normal fibrinogen group (fibrinogen < 3.5 g/L) and high fibrinogen group (fibrinogen ≥ 3.5 g/L) according to preoperative fibrinogen concentration. The primary outcome was LOS. To correct for confounding and investigate the effect of preoperative fibrinogen concentration on the short-term outcomes and LOS, we employed propensity score matching (PSM). The correlation between fibriongen concentration and LOS in subgroups was examined using subgroup analysis. RESULTS We categorized 344 and 289 patients in the "normal fibrinogen group" and "high fibrinogen group", respectively. After PSM, compared to the normal fibrinogen group, the high fibrinogen group had a longer LOS [12.00 (9.00-15.00) vs. 13.00 (10.00-16.00), P = 0.028] and higher incidence of postoperative renal impairment [49 (22.1%) vs. 72 (32.4%), P = 0.014]. Cardiopulmonary bypass (CPB) or non-CPB CABG patients showed similar correlations between various fibrinogen concentrations and LOS, according to subgroup analyses. CONCLUSIONS Fibrinogen is an independent preoperative predictor of both the LOS and the postoperative renal impairment that occurs after CABG. Patients with high preoperative fibrinogen concentration had a higher incidence of postoperative renal impairment and a longer LOS, emphasizing the significance of preoperative fibrinogen management.
Collapse
|
30
|
Huang C. Effect of new cardiac rehabilitation mode on cardiac function, mental state and quality of life of postoperative patients with acute myocardial infarction treated with atorvastatin calcium tablet. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2023; 27:3406-3419. [PMID: 37140290 DOI: 10.26355/eurrev_202304_32111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE The purpose of this study was to explore the effect of a new cardiac rehabilitation mode on the cardiac function, mental state and quality of life of patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) with atorvastatin calcium tablets. PATIENTS AND METHODS A total of 120 AMI patients treated with PCI and atorvastatin calcium tablets between January 2018 and January 2019 were recruited and assigned 1:1 to receive either novel cardiac rehabilitation (experimental group) or conventional cardiac rehabilitation (control group), with 60 cases in each group. Outcome measures for evaluating the effectiveness of the novel cardiac rehabilitation mode included cardiac function indices, 6 minutes walking distance test (6MWD), adverse mental state, quality of life (QOL), incidence of complications, and satisfaction on recovery. RESULTS Patients after novel cardiac rehabilitation care showed better cardiac function than those with conventional care (p<0.001). Patients had longer 6MWD and higher QOL after novel cardiac rehabilitation care vs. those given conventional care (p<0.001). The lower scores of adverse mental state in the experimental group suggested a better psychological status of patients after receiving novel cardiac rehabilitation care when compared with those with conventional care (p<0.001). Patients were also more satisfied with the novel modality of cardiac rehabilitation care than with conventional care (p<0.05). CONCLUSIONS The new cardiac rehabilitation mode can effectively improve the cardiac function of AMI patients after PCI plus atorvastatin calcium tablets, enhance their cardiac function, mitigate their negative emotions, and reduce the risk of complications. Further trials are required prior to clinical promotion.
Collapse
|
31
|
Huang C, Sanaei F, Verdurmen WPR, Yang F, Ji W, Walboomers XF. The Application of Organs-on-a-Chip in Dental, Oral, and Craniofacial Research. J Dent Res 2023; 102:364-375. [PMID: 36726271 PMCID: PMC10031637 DOI: 10.1177/00220345221145555] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The current development of microfluidics-based microphysiological systems (MPSs) will rapidly lead to a paradigm shift from traditional static 2-dimensional cell cultivation towards organized tissue culture within a dynamic cellular milieu. Especially organs-on-a-chip (OoCs) can very precisely re-create the mechanical and unique anatomical structures of the oral environment. This review provides an introduction to such technology, from commonly used chip materials and fabrication methods to the application of OoC in in vitro culture. OoCs are advantageous because of their small-scaled culture environment, the highly controlled dynamic experimental conditions, and the likeness to the in vivo structure. We specifically focus on current chip designs in dental, oral, and craniofacial (DOC) research. Also, future perspectives are discussed, like model standardization and the development of integrated platforms with advanced read-out functionality. By doing so, it will be possible for OoCs to serve as an alternative for animal testing and to develop highly predictive human models for clinical experiments and even personalized medicine.
Collapse
|
32
|
Zhang JT, Qi WT, Zhou YZ, Huang C, Zhao JL, Li MT, Zeng XF. [Clinical characteristics of 37 antiphospholipid syndrome patients complicated by autoimmune hemolytic anemia]. ZHONGHUA NEI KE ZA ZHI 2023; 62:147-155. [PMID: 36740405 DOI: 10.3760/cma.j.cn112138-20220429-00325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: We sought to investigate the clinical characteristics and risk factors of antiphospholipid syndrome (APS) complicated by autoimmune hemolytic anemia (AIHA). Methods: Retrospective anaysis.Three hundred fifteen consecutive patients with APS were enrolled at the Department of Rheumatology of Peking Union Medical College Hospital between May 2017 to May 2021, and their clinical manifestations[including initial symptoms, time interval between APS onset and diagnosis, systemic lupus erythematosus(SLE), thrombotic events, obstetric morbidity, and extra-criteria manifestations] and laboratory test results[including blood routine, antiphospholipid antibodies(aPLs), blood lipid profile, homocysteine, anti-nuclear antibody profile, immunoglobulin levels, and complement levels] were collected. Then, univariate and multivariate logistic regression analyses were performed. Clinical features and risk factors were analyzed using univariable and multivariable logistic regression analysis. Results: Among 315 APS patients, 37 cases (11.7%) were complicated by AIHA, and AIHA was the first manifestation or co-occurrence. The median time interval between APS onset and diagnosis was 12 months. The proportion of SLE in APS patients combined with AIHA was higher than that in APS patients without AIHA[62.2%(23/37) vs. 19.4%(54/278), P<0.001]. There was no significant difference in the proportions of thrombosis and pregnancy morbidity between the two groups. In terms of extra-criteria manifestations, APS patients with AIHA had a significantly (P<0.05) greater risk of thrombocytopenia (OR=6.19, 95%CI 2.81-13.65) and higher proportions of hypocomplementemia, a positive lupus anticoagulant (LA) result, double aPLs positivity[i.e., any two of the following antibodies were positive: LA, anticardilolipin antibody(aCL), and anti-β2 glycoprotein Ⅰ(β2GPⅠ)], and triple aPLs positivity (i.e., LA, aCL, and anti-β2GPⅠ antibodies were all positive). Multivariate logistic regression analysis showed that SLE (OR=3.46,95%CI 1.60-7.48), thrombocytopenia (OR=2.56,95%CI 1.15-5.67), and hypocomplementemia (OR=4.29,95%CI 2.03-9.04) were independent risk factors for the complication of APS. In the primary APS subgroup, multivariate logistic regression analysis showed that livedo reticularis (OR=10.51,95%CI 1.06-103.78), thrombocytopenia (OR=3.77, 95%CI 1.23-11.57), and hypocomplementemia (OR=5.92,95%CI 1.95-17.95) were independent risk factors for the complication of APS. Conclusions: AIHA is not rare in APS patients; moreover, it occurs more frequently in APS secondary to SLE and is more likely to present with a variety of extra-criteria manifestations. Patients with AIHA should be promptly tested for antiphospholipid antibody profiles and alerted to the possibility of thrombotic events.
Collapse
|
33
|
Luo GX, Lu YF, Huang C. [Role of functional hydrogel in promoting wound healing]. ZHONGHUA SHAO SHANG YU CHUANG MIAN XIU FU ZA ZHI 2023; 39:9-14. [PMID: 36740421 DOI: 10.3760/cma.j.cn501225-20221123-00503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cutaneous wounds are one of the commonest clinical diseases. At present, there are still many challenges in how to repair wounds quickly with high quality. With the rapid development and cross-integration of materials science and biomedicine, hydrogels that can integrate various excellent properties through flexible structural modification and combination of different functional components are widely applied in wound management and research. This paper attempted to summarize the role of hydrogel in promoting wound repair from the respects of matrix materials, special structures, and diverse functions of hydrogel.
Collapse
|
34
|
Chou F, Buchanan M, McDonald M, Westwood M, Huang C. Narrative Themes of Chinese Canadian Intergenerational Trauma: Parental Experiences. COUNSELLING PSYCHOLOGY QUARTERLY 2023. [DOI: 10.1080/09515070.2022.2160431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
35
|
Huang C, Zhang B, Xu D. The effects of natural active substances in food on the toxicity of patulin. WORLD MYCOTOXIN J 2022. [DOI: 10.3920/wmj2022.2794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Patulin (PAT) is a mycotoxin, a secondary metabolite mainly produced by fungi of the genera Aspergillus, Byssochlamys, and Penicillium. Many studies have looked into the potential impacts of this mycotoxin due to its high risk. Researchers are currently doing a more in-depth investigation of and employing physical, chemical, and biological ways to remove PAT. However, existing technology cannot completely remove it, and the residual PAT will continue to pose a threat to human health. As a result, substances capable of reducing PAT toxicity need be discovered. According to previous studies, natural components in food could reduce the toxicity of PAT. This article will review the different types of active compounds and discus the detoxification processes, as well as give recommendations for decreasing the toxicity of PAT and future research directions.
Collapse
|
36
|
Cicala C, Vimopatranon S, Goes L, Jiang A, Huang C, Huang D, Yolitz J, Wei D, Virtaneva K, Martens C, Soares M, Fauci A, Arthos J. PP 4.13 – 00151 Soluble Factors Drive Naïve CD4+ T Cells to Differentiate into CCR5 + Tissue Resident Memory Cells that are Highly Susceptible to HIV infection. J Virus Erad 2022. [DOI: 10.1016/j.jve.2022.100221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
37
|
Huang C, Zhu H. Functional hybrid factor regression model for handling heterogeneity in imaging studies. Biometrika 2022; 109:1133-1148. [PMID: 36531154 PMCID: PMC9754099 DOI: 10.1093/biomet/asac007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
This paper develops a functional hybrid factor regression modelling framework to handle the heterogeneity of many large-scale imaging studies, such as the Alzheimer's disease neuroimaging initiative study. Despite the numerous successes of those imaging studies, such heterogeneity may be caused by the differences in study environment, population, design, protocols or other hidden factors, and it has posed major challenges in integrative analysis of imaging data collected from multicentres or multistudies. We propose both estimation and inference procedures for estimating unknown parameters and detecting unknown factors under our new model. The asymptotic properties of both estimation and inference procedures are systematically investigated. The finite-sample performance of our proposed procedures is assessed by using Monte Carlo simulations and a real data example on hippocampal surface data from the Alzheimer's disease study.
Collapse
|
38
|
Dudzinski S, Huang C, Wang J, Tendulkar R. Effects of the Virtual Match Process on Radiation Oncology Applicants' Interview Experience and their Approach to the Match. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
39
|
Vasudevan V, Shen L, Huang C, Chuang C, Islam M, Ren H, Yang Y, Dong P, Xing L. Neural Representation for Three-Dimensional Dose Distribution and its Applications in Precision Radiation Therapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
40
|
Chong SY, Wang X, Van Bloois L, Huang C, Yu X, Sayed N, Zhang S, Ting HJ, Thiam CH, Lim SY, Lim HY, Zharkova O, Angeli V, Storm G, Wang JW. Liposomal docosahexaenoic acid halts atherosclerosis progression. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atherosclerosis is the main cause underlying cardiovascular disease (CVD). Docosahexaenoic acid (DHA, 22:6n-3) is a hydrophobic polyunsaturated fatty acid that exerts anti-inflammatory and antioxidant activities. However, the beneficial effects of DHA on CVD have been controversial likely due to variations in bioavailability after oral intake.
Purpose
In this study, we aim to investigate the potential inhibiting properties of liposomal DHA on atherosclerosis progression upon intravenous administration.
Methods
Four weeks old ApoE−/− and LDLr−/− mice were fed on athero-inducing high fat diet for 4 weeks and then randomly divided into two groups. The mice received either control liposomes (control group) or liposomes containing DHA (liposomal DHA treatment group) via intravenous injection, twice a week for 8 weeks while still being fed on high fat diet. At the experiment endpoint, whole aortas were collected for Oil Red O staining to quantify plaque area or for biochemical analysis. Plasma was collected for total cholesterol measurement and lipidomic analysis. Aortic roots were used for histological analysis.
Results
Upon intravenous injection, as shown by IVIS imaging, DHA-containing liposomes accumulated preferentially in the atherosclerotic plaques. Compared to control liposomes, liposomal DHA treatment reduced the atherosclerotic plaque area in both atherosclerosis animal models, with the total plaque area decreased by 35.8% in ApoE−/− mice, (p<0.001) and by 22.4% in LDLr−/− mice (p<0.05). Plaque composition analysis revealed that liposomal DHA treatment increased collagen content and reduced the number of macrophages and neutral lipid within the plaques, resulting in a lower plaque vulnerability index (1.095 for liposomal DHA treated group vs. 1.692 for control group, p<0.05). Among those plaque macrophages, as demonstrated by immunohistology, M2 (anti-inflammatory) macrophages accounted for 4.44% in liposomal DHA treated mice and 2.24% in control liposomes treated mice (p<0.05). In agreement with the histology results, higher mRNA expression levels of anti-inflammatory markers (IL-10, CD206 and CD163) and collagen type 1 were determined in aortic tissue after liposomal DHA treatment. Moreover, liposomal DHA did not change total cholesterol level in the blood but significantly lowered plasma levels of several species of triglycerides. In vitro experiment with bone marrow derived macrophages showed that liposomal DHA was able to suppress lipopolysaccharide-induced inflammatory response and oxidative stress.
Conclusions
Our findings demonstrate that incorporation of DHA in injectable liposomes is an effective way to increase the inhibitory effects of DHA on halting the progression of atherosclerosis via lowering circulating triglycerides, reducing plaque inflammation, and enhancing plaque stability. Intravenous administration of liposomal DHA may become an efficacious strategy for the treatment of atherosclerosis.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): NUSMed Seed Fund
Collapse
|
41
|
Huang C, Mezger STP, Looi WD, Muralidharan S, Ji S, Pastor BC, Tan SH, Charles CJ, Kofidis T, Richard AM, Chan MY, Torta FT, Heeren RMA, Bonney GK, Wang JW. Spatial-temporal lipidomics profile of acute myocardial injury. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Lipidome disturbance has long been recognized to occur after myocardial infarction (MI). Accumulation of excessive fatty acids induces production of reactive oxygen species and consequently deteriorates cardiac injury in MI. However, the spatial and temporal lipid profile in the heart following ischemic injury remains unknown.
Purpose
We aim to uncover the temporal-spatial lipidome profile of the heart following ischemia reperfusion (I/R) injury and identify circulating lipids released from injured myocardium that are potentially useful for diagnosis of ischemic heart disease.
Methods
C57/BL6 mice were subjected to 30 min myocardial ischemia followed by removal of the ligature to establish reperfusion injury. Porcine I/R injury was induced by 105 min myocardial ischemia followed by reperfusion. Human plasma was obtained from 143 post-MI patients. Myocardial lipid profiles were generated by matrix-assisted laser desorption/ionization (MALDI) mass spectrometry imaging (MALDI-MSI) in different regions (infarct, remote and peri-infarct) at different time points. Moreover, the lipids in the heart and plasma were analysed by LC-MS/MS.
Results
We observed a drastic alteration in the lipidome with distinct spatial-temporal features in the injured heart by both MALDI-MSI and LC-MS/MS. In the infarct heart tissue, as revealed by LC-MS/MS, we observed an elevation of glycerolipids that peaked at 3 hours after I/R, and a sustained elevation of phospholipids and sphingolipids up to 3 days. Similar alternations in lipid profile was observed but much weaker in the remote and peri-infarct heart tissue compared to the infarct tissue. Among those lipids, PC 32:0 detected by MALDI-MSI highly overlapped CD68 staining at a single-cell level, showing a strong correlation of PC 32:0 with macrophage infiltration in mouse hearts (R2=0.93, p<0.0001). A similar increase of PC 32:0 in the infarct area was also observed in porcine hearts following I/R injury. Surprisingly, plasma levels of PC 32:0 in the mice decreased after I/R injury. In humans, plasma levels of PC 32:0 in post-MI patients were lower than that in healthy individuals (p=0.03). Further analysis demonstrated that plasma levels of PC 32:0 determined within 72 hours after percutaneous coronary intervention were negatively correlated with the 6-month post-MI cardiac ejection fraction in patients (R2=0.08, p<0.001).
Conclusions
A temporal-spatial lipidome profile was established in heart injury by synergizing LC-MS/MS and mass spectrometry imaging. PC 32:0 levels are positively correlated with myocardial macrophage infiltration but negatively correlated with cardiac function in cardiac I/R injury. Our findings indicate that PC 32:0 is a potential biomarker for cardiac injury and the inflammatory status in the injured heart.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Singapore Ministry of Health's National Medical Research Council
Collapse
|
42
|
Bednarski B, Williams MC, Pieszko K, Miller RJH, Huang C, Kwiecinski J, Sharir T, Di Carli M, Fish MB, Ruddy TD, Hasuer T, Miller EJ, Acampa W, Berman DS, Slomka PJ. Unsupervised machine learning improves risk stratification of patients with visual normal SPECT myocardial perfusion imaging assessments. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Unsupervised machine learning has the potential to identify new cardiovascular phenotypes and more accurately assess individual risk in an unbiased fashion.
Purpose
We aimed to use unsupervised learning to identify, analyze, and risk-stratify subgroups of patients with normal perfusion by visual interpretation on single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI).
Methods
We included consecutive patients with visual normal clinical assessment (summed stress score of 0) from the multicenter (9 sites), REFINE SPECT registry. We considered 23 clinical, 17 image-acquisition, and 26 imaging variables. Optimal dimensionality reduction (Uniform Manifold Approximation and Projection), clustering (Gaussian Mixture Model), and number of clusters were selected to maximize the silhouette coefficient (how similar a patient is to those in their own cluster compared to other clusters). Risk stratification for all-cause mortality (ACM) and major adverse cardiac events (MACE) was assessed within these clusters and compared to risk stratification by quantitative ischemia (<5%, 5–10%, >10%) using Kaplan-Meier curves and Cox Proportional-Hazards analysis.
Results
In total, 17,527 (of 30,351) patients in the registry had visually normal perfusion, 49.7% female, median age of 64 [55, 72] years. There were 1,138 ACM events and 2,091 MACE events with a median follow-up of 4.1 [2.9, 5.7] years. Unsupervised learning provided better risk stratification for both ACM and MACE compared to quantitative ischemia (Figure). Notably, the high-risk cluster by unsupervised learning had a hazard ratio (HR) of 9.5 (95% confidence interval [CI]: 7.7–11.7) compared to 1.4 (95% CI: 1.1–1.9) for quantitative ischemia >10%. The high-risk cluster had proportionally more women (45% [low-risk], 51% [medium-risk], 57% [high-risk], all p<0.001), higher body mass indices (26.9, 27.4, 29.6, all p<0.001), prevalence of diabetes (17%, 22%, 33%, all p<0.001), and abnormal rest ECGs (30%, 43%, 64%, p<0.001); with lower rates of family history of coronary artery disease (40%, 33%, 24%, p<0.001). Patients in the low-risk cluster were more likely to undergo exercise stress (100%, 38%, 0%, all p<0.001), had lower rest peak systolic blood pressure (130, 131, 140 mmHg, all p<0.001), and higher stress peak systolic blood pressure (164, 150, 131 mmHg, all p<0.001). Patients in the high-risk cluster had higher left ventricular mass (129, 135.45, 143.9 g, all p<0.001) and stress volume (57, 59, 66 ml, all p<0.001).
Conclusion
Unsupervised learning identified new phenotypic clusters for SPECT MPI patients with visual normal assessments which provided improved risk stratification for ACM and MACE compared to SPECT ischemia. Such individualized risk assessment may allow better targeted management of patients with visually normal perfusion.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Research reported in this publication was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R01HL089765. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Collapse
|
43
|
Christie E, Huang C, Zhang V, Cowley K, Simpson K, Wang G, Cao P, Wiedemeyer W. Identification of novel therapeutic targets to overcome chemoresistance in high-grade serous ovarian cancer. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01101-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
44
|
Guo S, Huang C, Shrishrimal S, Cui J, Zhang V, Deng N, Dong I, Wang G, Begley C, Luo S, Cao P, Wiedemeyer W. Covalent pan-TEAD inhibitors for the treatment of cancers with Hippo pathway alterations. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00909-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
45
|
Shi W, Huang C, Chen S, Yang C, Liu N, Zhu X, Su X, Zhu X, Lin J. Long-term exposure to air pollution increases hip fracture incidence rate and related mortality: analysis of National Hip Fracture Database. Osteoporos Int 2022; 33:1949-1955. [PMID: 35654856 DOI: 10.1007/s00198-022-06445-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/24/2022] [Indexed: 11/25/2022]
Abstract
UNLABELLED To explore the association of air pollution and hip fracture and related mortality in the UK. The average levels of PM2.5, PM10, and NO2 exhibited a positive association with hip fracture and short-term mortality while O3 did not. Our study highlights the association of air pollution and hip fracture. INTRODUCTION Until now, the influence of air pollution on bone mineral density and associated fractures has drawn little attention, and the consequences are controversial. To investigate the association between air pollution and hip fracture incidence and related short-term mortality. METHODS We constructed a cohort of all the National Hip Fracture Database beneficiaries (513,540 patients) in the UK from 2013 to 2018. Per year averages of PM2.5, PM10, O3, NO2, and SO2 were estimated according to the person's residence. The incidence rate ratio with 95% confidence interval and all-cause mortality within 30-day post-fracture (ACM30D) rate ratios were estimated using generalized additive models. RESULTS The average levels of PM2.5, PM10, and NO2 exhibited a positive association with the incidence rate of hip fracture (IHF) and ACM30D. Whereas, this association was negative for O3 levels. Each increase of 5 μg per cubic meter in PM2.5, PM10, and NO2 leads to 9.5%, 9.2%, and 4.1% higher hip fracture rate, respectively, and also 9.3%, 8.3%, and 2.9% higher ACM30D, respectively. When we restricted the analysis to low-level exposure of air pollutants, similar results were obtained. CONCLUSION Our study found a moderate, positive association between IHF, ACM30D, and the levels of specific air pollutants in the entire National Hip Fracture Database population. A reduction in the levels of PM2.5, PM10, and NO2 may decrease the hip fracture incidence rate and associated short-term mortality in older adults. Our study highlights the influence of air pollution on hip fracture.
Collapse
|
46
|
Hurvitz S, Kalinsky K, Tripathy D, Sledge G, Gradishar W, O'Shaughnessy J, Modi S, Park H, McCartney A, Frentzas S, Shannon C, Cuff K, Eek R, Martin Jimenez M, Curigliano G, Jerusalem G, Huang C, Press M, Lu J. 273TiP ACE-Breast-03: A phase II study patients with HER2-positive metastatic breast cancer whose disease is resistant or refractory to T-DM1, and/or T-DXd, and/or tucatinib-containing regimens treated with ARX788. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
47
|
Liu N, Huang C, He J, Lu J, Wang S. 599P Tumor mutation burden is a predictive biomarker for survival to patients with ovarian carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
48
|
Zhao Y, Yang XX, Huang C, Zhao JL, Li MT. [Systemic lupus erythematosus complicated with type Ⅱ pulmonary hypertension: a case report]. ZHONGHUA NEI KE ZA ZHI 2022; 61:1049-1052. [PMID: 36008299 DOI: 10.3760/cma.j.cn112138-20220117-00052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
|
49
|
Hu X, Broughton E, Li W, Sun T, Shen K, Huang C, Sriuranpong V, Ngan K, Chia Y, Bhattacharyya H, Zhao H, Shen J, Xu B. 218P Patient-reported quality of life in patients with hormone receptor–positive/human epidermal growth factor receptor 2–negative (HR+/HER2–) advanced breast cancer (ABC) treated with palbociclib (PAL) plus letrozole (LET): Results from PALOMA-4. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
50
|
Papusha M, Huang C, Kiecherer J, Leonhard K. Exploration of the chemical reaction space through selectively accelerated reactive molecular dynamics without prior knowledge. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|