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Xu M, Chen R, Xing P, Kong Y, Zhang J, Zhao X, Zhang L. An Innovative Regimen Basing on HFRT/SBRT and RC48-ADC Coactivation for Salvage Therapy in Patients with HER2-Expressing Advanced Solid Tumors. Int J Radiat Oncol Biol Phys 2023; 117:e158. [PMID: 37784749 DOI: 10.1016/j.ijrobp.2023.06.985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) It is now widely accepted that radiotherapy, especially hypofractionated radiation therapy (HFRT) or stereotactic radiotherapy (SBRT), can modulate tumor phenotypes, enhance antigen presentation and provoke a systemic immune response which gives a strong rationale for the combination of RT and immunotherapy (iRT). The PRaG therapy is an innovative iRT, when combined with HFRT/SBRT, PD-1/L1 inhibitor and GM-CSF to activate the immune response and modulate the tumor microenvironment to exert the desired in abscopal effect. Previous studies have demonstrated encouraging efficacy of the PRaG regimen in the treatment of advanced refractory tumors. RC48-ADC is a promising anti-HER2 antibody-drug conjugate with inducing immunogenic cell death and widespread release of cancer cell antigens, synergize with immunotherapy by promoting effector T-cell activation. The aim of this study is to explore efficacy and safety of RC48-ADC combined with radiotherapy, PD-1/L1 inhibitor sequential GM-CSF and IL-2(PRaG3.0 regimen) for treatment of HER2-expressing advanced solid tumors. MATERIALS/METHODS Participants with advanced, confirmed HER2-expressing (IHC3+, 2+ or 1+) solid tumors that had progressed after standard treatment, or intolerance were enrolled. In a PRaG3.0 regimen cycle, those received RC48-ADC (2.0 mg/kg d1, every 3 weeks), then HFRT (2-3 doses of 5-8 Gy) was delivered for one metastatic lesion every other day, followed by GM-CSF (200 μg d3-7), sequential IL-2(2million IU d8-12), and PD-1/L1 inhibitor was dosing within one week after completion of HFRT. After RC48-ADC combined with PD-1/L1 inhibitor sequential GM-CSF and IL-2 for at least 6 cycles, then maintenance with PD-1/L1 inhibitor was administered until disease progression or unacceptable toxicity. The primary endpoint was objective response rate (ORR). This trial is registered with ClinicalTrials.gov, number NCT05115500. RESULTS With the cutoff date of 31 December 2022, a total of 30 patients (n = 6 for gynecological cancer, n = 5 for pancreatic cancer, n = 19 for other cancers) were enrolled, in which 21 patients completed at least 1 tumor assessment. The objective response rate (ORR) was 42.9%, and the disease control rate was 71.4% by RECIST1.1. The ORR was 66.7% in gynecological cancer, 25.3% in pancreatic cancer, and 36.4% in other cancers. Median progression-free survival (PFS) for all patients was 7.0 months (95% CI: 3.4, 10.7). The most common treatment-related adverse events (TRAEs) included fatigue, fever, alopecia and anorexia. Grade ≥3 TRAEs occurred in two patients (6.7%). CONCLUSION These preliminary results show that of PRaG3.0 regimen has a manageable safety profile and encouraging antitumor activity in heavily pretreated patients with HER2- expressing cancers. Ultimately the regimen achieved the accurate integration of RT, immunotherapy and targeted therapy.
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Inkman M, Eaton A, Zhang H, Waters MR, Swamidass J, Mazur TR, Jha A, Schwarz JK, Zhang J. Development of a Radiomic Signature from Pre-Treatment FDG-PET for Recurrence Prediction in Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e469. [PMID: 37785492 DOI: 10.1016/j.ijrobp.2023.06.1674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) As many as 30-50% of patients with locally advanced cervical cancer (LACC) experience recurrence after standard-of-care chemoradiation therapy (CRT), creating a critical need to identify pre-treatment biomarkers of treatment failure. The purpose of this study is to identify whether radiomic features derived from pre-treatment FDG-PET imaging can be used to construct a predictive signature useful for assessing risk of recurrence during treatment planning. MATERIALS/METHODS Standardized uptake values (SUV) were obtained from within the physician-defined metabolic tumor volumes (MTV) delineated on FDG-PET scans acquired for 90 LACC patients at our institution prior to standard of care curative-intent CRT. Clinical outcome data of these patients has a median follow-up time of 85 months. The clinical endpoint was local recurrence within 3 years of treatment. 851 quantitative radiomic features describing intensity, shape, texture and high and low frequency spatial filters of the MTV were extracted for each patient. Low information features, defined by pairwise correlation > 0.85 with another feature or a maximum deviation within 20% of the mean, were discarded, leaving 146 features. Predictive signatures were constructed from features using multiple techniques, including multivariate Cox modelling, a set of machine learning models (random forest (RF), support vector classifier (SVC), ridge regression, LASSO regression, and elastic net regression), and a deep neural network (DNN) classifier. RESULTS The DNN classifier had the best overall performance, predicting a patient's recurrence group with an F1 score of 0.917 ± 0.028 under 5-fold cross-validation. By contrast, the Cox model classifier yielded an F1 score of 0.604 ± 0.085 and the best performing of the alternative machine learning models, elastic net, yielded F1 score of 0.868 ± 0.018. A set of textural features contributed the most to the output of the DNN classifier, including Large Area Low Gray Level Emphasis of the gray level size zone matrix (GLSZM) and coarseness and busyness of the neighboring gray tone difference matrix (NGTDM), reflecting the important role patterns of tumor heterogeneity play in post-treatment recurrence. CONCLUSION In this pilot study, we investigated multiple techniques to construct predictive radiomic signatures for local recurrence in LACC, determining that a DNN classifier is most capable of stratifying patients by risk of early recurrence. Future work will seek to validate this result on additional PET imaging data sets and to integrate radiomic features with gene expression data from matched tumor samples to establish radiogenomic biomarkers for recurrence.
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Zhang J, Peng G, Ding Q, Qin Y, Wu B, Zhang Z, Zou Z, Shi L, Hong X, Han J, Liang Z, Yang K, Huang J. Standard Therapy vs. Individualized Therapy in Elderly Locally Advanced Nasopharyngeal Carcinoma: A Real-World Study. Int J Radiat Oncol Biol Phys 2023; 117:e589. [PMID: 37785782 DOI: 10.1016/j.ijrobp.2023.06.1937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Concurrent chemoradiotherapy (CRT) with/without induction chemotherapy has been the standard therapy (ST) for locally advanced nasopharyngeal carcinoma (LA-NPC). However, most patients supporting these clinical trials were younger than 65 years of age. For the toxicity of CRT and the poor tolerance of elderly patients, it is still controversial whether ST could bring the most promising survival benefits for elderly NPC compared with individualized therapy (IT). Thus, in this real-world study we compared the survival and safety of ST with IT in elderly LA-NPC to explore an effective and tolerable treatment strategy for elderly LA-NPC. MATERIALS/METHODS A total of 109 newly diagnosed elderly LA-NPC (>65 years old) from Jan. 2013-Jul. 2020 were retrospectively enrolled and divided into the ST group and IT group according to the original treatment tendency. ST refers to CRT with/without induction chemotherapy. IT group included patients not suitable for CRT and were given individualized treatment fully discussed by at least two oncologists from our head and neck team. A 1:1 propensity score matching (PSM) generated a matched cohort of ST and IT. The survivals and treatment related toxicities were compared between the two groups. RESULTS There were 46 cases in the ST group and 63 cases in the IT group. The 5-year overall survival (OS) rate, cancer-specific survival (CSS) rate, progression- free survival (PFS) rate, local recurrence-free survival (LRFS) rate and distant metastasis-free survival (DMFS) rate were 68.64%, 76.42%, 73.69%, 85.67% and 86.82%, respectively. By 1:1PSM, 35 cases in each group were matched. No significant differences of OS, CSS, PFS, LRFS and DMFS were found between ST and IT groups in the PSM-matched cohorts (P = 0.87, P = 0.79, P = 0.51, P = 0.81 and P = 0.24, respectively). Compared with patients in the ST group, cases received IT were associated with less severe acute toxicities including anemia, leucopenia, neutropenia, and thrombocytopenia. CONCLUSION For elderly LA-NPC, IT had similar survivals while less severe toxicities compared with ST, which revolutionarily challenged the role of ST for elderly LA-NPC. In the future, more studies are need to explore a less toxic treatment modality with noninferior efficacy for elderly LA-NPC.
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Qiu Z, Huang Z, Zhu L, Huang X, Wang WH, Tie J, Shen L, Shi M, Chen J, Liu M, Cheng J, Zhang J, Li Y, Wang S. A Nomogram to Predict Pathological Axillary Status in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e202. [PMID: 37784855 DOI: 10.1016/j.ijrobp.2023.06.1080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) This study aimed to identify factors influencing axillary pathological complete response (pCR) and to develop a predictive nomogram to evaluate axillary pCR rate in breast cancer patients treated with neoadjuvant chemotherapy (NAC). MATERIALS/METHODS A total of 2368 patients who received NAC and mastectomy between 2000 and 2014 from 12 grade A tertiary hospitals in China were analyzed retrospectively. The patients treated in three cancer hospitals (training set, n = 1629) were used to construct the nomogram based on multivariate logistic regression analyses. The nomograph was validated by the area under the receiver operating characteristic curve (AUC) and calibration curve in patients from 9 other general hospitals (validation set, n = 739). RESULTS The nomogram incorporated seven predicting factors including NACT cycles, response to NACT, clinical T stage, clinical N stage, grade, LVI, and molecular subtype. The AUC for the training set and validation set were 0.762 and 0.802, respectively. In addition, the calibration curve also showed good agreement between the nomogram-based predictions and the actual observations. CONCLUSION A nomogram was established to predict the status of axillary lymph nodes in breast cancer patients after NAC. The predictive model performed well both in the training set and external validation set.
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Shao S, Xiao J, Yang M, Zhao Y, Liao W, Zhang J, Zhang S. Hypofractionated Radiotherapy with Prolonged Inter-Fraction Interval (Hypo-Slow RT) to Facilitate Immune Priming of Tumor. Int J Radiat Oncol Biol Phys 2023; 117:e278. [PMID: 37785043 DOI: 10.1016/j.ijrobp.2023.06.1257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Daily fractionated radiotherapy may pose constant stress for immune activation. A mouse model was built to explore whether hypofractionated radiotherapy with prolonged inter-fraction interval (Hypo-Slow Radiotherapy, HSRT) may enable better immune-priming of tumor than daily radiotherapy. MATERIALS/METHODS A subcutaneous MC38 murine colon cancer mouse model was irradiated at different radiation regimens. The impact of inter-fraction interval and dose per fraction on tumor control, immune mobilization, and synergistic effect with anti-PD-1 immunotherapy was explored. Immune activation was assessed by analyzing CD4+ and CD8+ T cells from peripheral blood, and intratumoral CD4+ and CD8+ T cells by flow cytometry; both were sampled three days after the completion of scheduled irradiation. RESULTS In a fixed dose per fraction experiment, the 6×5Gy QOD and 6×5Gy QD irradiation schemes resulted in identical tumor control, while the 6×5Gy BIW scheme led to tumor progression; moreover, both QOD and BIW regimens showed ability to activate immune response whereas QD regimen did not. In a fixed biological equivalent dose (BED) experiment, the comparison of different regimens with increased dose per fraction and prolonged inter-fraction interval showed that 12×3Gy QD regimen, HSRT regimens, including 6×5Gy QOD, 4×7Gy BIW, and 2×11Gy QW, led to identical tumor control. Importantly, all HSRT regimens showed significant mobilization of host immunity whereas 12×3Gy QD did not. Both peripheral and intratumor CD4+ and CD8+ cell increase with increased inter-fraction interval and dose per fraction. Finally, all HSRT regimens combined with anti-PD-1 immunotherapy showed enhanced tumor growth delay than any single treatment while 12×3Gy QD regimen did not. CONCLUSION This pre-clinical model demonstrated that conventional daily fractionated radiotherapy is not beneficial for host immune activation against tumor. Preliminary results suggested that prolonged inter-fraction interval with increased dose per fraction may be an optional strategy to balance the tumor control and immune activation.
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Waters MR, Inkman M, Habimana-Griffin L, Cohen A, Zhang J, Contreras J, Schwarz JK, Markovina S. Mutational Landscape of ER Receptor Negative Endometrial Cancer Patients Categorized as No Specific Molecular Profile (NSMP). Int J Radiat Oncol Biol Phys 2023; 117:S9-S10. [PMID: 37784600 DOI: 10.1016/j.ijrobp.2023.06.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The endometrial cancer (EC) molecular classification introduced by The Cancer Genome Atlas (TCGA) has initiated molecular-based classification with clear prognostic value. Four major tumor subtypes exist: 1) TP53 mutation (p53abn); 2) POLE mutation (POLEmut); 3) mismatch repair protein deficient (MMRd); and 4) no specific molecular profile (NSMP). Of these subtypes, p53abn patients exhibited the worst prognosis. Recently, a prognostic refinement of NSMP EC using estrogen receptor (ER) status, from PORTEC-III trial data, showed that (ER-) NSMP patients had a strikingly poor prognosis, similar to p53abn patients. Currently, drivers of NSMP (ER-) disease are unknown and require genomic characterization. In this study, we perform an integrated molecular analysis to characterize this aggressive and poorly understood cohort. MATERIALS/METHODS RNAseq and mutational data was downloaded from the TCGA, PanCancer Atlas, Uterine Endometrial Carcinoma dataset via the genomic data commons (GDC). All patients in this cohort demonstrated endometrioid histology. P53abn, and POLE mutated patients were filtered using mutational data. MMRd and NSMP ESR1 gene low expressors (ER Low) were filtered using Z-score cutoffs of RNAseq expression data. Survival analysis was performed using the Survival R-package. Gene expression testing was performed using the EdgeR R-package. Pathway Enrichment analysis was conducted using EnrichR software. RESULTS Forty-two patients out of 529 samples met our GDC NSMP (ER low) filtering criteria (7%), similar to the 5% of PORTEC-III patients classified as NSMP (ER -). Strikingly 83% percent of GDC NSMP (ER low) patients harbored a mutation in the PI3K-AKT-mTOR signaling pathway, with 48% of GDC NSMP (ER low) patients carrying a mutation in the p110 alpha (PIK3CA) gene. Interestingly, of the patients with PIK3CA mutant tumors, 2/20 patients died in 5 years (10%), compared to 9/22 patients whose tumors were PIK3CA WT (41%) (p = 0.02). Among GDC NSMP (ER low) patients with PIK3CA WT tumors gene expression signatures were enriched for MYC target genes (p = 1.1e-51), DNA replication (p = 4.3e-30), cell cycle (p = 9.32e-20), and cell cycle checkpoints (p = 6.4e-20) pathways. Additionally, strongly in PIK3CA WT tumors are mitochondrial membrane proteins (p = 1.63e-37) and ribosomal proteins (2.9e-24). CONCLUSION In this analysis, we show that GDC NSMP (ER low) tumors nearly all harbor a mutation in the PI3K-AKT-mTOR signaling pathway. Further we demonstrate that the most common gene mutation in the cohort, PIK3CA, is counterintuitively a marker of improved survival. Additionally, we show that within that this subpopulation, PIK3CA WT patients exhibit robustly upregulated gene expression programs dedicated to energy production, cell cycling, and division.
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Lin D, Wu X, Karpinets T, Alam MBE, Sammouri J, Lynn EJ, Harris T, Lo DK, Wang R, Ajami NJ, Zhang J, Klopp AH, Colbert L. Changes in the Abundances of Cervical and Rectal Mycobiota during Chemoradiotherapy in Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e527. [PMID: 37785637 DOI: 10.1016/j.ijrobp.2023.06.1804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Globally, cervical cancer is the fourth most frequent cancer in women. The local and gut microbiomes of cervical cancer patients primarily consist of bacteria, viruses, and fungi. Bacterial composition has been previously associated with response to chemoradiotherapy (CRT) and patient outcome. Recently, our group has demonstrated that the HPV virome dynamically shifts during treatment and was associated with treatment response. Although connections between fungi and cervicovaginal health have been established, little is known about the fungal microbiome during treatment of cervical cancer. In this study, we sought to explore changes in fungal distribution throughout CRT for a cohort of cervical cancer patients. MATERIALS/METHODS This study includes 57 patients diagnosed with cervical cancer at a single institution with samples collected throughout CRT timepoints: baseline, week 1, week 3, and week 5. 170 swab specimens were included in this analysis: 138 cervical swabs from 56 patients and 32 rectal swabs from 9 patients. Whole genome sequencing data was obtained from the swabs using the Illumina HiSeqX platform (2 × 150bp). Fungal reads were log transformed to reduce variability and skewness and normalized to the total library size resulting in log normalized fungal reads per million (RPM). Bacterial reads were normalized with the same methodology. Timepoint analysis was performed using Wilcoxon signed rank tests or Friedman tests (with Dunn's multiple comparisons test) when comparing two or more time points, respectively. RESULTS All swab samples contained reads mapped to fungi. Of the 3.70 × 109 total reads across all sequenced samples, 19.2% did not map specifically to the human genome: 91.8% of these non-human reads could not be mapped to an individual microbial genome. Of the remaining 8.2% of non-human reads that mapped to a specific microbial genome (1.6% of total), 97.4% were classified as bacterial (1.5% of total), 0.71% as virus (0.011% of total), and 0.44% as fungal (0.0069% of total). Comparison of fungal RPM in the cervical and rectal microbiome revealed a significant decrease during treatment from baseline to week 5 (cervical, P = 0.0002; rectal, P = 0.0273). Distribution of bacterial reads exhibited similar trends as decreases were observed between baseline and week 5 for both cervical (P = 0.0116) and rectal (P = 0.0195) samples. Fungi to bacteria distribution ratios in the rectal microbiome revealed significant differences when comparing across all timepoints (P = 0.0041), baseline vs. week 1 (P = 0.0028), baseline vs. week 3 (P = 0.0389), and baseline vs. week 5 (P = 0.0113) with all three later timepoints higher relative to baseline. CONCLUSION The distributions of cervical and gut fungal reads and their relationship to the bacteriome shift during CRT. Further investigation into characterizing fungi and their relationship with other microbiota will be valuable to understanding its potential associations with cervical cancer and treatment response.
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Hou X, Sun S, Jiao S, Zhang J, Huang Y, Wang W, Hu K, Zhang F. Risk Stratification of Postoperative Adjuvant Therapy for Endometrial Cancer (POAT-ENDORISK) Based on Bayesian Network Model: A Development and Validation Study. Int J Radiat Oncol Biol Phys 2023; 117:e518. [PMID: 37785615 DOI: 10.1016/j.ijrobp.2023.06.1783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To establish a Bayesian network (BN) model for postoperative adjuvant treatment of early endometrial carcinoma (EC) patients. MATERIALS/METHODS We retrospectively analyzed the data of 1280 early EC patients treated by multiple institutions in China from 1999 to 2017. All patients received primary hysterectomy/bilateral salpingo-oophorectomy and adjuvant radiotherapy. The FIGO 2009 stage of all patients is stage I and stage II EC, and the median age is 57 years old. All patients are grouped according to the ESMO-ESGO-ESTRO risk stratification. The clinicopathologic factors, treatment-related factors, local regional recurrence, distant metastasis and cancer-specific survival rate (CSS) of all patients were reviewed. We divide the original data set into training set and Validation set according to the ratio of 7:3. The training of the Bayesian network model is completed on Netica, and the test of the model effect is finally completed on the test set. RESULTS After variable screening, a total of 14 characteristic variables entered the final model. A total of 896 patients were used for the development of BN model, and 384 patients were used for the validation of BN model. The results of the model showed that the factors directly related to CSS were locoregional failure (LRF), radiotherapy mode, distant metastasis (DM). Factors directly related to DM were chemotherapy, LRF, CSS. The factors directly related to LRF were risk stratification, preoperative serum CA125 and preoperative HB. The accuracy, sensibility, specificity, micro-f1, micro-f1, weighted-f1 and AUC of BN model in predicting DM and CSS were better than XGBoost model. CONCLUSION In this study, we integrated almost all clinical pathology and treatment information related to postoperative adjuvant treatment of early EC patients and established a BN model for personalized clinical decision-making of postoperative adjuvant treatment of early EC patients. The results showed the complex correlation among the variables, and the overall prediction ability and visualization effect of BN model was significantly better than XGBoost model. Prospective research is needed before clinical implementation.
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Zhang J, Jason L, Ganguly S, Zhao Y, Baker J, Cao Y, Chang J. Implementation of L4 Automation for Patient-Specific Quality Assurance Using the AUTOFRAME Platform and a Robotic Mechanism. Int J Radiat Oncol Biol Phys 2023; 117:e745. [PMID: 37786161 DOI: 10.1016/j.ijrobp.2023.06.2283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The AUTOFRAME platform has been previously developed for automating clinical workflows and has achieved L3 automation for patient-specific quality assurance (PSQA). The aim of this study is to further develop the platform to achieve L4 automation, which extends AUTOFRAME to operate Varian's control console (VCC) for the linear accelerator. The goal is to automate all PSQA operations outside of the treatment room. MATERIALS/METHODS The automated stages, listed in Table 1, are ranging from L0 to L5. The current study focuses on L4 automation of PSQA, which uses a 6-axis robot arm to control buttons on the VCC. The robotic arm is mounted on a custom frame that is attached onto the VCC to maintain its relative position. The arm is controlled through python scripts, which is run on a raspberry pi and communicates with the AUTOFRAME platform via the PyFlow and AutoFlow subsystems. This integration allows the robotic arm to receive commands from AutoFlow and execute them through PyFlow, activating real-time button-pressing actions. RESULTS The integrated L4 system was tested using real PSQA verification plans, which involved a minimum of 4 actions and a maximum of 9 actions on the VCC, including a couch kick that required overriding the couch position. The results showed that the 6-axis arm was able to correctly execute the action groups and guide the robotic arm to consistently press and hold each button with sufficient force and accuracy. All buttons on the VCC, including the Motion-enable, Preparing, Readying, and Delivering buttons, were correctly pushed and held according to the PSQA steps. The system successfully delivered all beams without interruption, and all beam delivery data was collected by the detector for PSQA analysis. CONCLUSION The study has further developed the AUTOFRAME platform for L4 automation of PSQA procedures can be achieved. The robotic arm is capable of pushing all required buttons, eliminating all human interactions on the VCC. When combined with previous L0-L3 automations, this will move towards full automation of PSQA procedures. Future work will focus on improving the system's flexibility, stability, and extending its operations to other QA tasks.
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Song Y, Kong J, Li N, Liu X, Li X, Zhu L, Wang Y, Fang H, Jing H, Tang Y, Li Y, Wang XH, Zhang J, Wang S. Comparison of Supraclavicular Surgery plus Radiotherapy vs. Radiotherapy Alone in Breast Cancer Patients with Synchronous Ipsilateral Supraclavicular Lymph Node Metastasis: A Multicenter Retrospective Study. Int J Radiat Oncol Biol Phys 2023; 117:e208. [PMID: 37784870 DOI: 10.1016/j.ijrobp.2023.06.1094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To evaluate and compare the outcomes of supraclavicular lymph node dissection (SLND) plus radiotherapy (RT) and RT alone for patients with synchronous ipsilateral supraclavicular lymph node metastasis (sISLM). MATERIALS/METHODS In all, 293 patients with sISLM across three centers were included. Of these, 85 (29.0%) received SLND plus RT and 208 (71.0%) received RT alone. All patients received preoperative systemic therapy followed by mastectomy or lumpectomy and axillary dissection. Supraclavicular recurrence-free survival (SCRFS), locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were evaluated by using the Kaplan-Meier method and multivariate Cox models. Multiple imputation was used for missing data. RESULTS The median follow-up duration of the RT and SLND+RT groups were 53.7 and 63.5 months, respectively. For the RT and SLND+RT groups, the 5-year SCRFS rates were 91.7% vs. 85.5% (P = 0.522), LRRFS rates were 79.1% vs. 73.1% (P = 0.412), DMFS rates were 60.4 vs. 58.8% (P = 0.708), DFS rates were 57.6% vs. 49.7% (P = 0.291), and OS rates were 71.9% vs. 62.2% (P = 0.272), respectively. There was no significant effect on any outcome when comparing SLND+RT versus RT alone in the multivariate analysis. Based on four risk factors of DFS, patients were classified into three risk groups: the intermediate- and high-risk groups had significantly lower survival outcomes than the low-risk group. SLND+RT did not improve outcomes of any risk group compared with RT alone. CONCLUSION Patients with sISLM may not benefit from SLND. Distant metastasis remained the major failure pattern, especially for intermediate- and high-risk groups with sISLM may not benefit from SLND. Distant metastasis remained the major failure pattern, especially for intermediate- and high-risk groups.
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Kong L, Li Z, Liu Y, Zhang J, Chen M, Zhou Q, Qi X, Deng XW, Peng Y. A Generalized Deep Learning Method for Synthetic CT Generation. Int J Radiat Oncol Biol Phys 2023; 117:e472. [PMID: 37785502 DOI: 10.1016/j.ijrobp.2023.06.1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The application of deep learning to generate synthetic CT (sCT) has been widely studied in radiotherapy. Existing methods generally involve data from two different image modalities, such as CBCT-CT or MRI-CT, the quality of sCT is adversely affected by source image quality. We propose a unique method of synthesizing MRI and CBCT into sCT based on single-modal CT for training, and call it SmGAN. MATERIALS/METHODS We used planning CT of a group of 35 head and neck cases to as training data. We then applied two different spatial transformations to the planning CT image to produce the transformed CT1 and CT2. And We used a random style enhancement technique (Shuffle Remap) to modify the image distribution of CT1 which we termed CT1+E. CT1+E was used to simulate the patient's "image of the day" while CT2 to simulate the "planning image". After feeding both CT1+E and CT2 into the generator, we obtained the sCT predicted by the generator. The generator was trained using the Mean Absolute Error (MAE) loss between sCT and CT1. In the actual clinical process, we use the patient's CBCT or MRI instead of CT1+E and the patient's planning CT instead of CT2 as the input of the generator. After processing, we get an sCT that can maintain the spatial position of the image taken on the day, while presenting features similar to the planning CT. The evaluation data we have includes 10 pairs of MRI-Def_CT and 10 pairs of CBCT-Def_CT Head and Neck patients. Def_CT is obtained from the planning CT based on the spatial position deformation of MRI and CBCT. To evaluate the accuracy of sCT based on MRI and CBCT with Def CT, we use a range of metrics, including Hounsfield Unit (HU) difference, peak signal-to-noise ratio (PSNR), structural similarity (SSIM) and gamma pass rate. All results will be benchmarks against the advanced method RegGAN for comparison. RESULTS Compared to RegGAN, the results of SmGAN were significantly better. The mean absolute errors within the body were (44.7±216.2 HU vs. 36.7±131.4 HU) and (64.9±123.7 HU vs. 58.2±152.8 HU) for the CBCT-SCT and MRI-SCT, respectively (Table 1). In addition, experimental results show that SmGAN also outperforms RegGAN in dose calculation accuracy. For example, under the 10% threshold, SmGAN's gamma pass rate of 1mm and 1% is 0.926±0.02, compared with gamma rate of 0.896±0.02 for RegGAN. CONCLUSION We proposed a generalized deep learning model for synthetic CT generation, based on CBCT or MRI images. The proposed algorithm achieved high accuracy of dosimetric metrics, as well as excellent IMRT QA verification results. Compared to other existing synthetic CT generation methods, the proposed SmGAN required a single-modal image for training, which is considered as a major breakthrough in the industry, and is expected to have wide spread of clinical applications.
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Zhang J, Wang F, Shang S, Yan W, Ma Y, Ren Z, Wu M, Ma J, Zhang Y, Yu J, Chen D. HPK1 Inhibition Enhancing HFRT Anti-Tumor Immune Response. Int J Radiat Oncol Biol Phys 2023; 117:S120-S121. [PMID: 37784312 DOI: 10.1016/j.ijrobp.2023.06.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation therapy, as one of the canonical treatments for classic tumors, results in impressive clinical responses. Stereotactic body radiotherapy (SBRT) has been increasingly used as one main therapy in early-stage non-small-cell lung cancer (NSCLC). SBRT affords good local tumor control, however, recurrence and metastasis are still the main causes of treatment failure. With the continuous deepening of the relationship between radiotherapy (RT) and immunity, reversing RT induced immunosuppression is considered to be a promising strategy to improve radiotherapy efficacy. Hematopoietic progenitor kinase 1 (HPK1) is mainly expressed in immune cells while rarely expressed in tumor cells. It has been proven to play a negative regulatory role in T cell receptor (TCR) signal. Therefore, we hypothesized that the combination of HPK1 inhibitor with SBRT would boost local and systemic anti-tumor immune responses by potentiating the anti-tumor effects of SBRT. MATERIALS/METHODS Using Digital Spatial Profiler (DSP), we analyzed HPK1 expression in the tumor specimens of 39 NSCLC patients treated with SBRT. By establishing mice subcutaneous tumor models, we assessed the combination of a HPK1 inhibitor and local hyper-fractionated radiotherapy (HFRT) on local and systemic tumor control and mouse survival. Using Single-cell RNA sequencing, Flow cytometry and pharmacological treatment, we analyzed and verified Tumor-infiltrating lymphocytes (TILs), and excavated the specific mechanism of the HPK1 inhibitor enhancing HFRT -induced anti -tumor immune response. RESULTS In the tumor specimens of NSCLC patients treated with SBRT, we found that high expression HPK1 in TILs predicted poor progression-free survival (PFS). Among the C57BL/6 mice model, HFRT combined with a HPK1 inhibitor promoted local response, and improved the survival rate of mice, showing better anti-tumor curative effects. We further showed that HFRT promoted CD8+ T cell cytotoxic activity, and also aggravated CD8+ T cell exhaustion. After the intervention of HPK1 small molecular inhibitors, the proportion of exhaustion CD8+T cells was significantly reduced, while CD8+T cell cytotoxic activity was further enhanced in the later period. Single-cell RNA sequencing and pharmacological inhibition of HPK1 revealed that HPK1 mediated the exhaustion of CD8+T cells by regulating RGS16. In abscopal effects preclinical models, BGB-15025 induced obvious abscopal effect. CONCLUSION Thus, we demonstrate that HPK1 mediates HFRT-induced CD8+T cell exhaustion by regulating RGS16, and HPK1 is an attractive drug target for enhancing local and systemic radiotherapy.
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Wang L, Zang J, Zhang Y, Yin Y, Wang P, Zhang J, Long X, Zhao LN. Investigating Incidence of Nausea and Vomiting in Patients Receiving Concurrent Chemoradiotherapy: A Real-World Cohort Study. Int J Radiat Oncol Biol Phys 2023; 117:e448-e449. [PMID: 37785445 DOI: 10.1016/j.ijrobp.2023.06.1632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Vomiting and nausea (VN) caused by anticancer agents and/or radiation therapy (RT) can significantly affect a patient's quality of life, leading to poor compliance with further anticancer agents and/or RT. Few studies pay attention to synergistic effect of RT and concurrent highly emetogenic chemotherapy for inducing vomiting and nausea. The aim of this real-world study is to investigate the incidence of VN in patients receiving concurrent chemoradiotherapy (CCRT). MATERIALS/METHODS From June 2022 to December 2022, patients receiving concurrent chemoradiotherapy in our center were consecutively enrolled in this study. Patients received moderate and low emetic agents were excluded. The antiemesis regimens were NK1 receptor antagonist plus 5-HT3 antagonist and dexamethasone (NHD) with or without olanzapine, which were recommended by guideline of National Comprehensive Cancer Network. Acute and delayed VN were analyzed in the following stratification factors: tumor site and antiemesis regimen. Acute VN usually occurred after administration of anticancer agents and commonly resolves within the first 24 hours. Delayed VN develops in patients more than 24 hours after anticancer agent administration. The grade of VN was evaluated according to Common Terminology Criteria for Adverse Events Criteria. RESULTS A total of 312 patients were enrolled for analysis. During the CCRT period, the incidence rate of acute VN in all patients was 28.2%, the delayed VN occurred in 139 of 312 patients (44.6%). The incidence rate of acute nausea in head and neck, thorax and abdomen were 33.8%, 28.9% and 25.2%, respectively. The incidence rate of acute vomiting in head and neck, thorax and abdomen were 7.0%, 3.9% and 5.2%, respectively. The incidence rate of delayed nausea in head and neck, thorax and abdomen were 51.1%, 35.5% and 45.9%, respectively. The incidence rate of delayed vomiting in head and neck, thorax and abdomen were 14.0%, 5.3% and 9.6%, respectively. There were not significant differences between NHD regimen and NHD plus olanzapine in VN (acute nausea, 25.5% vs. 30.3%, P = 0.356; acute vomiting, 4.4% vs. 6.8%, P = 0.352; delayed nausea, 40.1% vs. 48%, P = 0.166; delayed vomiting, 8.0% vs. 10.8%, P = 0.4). Multivariate logistic regression analysis showed age <50 years (P = 0.030. HR, 95% CI: 1.893, 1.062-3.374) and history of vomiting = 0.017, HR, 95% CI: 2.249, 1.154-4.384) were risk factor for acute nausea; female (P = 0.026, HR, 95% CI: 4.254, 1.192-15.186) and sleeping time <7 hours (p = 0.049, HR, 95% CI: 3.373, 1.003-11.344) were risk factors for acute vomiting; pregnancy (P = 0.011, HR, 95% CI: 2.424, 1.228-4.783) was risk factor for delayed nausea; pregnancy = 0.013, HR, 95% CI: 3.060, 1.269-7.380) and history of vomiting = 0.020, HR, 95% CI: 2.845, 1.182-6.844) were risk factors for delayed vomiting in patients receiving CCRT. CONCLUSION CCRT still contributed high incidence of delayed nausea in patients receiving standard antiemesis regimen.
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Gao Y, Fu X, Hu H, Li T, Yuan L, Zhang J, Wu Y, Wang M, Ke Y, Li X, Hu F, Zhang M, Sun L, Wen H, Guan R, Gao P, Chai W, Zhao Y, Hu D. Impact of shift work on dementia: a systematic review and dose-response meta-analysis. Public Health 2023; 223:80-86. [PMID: 37625271 DOI: 10.1016/j.puhe.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/26/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES Although shift work has been reported as having a link to dementia, evidence remains inconsistent, and a comprehensive dose-response meta-analysis of the association is still lacking. We therefore conducted this meta-analysis to explore the association between shift work and the risk of dementia. STUDY DESIGN Systematic review and dose-response meta-analysis. METHODS PubMed, Embase, and Web of Science databases were systematically searched. Fixed or random-effects models were used to estimate the summary relative risks (RRs) and 95% confidence intervals (95% CIs). Generalized least squares regression was used to estimate dose-response associations, and restricted cubic splines were used to examine possible linear or non-linear associations. RESULTS Five articles (10 studies) with 72,999 participants and 23,067 cases were eventually included in the meta-analysis. The summary RRs and 95% CIs of dementia risk with shift work and night shift work versus daytime work were 1.13 (95% CI: 1.05-1.21, I2 = 46.70%) and 1.13 (95% CI: 1.03-1.24, I2 = 9.20%), respectively. The risk of dementia increased by 1% (RR = 1.01, 95% CI: 1.01-1.02, I2 = 41.3%) with each 1-year increase in the duration of shift work. We found a non-linear dose-response association between the duration of shift work and the risk of dementia (Pnon-linearity = 0.006). Though the shape of the curve was steeper with the duration of shift work <7 years, the increase was more gradual after 7 years. CONCLUSION Our findings suggest that shift work may be a risk factor for future dementia and that controlling the length of shift work is a feasible measure that may contribute to prevent dementia.
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Sun G, Ye H, Yang Q, Zhu J, Qiu C, Shi J, Dai L, Wang K, Zhang J, Wang P. Using Proteome Microarray and Gene Expression Omnibus Database to Screen Tumour-Associated Antigens to Construct the Optimal Diagnostic Model of Oesophageal Squamous Cell Carcinoma. Clin Oncol (R Coll Radiol) 2023; 35:e582-e592. [PMID: 37433700 DOI: 10.1016/j.clon.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/09/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023]
Abstract
AIMS Autoantibodies against tumour-associated antigens (TAAs) are promising biomarkers for early immunodiagnosis of cancers. This study was designed to screen and verify autoantibodies against TAAs in sera as diagnostic biomarkers for oesophageal squamous cell carcinoma (ESCC). MATERIALS AND METHODS The customised proteome microarray based on cancer driver genes and the Gene Expression Omnibus database were used to identify potential TAAs. The expression levels of the corresponding autoantibodies in serum samples obtained from 243 ESCC patients and 243 healthy controls were investigated by enzyme-linked immunosorbent assay (ELISA). In total, 486 serum samples were randomly divided into the training set and the validation set in the ratio of 2:1. Logistic regression analysis, recursive partition analysis and support vector machine were performed to establish different diagnostic models. RESULTS Five and nine candidate TAAs were screened out by proteome microarray and bioinformatics analysis, respectively. Among these 14 anti-TAAs autoantibodies, the expression level of nine (p53, PTEN, GNA11, SRSF2, CXCL8, MMP1, MSH6, LAMC2 and SLC2A1) anti-TAAs autoantibodies in the cancer patient group was higher than that in the healthy control group based on the results from ELISA. In the three constructed models, a logistic regression model including four anti-TAA autoantibodies (p53, SLC2A1, GNA11 and MMP1) was considered to be the optimal diagnosis model. The sensitivity and specificity of the model in the training set and the validation set were 70.4%, 72.8% and 67.9%, 67.9%, respectively. The area under the receiver operating characteristic curve for detecting early patients in the training set and the validation set were 0.84 and 0.85, respectively. CONCLUSIONS This approach to screen novel TAAs is feasible, and the model including four autoantibodies could pave the way for the diagnosis of ESCC.
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Bi N, Deng L, Hu X, Shayan G, Zhao L, Zhang L, Jiang W, Zhang J, Zhu X, Wang Y, Ge H, Cao J, Lin Q, Chen M, Wang L. 30 Gy vs. 45 Gy Consolidative Thoracic Radiation (cTRT) for Extensive Stage Small Cell Lung Cancer (ES-SCLC): A Multicenter, Randomized, Phase 3 Trial. Int J Radiat Oncol Biol Phys 2023; 117:S56-S57. [PMID: 37784527 DOI: 10.1016/j.ijrobp.2023.06.350] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Consolidative thoracic radiotherapy (cTRT) showed potential benefit to extensive stage small cell lung cancer (ES-SCLC). However, the optimum dose of cTRT is unknown. The purpose of this randomized trial was to compare the effect of 45 Gy in 15 fractions with 30 Gy in 10 fractions cTRT in ES-SCLC. MATERIALS/METHODS This phase III, randomized trial was conducted in 12 public hospitals in China. Eligible patients with pathologically confirmed ES-SCLC who responded to 4-6 cycles of etoposide plus cisplatin (EP) or carboplatin (EC) chemotherapy were randomized 1:1 to receive either 30 Gy in 10 fractions or 45 Gy in 15 fractions cTRT. The primary outcome was 2-year overall survival (OS). Secondary outcomes included 2-year progression-free survival (PFS), 2-year local control (LC) and radiation treatment related toxicity. The primary objective was to detect an OS improvement in 45 Gy cTRT group at 2 years from 13% to 26% assuming a two-sided a = 0.05 and power of 85%, with a planned sample size of 186 patients. This trial was registered with Clinical Trials.gov, number NCT02675088. RESULTS Between January 15, 2016, and September 20, 2022, 90 patients were randomly assigned either 30 Gy in 10 fractions (n = 50) or 45 Gy in 15 fractions (n = 40) cTRT group. Recruitment to the trial closed early due to slow accrual since first-line chemoimmunotherapy has become the new standard of care for ES-SCLC. The median age of patients was 58 years, 87.8% were male, 76.7% had a smoking history, 95.6% received IMRT, and 58.9% received prophylactic cranial irradiation. At a median follow-up of 39.9 months (IQR 27.2-59.2), there was no significant difference in the 2-year OS between the 45 Gy group and the 30 Gy group, at 43.4% (95% CI 29.3%-64.3%) and 40.0% (95% CI 27.9%-59.1%), respectively (log-rank p = 0.62; HR 1.13 [95% CI 0.69-1.84]). The 2-year PFS was 12.1% (95% CI 4.3%-33.8%) in the 45 Gy group and 9.0% (95% CI 3.2%-25.2%) in the 30 Gy group (log-rank p = 0.25, HR 0.76(95% CI [0.478-1.22]). There were also no significant differences in locoregional recurrence free survival (log-rank p = 0.75; HR 0.888 [95% CI 0.423-1.863]) and distant metastasis free survival (log-rank p = 0.95; HR 1.015 [95% CI 0.624-1.651]) between two groups. No grade 5 toxicity was observed in both groups. Patients treated with higher cTRT dose presented with increased incidence of grade 3+ radiation pneumonitis (10% vs 2%) and hematological toxicity (20% vs 12.5%). CONCLUSION This randomized trial did not find a higher probability of survival improvement in patients with ES-SCLC receiving cTRT of 45 Gy in 15 fractions compared with 30 Gy in 10 fractions. In contrast, there was an increase in toxicity, especially radiation pneumonitis. Additional randomized studies investigating the role of cTRT in ES-SCLC after a response to chemoimmunotherapy are warranted.
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Li Y, Zhang J, Cai W, Wang C, Yu Z, Jiang Z, Lai K, Wang Y, Yang G. CREB3L2 Regulates Hemidesmosome Formation during Epithelial Sealing. J Dent Res 2023; 102:1199-1209. [PMID: 37555472 DOI: 10.1177/00220345231176520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
The long-term success rate of dental implants can be improved by establishing a favorable biological sealing with a high-quality epithelial attachment. The application of mesenchymal stem cells (MSCs) holds promise for facilitating the soft tissue integration around implants, but the molecular mechanism is still unclear and the general application of MSC sheet for soft tissue integration is also relatively unexplored. We found that gingival tissue-derived MSC (GMSC) sheet treatment significantly promoted the expression of hemidesmosome (HD)-related genes and proteins in gingival epithelial cells (GECs). The formation of HDs played a key role in strengthening peri-implant epithelium (PIE) sealing. Further, high-throughput transcriptome sequencing showed that GMSC sheet significantly upregulated the PI3K/AKT pathway, confirming that cell adhesion and HD expression in GECs were regulated by GMSC sheet. We observed that the expression of transcription factor CREB3L2 in GECs was downregulated. After treatment with PI3K pathway inhibitor LY294002, CREB3L2 messenger RNA and protein expression levels were upregulated. Further experiments showed that overexpression or knockdown of CREB3L2 could significantly inhibit or promote HD-related genes and proteins, respectively. We confirmed that CREB3L2 was a transcription factor downstream of the PI3K/AKT pathway and participated in the formation of HDs regulated by GMSC sheet. Finally, through the establishment of early implant placement model in rats, we clarified the molecular function of CREB3L2 in PIE sealing as a mechanical transmission molecule in GECs. The application of GMSC sheet-implant complex could enhance the formation of HDs at the implant-PIE interface and decrease the penetration distance of horseradish peroxidase between the implant and PIE. Meanwhile, GMSC sheet reduced the length of CREB3L2 protein expression on PIE. These findings elucidate the potential function and molecular mechanism of MSC sheet regulating the epithelial sealing around implants, providing new insights and ideas for the application of stem cell therapy in regenerative medicine.
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Zhang J, Shang S, Wang F, Wang R, Shangguan J, Zhang Y, Wu M, Ma J, Yu J, Chen D. The Baseline Serum Lipid Levels and Outcomes of NSCLC Patients Receiving Immunotherapy Combined or Non-Combined with Radiotherapy: A Single Center Retrospective Study. Int J Radiat Oncol Biol Phys 2023; 117:e11. [PMID: 37784645 DOI: 10.1016/j.ijrobp.2023.06.670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In recent years, many studies have shown that lipids and lipid-like substances are key regulatory factors in tumor development and play an important role in immune regulation. However, it remains unclear whether serum lipids influence the outcome of immunotherapy. Therefore, determining the serum lipid levels of the immune treatment-beneficiary population may be valuable. The aim of this study is to evaluate the prognostic value of baseline serum lipid levels in non-small cell lung cancer (NSCLC) patients receiving immunotherapy. MATERIALS/METHODS We retrospectively included 294 patients with stage III-IV NSCLC who received immunotherapy continuously from December 2018 to November 2021 at our hospital, collecting their pre-treatment lipid levels, such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Of these, 160 receiving immunotherapy without combined radiotherapy (ICIs-nRT) and 134 combined with radiotherapy (iRT). The endpoint was the correlation between pre-treatment serum lipid levels and overall survival (OS), as well as progression-free survival (PFS). The X-tile tool was used to determine the optimal cut-off value of the indicators. The Kaplan-Meier survival curves were used to calculate OS and PFS and log rank tests were used for comparison. And the Cox proportional hazard model were used for univariate and multivariate analysis. RESULTS In all 294 patients, low TG, low TC, and low HDL-C predicted poor OS (P<0.001) and poor PFS (P<0.05). Low LDL-C was associated with poor OS (P = 0.0001). Among 160 patients receiving ICIs-nRT and 134 iRT patients, low levels of TG (P = 0.0134, 0.0024), TC (P = 0.0003, 0.0023), HDL-C (P = 0.0004, 0.0043), and LDL-C (P = 0.0003, 0.0419) were associated with worse OS compared to high levels of them. In the ICIs-nRT patients, low HDL-C predicted poor PFS (P = 0.0011). In 134 iRT patients, low levels of TG (P = 0.0017), TC (P = 0.0028), and LDL-C (P = 0.0330) were poor prognostic factors for PFS. In the univariate and multivariate analysis with OS in all patients, TG and HDL-C were independent risk factors, while TG was an independent risk factor in the analysis with PFS. In ICIs-nRT patients, HDL-C was an independent prognostic factor for patients' OS and PFS. In iRT patients, both TG and HDL-C were prognostic risk factors for OS. CONCLUSION These data confirm that higher serum lipid levels are associated with better outcomes in patients with NSCLC undergoing immunotherapy. Serum lipids may identify tumors that are more likely to respond to immunotherapy. Radiation therapy may affect lipid metabolism within the body to enhance the efficacy of immunotherapy.
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Zhang J, Wang L, Li X, Xu B. Respiratory Motion Compensation Using Xsight Diaphragm Tracking for Liver Tumor in CK Synchrony Treatment: A Feasibility Study. Int J Radiat Oncol Biol Phys 2023; 117:e744-e745. [PMID: 37786159 DOI: 10.1016/j.ijrobp.2023.06.2282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) This study investigates the feasibility of using Xsight Diaphragm Tracking (XDT) for liver tumors located near or in the diaphragm during CyberKnife Synchrony Treatment. MATERIALS/METHODS Eight patients (46 fractions) with liver tumors located near or in the diaphragm were reviewed retrospectively. Prior to motion data analysis, baselines were flattened to remove the portions with significant changes and improve accuracy. To reduce the uncertainty about sudden irregular breathing, respiratory data were calculated as a rolling average. The overall tracking accuracy based on the patient-specific respiratory curve was evaluated using E2E testing with CIRS (18023-A) dynamic phantom. RESULTS Three main trajectories were observed in this work: Linearity (1/8), Linear radial type (6/8) and Hysteresis (1/1). The mean amplitude was 8.56±4.54 mm, 2.77±2.83 mm, and 4.23±3.92 mm for S-I, L-R, and A-P components. The linear trajectory patient had a more concentrated amplitude distribution. The baseline shifts were 5.88 mm (S-I), 2.53 mm (L-R), and 3.48 mm (A-P). Except for patient 2, all standard deviations of the center phase shift were less than 1 mm. The values of XDT correlation and prediction errors were 1.38±0.65 mm vs. 0.65±0.16 mm (S-I), 1.28±0.48 mm vs. 0.34±0.10 mm (L-R), and 0.96±0.32 mm vs. 0.22±0.072 mm (A-P), respectively. The strong positive correlations were amplitude vs. prediction error, SD of center phase vs. prediction error, and SD of center phase vs. amplitude. The median patient curve-based targeting accuracy was less than 1mm. Additionally, the mean target coverage for all patients with a 3 mm margin was 98.03±1.54%. CONCLUSION This study proved that the diaphragm could be used as a tracking surrogate for liver tumors located in or near the diaphragm instead of placing golden fiducial markers. A reduction in motion amplitude and respiration training were necessary during liver SABR treatment, along with respiration control and evaluation.
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Xing P, Yang J, Xu M, Kong Y, Zhang J, Zhao X, Zhang L. A Prospective Clinical Trial of Radiotherapy Combined with PD-1 Inhibitors and GM-CSF, Sequentially Followed by IL-2 (PRaG 2.0) Regimen in Advanced Refractory Solid Tumors. Int J Radiat Oncol Biol Phys 2023; 117:e157-e158. [PMID: 37784748 DOI: 10.1016/j.ijrobp.2023.06.984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiotherapy could stimulate the immune response and might synergize with PD-1/PD-L1 inhibitors in the clinical treatment of malignancies. Our previous PRaG trial also demonstrated that SBRT/HFRT in combination with PD-1 inhibitors and granulocyte macrophage-colony stimulating factor (GM-CSF) could improve clinical response in patients with advanced refractory solid tumors (ChiCTR1900026175). To further improve the efficacy of immunotherapy combined with radiotherapy, we conducted the PRaG 2.0 trial (ClinicalTrials.gov: NCT04892498) and optimized the PRaG regimen by adding interleukin-2 (IL-2). Preliminary results of PRaG 2.0 had been reported in the 64th ASTRO. Now we report an updated result. MATERIALS/METHODS The PRaG 2.0 regimen was administered to patients with advanced refractory solid tumors who lacked or were unable to tolerate standard-of-care treatments. A treatment cycle consisted of SBRT or HFRT (5 or 8 Gy×2-3f) delivered for one metastatic lesion, PD-1 inhibitor dosing within one week after completion of radiotherapy, GM-CSF 200μg subcutaneous (SC) injection once daily for 7 days, and then sequentially followed by IL-2 2million IU SC once daily for 7 days. PRaG 2.0 regimen was repeated every 21 days for at least 2 cycles until no appropriate lesions for irradiation or reached the tolerance dose of normal tissues. Patients who could not continue radiotherapy and had not yet developed progression disease (PD) allowed PD-1 inhibitors to be continued as maintenance therapy until PD or unacceptable toxicity but no more than one year. The primary endpoint was Progression-Free Survival (PFS). RESULTS As of 31st October 2022, 51 patients were enrolled in the study, and 42 completed at least one tumor assessment. The median Progression-Free Survival (PFS) was 5.8 months, and the median overall survival (OS) was 13.5 months. The objective response rate (ORR) was 21.4%, and the disease control rate (DCR) was 61.9% according to RECIST version 1.1. Lower plasma levels of Interleukin (IL)-6 and IL-17 at baseline were found to be associated with improved PFS. Treatment-related adverse events (TRAE) occurred in 34 of 42 (78.6%) patients, Grade ≥ 3 TRAEs occurred in 4 patients (9.5%). TRAEs leading to discontinuation of all study treatments occurred in three patients (7.1%). CONCLUSION The PRaG 2.0 trial demonstrates that PD-1 inhibitors in combination with SBRT/HFRT, GM-CSF, and IL-2 could be a potential treatment regimen for patients with advanced refractory solid tumors, with an acceptable benefit/risk profile.
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Liu Q, Lun L, Meng S, Wang Z, Qu Y, Huang X, Chen X, Wang J, Zhang J, Wang K, Wu R, Zhang Y, Yi J, Luo J. Feasibility of Omitting Contralateral Neck Irradiation in Patients with Node-Negative Sinonasal Squamous Cell Carcinoma Crossing the Midline. Int J Radiat Oncol Biol Phys 2023; 117:e600. [PMID: 37785813 DOI: 10.1016/j.ijrobp.2023.06.1961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) This study aims to analyze the nodal target volume in patients with node-negative SNSCC crossing the midline. MATERIALS/METHODS One hundred and four patients with node-negative advanced sinonasal squamous cell carcinoma (SNSCC) crossing the midline were included. Survival rates were estimated and compared between treatment groups. RESULTS Sixty-four patients received contralateral ENI (contralateral ENI group), while forty patients did not (non-contralateral ENI group). The median follow-up time was 89.99 and 95.01 months in the contralateral and non-contralateral ENI groups, respectively. At 5 years, the regional relapse-free survival and contralateral regional relapse-free survival were 57.68% vs. 55.83% (p = 0.372), and 57.68% vs. 61.62% (p = 0.541), in contralateral ENI group vs. non-contralateral ENI group, respectively. Five-year overall survival, local relapse-free survival, and distant metastasis-free survival were similar in the two groups (all p > 0.05). CONCLUSION In patients with node-negative SNSCC crossing the midline, omission of contralateral ENI did not affect regional control and survival outcomes on the premise of receiving ipsilateral ENI covering at least levels Ib and II.
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Zhang X, Yang M, Zhang J, Ye P, Wong RMY, Cheung WH, Armstrong E, Johansen A, Ivers R, Wu X, Tian M. Establishing a Chinese older hip fracture registry for older patients: a Delphi study to define the focus and key variables for this registry. Osteoporos Int 2023; 34:1763-1770. [PMID: 37341729 DOI: 10.1007/s00198-023-06832-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023]
Abstract
A national hip fracture registry does not yet exist in China. This is the first to recommend a core variable set for the establishment of a Chinese national hip fracture registry. Thousands of Chinese hospitals will build on this and improve the quality of management for older hip fracture patients. The rapidly ageing population of China already experiences over half a million hip fractures every year. Many countries have developed national hip fracture registries to improve the quality of hip fracture management, but such a registry does not exist in China. The study is aimed at determining the core variables of a national hip fracture registry for older hip fracture patients in China. A rapid literature review was conducted to develop a preliminary pool of variables from existing global hip fracture registries. Two rounds of an e-Delphi survey were conducted with experts. The e-Delphi survey used a Likert 5-point scale and boundary value analysis to filter the preliminary pool of variables. The list of core variables was finalised following an online consensus meeting with the experts. Thirty-one experts participated. Most of the experts have senior titles and have worked in a corresponding area for more than 15 years. The response rate of the e-Delphi was 100% for both rounds. The preliminary pool of 89 variables was established after reviewing 13 national hip fracture registries. With two rounds of the e-Delphi and the expert consensus meeting, 86 core variables were recommended for inclusion in the registry. This study is the first to recommend a core variable set for the establishment of a Chinese national hip fracture registry. The further development of a registry to routinely collect data from thousands of hospitals will build on this work and improve the quality of management for older hip fracture patients in China.
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Zhang J, Luo X, Zhou R, Dai Z, Guo C, Qu G, Li J, Zhang Z. The axial and sagittal CT values of the 7th thoracic vertebrae in screening for osteoporosis and osteopenia. Clin Radiol 2023; 78:763-771. [PMID: 37573241 DOI: 10.1016/j.crad.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 08/14/2023]
Abstract
AIM To evaluate the difference in computed tomography (CT) attenuation value of different planes of the 7th thoracic vertebra and investigate the efficacy of axial and sagittal vertebral CT measurements in predicting osteoporosis. MATERIALS AND METHODS Patients who underwent routine chest CT and dual-energy X-ray absorptiometry (DXA) within 1 month were included in this retrospective study. The CT attenuation values of different planes were compared. Logistic regression and receiver operating characteristic (ROC) were used to analyse the difference of each plane in the diagnosis of osteoporosis. RESULTS The study included 1,338 patients (mean age of 61.9±11.9; 54% female). The CT attenuation values decreased successively in the normal group, osteopenia group, and osteoporosis group. The paired t-test results showed that the mid-axial measurements were greater than mid-sagittal measurements, with a mean difference of 9 HU, the difference was statistically significant (p<0.001, 95% confidence interval [CI] = 7.8-10.1). For each one-unit reduction in mid-sagittal CT attenuation value, the risk of osteopenia or osteoporosis increased by 3.6%. To distinguish osteoporosis from non-osteoporosis (osteopenia + normal), the sensitivity was 90% and the specificity was 52.4% at the mid-sagittal threshold of 113.7 HU. CONCLUSIONS The CT attenuation values of mid-sagittal plane have higher diagnostic efficacy than axial planes in predicting osteoporosis. For patients with a sagittal CT attenuation value of <113.7 HU in the T7, further DXA examination is warranted.
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Wang X, Wang L, Zhang J, Liu Y, Xie H, Zeng J, Cheng P. Photoredox catalysed reductive aminomethylation of quaternary benzophenanthridine alkaloids. Nat Prod Res 2023; 37:3551-3555. [PMID: 35767365 DOI: 10.1080/14786419.2022.2092732] [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: 03/08/2022] [Revised: 05/12/2022] [Accepted: 06/11/2022] [Indexed: 10/17/2022]
Abstract
Reduction of C = N double bond is the most important phase I metabolism process of quaternary benzophenanthridine alkaloids (QBAs). Inspired by the NADPH mediated reduction in QBAs, a visible-light promoted reductive aminomethylation of QBAs for synthesis of 6-substituted benzophenanthridines was reported using QBAs and N,N-dimethylaniline as coupling partners in this study. An α-amino radical that derived from QBAs was supposed to be the key intermediate in this visible-light promoted reductive aminomethylation reaction.
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Gu Y, Fan X, Zhang X, Zhang J, Lai S. A Comparative Population-Based Study of Tracheal and Lung Adenoid Cystic Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e21. [PMID: 37784873 DOI: 10.1016/j.ijrobp.2023.06.693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Thoracic adenoid cystic carcinoma (ACC) is very rare, and its clinicopathological characteristics, treatment and prognosis have not been fully elucidated. Previous studies did not differentiate between tracheal and lung lesions. MATERIALS/METHODS We identified tracheal ACC (TACC) and lung and bronchus ACC (LACC) patients from our cancer center (from 2005 to 2022) and the Surveillance, Epidemiology, and End Results (SEER) database (from 2000 to 2009). Incidence was calculated and trends were quantified. Significant prognostic factors for overall survival (OS) were reviewed and analyzed by using Cox proportional hazards regression. Then, two nomograms predicting OS of TACC and LACC were constructed based on the SEER database and validated externally by using the separate cohort. RESULTS There was an upward trend from 2000 to 2019 for LACC while a downward trend from 2000 to 2009 was shown for TACC. Totally, 55 TACC and 25 LACC were included in our cohort, 121 TACC and 162 LACC included in the SEER cohort. There were larger tumor sizes, more lymph nodes and distant metastases for LACC patients than TACC patients. The proportion of patients receiving radiotherapy were higher for TACC than LACC. More patients with TACC received surgery and perioperative radiotherapy than those with LACC. Patients with LACC had significantly worse OS than patients with TACC (SEER cohort: 93.7 mons vs. 127.0 mons, p = 0.001, our cohort: 72.2 months vs. 130.8months, p = 0.061). Age, lymph node metastasis, distant metastasis and radiation and/or surgery were identified as independent prognostic factors for OS of TACC. Laterality, distant metastasis and surgery were identified for LACC. The discrimination of the nomogram revealed good prognostic accuracy and clinical applicability as indicated by C-index values of 0.753 and 0.833 for the training cohort and the external validation cohort for TACC, and 0.739 and 0.786 for LACC. CONCLUSION TACC and LACC are different in incidence, clinical features, prognosis. Compared with LACC, radiotherapy combined with surgery is more important for TACC. Two nomograms were established for TACC and LACC respectively to help physicians make more individualized survival predictions and clinical decisions.
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Lan F, Ma L, Chen P, Lei L, Zou T, Zhang J, Jin J. Prospective Efficacy of Two Cycles Toripalimab Plus Induction Chemotherapy in T4 or N3 Locoregionally Advanced Nasopharyngeal Carcinoma: A Retrospective and Mechanistic Study. Int J Radiat Oncol Biol Phys 2023; 117:S70. [PMID: 37784558 DOI: 10.1016/j.ijrobp.2023.06.377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Gemcitabine-cisplatin (GP) as the most commonly used induction chemotherapy is the standard first-line systemic treatment for advanced nasopharyngeal carcinoma. However, the toxicity of three cycles induction chemotherapy following on chemoradiotherapy remains a pertinent issue. Additional monoclonal antibody against human programmed death-1 (PD-1) has shown promising efficacy in recurrent or metastatic nasopharyngeal carcinoma. MATERIALS/METHODS In this study, we compared three cycles of gemcitabine and cisplatin as classical induction chemotherapy with two cycles of induction chemotherapy plus toripalimab, and then both groups treated with the similar concurrent chemoradiotherapy. Patients with locoregionally advanced nasopharyngeal carcinoma staging T4 or N3 were randomly assigned in a 1:1 ratio to receive gemcitabine (at a dose of 1 g per square meter of body-surface area on days 1 and 8) plus cisplatin (80 mg per square meter on day 1-3), administered every 3 weeks for three cycles, or GP combined with toripalimab (at a dose of 240mg) for two cycles. The primary end point was recurrence-free survival (i.e., freedom from disease recurrence [distant metastasis or locoregional recurrence] or death from any cause) in the intention-to-treat population. Secondary end points included overall survival, treatment adherence, and safety. RESULTS A total of 60 patients were included in the trial (30 patients in the toripalimab combined induction chemotherapy group and another 30 in the standard-therapy group). Among 60 patients evaluable for response assessment after induction therapy, all patients had overall response in combined group, including 10 patients (30%) with complete response (CR) in the primary tumor site. 21 patients (70%) were evaluated as partial response (PR) in the standard induction chemotherapy, and another 9 patients were assessed as SDa. At a median follow-up of 27.6 months, the 6-months, 1-, 2-year recurrence-free survival was 100% vs 86.7%, 100% vs 80%, 93% vs 70% in the toripalimab combined induction chemotherapy group and standard-therapy group (stratified hazard ratio for recurrence or death, 0.62; 95% confidence interval [CI], 0.38 to 0.87; P = 0.001). Overall survival at 2 years was 93.3% and 100%, respectively (stratified hazard ratio for death, 0.53; 95% CI, 0.29 to 0.79). The incidence of acute adverse events of grade 3 or 4 was 76.8% in the standard-induction chemotherapy group and 56% in the standard-therapy group, with a higher incidence of neutropenia, thrombocytopenia, anemia, nausea, and vomiting in the induction chemotherapy group. The incidence of grade 3 or 4 late toxic effects was 10.2% in the induction chemotherapy group and 10.4% in the combined-therapy group. CONCLUSION Two cycles of toripalimab combined with induction chemotherapy of and CCRT shows excellent distant metastatic control with acceptable safety, which is a new promising and effective systemic therapy regimen for high-risk of metastatic NPC patients.
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Zhang J, Ganguly S, Jason L, Zhao Y, Baker J, Cao Y, Chang J. Auto Assistant VMAT Planning with HID Automation. Int J Radiat Oncol Biol Phys 2023; 117:e745-e746. [PMID: 37786160 DOI: 10.1016/j.ijrobp.2023.06.2284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To develop a complete, robust, adaptable and fully customizable software interface for assisting treatment planning procedures on FDA approved commercial system. This will standardize treatment planning process and provide opening interface to other third-party clinical software packages, and introduce AI inference to optimize plan without breaking current clinical planning workflow. MATERIALS/METHODS Based on our clinical planning workflow, Varian Eclipse TPS were used. The general HID interface AUTOFLOW was developed with scripting language AutoIt and includes optical character reorganization (OCR) ability. The AUTOFLOW is fully customizable and adaptable for different VMAT planning process. The planning workflow and objective constraints template defined by Northwell health, CFAM are applied. AUTOFLOW operates automatically 3 standard planning interfaces (contouring, external beam planning and optimization) of Eclipse based on information in action tables. The information in the tables, such as auxiliary structures, field set up and initial optimization parameters, can be preset according to the plan template or from other 3rd party packages. Based on Northwell CFAM clinical planning protocol, the planning starts from post-contour approval. AUTOFLOW operates Eclipse to create auxiliary structures, set up planning fields then initiate plan optimization. During the optimization, the AUTOFLOW fills the constraint parameters and monitor the objective goals achievement by OCR. The updated parameters are introduced with our developing machine learning package. The whole planning process were assisted by AUTOFLOW automatically, while the planner can intercept the planning process as need. RESULTS The general interface, AUTOFLOW was developed and applied to automatically assist the VMAT procedure in prostate cases. For each prostate case, more than 213 human HID operations on computers were removed from the plan procedure in our CFAM planning protocol. 12 prostate cases without manual interception were tested. The interface succeeds to reducing the VMAT planning time and planner still own the planning control. CONCLUSION The AUTOFLOW software interface can be used to perform VMAT planning in current commercial clinical planning system. It can automatically assist planner operation and provide standard interface to 3rd party software packages. The future works will focus on building a cohesive UI, reducing the time further by improving the prediction of optimization parameters and other treatment sites.
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Zhao X, Fang H, Jing H, Zhang N, Zhang J, Jin J, Zhong Q, Yang WF, Zhong Y, Dong L, Tie J, Wu HF, Wang XH, Lu Y, Hou X, Zhao L, Qi S, Song Y, Liu Y, Tang Y, Lu N, Chen B, Tang Y, Li Y, Wang S. Lymphocyte Count Kinetics and the Effect of Different Radiotherapy Techniques on Radiation-Induced Lymphopenia in Patients with Breast Cancer Receiving Hypofractionated Postmastectomy Radiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e216-e217. [PMID: 37784888 DOI: 10.1016/j.ijrobp.2023.06.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation-induced lymphopenia (RIL) is associated with poor prognosis in solid tumors. This study aimed to describe the lymphocyte kinetics in patients with breast cancer receiving hypofractionated postmastectomy radiotherapy (RT) and to investigate the association of different RT techniques with RIL. MATERIALS/METHODS We assessed 607 patients who received hypofractionated postmastectomy RT for breast cancer in our prospective clinical database from 8 hospitals. All patients received irradiation to the chest wall and supraclavicular fossa. RT techniques included integrated RT with the photon-based intensity modulated techniques to irradiate all target volumes (integrated RT) and a hybrid approach combining photon irradiation to supraclavicular nodes and electron irradiation to the chest wall (hybrid RT). Peripheral lymphocyte counts (PLC) were tested prior to RT (baseline), weekly during RT, at 1, 2 weeks, 3, 6 months after RT, and then every 6 months. Grade 3+ RIL was defined as PLC nadir during RT of <0.5 ×103/ml. Mean PLC was compared by the t test. Univariate, multivariate, and propensity score matching (PSM) analyses were used to evaluate the effect of different RT techniques on grade 3+ RIL. RESULTS During RT, 121 (19.9%) of patients had grade 3+ RIL. The PLC started to recover at 1 week and reached baseline levels 1 year after RT. A greater proportion of the patients treated with the integrated RT (90/269, 33.5%) developed grade 3+ PLC compared with those receiving hybrid RT (31/338, 9.2%, P < 0.001). After conducting PSM, multivariate analyses showed lower baseline PLC (HR = 0.15, P<0.001) and RT technique (the integrated RT vs. hybrid RT, HR = 4.76, P<0.001) were independent risk factors for grade 3+ RIL. The PLC in patients receiving the integrated RT after RT were higher than that in those receiving hybrid RT (p<0.05). CONCLUSION RT technique affect the risk of and recovery from RIL, which may impact survival. Choosing appropriate RT technique to minimize RIL might be considered to benefit their outcomes.
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Wang DQ, Huang Z, Zhu L, Huang XB, Wang WH, Tie J, Shen L, Shi M, Chen JY, Liu M, Cheng J, Zhang J, Li YX, Wang S. Recurrence Risk Score Model for Evaluating the Impact of Postmastectomy Radiotherapy in Breast Cancer Patients with Pathologic Nodal Negative after Neoadjuvant Chemotherapy and Mastectomy. Int J Radiat Oncol Biol Phys 2023; 117:e211. [PMID: 37784877 DOI: 10.1016/j.ijrobp.2023.06.1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Recurrence risk score model was established to distinguish the recurrent risk of patients with pathologic nodal negative (ypN0) after neoadjuvant chemotherapy (NACT) and mastectomy and determine the impact of postmastectomy radiotherapy (PMRT). MATERIALS/METHODS This multicenter retrospective study reviewed 766 patients who underwent mastectomy and NACT with ypN0 from 2000 to 2014. Recurrent risk score model was assigned proportionally to the relative contribution of independent prognostic factors in the multivariate Cox model of disease-free survival (DFS). Decision tree analysis was conducted to determine two optimal cutoff points for stratification. RESULTS The median follow-up time was 74 months. The 5-year locoregional control (LRC), DFS, and overall survival (OS) rates for the entire group were 96.5%, 89.1% and 95.3%, respectively. 353 (46.1%) patients received PMRT and 413 (53.9%) patients did not. Patients with PMRT have more high-risk factors, including age <40 years, clinical stage III, grade III, or ER and PR negative. Chest wall and regional nodal region were irradiated in 307 (87.0%) and chest wall only in 46 (13.0%). The median radiation dose was 50 Gy (range: 36-60 Gy) in 25 fractions (range: 15-30 fractions). There were no significant differences between the PMRT and No-PMRT groups in the LRC, DFS and OS rates. Recurrent risk score model consisted of five factors and used a range of zero to eleven scoring points: age <40 years and clinical N1 stage for one point; clinical N2, NACT ≥4 cycles, lymphovascular invasion and ypT1-2 for two points; ypT3-4 for four points. 456 (59.5%) patients scoring zero to four points, 188 (24.5%) scoring five points and 122 (15.9%) scoring six to eleven points were assigned to the low-, intermediate-, and high-risk group. LRC, DFS and OS rates in three risk groups were significantly distinct from each other (5yr-LRC: 98.6% vs. 95.5% vs. 89.8%, p < .001; 5yr-DFS: 94.4% vs. 87.4% vs. 71.5%, p < .001; 5yr-OS: 97.6% vs. 93.2% vs. 90.0%, p < .001). PMRT had no impact on the LRC, DFS and OS rates in either low-, intermediate-, or high-risk group. CONCLUSION The recurrence risk score model can effectively distinguish patients with different recurrent risk stratification. PMRT in patients with ypN0 after NAC and mastectomy cannot improve LRC, DFS or OS. Table 1. Survival outcomes and comparison between PMRT and No-PMRT arms in different groups.
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Chen N, Zhou R, Luo Q, Liu Y, Li C, Zhang J, Guo J, Zhou Y, Jiang H, Qiu B, Liu H. Combining Dosimetric and Radiomics Features for the Prediction of Radiation Pneumonitis in Locally Advanced Non-Small Cell Lung Cancer by Machine Learning. Int J Radiat Oncol Biol Phys 2023; 117:e38. [PMID: 37785286 DOI: 10.1016/j.ijrobp.2023.06.732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) This study aimed to analyze the dosimetric factors and radiomics features of tumor and lungs in locally advanced non-small cell lung cancer (LANSCLC) to establish machine learning models and improve the prediction of grade (G) 2 radiation pneumonitis (RP). MATERIALS/METHODS This study retrospectively collected data of 284 LANSCLC patients underwent concurrent chemoradiotherapy (CCRT) to a median dose of 64 Gy in 20-33 fractions between 2013 and 2021. Of this cohort, 21.1% of patients had ≥ G2 RP. There were 4 regions of interest (ROIs) had been identified in planning computed tomography images: gross tumor volume (GTV), ipsilesional lung (IL), contralesional lung (CL), and total lung (TL). We calculated the dose-volume histogram (DVH) from the lowest dose to the maximum dose increasing by degrees with 1 Gy, and extracted a total of 172 radiomics features from all the 4 ROIs. We selected the best predictors for classifying 2 groups of patients using a sequential backward elimination support vector machine model. RESULTS The best predictors for ≥ G2 RP were the combination of 8 radiomics features and 7 dosimetric factors in training group, and the validation group achieved an area under the curve (AUC) of 0.847 (accuracy, 80.38%; sensitivity, 78.95%; specificity, 81.82%). The eight radiomic features included 2 from GTV while 1, 2 and 3 from IL, CL and TL, respectively. For dosimetric factors, V65 of GTV, V20, V50 and V55 of IL, V10 of CL, V20 and V55 of TL appeared to be significantly related to symptomatic RP. These dosimetric factors should be constrained to less than 99.2%, 50.0%, 17.5%, 13.0%, 39.5%, 32.0%, and 6.6%, respectively. CONCLUSION Combining dosimetric factors and radiomics features within GTV, IL, CL and TL can improve the prediction of symptomatic RP in LANSCLC patients treated with CCRT. The results suggested the importance of V65 of GTV, V20, V50 and V55 of IL, V10 of CL, V20 and V55 of TL as predictors of symptomatic RP and provide useful information for optimization of treatment planning in the era of combination of radiotherapy and immunotherapy.
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Oh N, Nakashima J, Chadha JS, Kish JA, Manley B, Pow-Sang J, Yu A, Zhang J, Spiess P, Chatwal MS, Jain R, Zemp LW, Poch M, Sexton WJ, Li R, Gilbert SM, Johnstone PAS, Torres-Roca JF, Yamoah K, Grass D. An Analysis of Patients Treated with Stereotactic Body Radiotherapy for Metastatic Urinary Tract Tumors to Identify Predictors of Response. Int J Radiat Oncol Biol Phys 2023; 117:e424-e425. [PMID: 37785392 DOI: 10.1016/j.ijrobp.2023.06.1583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To identify selection criteria linked to outcomes in patients treated with stereotactic body radiotherapy (SBRT) for metastatic tumors of the urinary tract (UT). MATERIALS/METHODS Single institution retrospective analysis of SBRT treated patients for oligometastatic/progressive UT tumors from 2006-2022. Charts were queried for M1 status at diagnosis or during disease course, treatment details (surgery, SBRT, systemic therapy), metabolic status (diabetes [DM], BMI) and outcomes. A linear quadratic formula was used to calculate the biologically effective dose (BED) using an α/β of 10 for tumor. Descriptive statistics portrayed the cohort, and analyses were done at patient and site level. Time-to-event analyses, including overall survival (OS) and progression-free survival (PFS) from SBRT, were assessed by the Kaplan-Meier method. Cox regression was used for univariable (UVA) and multivariable analyses (MVA) to identify predictors of outcomes. RESULTS A total of 35 patients were treated at 44 metastatic sites, including: bone (25%), node (36.4%), lung (20.5%), soft tissue (13.6%) and liver (4.5%). Most were male (74.3%) with a median age of 70 (range: 51-89), without DM (60%) having a median BMI of 29.8, and ECOG <2 (97.1%) at time of SBRT. Six (17.1%) patients were M1 at diagnosis. Of the 29 non-M1 patients, 86.2% received definitive local therapy (LT), 58.6% had at least T3/N+ disease, 75.8% received systemic therapy with a median of 2 agents (range: 1-6) prior to SBRT. Sixteen (45.7%) received immunotherapy (IO) with most receiving this before (75%) and after (56.2%) SBRT. Six patients had positive PD-L1 status (n = 10). The median RT dose, fractionation and BED was 40 Gy (range: 14-46), 5 fractions, and 72 (range: 28-132), respectively. At a median follow-up of 34.8, the median OS was 18.4 m (range: 9.3-27.4) with a 2-year OS of 35.9%. At patient level, 62.8% recurred after SBRT. The median PFS after SBRT was 5.3 m (range: 1.8-8.7) with a 2-yr PFS of 29.3%. Patient-level PFS was improved with LT (6.7 vs 1.4 m; p = 0.001) and DM (NR vs 2.9 m; p = 0.015), whereas improved OS was related with LT (18.9 vs 6.6 m; p = 0.03), DM (p = 0.04), ECOG (p = 0.004), and no relapse after SBRT (NR vs 9.8 m; p <0.001). Exposure to < 3 systemic agents prior to SBRT portended better PFS (6.7 vs 2.6 m; p = 0.04) without any impact by IO. At site level, 20.4% of sites had local relapse with 4 being the first event. Site was related with PFS (p = 0.009) with order of increased relapse risk being liver > bone > soft tissue > node > lung. No dosimetric feature was related with recurrence risk. On MVA, both DM (p = 0.02) and LT (p = 0.002) were predictive for PFS. Only recurrence after SBRT predicted for OS on MVA (HR: 6.7, 95% CI: 1.4-31; p = 0.014). In the IO subset, median PFS was 5.3 m and OS was 9.4 m, with no difference seen with IO-SBRT sequence or PDL1 status. CONCLUSION Optimized selection criteria for metastasis-directed therapy in patients with UT tumors is unclear, notably with IO. Future studies may benefit by assessing circulating tumor markers prior to SBRT.
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Zhang J, Zhang X, Zhang Q, Cheng XD, Wang LR, Jia LJ, Zhou S, Li BH, Yu NW. [Predictive value of plasma exosomal miR-124-3p for the risk of chronic cerebral hypoperfusion]. ZHONGHUA NEI KE ZA ZHI 2023; 62:1194-1199. [PMID: 37766438 DOI: 10.3760/cma.j.cn112138-20230510-00247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Objective: To investigate the predictive value of plasma exosomal microRNA (miR)-124-3p in the risk of chronic cerebral hypoperfusion (CCH). Methods: A case-control study. Thirty patients who were diagnosed with CCH (CCH group) based on cranial artery spin labeling (ASL) in the neurology outpatient clinic of Sichuan Provincial People's Hospital from March 2022 to June 2022 and 30 healthy volunteers (control group) were included. Age, gender, smoking history, alcohol consumption history, diabetes history, hypertension, hyperlipidemia history, uric acid, fasting blood glucose, homocysteine and plasma exosomal miR-124-3p expression level were compared between the two groups. Comparisons of categorical variables were analyzed by either χ2 test or Fisher's exact test. If the data of continuous variables followed a normal distribution, they were expressed as mean±standard deviation (SD) and compared by t-test for two independent samples; otherwise, the data were expressed as M(Q1, Q3), and analyzed by Mann-Whitney U test for comparison between two groups. The correlation between cerebral blood flow and exosomal miR-124-3p levels was analyzed by Pearson's correlation. Binary multifactorial logistic regression analysis was used to determine the risk factors associated with CCH, and corresponding odds ratios (OR) and 95% confidence intervals (CI) were calculated. P<0.05 was considered significant. Results: There was no significant difference in age (64±8 vs. 60±8 years old), gender (33.3% vs. 30.0%), history of smoking (20.0% vs. 3.3%), alcohol consumption (20.0% vs. 6.7%), diabetes mellitus (13.3% vs. 13.3%), hypertension (53.3% vs. 30.0%), history of hyperlipidemia (46.7% vs. 36.7%), uric acid (288±60 vs.319±67 μmol/L), and fasting glucose [4.99(4.63, 5.91) vs. 5.28(5.09, 6.05) mmol/L] and homocysteine [11.35(10.18, 13.08) vs.11.00(9.78, 13.03) μmol/L] between the CCH and control groups (P>0.05). Plasma exosomal miR-124-3p expression was significantly higher in the CCH group than in the control group [13.08 (8.59, 21.55) vs. 2.85 (1.44, 5.10), respectively; U=169.50, P<0.001]. Pearson's correlation test showed that the level of exosomal miR-124-3p was negatively correlated with cerebral blood flow in the hypoperfused region in patients with CCH (r=-0.932, P<0.001). Multi-factor logistic regression analysis showed that plasma exosomal miR-124-3p was independently associated with the risk of CCH (OR=1.169,95%CI 1.063-1.286,P=0.001). Conclusions: The expression of plasma exosomal miR-124-3p is negatively correlated with cerebral blood flow in areas of low perfusion and is an independent risk factor for CCH. Plasma exosomal miR-124-3p may thus serve as a valid biomarker for CCH risk prediction.
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Xiang J, Ding XY, Zhang W, Zhang J, Zhang YS, Li ZM, Xia N, Liang YZ. Clinical effectiveness of semaglutide on weight loss, body composition, and muscle strength in Chinese adults. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2023; 27:9908-9915. [PMID: 37916360 DOI: 10.26355/eurrev_202310_34169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the clinical effectiveness of semaglutide on weight loss, body composition and muscle strength in the Chinese population with obesity. PATIENTS AND METHODS Data were retrospectively analyzed for participants prescribed semaglutide in 2021 and 2022 from a Chinese weight management clinic. Changes in weight, body composition, biochemical indicators, calf circumference and handgrip strength were collected. Body fat and skeletal muscle were also measured using the bioelectrical impedance analysis. Paired t-test was used to compare the values after 6 months of treatment with the baseline values. RESULTS A total of 53 obese patients received 24 weeks of lifestyle intervention plus semaglutide treatment. 10 patients who failed to adhere to the follow-up were excluded, and 43 patients were studied. The average baseline body mass index (BMI) was 33.0 kg/m2, and the average body weight was 90.0 kg. After 6 months of treatment, the patient's weight was significantly reduced by 9.9 ± 3.9 kg (p < 0.001), and the weight loss percentage was 11.2 ± 4.5% (p< 0.001). The proportion of patients with weight loss ≥ 5% and ≥ 10% was 93% and 54%, respectively. Fasting blood glucose, fasting insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index, blood uric acid and blood lipid levels also decreased after treatment. Body composition analysis showed that the loss of skeletal muscle mass was 1.4 ± 1.3 kg (p < 0.001), which was significantly less than the loss of fat mass of 5.6 ± 3.7 kg (p < 0.001). By percentage, the fat mass loss was 15.6 ± 10.1%, and the muscle mass loss was 4.8 ± 4.4% (p < 0.001). The visceral fat area was significantly reduced by 24.4 ± 17.7 cm (p < 0.001). There was no significant change in skeletal muscle index (8.1 ± 1.0 kg/m2 at baseline and 7.9 ± 1.0 kg/m2 at 24 weeks). The calf circumference (42.6 ± 3.6 cm at baseline, 41.2 ± 3.8 cm at 24 weeks) and grip strength (33.3 ± 9.5 kg at baseline, 32.3 ± 9.0 kg at 24 weeks) did not decrease significantly. The main adverse reactions were mild gastrointestinal dysfunction (nausea, diarrhea and vomiting), without ketoacidosis. CONCLUSIONS In a real-world setting, semaglutide can reduce the weight and fat of obese patients while effectively maintaining muscle mass and muscle strength.
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Song Y, Hu Z, Yan XN, Fang H, Yu T, Jing H, Men K, Zhang N, Zhang J, Jin J, Zhong Q, Ma J, Yang WF, Zhong Y, Dong L, Wang XH, Wu HF, Du XH, Hou X, Tie J, Lu Y, Zhao L, Li YX, Wang S. Quality Assurance in a Phase III, Multicenter, Randomized Trial of POstmastectomy radioThErapy in Node posiTive Breast Cancer with or without Internal mAmmary nodaL Irradiation (POTENTIAL): A Planning Dummy Run. Int J Radiat Oncol Biol Phys 2023; 117:S97. [PMID: 37784615 DOI: 10.1016/j.ijrobp.2023.06.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To report the planning dummy run results of the POstmastectomy radioThErapy in Node posiTive breast cancer with or without Internal mAmmary nodaL irradiation (POTENTIAL) trial-a multicenter, randomized, phase 3 trial-to evaluate postmastectomy radiotherapy, with or without internal mammary nodal irradiation, for patients with high-risk breast cancer. MATERIALS/METHODS All participating institutions were provided the contours of the dummy run case, and they generated radiotherapy (RT) plans per protocol guidelines. The plans were reviewed and feedback were provided by the quality assurance team, after which the institutions resubmitted revised plans. The information on beams arrangement, skin flash, inhomogeneity corrections, and protocol compliance was assessed both in the primary and final submission. RESULTS Theplans from 26 institutions were included in the analysis. A number of major deviations were found in the primary submission, such as less strict constraint on organs at risk (OARs) V5Gy, and no application of chest wall skin flash. The protocol compliance rates of the dose coverage for the planning target volume of the chest wall (PTVcw), PTV of supra/infraclavicular fossa plus axilla levels I, II, III (PTVsc+ax), and PTV of the IMN region (PTVim) were all significantly improved in the final submission compared with those in the primary submission, which were 96.2% vs. 69.2%, 100% vs. 76.9%, and 88.4% vs. 53.8, respectively. For OARs, the protocol compliance rates of heart Dmean, left anterior descending coronary artery V40Gy, ipsilateral lung V5Gy, and stomach V5Gy were significantly improved. CONCLUSION All major deviations were corrected and protocol compliance was significantly improved and of high level in the final submission. Moreover, the variations were reduced. Therefore, a planning dummy run was essential to guarantee good RT plan quality and inter-institutional consistency for multicenter trials.
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Ma J, Zhang J, Shang S, Wang F, Yu J, Chen D. A Dosimetric Study Indicates the Spinal Cord Irradiation Contributes to Acute Hematologic Toxicities in Non-Small Cell Lung Cancer Patients Receiving Radiotherapy Combined with Immunotherapy. Int J Radiat Oncol Biol Phys 2023; 117:S154-S155. [PMID: 37784388 DOI: 10.1016/j.ijrobp.2023.06.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To assess the radiation therapy (RT) dose to radiation-associated hematologic toxicities (HTs) in patients with non-small cell lung cancer (NSCLC) after RT combined with immunotherapy. MATERIALS/METHODS Cases of NSCLC treated with RT combined with immunotherapy at Shandong Cancer Hospital in China were identified. The mean dose and the volume of the spinal cord receiving at least 5 to 40 Gy (V5-V40) were retrospectively recorded. Logistic regression was used to estimate associations between grade ≥3 HT (HT3+) and dosimetric/clinical parameters. Receiver operating characteristic analysis was used to determine dosimetric cut-points. RESULTS Ninety-nine patients were analyzed. The majority were male (n = 78, 78.8%) and received chemotherapy (n = 83, 83.9%). All patients received either anti-PD-1 immune checkpoint (n = 89, 89.9%) or anti-PD-L1 immune checkpoint (n = 10, 10.1%) therapy. The rate of HT3+ was 24.2% (n = 24). Spinal cord mean dose, V5 to V40 and BMI parameters associated with HT3+ were included in the multivariate analysis. On multivariate analysis, increasing mean spinal cord dose (per Gy) was associated with higher odds of developing HT3+ (odds ratio 1.053, 95% confidence interval 1.002-1.105, P = .041), as were increasing spinal cord V5 to V20 (As show in the Table below). The optimal cut-points identified were V5 = 52.5%, V10 = 47.5%, V20 = 39.4%, and mean dose = 23.3 Gy. Patients with values above these cut-points had an approximately 2-fold increased risk of HT3+. CONCLUSION We found that mean spinal cord dose and low-dose parameters (V5-V20) were associated with HT3+ in NSCLC patients after RT and immunotherapy. The mean dose of the spinal cord should be kept lower than 23.3 Gy for these patients. These data suggested that efforts to spare doses to the spinal cord might reduce rates of severe HT.
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Zhang J, Gao J, Jiang S, Zhou Y, Xu D, Yang X, Chu L, Chu X, Ni J, Zhu Z. Oligo-Residual Disease in PD-1/PD-L1 Inhibitors Treated Metastatic Non-Small Cell Lung Cancer: Incidence, Pattern of Failure and Clinical Value of Local Consolidative Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e80. [PMID: 37786187 DOI: 10.1016/j.ijrobp.2023.06.826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Growing numbers of clinical trials are testing the efficacy of incorporating local therapy into programmed death receptor (ligand) 1 (PD-1/PD-L1) inhibitors in metastatic non-small cell lung cancer (NSCLC), but the optimal timing and patient selection are still controversial. We aimed to examine the patterns of maximum tumor response and treatment failure in PD-1/PD-L1 inhibitor-treated NSCLC, and explore the potential clinical value of local consolidative therapy (LCT) in those with oligo-residual disease (ORD). MATERIALS/METHODS Metastatic NSCLC treated with PD-1/PD-L1 inhibitors in three academic centers from May 2018 to December 2021 were retrospectively reviewed and those derived clinical benefit, defined as having objective response or durable stable disease lasting≥6months, were finally enrolled. Patterns of tumor response and treatment failure were extensively analyzed. ORD was defined as residual tumor distribution limited to 3 organs and 5 lesions, otherwise was defined as multiple residual disease (MRD). Local therapies targeting the residual tumor lesions performed after PD-1/PD-L1 inhibitors initiation and before initial disease progression, were considered as LCT. The primary endpoints were the overall survival (OS) and progression-free survival (PFS). RESULTS Of the 318 patients enrolled, ORD and MRD were documented in 122 (38.4%) and 196 (61.6%) patients, respectively. Those who developed ORD had a significantly longer OS than those with MRD (p = 0.006). The median time to best response was 4 months and more than 50% of the initial disease progression developed only from the residual tumor lesions, providing the preliminary rationale of LCT. Among the 122 patients with ORD, those receiving LCT (n = 39) had significantly longer PFS (p = 0.04) and OS (p<0.001) than those without LCT. Moreover, LCT remained one of the independent predictors of improved PFS and OS after Cox analyses. CONCLUSION Local consolidative therapy seems to be feasible and may provide extra survival benefit for metastatic NSCLC patients with oligo-residual disease after PD-1/PD-L1 inhibitor treatment.
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Ma L, Xiang X, Lan F, Chen P, Lei L, Zou T, Wu R, Zhang J. Combining Radiotherapy with Chemotherapy and Immunotherapy as First-Line Treatment for De Novo Metastatic Nasopharyngeal Carcinoma: A Dual-Center Retrospective Analysis. Int J Radiat Oncol Biol Phys 2023; 117:e603-e604. [PMID: 37785819 DOI: 10.1016/j.ijrobp.2023.06.1970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Local regional radiotherapy combined with systemic chemotherapy significantly improves the prognosis of patients with metastatic nasopharyngeal carcinoma (NPC). Immunochemotherapy has become the first-line treatment for initial metastatic NPC. This study evaluated the safety and efficacy of local regional radiotherapy combined with immunochemotherapy as the first-line treatment of metastatic NPC. MATERIALS/METHODS Patients with histologically proven de novo metastatic NPC who received immunotherapy and chemotherapy followed by local-regional radiotherapy were included from 2 cancer centers. Toxicity and treatment response were assessed using CTCAE 5.0 and RECIST 1.1, respectively. Overall survival (OS) and progression free survival (PFS) were analyzed using the Kaplan-Meier method. RESULTS From 2019 to 2021, a total of 16 patients were retrospectively analyzed. The median age was 44.5-year-old (range 16-76). Patients with ≥3 metastatic lesions accounts for 58.8%. Bone metastasis was the most common metastatic site. The chemotherapy regimens were paclitaxel/gemcitabine and cisplatin. Toripalimab, camrelizumab and sintilimab were used for immunotherapy. All patients completed the local regional radiotherapy with 69.96Gy for primary nasopharyngeal tumor and positive lymph nodes, 60.06Gy for high-risk region and 50ཞ54.45Gy for low-risk region. Seven patients underwent radiotherapy for metastatic lesions. The median follow-up was 20.5 months (range 6-38 months). Two-year OS was 100%. Three patients experienced distant progression. One-year and 2-year PFS rate was 93.8% and 76.7%, respectively. After combination of chemotherapy and immunotherapy, the overall response rate (ORR) was 93.7% with a complete response (CR) of 6.3%. At the end of radiotherapy, the ORR was 100%. Nine patients (56.3%) achieved CR. Radiotherapy related acute severe (grade 3 or higher) toxicity was dermatitis (1/16, 6.3%) and mucositis (2/16, 12.5%). Immunotherapy related hypophysitis and capillary hyperplasia was 6.3% and 6.3%, respectively. No long-term toxicity was observed. CONCLUSION Loco-regional radiotherapy provided a promising efficacy with modest toxicity for patients with metastatic nasopharyngeal carcinoma who received immunochemotherapy.
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McHugh EG, Grady ST, Collins CM, Moy ML, Hart JE, Coull BA, Schwartz JD, Koutrakis P, Zhang J, Garshick E. Pulmonary, inflammatory, and oxidative effects of indoor nitrogen dioxide in patients with COPD. Environ Epidemiol 2023; 7:e271. [PMID: 37840862 PMCID: PMC10569754 DOI: 10.1097/ee9.0000000000000271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/26/2023] [Accepted: 08/29/2023] [Indexed: 10/17/2023] Open
Abstract
Introduction Indoor nitrogen dioxide (NO2) sources include gas heating, cooking, and infiltration from outdoors. Associations with pulmonary function, systemic inflammation, and oxidative stress in patients with chronic obstructive pulmonary disease (COPD) are uncertain. Methods We recruited 144 COPD patients at the VA Boston Healthcare System between 2012 and 2017. In-home NO2 was measured using an Ogawa passive sampling badge for a week seasonally followed by measuring plasma biomarkers of systemic inflammation (C-reactive protein [CRP] and interleukin-6 [IL-6]), urinary oxidative stress biomarkers (8-hydroxy-2'deoxyguanosine [8-OHdG] and malondialdehyde [MDA]), and pre- and postbronchodilator spirometry. Linear mixed effects regression with a random intercept for each subject was used to assess associations with weekly NO2. Effect modification by COPD severity and by body mass index (BMI) was examined using multiplicative interaction terms and stratum-specific effect estimates. Results Median (25%ile, 75%ile) concentration of indoor NO2 was 6.8 (4.4, 11.2) ppb. There were no associations observed between NO2 with CRP, 8-OHdG, or MDA. Although the confidence intervals were wide, there was a reduction in prebronchodilator FEV1 and FVC among participants with more severe COPD (FEV1: -17.36 mL; -58.35, 23.60 and FVC: -28.22 mL; -91.49, 35.07) that was greater than in patients with less severe COPD (FEV1: -1.64 mL; -24.80, 21.57 and FVC: -6.22 mL; -42.16, 29.71). In participants with a BMI <30, there was a reduction in FEV1 and FVC. Conclusions Low-level indoor NO2 was not associated with systemic inflammation or oxidative stress. There was a suggestive association with reduced lung function among patients with more severe COPD and among patients with a lower BMI.
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Tumasyan A, Adam W, Andrejkovic JW, Bergauer T, Chatterjee S, Damanakis K, Dragicevic M, Escalante Del Valle A, Hussain PS, Jeitler M, Krammer N, Lechner L, Liko D, Mikulec I, Paulitsch P, Schieck J, Schöfbeck R, Schwarz D, Sonawane M, Templ S, Waltenberger W, Wulz CE, Darwish MR, Janssen T, Kello T, Rejeb Sfar H, Van Mechelen P, Bols ES, D'Hondt J, De Moor A, Delcourt M, El Faham H, Lowette S, Morton A, Müller D, Sahasransu AR, Tavernier S, Van Doninck W, Van Putte S, Vannerom D, Clerbaux B, De Lentdecker G, Favart L, Hohov D, Jaramillo J, Lee K, Mahdavikhorrami M, Makarenko I, Malara A, Paredes S, Pétré L, Postiau N, Thomas L, Vanden Bemden M, Vander Velde C, Vanlaer P, Dobur D, Knolle J, Lambrecht L, Mestdach G, Rendón C, Samalan A, Skovpen K, Tytgat M, Van Den Bossche N, Vermassen B, Wezenbeek L, Benecke A, Bruno G, Bury F, Caputo C, David P, Delaere C, Donertas IS, Giammanco A, Jaffel K, Jain S, Lemaitre V, Mondal K, Taliercio A, Tran TT, Vischia P, Wertz S, Alves GA, Coelho E, Hensel C, Moraes A, Rebello Teles P, Aldá Júnior WL, Alves Gallo Pereira M, Barroso Ferreira Filho M, Brandao Malbouisson H, Carvalho W, Chinellato J, Da Costa EM, Da Silveira GG, De Jesus Damiao D, Dos Santos Sousa V, Fonseca De Souza S, Martins J, Mora Herrera C, Mota Amarilo K, Mundim L, Nogima H, Santoro A, Silva Do Amaral SM, Sznajder A, Thiel M, Vilela Pereira A, Bernardes CA, Calligaris L, Tomei TRFP, Gregores EM, Mercadante PG, Novaes SF, Padula SS, Aleksandrov A, Antchev G, Hadjiiska R, Iaydjiev P, Misheva M, Rodozov M, Shopova M, Sultanov G, Dimitrov A, Ivanov T, Litov L, Pavlov B, Petkov P, Petrov A, Shumka E, Thakur S, Cheng T, Javaid T, Mittal M, Yuan L, Ahmad M, Bauer G, Hu Z, Lezki S, Yi K, Chen GM, Chen HS, Chen M, Iemmi F, Jiang CH, Kapoor A, Liao H, Liu ZA, Milosevic V, Monti F, Sharma R, Tao J, Thomas-Wilsker J, Wang J, Zhang H, Zhao J, Agapitos A, An Y, Ban Y, Levin A, Li C, Li Q, Lyu X, Mao Y, Qian SJ, Sun X, Wang D, Xiao J, Yang H, Lu M, You Z, Lu N, Gao X, Leggat D, Okawa H, Zhang Y, Lin Z, Lu C, Xiao M, Avila C, Barbosa Trujillo DA, Cabrera A, Florez C, Fraga J, Mejia Guisao J, Ramirez F, Rodriguez M, Ruiz Alvarez JD, Giljanovic D, Godinovic N, Lelas D, Puljak I, Antunovic Z, Kovac M, Sculac T, Brigljevic V, Chitroda BK, Ferencek D, Mishra S, Roguljic M, Starodumov A, Susa T, Attikis A, Christoforou K, Konstantinou S, Mousa J, Nicolaou C, Ptochos F, Razis PA, Rykaczewski H, Saka H, Stepennov A, Finger M, Finger M, Kveton A, Ayala E, Carrera Jarrin E, Abdelalim AA, Salama E, Abdullah Al-Mashad M, Mahmoud MA, Bhowmik S, Dewanjee RK, Ehataht K, Kadastik M, Lange T, Nandan S, Nielsen C, Pata J, Raidal M, Tani L, Veelken C, Eerola P, Kirschenmann H, Osterberg K, Voutilainen M, Bharthuar S, Brücken E, Garcia F, Havukainen J, Kim MS, Kinnunen R, Lampén T, Lassila-Perini K, Lehti S, Lindén T, Lotti M, Martikainen L, Myllymäki M, Rantanen MM, Siikonen H, Tuominen E, Tuominiemi J, Luukka P, Petrow H, Tuuva T, Amendola C, Besancon M, Couderc F, Dejardin M, Denegri D, Faure JL, Ferri F, Ganjour S, Gras P, Hamel de Monchenault G, Lohezic V, Malcles J, Rander J, Rosowsky A, Sahin MÖ, Savoy-Navarro A, Simkina P, Titov M, Baldenegro Barrera C, Beaudette F, Buchot Perraguin A, Busson P, Cappati A, Charlot C, Damas F, Davignon O, Diab B, Falmagne G, Fontana Santos Alves BA, Ghosh S, Granier de Cassagnac R, Hakimi A, Harikrishnan B, Liu G, Motta J, Nguyen M, Ochando C, Portales L, Salerno R, Sarkar U, Sauvan JB, Sirois Y, Tarabini A, Vernazza E, Zabi A, Zghiche A, Agram JL, Andrea J, Apparu D, Bloch D, Bourgatte G, Brom JM, Chabert EC, Collard C, Darej D, Goerlach U, Grimault C, Le Bihan AC, Van Hove P, Beauceron S, Blancon B, Boudoul G, Carle A, Chanon N, Choi J, Contardo D, Depasse P, Dozen C, El Mamouni H, Fay J, Gascon S, Gouzevitch M, Grenier G, Ille B, Laktineh IB, Lethuillier M, Mirabito L, Perries S, Torterotot L, Vander Donckt M, Verdier P, Viret S, Lomidze I, Toriashvili T, Tsamalaidze Z, Botta V, Feld L, Klein K, Lipinski M, Meuser D, Pauls A, Röwert N, Teroerde M, Diekmann S, Dodonova A, Eich N, Eliseev D, Erdmann M, Fackeldey P, Fasanella D, Fischer B, Hebbeker T, Hoepfner K, Ivone F, Lee MY, Mastrolorenzo L, Merschmeyer M, Meyer A, Mondal S, Mukherjee S, Noll D, Novak A, Nowotny F, Pozdnyakov A, Rath Y, Redjeb W, Rehm F, Reithler H, Schmidt A, Schuler SC, Sharma A, Stein A, Torres Da Silva De Araujo F, Vigilante L, Wiedenbeck S, Zaleski S, Dziwok C, Flügge G, Haj Ahmad W, Hlushchenko O, Kress T, Nowack A, Pooth O, Stahl A, Ziemons T, Zotz A, Aarup Petersen H, Aldaya Martin M, Alimena J, Asmuss P, Baxter S, Bayatmakou M, Becerril Gonzalez H, Behnke O, Bhattacharya S, Blekman F, Borras K, Brunner D, Campbell A, Cardini A, Cheng C, Colombina F, Consuegra Rodríguez S, Correia Silva G, De Silva M, Eckerlin G, Eckstein D, Estevez Banos LI, Filatov O, Gallo E, Geiser A, Giraldi A, Greau G, Grohsjean A, Guglielmi V, Guthoff M, Jafari A, Jomhari NZ, Kaech B, Kasemann M, Kaveh H, Kleinwort C, Kogler R, Komm M, Krücker D, Lange W, Leyva Pernia D, Lipka K, Lohmann W, Mankel R, Melzer-Pellmann IA, Mendizabal Morentin M, Metwally J, Meyer AB, Milella G, Mormile M, Mussgiller A, Nürnberg A, Otarid Y, Pérez Adán D, Ranken E, Raspereza A, Ribeiro Lopes B, Rübenach J, Saggio A, Savitskyi M, Scham M, Scheurer V, Schnake S, Schütze P, Schwanenberger C, Shchedrolosiev M, Sosa Ricardo RE, Stafford D, Tonon N, Van De Klundert M, Vazzoler F, Ventura Barroso A, Walsh R, Walter D, Wang Q, Wen Y, Wichmann K, Wiens L, Wissing C, Wuchterl S, Yang Y, Zimermmane Castro Santos A, Albrecht A, Albrecht S, Antonello M, Bein S, Benato L, Bonanomi M, Connor P, De Leo K, Eich M, El Morabit K, Feindt F, Fröhlich A, Garbers C, Garutti E, Hajheidari M, Haller J, Hinzmann A, Jabusch HR, Kasieczka G, Keicher P, Klanner R, Korcari W, Kramer T, Kutzner V, Labe F, Lange J, Lobanov A, Matthies C, Mehta A, Moureaux L, Mrowietz M, Nigamova A, Nissan Y, Paasch A, Pena Rodriguez KJ, Quadfasel T, Rieger M, Rieger O, Savoiu D, Schindler J, Schleper P, Schröder M, Schwandt J, Sommerhalder M, Stadie H, Steinbrück G, Tews A, Wolf M, Brommer S, Burkart M, Butz E, Chwalek T, Dierlamm A, Droll A, Faltermann N, Giffels M, Gosewisch JO, Gottmann A, Hartmann F, Horzela M, Husemann U, Klute M, Koppenhöfer R, Link M, Lintuluoto A, Maier S, Mitra S, Müller T, Neukum M, Oh M, Quast G, Rabbertz K, Rauser J, Shvetsov I, Simonis HJ, Trevisani N, Ulrich R, van der Linden J, Von Cube RF, Wassmer M, Wieland S, Wolf R, Wozniewski S, Wunsch S, Zuo X, Anagnostou G, Assiouras P, Daskalakis G, Kyriakis A, Stakia A, Diamantopoulou M, Karasavvas D, Kontaxakis P, Manousakis-Katsikakis A, Panagiotou A, Papavergou I, Saoulidou N, Theofilatos K, Tziaferi E, Vellidis K, Zisopoulos I, Bakas G, Chatzistavrou T, Karapostoli G, Kousouris K, Papakrivopoulos I, Tsipolitis G, Zacharopoulou A, Adamidis K, Bestintzanos I, Evangelou I, Foudas C, Gianneios P, Kamtsikis C, Katsoulis P, Kokkas P, Kosmoglou Kioseoglou PG, Manthos N, Papadopoulos I, Strologas J, Csanád M, Farkas K, Gadallah MMA, Lökös S, Major P, Mandal K, Pásztor G, Rádl AJ, Surányi O, Veres GI, Bartók M, Bencze G, Hajdu C, Horvath D, Sikler F, Veszpremi V, Beni N, Czellar S, Karancsi J, Molnar J, Szillasi Z, Teyssier D, Raics P, Ujvari B, Zilizi G, Csorgo T, Nemes F, Novak T, Babbar J, Bansal S, Beri SB, Bhatnagar V, Chaudhary G, Chauhan S, Dhingra N, Gupta R, Kaur A, Kaur A, Kaur H, Kaur M, Kumar S, Kumari P, Meena M, Sandeep K, Sheokand T, Singh JB, Singla A, Ahmed A, Bhardwaj A, Chhetri A, Choudhary BC, Kumar A, Naimuddin M, Ranjan K, Saumya S, Baradia S, Barman S, Bhattacharya S, Bhowmik D, Dutta S, Dutta S, Gomber B, Maity M, Palit P, Saha G, Sahu B, Sarkar S, Behera PK, Behera SC, Chatterjee S, Kalbhor P, Komaragiri JR, Kumar D, Muhammad A, Panwar L, Pradhan R, Pujahari PR, Saha NR, Sharma A, Sikdar AK, Verma S, Naskar K, Aziz T, Das I, Dugad S, Kumar M, Mohanty GB, Suryadevara P, Banerjee S, Guchait M, Karmakar S, Kumar S, Majumder G, Mazumdar K, Mukherjee S, Thachayath A, Bahinipati S, Das AK, Kar C, Mal P, Mishra T, Muraleedharan Nair Bindhu VK, Nayak A, Saha P, Swain SK, Vats D, Alpana A, Dube S, Kansal B, Laha A, Pandey S, Rastogi A, Sharma S, Bakhshiansohi H, Khazaie E, Zeinali M, Chenarani S, Etesami SM, Khakzad M, Mohammadi Najafabadi M, Grunewald M, Abbrescia M, Aly R, Aruta C, Colaleo A, Creanza D, Cristella L, De Filippis N, De Palma M, Di Florio A, Elmetenawee W, Errico F, Fiore L, Iaselli G, Maggi G, Maggi M, Margjeka I, Mastrapasqua V, My S, Nuzzo S, Pellecchia A, Pompili A, Pugliese G, Radogna R, Ramos D, Ranieri A, Selvaggi G, Silvestris L, Simone FM, Sözbilir Ü, Stamerra A, Venditti R, Verwilligen P, Abbiendi G, Battilana C, Bonacorsi D, Borgonovi L, Brigliadori L, Campanini R, Capiluppi P, Castro A, Cavallo FR, Cuffiani M, Dallavalle GM, Diotalevi T, Fabbri F, Fanfani A, Giacomelli P, Giommi L, Grandi C, Guiducci L, Lo Meo S, Lunerti L, Marcellini S, Masetti G, Navarria FL, Perrotta A, Primavera F, Rossi AM, Rovelli T, Siroli GP, Costa S, Di Mattia A, Potenza R, Tricomi A, Tuve C, Barbagli G, Bardelli G, Camaiani B, Cassese A, Ceccarelli R, Ciulli V, Civinini C, D'Alessandro R, Focardi E, Latino G, Lenzi P, Lizzo M, Meschini M, Paoletti S, Sguazzoni G, Viliani L, Benussi L, Bianco S, Meola S, Piccolo D, Bozzo M, Chatagnon P, Ferro F, Robutti E, Tosi S, Benaglia A, Boldrini G, Brivio F, Cetorelli F, De Guio F, Dinardo ME, Dini P, Gennai S, Ghezzi A, Govoni P, Guzzi L, Lucchini MT, Malberti M, Malvezzi S, Massironi A, Menasce D, Moroni L, Paganoni M, Pedrini D, Pinolini BS, Ragazzi S, Redaelli N, Tabarelli de Fatis T, Zuolo D, Buontempo S, Carnevali F, Cavallo N, De Iorio A, Fabozzi F, Iorio AOM, Lista L, Paolucci P, Rossi B, Sciacca C, Azzi P, Bacchetta N, Bisello D, Bortignon P, Bragagnolo A, Carlin R, Checchia P, Dorigo T, Gasparini F, Gasparini U, Grosso G, Gulmini M, Layer L, Lusiani E, Margoni M, Meneguzzo AT, Pazzini J, Ronchese P, Rossin R, Simonetto F, Strong G, Tosi M, Yarar H, Zanetti M, 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Litomin A, Lychkovskaya N, Makarenko V, Malakhov A, Matveev V, Murzin V, Nikitenko A, Obraztsov S, Ovtin I, Palichik V, Perelygin V, Petrushanko S, Polikarpov S, Popov V, Radchenko O, Savina M, Savrin V, Selivanova D, Shalaev V, Shmatov S, Shulha S, Skovpen Y, Slabospitskii S, Smirnov V, Snigirev A, Sosnov D, Sulimov V, Tcherniaev E, Terkulov A, Teryaev O, Tlisova I, Toropin A, Uvarov L, Uzunian A, Vorobyev A, Voytishin N, Yuldashev BS, Zarubin A, Zhizhin I, Zhokin A. Measurement of the Dependence of the Hadron Production Fraction Ratios f_{s}/f_{u} and f_{d}/f_{u} on B Meson Kinematic Variables in Proton-Proton Collisions at sqrt[s]=13 TeV. PHYSICAL REVIEW LETTERS 2023; 131:121901. [PMID: 37802954 DOI: 10.1103/physrevlett.131.121901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/27/2023] [Accepted: 06/20/2023] [Indexed: 10/08/2023]
Abstract
The dependence of the ratio between the B_{s}^{0} and B^{+} hadron production fractions, f_{s}/f_{u}, on the transverse momentum (p_{T}) and rapidity of the B mesons is studied using the decay channels B_{s}^{0}→J/ψϕ and B^{+}→J/ψK^{+}. The analysis uses a data sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the CMS experiment in 2018 and corresponding to an integrated luminosity of 61.6 fb^{-1}. The f_{s}/f_{u} ratio is observed to depend on the B p_{T} and to be consistent with becoming asymptotically constant at large p_{T}. No rapidity dependence is observed. The ratio of the B^{0} to B^{+} meson production fractions, f_{d}/f_{u}, is also measured, for the first time in proton-proton collisions, using the B^{0}→J/ψK^{*0} decay channel. The result is found to be within 1 standard deviation of unity and independent of p_{T} and rapidity, as expected from isospin invariance.
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Wang ZG, Pei JM, Liu CH, Zhang J, Song BQ. [Clinical effects of free transplanted pre-expanded scapular flap in reconstructing scar contracture deformity of neck]. ZHONGHUA SHAO SHANG YU CHUANG MIAN XIU FU ZA ZHI 2023; 39:813-819. [PMID: 37805796 DOI: 10.3760/cma.j.cn501225-20230225-00059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To investigate the clinical effects of free transplanted pre-expanded scapular flap in reconstructing scar contracture deformity of neck. Methods: A retrospective observational study was conducted. From February 2010 to August 2020, 17 cervical scar deformity patients (9 males and 8 females, aged 8-42 years) who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University. The patients underwent skin and soft tissue expander (hereinafter referred to as expander) implantation in scapular region in stage Ⅰ procedures, and the free transplanted pre-expanded flaps were used to resurface the wounds followed by neck scar resection in the stage Ⅱ procedures. The wound size after neck scar release was 12.0 cm×6.0 cm-30.0 cm×24.0 cm, and the size of the flap ranged from 13.0 cm×7.5 cm to 31.5 cm×25.0 cm. The wounds in donor site of 15 patients were sutured directly, and the wounds in donor site of 2 patients were covered with full-thickness skin graft from abdominal area. The survival of flaps was observed after the operation of stage Ⅱ. Six months after stage Ⅱ surgery, Z plasty was performed to treat the incision scar contracture in 2 patients. For the 5 patients of overweight or bloating appearance in the 1/3 proximal flap underwent debulking procedures in 6-9 months after stage Ⅱsurgery. Before the stage Ⅰ surgery and six months after the last procedure (stage Ⅱ or stage Ⅲ), mental cervical angle (MCA) and cervical mandibular angle (CMA) were measured and the improvement of neck scar was evaluated by the angle values. The cervical motor function, skin color and texture in recipient areas, and scar in the donor sites assessed by Vancouver scar scale (VSS) were observed during follow-up. Data were statistically analyzed with paired sample t test. Results: After stage Ⅱ surgery, 15 patients' flaps survived well; venous crisis occurred in 2 flaps within 24 h after operation, and the flaps survived well after emergency exploration and thrombus removal+vascular re-anastomosis. Compared with the angle values of MCA of (126±12)° and CMA of (148±13)° of patients before the stage Ⅰ surgery, the angle values of MCA of (107±12)° and CMA of (123±11)° of patients in six months after the last procedure were significantly decreased (with t values of 10.68 and 6.54, respectively, P<0.05). After 2 years of follow-up, the patient's neck dorsiflexion, lateral bending, or other motor functions were not restricted; the color and texture of the flap in recipient site were close to those of the normal neck skin; the patient cases with VSS scores of scarring of 3, 4, 5, 6, and 7 were 1, 3, 7, 5, and 1 case, respectively. Conclusions: The free transplantation of the pre-expanded scapular flaps can provide sufficient tissue for wound coverage after the release of cervical scar contracture deformity; the expanded skin tissue is featured by thin soft tissue and good pliability, which is conducive to restore the neck appearance; the donor sites are relatively covert with less tension, therefore, the treatment is an effective method for correcting the contracture in the neck.
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Sun LH, Shaniya N, Xu Q, Pan KJ, Bao YXM, Han D, Zhang J. [Expanding antiviral indications for chronic hepatitis B using the concept of chronic disease health management: act again!]. ZHONGHUA GAN ZANG BING ZA ZHI = ZHONGHUA GANZANGBING ZAZHI = CHINESE JOURNAL OF HEPATOLOGY 2023; 31:1002-1003. [PMID: 37872098 DOI: 10.3760/cma.j.cn501113-20220501-00233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
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Cheng Z, Cai Y, Zhang K, Zhang J, Gui H, Luo YS, Zhou J, DeVeale B. MAP3K19 regulatory variation in populations with African ancestry may increase COVID-19 severity. iScience 2023; 26:107555. [PMID: 37649700 PMCID: PMC10462844 DOI: 10.1016/j.isci.2023.107555] [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: 11/29/2022] [Revised: 05/20/2023] [Accepted: 08/03/2023] [Indexed: 09/01/2023] Open
Abstract
To identify ancestry-linked genetic risk variants associated with COVID-19 hospitalization, we performed an integrative analysis of two genome-wide association studies and resolved four single nucleotide polymorphisms more frequent in COVID-19-hospitalized patients with non-European ancestry. Among them, the COVID-19 risk SNP rs16831827 shows the largest difference in minor allele frequency (MAF) between populations with African and European ancestry and also shows higher MAF in hospitalized COVID-19 patients among cohorts of mixed ancestry (odds ratio [OR] = 1.20, 95% CI: 1.10-1.30) and entirely African ancestry (OR = 1.30, 95% CI: 1.02-1.67). rs16831827 is an expression quantitative trait locus of MAP3K19. MAP3K19 expression is induced during ciliogenesis and most abundant in ciliated tissues including lungs. Single-cell RNA sequencing analyses revealed that MAP3K19 is highly expressed in multiple ciliated cell types. As rs16831827∗T is associated with reduced MAP3K19 expression, it may increase the risk of severe COVID-19 by reducing MAP3K19 expression.
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Verdier P, Viret S, Chokheli D, Lomidze I, Tsamalaidze Z, Botta V, Feld L, Klein K, Lipinski M, Meuser D, Pauls A, Röwert N, Teroerde M, Diekmann S, Dodonova A, Eich N, Eliseev D, Erdmann M, Fackeldey P, Fasanella D, Fischer B, Hebbeker T, Hoepfner K, Ivone F, Lee MY, Mastrolorenzo L, Merschmeyer M, Meyer A, Mondal S, Mukherjee S, Noll D, Novak A, Nowotny F, Pozdnyakov A, Rath Y, Redjeb W, Reithler H, Schmidt A, Schuler SC, Sharma A, Vigilante L, Wiedenbeck S, Zaleski S, Dziwok C, Flügge G, Haj Ahmad W, Hlushchenko O, Kress T, Nowack A, Pooth O, Stahl A, Ziemons T, Zotz A, Aarup Petersen H, Aldaya Martin M, Asmuss P, Baxter S, Bayatmakou M, Behnke O, Bermúdez Martínez A, Bhattacharya S, Bin Anuar AA, Blekman F, Borras K, Brunner D, Campbell A, Cardini A, Cheng C, Colombina F, Consuegra Rodríguez S, Correia Silva G, De Silva M, Didukh L, Eckerlin G, Eckstein D, Estevez Banos LI, Filatov O, Gallo E, Geiser A, Giraldi A, Greau G, Grohsjean A, Guglielmi V, Guthoff M, Jafari A, Jomhari NZ, 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KJ, Rieger M, Rieger O, Schleper P, Schröder M, Schwandt J, Stadie H, Steinbrück G, Tews A, Wolf M, Bechtel J, Brommer S, Burkart M, Butz E, Caspart R, Chwalek T, Dierlamm A, Droll A, Faltermann N, Giffels M, Gosewisch JO, Gottmann A, Hartmann F, Horzela M, Husemann U, Keicher P, Klute M, Koppenhöfer R, Maier S, Mitra S, Müller T, Neukum M, Quast G, Rabbertz K, Rauser J, Savoiu D, Schnepf M, Seith D, Shvetsov I, Simonis HJ, Trevisani N, Ulrich R, van der Linden J, Von Cube RF, Wassmer M, Wieland S, Wolf R, Wozniewski S, Wunsch S, Anagnostou G, Assiouras P, Daskalakis G, Kyriakis A, Stakia A, Diamantopoulou M, Karasavvas D, Kontaxakis P, Manousakis-Katsikakis A, Panagiotou A, Papavergou I, Saoulidou N, Theofilatos K, Tziaferi E, Vellidis K, Vourliotis E, Zisopoulos I, Bakas G, Chatzistavrou T, Kousouris K, Papakrivopoulos I, Tsipolitis G, Zacharopoulou A, Adamidis K, Bestintzanos I, Evangelou I, Foudas C, Gianneios P, Kamtsikis C, Katsoulis P, Kokkas P, Kosmoglou Kioseoglou PG, Manthos 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P, Gallinaro M, Hollar J, Leonardo N, Niknejad T, Pisano M, Seixas J, Varela J, Adzic P, Dordevic M, Milenovic P, Milosevic J, Aguilar-Benitez M, Alcaraz Maestre J, Álvarez Fernández A, Barrio Luna M, Bedoya CF, Carrillo Montoya CA, Cepeda M, Cerrada M, Colino N, De La Cruz B, Delgado Peris A, Fernández Del Val D, Fernández Ramos JP, Flix J, Fouz MC, Gonzalez Lopez O, Goy Lopez S, Hernandez JM, Josa MI, León Holgado J, Moran D, Perez Dengra C, Pérez-Calero Yzquierdo A, Puerta Pelayo J, Redondo I, Redondo Ferrero DD, Romero L, Sánchez Navas S, Sastre J, Urda Gómez L, Vazquez Escobar J, Willmott C, de Trocóniz JF, Alvarez Gonzalez B, Cuevas J, Fernandez Menendez J, Folgueras S, Gonzalez Caballero I, González Fernández JR, Palencia Cortezon E, Ramón Álvarez C, Rodríguez Bouza V, Soto Rodríguez A, Trapote A, Vico Villalba C, Brochero Cifuentes JA, Cabrillo IJ, Calderon A, Duarte Campderros J, Fernandez M, Fernandez Madrazo C, García Alonso A, Gomez G, Lasaosa García C, Martinez Rivero C, Martinez Ruiz Del Arbol P, Matorras F, Matorras Cuevas P, Piedra Gomez J, Prieels C, Ruiz-Jimeno A, Scodellaro L, Vila I, Vizan Garcia JM, Jayananda MK, Kailasapathy B, Sonnadara DUJ, Wickramarathna DDC, Dharmaratna WGD, Liyanage K, Perera N, Wickramage N, Abbaneo D, Alimena J, Auffray E, Auzinger G, Baechler J, Baillon P, Barney D, Bendavid J, Bianco M, Bilin B, Bocci A, Brondolin E, Caillol C, Camporesi T, Cerminara G, Chernyavskaya N, Chhibra SS, Choudhury S, Cipriani M, Cristella L, d'Enterria D, Dabrowski A, David A, De Roeck A, Defranchis MM, Deile M, Dobson M, Dünser M, Dupont N, Elliott-Peisert A, Fallavollita F, Florent A, Forthomme L, Franzoni G, Funk W, Ghosh S, Giani S, Gigi D, Gill K, Glege F, Gouskos L, Govorkova E, Haranko M, Hegeman J, Innocente V, James T, Janot P, Kaspar J, Kieseler J, Kratochwil N, Laurila S, Lecoq P, Leutgeb E, Lintuluoto A, Lourenço C, Maier B, Malgeri L, Mannelli M, Marini AC, Meijers F, Mersi S, Meschi E, Moortgat F, Mulders M, Orfanelli S, Orsini L, Pantaleo F, Perez E, Peruzzi M, Petrilli A, Petrucciani G, Pfeiffer A, Pierini M, Piparo D, Pitt M, Qu H, Quast T, Rabady D, Racz A, Reales Gutiérrez G, Rovere M, Sakulin H, Salfeld-Nebgen J, Scarfi S, Selvaggi M, Sharma A, Silva P, Sphicas P, Stahl Leiton AG, Summers S, Tatar K, Tavolaro VR, Treille D, Tropea P, Tsirou A, Wanczyk J, Wozniak KA, Zeuner WD, Caminada L, Ebrahimi A, Erdmann W, Horisberger R, Ingram Q, Kaestli HC, Kotlinski D, Lange C, Missiroli M, Noehte L, Rohe T, Aarrestad TK, Androsov K, Backhaus M, Berger P, Calandri A, Datta K, De Cosa A, Dissertori G, Dittmar M, Donegà M, Eble F, Galli M, Gedia K, Glessgen F, Gómez Espinosa TA, Grab C, Hits D, Lustermann W, Lyon AM, Manzoni RA, Marchese L, Martin Perez C, Mascellani A, Meinhard MT, Nessi-Tedaldi F, Niedziela J, Pauss F, Perovic V, Pigazzini S, Ratti MG, Reichmann M, Reissel C, Reitenspiess T, Ristic B, Riti F, Ruini D, Sanz Becerra DA, Steggemann J, Valsecchi D, Wallny R, Amsler C, Bärtschi P, Botta C, Brzhechko D, Canelli MF, Cormier K, De Wit A, Del Burgo R, Heikkilä JK, Huwiler M, Jin W, Jofrehei A, Kilminster B, Leontsinis S, Liechti SP, Macchiolo A, Meiring P, Mikuni VM, Molinatti U, Neutelings I, Reimers A, Robmann P, Sanchez Cruz S, Schweiger K, Senger M, Takahashi Y, Adloff C, Kuo CM, Lin W, Yu SS, Ceard L, Chao Y, Chen KF, Chen PS, Cheng H, Hou WS, Khurana R, Li YY, Lu RS, Paganis E, Psallidas A, Steen A, Wu HY, Yazgan E, Yu PR, Asawatangtrakuldee C, Srimanobhas N, Agyel D, Boran F, Demiroglu ZS, Dolek F, Dumanoglu I, Eskut E, Guler Y, Gurpinar Guler E, Isik C, Kara O, Kayis Topaksu A, Kiminsu U, Onengut G, Ozdemir K, Polatoz A, Simsek AE, Tali B, Tok UG, Turkcapar S, Uslan E, Zorbakir IS, Karapinar G, Ocalan K, Yalvac M, Akgun B, Atakisi IO, Gülmez E, Kaya M, Kaya O, Özçelik Ö, Tekten S, Cakir A, Cankocak K, Komurcu Y, Sen S, Aydilek O, Cerci S, Hacisahinoglu B, Hos I, Isildak B, Kaynak B, Ozkorucuklu S, Simsek C, Sunar Cerci D, Grynyov B, Levchuk L, Anthony D, Bhal E, Brooke JJ, Bundock A, Clement E, Cussans D, Flacher H, Glowacki M, Goldstein J, Heath GP, Heath HF, Kreczko L, Krikler B, Paramesvaran S, Seif El Nasr-Storey S, Smith VJ, Stylianou N, Walkingshaw Pass K, White R, Ball AH, Bell KW, Belyaev A, Brew C, Brown RM, Cockerill DJA, Cooke C, Ellis KV, Harder K, Harper S, Holmberg ML, Linacre J, Manolopoulos K, Newbold DM, Olaiya E, Petyt D, Reis T, Salvi G, Schuh T, Shepherd-Themistocleous CH, Tomalin IR, Williams T, Bainbridge R, Bloch P, Bonomally S, Borg J, Breeze S, Brown CE, Buchmuller O, Cacchio V, Cepaitis V, Chahal GS, Colling D, Dancu JS, Dauncey P, Davies G, Davies J, Della Negra M, Fayer S, Fedi G, Hall G, Hassanshahi MH, Howard A, Iles G, Langford J, Lyons L, Magnan AM, Malik S, Martelli A, Mieskolainen M, Monk DG, Nash J, Pesaresi M, Radburn-Smith BC, Raymond DM, Richards A, Rose A, Scott E, Seez C, Shtipliyski A, Shukla R, Tapper A, Uchida K, Uttley GP, Vage LH, Virdee T, Vojinovic M, Wardle N, Webb SN, Winterbottom D, Coldham K, Cole JE, Khan A, Kyberd P, Reid ID, Abdullin S, Brinkerhoff A, Caraway B, Dittmann J, Hatakeyama K, Kanuganti AR, McMaster B, Saunders M, Sawant S, Sutantawibul C, Wilson J, Bartek R, Dominguez A, Uniyal R, Vargas Hernandez AM, Buccilli A, Cooper SI, Di Croce D, Gleyzer SV, Henderson C, Perez CU, Rumerio P, West C, Akpinar A, Albert A, Arcaro D, Cosby C, Demiragli Z, Erice C, Fontanesi E, Gastler D, May S, Rohlf J, Salyer K, Sperka D, Spitzbart D, Suarez I, Tsatsos A, Yuan S, Benelli G, Burkle B, Coubez X, Cutts D, Hadley M, Heintz U, Hogan JM, Kwon T, Landsberg G, Lau KT, Li D, Luo J, Narain M, Pervan N, Sagir S, Simpson F, Usai E, Wong WY, Yan X, Yu D, Zhang W, Bonilla J, Brainerd C, Breedon R, Calderon De La Barca Sanchez M, Chertok M, Conway J, Cox PT, Erbacher R, Haza G, Jensen F, Kukral O, Mocellin G, Mulhearn M, Pellett D, Regnery B, Taylor D, Yao Y, Zhang F, Bachtis M, Cousins R, Datta A, Hamilton D, Hauser J, Ignatenko M, Iqbal MA, Lam T, Manca E, Nash WA, Regnard S, Saltzberg D, Stone B, Valuev V, Chen Y, Clare R, Gary JW, Gordon M, Hanson G, Karapostoli G, Long OR, Manganelli N, Si W, Wimpenny S, Branson JG, Chang P, Cittolin S, Cooperstein S, Diaz D, Duarte J, Gerosa R, Giannini L, Guiang J, Kansal R, Krutelyov V, Lee R, Letts J, Masciovecchio M, Mokhtar F, Pieri M, Sathia Narayanan BV, Sharma V, Tadel M, Würthwein F, Xiang Y, Yagil A, Amin N, Campagnari C, Citron M, Collura G, Dorsett A, Dutta V, Incandela J, Kilpatrick M, Kim J, Li AJ, Masterson P, Mei H, Oshiro M, Quinnan M, Richman J, Sarica U, Schmitz R, Setti F, Sheplock J, Siddireddy P, Stuart D, Wang S, Bornheim A, Cerri O, Dutta I, Lawhorn JM, Lu N, Mao J, Newman HB, Nguyen TQ, Spiropulu M, Vlimant JR, Wang C, Xie S, Zhu RY, Alison J, An S, Andrews MB, Bryant P, Ferguson T, Harilal A, Liu C, Mudholkar T, Murthy S, Paulini M, Roberts A, Sanchez A, Terrill W, Cumalat JP, Ford WT, Hassani A, Karathanasis G, MacDonald E, Marini F, Patel R, Perloff A, Savard C, Schonbeck N, Stenson K, Ulmer KA, Wagner SR, Zipper N, Alexander J, Bright-Thonney S, Chen X, Cranshaw DJ, Fan J, Fan X, Gadkari D, Hogan S, Monroy J, Patterson JR, Quach D, Reichert J, Reid M, Ryd A, Thom J, Wittich P, Zou R, Albrow M, Alyari M, Apollinari G, Apresyan A, Bauerdick LAT, Berry D, Berryhill J, Bhat PC, Burkett K, Butler JN, Canepa A, Cerati GB, Cheung HWK, Chlebana F, Di Petrillo KF, Dickinson J, Elvira VD, Feng Y, Freeman J, Gandrakota A, Gecse Z, Gray L, Green D, Grünendahl S, Gutsche O, Harris RM, Heller R, Herwig TC, Hirschauer J, Horyn L, Jayatilaka B, Jindariani S, Johnson M, Joshi U, Klijnsma T, Klima B, Kwok KHM, Lammel S, Lincoln D, Lipton R, Liu T, Madrid C, Maeshima K, Mantilla C, Mason D, McBride P, Merkel P, Mrenna S, Nahn S, Ngadiuba J, Noonan D, Papadimitriou V, Pastika N, Pedro K, Pena C, Ravera F, Reinsvold Hall A, Ristori L, Sexton-Kennedy E, Smith N, Soha A, Spiegel L, Strait J, Taylor L, Tkaczyk S, Tran NV, Uplegger L, Vaandering EW, Weber HA, Zoi I, Avery P, Bourilkov D, Cadamuro L, Cherepanov V, Field RD, Guerrero D, Kim M, Koenig E, Konigsberg J, Korytov A, Lo KH, Matchev K, Menendez N, Mitselmakher G, Muthirakalayil Madhu A, Rawal N, Rosenzweig D, Rosenzweig S, Shi K, Wang J, Wu Z, Adams T, Askew A, Habibullah R, Hagopian V, Kolberg T, Martinez G, Prosper H, Schiber C, Viazlo O, Yohay R, Zhang J, Baarmand MM, Butalla S, Elkafrawy T, Hohlmann M, Kumar Verma R, Rahmani M, Yumiceva F, Adams MR, Becerril Gonzalez H, Cavanaugh R, Dittmer S, Evdokimov O, Gerber CE, Hofman DJ, Lemos DS, Merrit AH, Mills C, Oh G, Roy T, Rudrabhatla S, Tonjes MB, Varelas N, Wang X, Ye Z, Yoo J, Alhusseini M, Dilsiz K, Emediato L, Gandrajula RP, Karaman G, Köseyan OK, Merlo JP, Mestvirishvili A, Nachtman J, Neogi O, Ogul H, Onel Y, Penzo A, Snyder C, Tiras E, Amram O, Blumenfeld B, Corcodilos L, Davis J, Gritsan AV, Kang L, Kyriacou S, Maksimovic P, Roskes J, Sekhar S, Swartz M, Vámi TÁ, Abreu A, Alcerro Alcerro LF, Anguiano J, Baringer P, Bean A, Flowers Z, Isidori T, Khalil S, King J, Krintiras G, Lazarovits M, Le Mahieu C, Lindsey C, Marquez J, Minafra N, Murray M, Nickel M, Rogan C, Royon C, Salvatico R, Sanders S, Smith C, Wang Q, Williams J, Wilson G, Allmond B, Duric S, Gujju Gurunadha R, Ivanov A, Kaadze K, Kim D, Maravin Y, Mitchell T, Modak A, Nam K, Natoli J, Roy D, Rebassoo F, Wright D, Adams E, Baden A, Baron O, Belloni A, Bethani A, Eno SC, Hadley NJ, Jabeen S, Kellogg RG, Koeth T, Lai Y, Lascio S, Mignerey AC, Nabili S, Palmer C, Papageorgakis C, Wang L, Wong K, Abercrombie D, Busza W, Cali IA, Chen Y, D'Alfonso M, Eysermans J, Freer C, Gomez-Ceballos G, Goncharov M, Harris P, Hu M, Kovalskyi D, Krupa J, Lee YJ, Long K, Mironov C, Paus C, Rankin D, Roland C, Roland G, Shi Z, Stephans GSF, Wang J, Wang Z, Wyslouch B, Chatterjee RM, Crossman B, Evans A, Hiltbrand J, Jain S, Joshi BM, Kapsiak C, Krohn M, Kubota Y, Mans J, Revering M, Rusack R, Saradhy R, Schroeder N, Strobbe N, Wadud MA, Cremaldi LM, Bloom K, Bryson M, Claes DR, Fangmeier C, Finco L, Golf F, Joo C, Kravchenko I, Reed I, Siado JE, Snow GR, Tabb W, Wightman A, Yan F, Zecchinelli AG, Agarwal G, Bandyopadhyay H, Hay L, Iashvili I, Kharchilava A, McLean C, Morris M, Nguyen D, Pekkanen J, Rappoccio S, Williams A, Alverson G, Barberis E, Haddad Y, Han Y, Krishna A, Li J, Lidrych J, Madigan G, Marzocchi B, Morse DM, Nguyen V, Orimoto T, Parker A, Skinnari L, Tishelman-Charny A, Wamorkar T, Wang B, Wisecarver A, Wood D, Bhattacharya S, Bueghly J, Chen Z, Gilbert A, Hahn KA, Liu Y, Odell N, Schmitt MH, Velasco M, Band R, Bucci R, Castells S, Cremonesi M, Das A, Goldouzian R, Hildreth M, Hurtado Anampa K, Jessop C, Lannon K, Lawrence J, Loukas N, Lutton L, Mariano J, Marinelli N, Mcalister I, McCauley T, Mcgrady C, Mohrman K, Moore C, Musienko Y, Nelson H, Ruchti R, Townsend A, Wayne M, Yockey H, Zarucki M, Zygala L, Bylsma B, Carrigan M, Durkin LS, Francis B, Hill C, Lesauvage A, Nunez Ornelas M, Wei K, Winer BL, Yates BR, Addesa FM, Das P, Dezoort G, Elmer P, Frankenthal A, Greenberg B, Haubrich N, Higginbotham S, Kalogeropoulos A, Kopp G, Kwan S, Lange D, Marlow D, Mei K, Ojalvo I, Olsen J, Stickland D, Tully C, Malik S, Norberg S, Bakshi AS, Barnes VE, Chawla R, Das S, Gutay L, Jones M, Jung AW, Kondratyev D, Koshy AM, Liu M, Negro G, Neumeister N, Paspalaki G, Piperov S, Purohit A, Schulte JF, Stojanovic M, Thieman J, Wang F, Xiao R, Xie W, Dolen J, Parashar N, Acosta D, Baty A, Carnahan T, Decaro M, Dildick S, Ecklund KM, Fernández Manteca PJ, Freed S, Gardner P, Geurts FJM, Kumar A, Li W, Padley BP, Redjimi R, Rotter J, Shi W, Yang S, Yigitbasi E, Zhang L, Zhang Y, Zuo X, Bodek A, de Barbaro P, Demina R, Dulemba JL, Fallon C, Ferbel T, Galanti M, Garcia-Bellido A, Hindrichs O, Khukhunaishvili A, Ranken E, Taus R, Van Onsem GP, Goulianos K, Chiarito B, Chou JP, Gershtein Y, Halkiadakis E, Hart A, Heindl M, Jaroslawski D, Karacheban O, Laflotte I, Lath A, Montalvo R, Nash K, Osherson M, Salur S, Schnetzer S, Somalwar S, Stone R, Thayil SA, Thomas S, Wang H, Acharya H, Delannoy AG, Fiorendi S, Holmes T, Nibigira E, Spanier S, Bouhali O, Dalchenko M, Delgado A, Eusebi R, Gilmore J, Huang T, Kamon T, Kim H, Luo S, Malhotra S, Mueller R, Overton D, Rathjens D, Safonov A, Akchurin N, Damgov J, Hegde V, Lamichhane K, Lee SW, Mengke T, Muthumuni S, Peltola T, Volobouev I, Wang Z, Whitbeck A, Appelt E, Greene S, Gurrola A, Johns W, Melo A, Romeo F, Sheldon P, Tuo S, Velkovska J, Viinikainen J, Cardwell B, Cox B, Cummings G, Hakala J, Hirosky R, Joyce M, Ledovskoy A, Li A, Neu C, Perez Lara CE, Tannenwald B, Karchin PE, Poudyal N, Banerjee S, Black K, Bose T, Dasu S, De Bruyn I, Everaerts P, Galloni C, He H, Herndon M, Herve A, Koraka CK, Lanaro A, Loeliger A, Loveless R, Madhusudanan Sreekala J, Mallampalli A, Mohammadi A, Mondal S, Parida G, Pinna D, Savin A, Shang V, Sharma V, Smith WH, Teague D, Tsoi HF, Vetens W, Afanasiev S, Andreev V, Andreev Y, Aushev T, Azarkin M, Babaev A, Belyaev A, Blinov V, Boos E, Borshch V, Budkouski D, Bunichev V, Bychkova O, Chekhovsky V, Chistov R, Danilov M, Dermenev A, Dimova T, Dremin I, Dubinin M, Dudko L, Epshteyn V, Ershov A, Gavrilov G, Gavrilov V, Gninenko S, Golovtcov V, Golubev N, Golutvin I, Gorbunov I, Ivanchenko V, Ivanov Y, Kachanov V, Kardapoltsev L, Karjavine V, Karneyeu A, Kim V, Kirakosyan M, Kirpichnikov D, Kirsanov M, Klyukhin V, Kodolova O, Konstantinov D, Korenkov V, Kozyrev A, Krasnikov N, Kuznetsova E, Lanev A, Levchenko P, Litomin A, Lychkovskaya N, Makarenko V, Malakhov A, Matveev V, Murzin V, Nikitenko A, Obraztsov S, Okhotnikov V, Ovtin I, Palichik V, Parygin P, Perelygin V, Perfilov M, Petrushanko S, Pivovarov G, Polikarpov S, Popov V, Radchenko O, Savina M, Savrin V, Selivanova D, Shalaev V, Shmatov S, Shulha S, Skovpen Y, Slabospitskii S, Smirnov V, Sosnov D, Stepennov A, Sulimov V, Tcherniaev E, Terkulov A, Teryaev O, Tlisova I, Toms M, Toropin A, Uvarov L, Uzunian A, Vlasov E, Vorobyev A, Voytishin N, Yuldashev BS, Zarubin A, Zhizhin I, Zhokin A. Search for Exotic Higgs Boson Decays H→AA→4γ with Events Containing Two Merged Diphotons in Proton-Proton Collisions at sqrt[s]=13 TeV. PHYSICAL REVIEW LETTERS 2023; 131:101801. [PMID: 37739361 DOI: 10.1103/physrevlett.131.101801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/19/2023] [Indexed: 09/24/2023]
Abstract
We present the first direct search for exotic Higgs boson decays H→AA, A→γγ in events with two photonlike objects. The hypothetical particle A is a low-mass spin-0 particle decaying promptly to a merged diphoton reconstructed as a single photonlike object. We analyze the data collected by the CMS experiment at sqrt[s]=13 TeV corresponding to an integrated luminosity of 136 fb^{-1}. No excess above the estimated background is found. We set upper limits on the branching fraction B(H→AA→4γ) of (0.9-3.3)×10^{-3} at 95% confidence level for masses of A in the range 0.1-1.2 GeV.
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Zhao B, Wang Q, Wang L, Chen J, Yin T, Zhang J, Cheng X, Hou R. Effect of acceptance and commitment therapy for depressive disorders: a meta-analysis. Ann Gen Psychiatry 2023; 22:34. [PMID: 37679716 PMCID: PMC10486021 DOI: 10.1186/s12991-023-00462-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVE To systematically evaluate the effect of Acceptance and Commitment Therapy (ACT) on depressive disorders. METHODS The electronic databases of Web of Science Core Collection, Pubmed, EMBASE, Cochrane Library, PsycInfo, CNKI, Wanfang and Weipu were used to select relevant publications. Screening, data extraction, and quality assessment were undertaken following PRISMA guidelines for preferred reporting of systematic reviews and meta-analysis. RevMan5.4 was used for meta-analysis. RESULTS 11 studies with a total of 962 patients were included. Random-effects model analysis showed that ACT could effectively reduce the level of depressive symptoms in patients with depressive disorders (SMD = - 1.05, 95% CI: - 1.43-- 0.66, P < 0.00001), improve psychological flexibility (MD = 4.84, 95% CI: 2.70-6.97, P < 0.00001), and have good maintenance effect (SMD = - 0.70, 95% CI: - 1.15-- 0.25, P = 0.002). All differences were statistically significant. CONCLUSIONS ACT not only improves depressive symptoms and psychological flexibility, but also has a good maintenance effect, and it is particularly effective in Chinese patients. Large randomized controlled trials are needed to validate the findings from this meta-analysis.
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Dong MY, Jiang HY, Wang YY, Zhao H, Jiang RJ, Liang CY, Zhang J, Jia S, Hsu BL, Fang W, Cheng G. Gelanxinning capsule improves coronary microvascular dysfunction by inhibiting inflammation and restoring endothelial function. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2023; 27:8579-8587. [PMID: 37782173 DOI: 10.26355/eurrev_202309_33782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Gelanxinning capsule (GXSC) is a Chinese medicine to cure coronary artery disease (CAD) and a compound of Pueraria lobata, hawthorn extract, and gypenosides. However, whether GXSC could improve coronary microvascular dysfunction (CMD) is unknown. We aimed to demonstrate the therapeutic effect of GXSC on CMD and its underlying mechanisms in CAD patients. PATIENTS AND METHODS This was a single-center, randomized control trial. A total of 78 patients diagnosed by selective coronary angiography (CAG) participated in this study. Patients' demographics, medical history, medications, and results of laboratory testing were collected. The index of microcirculatory resistance (IMR) and coronary flow reserve (CFR) were obtained by CAG and single-photon emission computed tomography (SPECT) separately. Fasting blood samples were obtained on the morning following the admission day. Concentrations of several molecules of inflammation, endothelial function, and coronary microvascular function were measured by ELISA. Patients were followed-up two months after discharge and fasting blood samples were also acquired. RESULTS All patients were randomly divided into 2 groups: GXSC, 38 (48.7%), and control, 40 (51.3%). The intergroup comparison revealed no significant differences with respect to all baseline variables. As for inflammation biomarkers, proinflammatory NOD-like receptor thermal protein domain associated protein 3 (NLRP3) and interleukin (IL)-1 were significantly decreased in GXSC compared with the control group (0.71±0.08 vs. 1.04±0.07, p<0.01 and 7.16±0.59 vs. 10.93±1.04, p<0.01). Anti-inflammatory adropin was increased in the GXSC group (7.75±0.59 vs. 5.71±0.68, p=0.03). As for indexes of endothelial function, the concentrations of syndecan (SDC) 1, SDC4 and heparan sulphates (HS) were significantly downregulated in 2 months GXSC treatment (3.31±0.28 vs. 4.85±0.43, p<0.01, 3.79±0.56 vs. 5.69±0.68, p=0.03 and 21.31±2.79 vs. 35.18±4.11 p<0.01). In addition, the level of SIRTUIN 1 (SIRT1), which is a vascular protective protein, was upregulated in GXSC group (5.63±0.30 vs. 4.22±0.37, p<0.01). As for molecules of coronary microvascular function, endocan, soluble urokinase plasminogen activator receptor (suPAR), and growth differentiation factor (GDF)-15 were significantly decreased consistently in GXSC compared with the control group (0.09±0.01 vs. 0.19±0.03, p<0.01, 4.44±0.40 vs. 5.73±0.40, p=0.03 and 2.08±0.17 vs. 2.69±0.18, p=0.02). CONCLUSIONS In conclusion, GXSC could improve CMD by inhibiting inflammation and restoring endothelial function. GXSC might be an effective drug in CAD patients without obstructive epicardial coronary arteries but suffering from angina.
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Tan ZB, Zhang J. Recent advances in treatment strategies for hepatocellular carcinoma with portal vein cancer thrombus. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2023; 27:8119-8134. [PMID: 37750640 DOI: 10.26355/eurrev_202309_33572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
This is a review of current practices and advances in hepatocellular carcinoma (HCC) with portal vein cancer thrombus (PVTT). The treatment strategies of HCC with PVTT are non-uniform worldwide. Systemic treatment with molecularly targeted drugs and immune checkpoint inhibitors, such as sorafenib, lenflutinib, donafenib, atezolizumab plus bevacizumab, sintilimab plus IBI305, regorafenib, pembrolizumab and anti-Cytotoxic T Lymphocyte antigen 4 (CTLA-4) was recommended by guidelines, but with limited effectiveness for HCC patients with PVTT. More and more studies indicate that aggressive local or locoregional treatments, including liver resection, liver transplantation, radiation therapy, hepatic arterial infusion chemotherapy (HAIC), transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) benefit for selected HCC patients with PVTT. In recent years, the comprehensive treatment of HCC has advanced greatly. This review aims to provide an insight into the treatment modalities available for HCC patients with PVTT.
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Lu AT, Fei Z, Haghani A, Robeck TR, Zoller JA, Li CZ, Lowe R, Yan Q, Zhang J, Vu H, Ablaeva J, Acosta-Rodriguez VA, Adams DM, Almunia J, Aloysius A, Ardehali R, Arneson A, Baker CS, Banks G, Belov K, Bennett NC, Black P, Blumstein DT, Bors EK, Breeze CE, Brooke RT, Brown JL, Carter GG, Caulton A, Cavin JM, Chakrabarti L, Chatzistamou I, Chen H, Cheng K, Chiavellini P, Choi OW, Clarke SM, Cooper LN, Cossette ML, Day J, DeYoung J, DiRocco S, Dold C, Ehmke EE, Emmons CK, Emmrich S, Erbay E, Erlacher-Reid C, Faulkes CG, Ferguson SH, Finno CJ, Flower JE, Gaillard JM, Garde E, Gerber L, Gladyshev VN, Gorbunova V, Goya RG, Grant MJ, Green CB, Hales EN, Hanson MB, Hart DW, Haulena M, Herrick K, Hogan AN, Hogg CJ, Hore TA, Huang T, Izpisua Belmonte JC, Jasinska AJ, Jones G, Jourdain E, Kashpur O, Katcher H, Katsumata E, Kaza V, Kiaris H, Kobor MS, Kordowitzki P, Koski WR, Krützen M, Kwon SB, Larison B, Lee SG, Lehmann M, Lemaitre JF, Levine AJ, Li C, Li X, Lim AR, Lin DTS, Lindemann DM, Little TJ, Macoretta N, Maddox D, Matkin CO, Mattison JA, McClure M, Mergl J, Meudt JJ, Montano GA, Mozhui K, Munshi-South J, Naderi A, Nagy M, Narayan P, Nathanielsz PW, Nguyen NB, Niehrs C, O'Brien JK, O'Tierney Ginn P, Odom DT, Ophir AG, Osborn S, Ostrander EA, Parsons KM, Paul KC, Pellegrini M, Peters KJ, Pedersen AB, Petersen JL, Pietersen DW, Pinho GM, Plassais J, Poganik JR, Prado NA, Reddy P, Rey B, Ritz BR, Robbins J, Rodriguez M, Russell J, Rydkina E, Sailer LL, Salmon AB, Sanghavi A, Schachtschneider KM, Schmitt D, Schmitt T, Schomacher L, Schook LB, Sears KE, Seifert AW, Seluanov A, Shafer ABA, Shanmuganayagam D, Shindyapina AV, Simmons M, Singh K, Sinha I, Slone J, Snell RG, Soltanmaohammadi E, Spangler ML, Spriggs MC, Staggs L, Stedman N, Steinman KJ, Stewart DT, Sugrue VJ, Szladovits B, Takahashi JS, Takasugi M, Teeling EC, Thompson MJ, Van Bonn B, Vernes SC, Villar D, Vinters HV, Wallingford MC, Wang N, Wayne RK, Wilkinson GS, Williams CK, Williams RW, Yang XW, Yao M, Young BG, Zhang B, Zhang Z, Zhao P, Zhao Y, Zhou W, Zimmermann J, Ernst J, Raj K, Horvath S. Universal DNA methylation age across mammalian tissues. NATURE AGING 2023; 3:1144-1166. [PMID: 37563227 PMCID: PMC10501909 DOI: 10.1038/s43587-023-00462-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 06/21/2023] [Indexed: 08/12/2023]
Abstract
Aging, often considered a result of random cellular damage, can be accurately estimated using DNA methylation profiles, the foundation of pan-tissue epigenetic clocks. Here, we demonstrate the development of universal pan-mammalian clocks, using 11,754 methylation arrays from our Mammalian Methylation Consortium, which encompass 59 tissue types across 185 mammalian species. These predictive models estimate mammalian tissue age with high accuracy (r > 0.96). Age deviations correlate with human mortality risk, mouse somatotropic axis mutations and caloric restriction. We identified specific cytosines with methylation levels that change with age across numerous species. These sites, highly enriched in polycomb repressive complex 2-binding locations, are near genes implicated in mammalian development, cancer, obesity and longevity. Our findings offer new evidence suggesting that aging is evolutionarily conserved and intertwined with developmental processes across all mammals.
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Tumasyan A, Adam W, Andrejkovic JW, Bergauer T, Chatterjee S, Damanakis K, Dragicevic M, Escalante Del Valle A, Hussain PS, Jeitler M, Krammer N, Lechner L, Liko D, Mikulec I, Paulitsch P, Pitters FM, Schieck J, Schöfbeck R, Schwarz D, Templ S, Waltenberger W, Wulz CE, Darwish MR, Janssen T, Kello T, Rejeb Sfar H, Van Mechelen P, Bols ES, D'Hondt J, De Moor A, Delcourt M, El Faham H, Lowette S, Moortgat S, Morton A, Müller D, Sahasransu AR, Tavernier S, Van Doninck W, Vannerom D, Clerbaux B, De Lentdecker G, Favart L, Hohov D, Jaramillo J, Lee K, Mahdavikhorrami M, Makarenko I, Malara A, Paredes S, Pétré L, Postiau N, Starling E, Thomas L, Vanden Bemden M, Vander Velde C, Vanlaer P, Dobur D, Knolle J, Lambrecht L, Mestdach G, Niedziela M, Rendón C, Roskas C, Samalan A, Skovpen K, Tytgat M, Van Den Bossche N, Vermassen B, Wezenbeek L, Benecke A, Bruno G, Bury F, Caputo C, David P, Delaere C, Donertas IS, Giammanco A, Jaffel K, Jain S, Lemaitre V, Mondal K, Prisciandaro J, Taliercio A, Tran TT, Vischia P, Wertz S, Alves GA, Coelho E, Hensel C, Moraes A, Rebello Teles P, Aldá Júnior WL, Alves Gallo Pereira M, Barroso Ferreira Filho M, Brandao Malbouisson H, Carvalho W, Chinellato J, Da Costa EM, Da Silveira GG, De Jesus Damiao D, Dos Santos Sousa V, Fonseca De Souza S, Martins J, Mora Herrera C, Mota Amarilo K, Mundim L, Nogima H, Santoro A, Silva Do Amaral SM, Sznajder A, Thiel M, Torres Da Silva De Araujo F, Vilela Pereira A, Bernardes CA, Calligaris L, Tomei TRFP, Gregores EM, Mercadante PG, Novaes SF, Padula SS, Aleksandrov A, Antchev G, Hadjiiska R, Iaydjiev P, Misheva M, Rodozov M, Shopova M, Sultanov G, Dimitrov A, Ivanov T, Litov L, Pavlov B, Petkov P, Petrov A, Shumka E, Cheng T, Javaid T, Mittal M, Yuan L, Ahmad M, Bauer G, Hu Z, Lezki S, Yi K, Chen GM, Chen HS, Chen M, Iemmi F, Jiang CH, Kapoor A, Liao H, Liu ZA, Milosevic V, Monti F, Sharma R, Tao J, Thomas-Wilsker J, Wang J, Zhang H, Zhao J, Agapitos A, An Y, Ban Y, Chen C, Levin A, Li C, Li Q, Lyu X, Mao Y, Qian SJ, Sun X, Wang D, Xiao J, Yang H, Li J, Lu M, You Z, Gao X, Leggat D, Okawa H, Zhang Y, Lin Z, Lu C, Xiao M, Avila C, Barbosa Trujillo DA, Cabrera A, Florez C, Fraga J, Mejia Guisao J, Ramirez F, Rodriguez M, Ruiz Alvarez JD, Giljanovic D, Godinovic N, Lelas D, Puljak I, Antunovic Z, Kovac M, Sculac T, Brigljevic V, Chitroda BK, Ferencek D, Majumder D, Roguljic M, Starodumov A, Susa T, Attikis A, Christoforou K, Kole G, Kolosova M, Konstantinou S, Mousa J, Nicolaou C, Ptochos F, Razis PA, Rykaczewski H, Saka H, Finger M, Finger M, Kveton A, Ayala E, Carrera Jarrin E, Assran Y, Elgammal S, Mahmoud MA, Mohammed Y, Bhowmik S, Dewanjee RK, Ehataht K, Kadastik M, Lange T, Nandan S, Nielsen C, Pata J, Raidal M, Tani L, Veelken C, Eerola P, Kirschenmann H, Osterberg K, Voutilainen M, Bharthuar S, Brücken E, Garcia F, Havukainen J, Kim MS, Kinnunen R, Lampén T, Lassila-Perini K, Lehti S, Lindén T, Lotti M, Martikainen L, Myllymäki M, Ott J, Rantanen MM, Siikonen H, Tuominen E, Tuominiemi J, Luukka P, Petrow H, Tuuva T, Amendola C, Besancon M, Couderc F, Dejardin M, Denegri D, Faure JL, Ferri F, Ganjour S, Gras P, Hamel de Monchenault G, Jarry P, Lohezic V, Malcles J, Rander J, Rosowsky A, Sahin MÖ, Savoy-Navarro A, Simkina P, Titov M, Baldenegro Barrera C, Beaudette F, Buchot Perraguin A, Busson P, Cappati A, Charlot C, Damas F, Davignon O, Diab B, Falmagne G, Fontana Santos Alves BA, Ghosh S, Granier de Cassagnac R, Hakimi A, Harikrishnan B, Liu G, Motta J, Nguyen M, Ochando C, Portales L, Rembser J, Salerno R, Sarkar U, Sauvan JB, Sirois Y, Tarabini A, Vernazza E, Zabi A, Zghiche A, Agram JL, Andrea J, Apparu D, Bloch D, Bourgatte G, Brom JM, Chabert EC, Collard C, Darej D, Goerlach U, Grimault C, Le Bihan AC, Van Hove P, Beauceron S, Bernet C, Blancon B, Boudoul G, Carle A, Chanon N, Choi J, Contardo D, Depasse P, Dozen C, El Mamouni H, Fay J, Gascon S, Gouzevitch M, Grenier G, Ille B, Laktineh IB, Lethuillier M, Mirabito L, Perries S, Sordini V, 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Katsoulis P, Kokkas P, Kosmoglou Kioseoglou PG, Manthos N, Papadopoulos I, Strologas J, Csanád M, Farkas K, Gadallah MMA, Komjáti C, Lökös S, Major P, Mandal K, Pásztor G, Rádl AJ, Surányi O, Veres GI, Bartók M, Bencze G, Hajdu C, Horvath D, Sikler F, Veszpremi V, Beni N, Czellar S, Karancsi J, Molnar J, Szillasi Z, Teyssier D, Raics P, Ujvari B, Csorgo T, Nemes F, Novak T, Babbar J, Bansal S, Beri SB, Bhatnagar V, Chaudhary G, Chauhan S, Dhingra N, Gupta R, Kaur A, Kaur A, Kaur H, Kaur M, Kumar S, Kumari P, Meena M, Sandeep K, Sheokand T, Singh JB, Singla A, Virdi AK, Ahmed A, Bhardwaj A, Choudhary BC, Gola M, Keshri S, Kumar A, Naimuddin M, Priyanka P, Ranjan K, Saumya S, Shah A, Baradia S, Barman S, Bhattacharya S, Bhowmik D, Dutta S, Dutta S, Gomber B, Maity M, Palit P, Rout PK, Saha G, Sahu B, Sarkar S, Behera PK, Behera SC, Kalbhor P, Komaragiri JR, Kumar D, Muhammad A, Panwar L, Pradhan R, Pujahari PR, Sharma A, Sikdar AK, Tiwari PC, Verma S, Naskar K, Aziz T, Das I, Dugad S, Kumar M, Mohanty GB, Suryadevara P, Banerjee S, Chudasama R, Guchait M, Karmakar S, Kumar S, Majumder G, Mazumdar K, Mukherjee S, Thachayath A, Bahinipati S, Das AK, Kar C, Mal P, Mishra T, Muraleedharan Nair Bindhu VK, Nayak A, Saha P, Sur N, Swain SK, Vats D, Alpana A, Dube S, Kansal B, Laha A, Pandey S, Rastogi A, Sharma S, Bakhshiansohi H, Khazaie E, Zeinali M, Chenarani S, Etesami SM, Khakzad M, Mohammadi Najafabadi M, Grunewald M, Abbrescia M, Aly R, Aruta C, Colaleo A, Creanza D, De Filippis N, De Palma M, Di Florio A, Elmetenawee W, Errico F, Fiore L, Iaselli G, Ince M, Maggi G, Maggi M, Margjeka I, Mastrapasqua V, My S, Nuzzo S, Pellecchia A, Pompili A, Pugliese G, Radogna R, Ramos D, Ranieri A, Selvaggi G, Silvestris L, Simone FM, Sözbilir Ü, Stamerra A, Venditti R, Verwilligen P, Abbiendi G, Battilana C, Bonacorsi D, Borgonovi L, Brigliadori L, Campanini R, Capiluppi P, Castro A, Cavallo FR, Cuffiani M, Dallavalle GM, Diotalevi T, Fabbri F, Fanfani A, Giacomelli P, Giommi L, Grandi C, Guiducci L, Lo Meo S, Lunerti L, Marcellini S, Masetti G, Navarria FL, Perrotta A, Primavera F, Rossi AM, Rovelli T, Siroli GP, Costa S, Di Mattia A, Potenza R, Tricomi A, Tuve C, Barbagli G, Camaiani B, Cassese A, Ceccarelli R, Ciulli V, Civinini C, D'Alessandro R, Focardi E, Latino G, Lenzi P, Lizzo M, Meschini M, Paoletti S, Seidita R, Sguazzoni G, Viliani L, Benussi L, Bianco S, Meola S, Piccolo D, Bozzo M, Ferro F, Mulargia R, Robutti E, Tosi S, Benaglia A, Boldrini G, Brivio F, Cetorelli F, De Guio F, Dinardo ME, Dini P, Gennai S, Ghezzi A, Govoni P, Guzzi L, Lucchini MT, Malberti M, Malvezzi S, Massironi A, Menasce D, Moroni L, Paganoni M, Pedrini D, Pinolini BS, Ragazzi S, Redaelli N, Tabarelli de Fatis T, Zuolo D, Buontempo S, Carnevali F, Cavallo N, De Iorio A, Fabozzi F, Iorio AOM, Lista L, Paolucci P, Rossi B, Sciacca C, Azzi P, Bacchetta N, Bortignon P, Bragagnolo A, Carlin R, Checchia P, Gasparini U, Grosso G, Layer L, Lusiani E, Margoni M, Meneguzzo AT, Passaseo M, Pazzini J, Ronchese P, Rossin R, Sgaravatto M, Simonetto F, Strong G, Tosi M, Ventura S, Yarar H, Zanetti M, Zotto P, Zucchetta A, Zumerle G, Abu Zeid S, Aimè C, Braghieri A, Calzaferri S, Fiorina D, Montagna P, Re V, Riccardi C, Salvini P, Vai I, Vitulo P, Asenov P, Bilei GM, Ciangottini D, Fanò L, Magherini M, Mantovani G, Mariani V, Menichelli M, Moscatelli F, Piccinelli A, Presilla M, Rossi A, Santocchia A, Spiga D, Tedeschi T, Azzurri P, Bagliesi G, Bertacchi V, Bhattacharya R, Bianchini L, Boccali T, Bossini E, Bruschini D, Castaldi R, Ciocci MA, D'Amante V, Dell'Orso R, Di Domenico MR, Donato S, Giassi A, Ligabue F, Manca E, Mandorli G, Matos Figueiredo D, Messineo A, Musich M, Palla F, Parolia S, Ramirez-Sanchez G, Rizzi A, Rolandi G, Roy Chowdhury S, Sarkar T, Scribano A, Shafiei N, Spagnolo P, Tenchini R, Tonelli G, Turini N, Venturi A, Verdini PG, Barria P, Campana M, Cavallari F, Del Re D, Di Marco E, Diemoz M, Longo E, Meridiani P, Organtini G, Pandolfi F, 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Duarte Campderros J, Fernandez M, Fernandez Madrazo C, García Alonso A, Gomez G, Lasaosa García C, Martinez Rivero C, Martinez Ruiz Del Arbol P, Matorras F, Matorras Cuevas P, Piedra Gomez J, Prieels C, Ruiz-Jimeno A, Scodellaro L, Vila I, Vizan Garcia JM, Jayananda MK, Kailasapathy B, Sonnadara DUJ, Wickramarathna DDC, Dharmaratna WGD, Liyanage K, Perera N, Wickramage N, Abbaneo D, Alimena J, Auffray E, Auzinger G, Baechler J, Baillon P, Barney D, Bendavid J, Bianco M, Bilin B, Bocci A, Brondolin E, Caillol C, Camporesi T, Cerminara G, Chernyavskaya N, Chhibra SS, Choudhury S, Cipriani M, Cristella L, d'Enterria D, Dabrowski A, David A, De Roeck A, Defranchis MM, Deile M, Dobson M, Dünser M, Dupont N, Elliott-Peisert A, Fallavollita F, Florent A, Forthomme L, Franzoni G, Funk W, Ghosh S, Giani S, Gigi D, Gill K, Glege F, Gouskos L, Govorkova E, Haranko M, Hegeman J, Innocente V, James T, Janot P, Kaspar J, Kieseler J, Kratochwil N, Laurila S, Lecoq P, Leutgeb E, Lintuluoto A, Lourenço C, Maier B, Malgeri L, Mannelli M, Marini AC, Meijers F, Mersi S, Meschi E, Moortgat F, Mulders M, Orfanelli S, Orsini L, Pantaleo F, Perez E, Peruzzi M, Petrilli A, Petrucciani G, Pfeiffer A, Pierini M, Piparo D, Pitt M, Qu H, Quast T, Rabady D, Racz A, Reales Gutiérrez G, Rovere M, Sakulin H, Salfeld-Nebgen J, Scarfi S, Selvaggi M, Sharma A, Silva P, Sphicas P, Stahl Leiton AG, Summers S, Tatar K, Tavolaro VR, Treille D, Tropea P, Tsirou A, Wanczyk J, Wozniak KA, Zeuner WD, Caminada L, Ebrahimi A, Erdmann W, Horisberger R, Ingram Q, Kaestli HC, Kotlinski D, Lange C, Missiroli M, Noehte L, Rohe T, Aarrestad TK, Androsov K, Backhaus M, Berger P, Calandri A, Datta K, De Cosa A, Dissertori G, Dittmar M, Donegà M, Eble F, Galli M, Gedia K, Glessgen F, Gómez Espinosa TA, Grab C, Hits D, Lustermann W, Lyon AM, Manzoni RA, Marchese L, Martin Perez C, Mascellani A, Meinhard MT, Nessi-Tedaldi F, Niedziela J, Pauss F, Perovic V, Pigazzini S, Ratti MG, Reichmann M, Reissel C, Reitenspiess T, Ristic B, Riti F, Ruini D, Sanz Becerra DA, Steggemann J, Valsecchi D, Wallny R, Amsler C, Bärtschi P, Botta C, Brzhechko D, Canelli MF, Cormier K, De Wit A, Del Burgo R, Heikkilä JK, Huwiler M, Jin W, Jofrehei A, Kilminster B, Leontsinis S, Liechti SP, Macchiolo A, Meiring P, Mikuni VM, Molinatti U, Neutelings I, Reimers A, Robmann P, Sanchez Cruz S, Schweiger K, Senger M, Takahashi Y, Adloff C, Kuo CM, Lin W, Yu SS, Ceard L, Chao Y, Chen KF, Chen PS, Cheng H, Hou WS, Li YY, Lu RS, Paganis E, Psallidas A, Steen A, Wu HY, Yazgan E, Yu PR, Asawatangtrakuldee C, Srimanobhas N, Agyel D, Boran F, Demiroglu ZS, Dolek F, Dumanoglu I, Eskut E, Guler Y, Gurpinar Guler E, Isik C, Kara O, Kayis Topaksu A, Kiminsu U, Onengut G, Ozdemir K, Polatoz A, Simsek AE, Tali B, Tok UG, Turkcapar S, Uslan E, Zorbakir IS, Karapinar G, Ocalan K, Yalvac M, Akgun B, Atakisi IO, Gülmez E, Kaya M, Kaya O, Özçelik Ö, Tekten S, Cakir A, Cankocak K, Komurcu Y, Sen S, Aydilek O, Cerci S, Hacisahinoglu B, Hos I, Isildak B, Kaynak B, Ozkorucuklu S, Simsek C, Sunar Cerci D, Grynyov B, Levchuk L, Anthony D, Bhal E, Brooke JJ, Bundock A, Clement E, Cussans D, Flacher H, Glowacki M, Goldstein J, Heath GP, Heath HF, Kreczko L, Krikler B, Paramesvaran S, Seif El Nasr-Storey S, Smith VJ, Stylianou N, Walkingshaw Pass K, White R, Ball AH, Bell KW, Belyaev A, Brew C, Brown RM, Cockerill DJA, Cooke C, Ellis KV, Harder K, Harper S, Holmberg ML, Linacre J, Manolopoulos K, Newbold DM, Olaiya E, Petyt D, Reis T, Salvi G, Schuh T, Shepherd-Themistocleous CH, Tomalin IR, Williams T, Bainbridge R, Bloch P, Bonomally S, Borg J, Breeze S, Brown CE, Buchmuller O, Cacchio V, Cepaitis V, Chahal GS, Colling D, Dancu JS, Dauncey P, Davies G, Davies J, Della Negra M, Fayer S, Fedi G, Hall G, Hassanshahi MH, Howard A, Iles G, Langford J, Lyons L, Magnan AM, Malik S, Martelli A, Mieskolainen M, Monk DG, Nash J, Pesaresi M, Radburn-Smith BC, Raymond DM, Richards A, Rose A, Scott E, Seez C, Shtipliyski A, Shukla R, Tapper A, Uchida K, Uttley GP, Vage LH, Virdee T, Vojinovic M, Wardle N, Webb SN, Winterbottom D, Coldham K, Cole JE, Khan A, Kyberd P, Reid ID, Abdullin S, Brinkerhoff A, Caraway B, Dittmann J, Hatakeyama K, Kanuganti AR, McMaster B, Saunders M, Sawant S, Sutantawibul C, Wilson J, Bartek R, Dominguez A, Uniyal R, Vargas Hernandez AM, Buccilli A, Cooper SI, Di Croce D, Gleyzer SV, Henderson C, Perez CU, Rumerio P, West C, Akpinar A, Albert A, Arcaro D, Cosby C, Demiragli Z, Erice C, Fontanesi E, Gastler D, May S, Rohlf J, Salyer K, Sperka D, Spitzbart D, Suarez I, Tsatsos A, Yuan S, Benelli G, Burkle B, Coubez X, Cutts D, Hadley M, Heintz U, Hogan JM, Kwon T, Landsberg G, Lau KT, Li D, Luo J, Narain M, Pervan N, Sagir S, Simpson F, Usai E, Wong WY, Yan X, Yu D, Zhang W, Bonilla J, Brainerd C, Breedon R, Calderon De La Barca Sanchez M, Chertok M, Conway J, Cox PT, Erbacher R, Haza G, Jensen F, Kukral O, Mocellin G, Mulhearn M, Pellett D, Regnery B, Taylor D, Yao Y, Zhang F, Bachtis M, Cousins R, Datta A, Hamilton D, Hauser J, Ignatenko M, Iqbal MA, Lam T, Nash WA, Regnard S, Saltzberg D, Stone B, Valuev V, Chen Y, Clare R, Gary JW, Gordon M, Hanson G, Karapostoli G, Long OR, Manganelli N, Si W, Wimpenny S, Branson JG, Chang P, Cittolin S, Cooperstein S, Diaz D, Duarte J, Gerosa R, Giannini L, Guiang J, Kansal R, Krutelyov V, Lee R, Letts J, Masciovecchio M, Mokhtar F, Pieri M, Sathia Narayanan BV, Sharma V, Tadel M, Würthwein F, Xiang Y, Yagil A, Amin N, Campagnari C, Citron M, Collura G, Dorsett A, Dutta V, Incandela J, Kilpatrick M, Kim J, Li AJ, Marsh B, Masterson P, Mei H, Oshiro M, Quinnan M, Richman J, Sarica U, Schmitz R, Setti F, Sheplock J, Siddireddy P, Stuart D, Wang S, Bornheim A, Cerri O, Dutta I, Lawhorn JM, Lu N, Mao J, Newman HB, Nguyen TQ, Spiropulu M, Vlimant JR, Wang C, Xie S, Zhu RY, Alison J, An S, Andrews MB, Bryant P, Ferguson T, Harilal A, Liu C, Mudholkar T, Murthy S, Paulini M, Roberts A, Sanchez A, Terrill W, Cumalat JP, Ford WT, Hassani A, Karathanasis G, MacDonald E, Marini F, Patel R, Perloff A, Savard C, Schonbeck N, Stenson K, Ulmer KA, Wagner SR, Zipper N, Alexander J, Bright-Thonney S, Chen X, Cranshaw DJ, Fan J, Fan X, Gadkari D, Hogan S, Monroy J, Patterson JR, Quach D, Reichert J, Reid M, Ryd A, Thom J, Wittich P, Zou R, Albrow M, Alyari M, Apollinari G, Apresyan A, Bauerdick LAT, Berry D, Berryhill J, Bhat PC, Burkett K, Butler JN, Canepa A, Cerati GB, Cheung HWK, Chlebana F, Di Petrillo KF, Dickinson J, Elvira VD, Feng Y, Freeman J, Gandrakota A, Gecse Z, Gray L, Green D, Grünendahl S, Gutsche O, Harris RM, Heller R, Herwig TC, Hirschauer J, Horyn L, Jayatilaka B, Jindariani S, Johnson M, Joshi U, Klijnsma T, Klima B, Kwok KHM, Lammel S, Lincoln D, Lipton R, Liu T, Madrid C, Maeshima K, Mantilla C, Mason D, McBride P, Merkel P, Mrenna S, Nahn S, Ngadiuba J, Noonan D, Papadimitriou V, Pastika N, Pedro K, Pena C, Ravera F, Reinsvold Hall A, Ristori L, Sexton-Kennedy E, Smith N, Soha A, Spiegel L, Strait J, Taylor L, Tkaczyk S, Tran NV, Uplegger L, Vaandering EW, Weber HA, Zoi I, Avery P, Bourilkov D, Cadamuro L, Cherepanov V, Field RD, Guerrero D, Kim M, Koenig E, Konigsberg J, Korytov A, Lo KH, Matchev K, Menendez N, Mitselmakher G, Muthirakalayil Madhu A, Rawal N, Rosenzweig D, Rosenzweig S, Shi K, Wang J, Wu Z, Adams T, Askew A, Habibullah R, Hagopian V, Khurana R, Kolberg T, Martinez G, Prosper H, Schiber C, Viazlo O, Yohay R, Zhang J, Baarmand MM, Butalla S, Elkafrawy T, Hohlmann M, Kumar Verma R, Rahmani M, Yumiceva F, Adams MR, Becerril Gonzalez H, Cavanaugh R, Dittmer S, Evdokimov O, Gerber CE, Hofman DJ, Lemos DS, Merrit AH, Mills C, Oh G, Roy T, Rudrabhatla S, Tonjes MB, Varelas N, Wang X, Ye Z, Yoo J, Alhusseini M, Dilsiz K, Emediato L, Gandrajula RP, Karaman G, Köseyan OK, Merlo JP, Mestvirishvili A, Nachtman J, Neogi O, Ogul H, Onel Y, Penzo A, Snyder C, Tiras E, Amram O, Blumenfeld B, Corcodilos L, Davis J, Gritsan AV, Kang L, Kyriacou S, Maksimovic P, Roskes J, Sekhar S, Swartz M, Vámi TÁ, Abreu A, Alcerro Alcerro LF, Anguiano J, Baringer P, Bean A, Flowers Z, Isidori T, Khalil S, King J, Krintiras G, Lazarovits M, Le Mahieu C, Lindsey C, Marquez J, Minafra N, Murray M, Nickel M, Rogan C, Royon C, Salvatico R, Sanders S, Schmitz E, Smith C, Wang Q, Williams J, Wilson G, Allmond B, Duric S, Gujju Gurunadha R, Ivanov A, Kaadze K, Kim D, Maravin Y, Mitchell T, Modak A, Nam K, Natoli J, Roy D, Rebassoo F, Wright D, Adams E, Baden A, Baron O, Belloni A, Bethani A, Eno SC, Hadley NJ, Jabeen S, Kellogg RG, Koeth T, Lai Y, Lascio S, Mignerey AC, Nabili S, Palmer C, Papageorgakis C, Seidel M, Wang L, Wong K, Abercrombie D, Bi R, Busza W, Cali IA, Chen Y, D'Alfonso M, Eysermans J, Freer C, Gomez-Ceballos G, Goncharov M, Harris P, Hu M, Kovalskyi D, Krupa J, Lee YJ, Long K, Mironov C, Paus C, Rankin D, Roland C, Roland G, Shi Z, Stephans GSF, Wang J, Wang Z, Wyslouch B, Chatterjee RM, Crossman B, Evans A, Hiltbrand J, Jain S, Joshi BM, Kapsiak C, Krohn M, Kubota Y, Mans J, Revering M, Rusack R, Saradhy R, Schroeder N, Strobbe N, Wadud MA, Cremaldi LM, Bloom K, Bryson M, Claes DR, Fangmeier C, Finco L, Golf F, Joo C, Kravchenko I, Reed I, Siado JE, Snow GR, Tabb W, Wightman A, Yan F, Zecchinelli AG, Agarwal G, Bandyopadhyay H, Hay L, Iashvili I, Kharchilava A, McLean C, Morris M, Nguyen D, Pekkanen J, Rappoccio S, Williams A, Alverson G, Barberis E, Haddad Y, Han Y, Krishna A, Li J, Lidrych J, Madigan G, Marzocchi B, Morse DM, Nguyen V, Orimoto T, Parker A, Skinnari L, Tishelman-Charny A, Wamorkar T, Wang B, Wisecarver A, Wood D, Bhattacharya S, Bueghly J, Chen Z, Gilbert A, Gunter T, Hahn KA, Liu Y, Odell N, Schmitt MH, Velasco M, Band R, Bucci R, Castells S, Cremonesi M, Das A, Goldouzian R, Hildreth M, Hurtado Anampa K, Jessop C, Lannon K, Lawrence J, Loukas N, Lutton L, Mariano J, Marinelli N, Mcalister I, McCauley T, Mcgrady C, Mohrman K, Moore C, Musienko Y, Nelson H, Ruchti R, Townsend A, Wayne M, Yockey H, Zarucki M, Zygala L, Bylsma B, Carrigan M, Durkin LS, Francis B, Hill C, Lesauvage A, Nunez Ornelas M, Wei K, Winer BL, Yates BR, Addesa FM, Bonham B, Das P, Dezoort G, Elmer P, Frankenthal A, Greenberg B, Haubrich N, Higginbotham S, Kalogeropoulos A, Kopp G, Kwan S, Lange D, Marlow D, Mei K, Ojalvo I, Olsen J, Stickland D, Tully C, Malik S, Norberg S, Bakshi AS, Barnes VE, Chawla R, Das S, Gutay L, Jones M, Jung AW, Kondratyev D, Koshy AM, Liu M, Negro G, Neumeister N, Paspalaki G, Piperov S, Purohit A, Schulte JF, Stojanovic M, Thieman J, Wang F, Xiao R, Xie W, Dolen J, Parashar N, Acosta D, Baty A, Carnahan T, Decaro M, Dildick S, Ecklund KM, Fernández Manteca PJ, Freed S, Gardner P, Geurts FJM, Kumar A, Li W, Padley BP, Redjimi R, Rotter J, Shi W, Yang S, Yigitbasi E, Zhang L, Zhang Y, Zuo X, Bodek A, de Barbaro P, Demina R, Dulemba JL, Fallon C, Ferbel T, Galanti M, Garcia-Bellido A, Hindrichs O, Khukhunaishvili A, Ranken E, Taus R, Van Onsem GP, Goulianos K, Chiarito B, Chou JP, Gershtein Y, Halkiadakis E, Hart A, Heindl M, Jaroslawski D, Karacheban O, Laflotte I, Lath A, Montalvo R, Nash K, Osherson M, Salur S, Schnetzer S, Somalwar S, Stone R, Thayil SA, Thomas S, Wang H, Acharya H, Delannoy AG, Fiorendi S, Holmes T, Nibigira E, Spanier S, Bouhali O, Dalchenko M, Delgado A, Eusebi R, Gilmore J, Huang T, Kamon T, Kim H, Luo S, Malhotra S, Mueller R, Overton D, Rathjens D, Safonov A, Akchurin N, Damgov J, Hegde V, Lamichhane K, Lee SW, Mengke T, Muthumuni S, Peltola T, Volobouev I, Wang Z, Whitbeck A, Appelt E, Greene S, Gurrola A, Johns W, Melo A, Romeo F, Sheldon P, Tuo S, Velkovska J, Viinikainen J, Cardwell B, Cox B, Cummings G, Hakala J, Hirosky R, Joyce M, Ledovskoy A, Li A, Neu C, Perez Lara CE, Tannenwald B, Karchin PE, Poudyal N, Banerjee S, Black K, Bose T, Dasu S, De Bruyn I, Everaerts P, Galloni C, He H, Herndon M, Herve A, Koraka CK, Lanaro A, Loeliger A, Loveless R, Madhusudanan Sreekala J, Mallampalli A, Mohammadi A, Mondal S, Parida G, Pinna D, Savin A, Shang V, Sharma V, Smith WH, Teague D, Tsoi HF, Vetens W, Afanasiev S, Andreev V, Andreev Y, Aushev T, Azarkin M, Babaev A, Belyaev A, Blinov V, Boos E, Borshch V, Budkouski D, Bunichev V, Chekhovsky V, Chistov R, Danilov M, Dermenev A, Dimova T, Dremin I, Dubinin M, Dudko L, Epshteyn V, Ershov A, Gavrilov G, Gavrilov V, Gninenko S, Golovtcov V, Golubev N, Golutvin I, Gorbunov I, Ivanchenko V, Ivanov Y, Kachanov V, Kardapoltsev L, Karjavine V, Karneyeu A, Kim V, Kirakosyan M, Kirpichnikov D, Kirsanov M, Klyukhin V, Kodolova O, Konstantinov D, Korenkov V, Kozyrev A, Krasnikov N, Kuznetsova E, Lanev A, Levchenko P, Litomin A, Lukina O, Lychkovskaya N, Makarenko V, Malakhov A, Matveev V, Murzin V, Nikitenko A, Obraztsov S, Okhotnikov V, Oskin A, Ovtin I, Palichik V, Parygin P, Perelygin V, Pivovarov G, Polikarpov S, Popov V, Radchenko O, Savina M, Savrin V, Selivanova D, Shalaev V, Shmatov S, Shulha S, Skovpen Y, Slabospitskii S, Smirnov V, Snigirev A, Sosnov D, Stepennov A, Sulimov V, Tcherniaev E, Terkulov A, Teryaev O, Tlisova I, Toms M, Toropin A, Uvarov L, Uzunian A, Vlasov E, Vorobyev A, Voytishin N, Yuldashev BS, Zarubin A, Zhizhin I, Zhokin A. Observation of Same-Sign WW Production from Double Parton Scattering in Proton-Proton Collisions at sqrt[s]=13 TeV. PHYSICAL REVIEW LETTERS 2023; 131:091803. [PMID: 37721845 DOI: 10.1103/physrevlett.131.091803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/18/2022] [Indexed: 09/20/2023]
Abstract
The first observation of the production of W^{±}W^{±} bosons from double parton scattering processes using same-sign electron-muon and dimuon events in proton-proton collisions is reported. The data sample corresponds to an integrated luminosity of 138 fb^{-1} recorded at a center-of-mass energy of 13 TeV using the CMS detector at the CERN LHC. Multivariate discriminants are used to distinguish the signal process from the main backgrounds. A binned maximum likelihood fit is performed to extract the signal cross section. The measured cross section for production of same-sign W bosons decaying leptonically is 80.7±11.2(stat) _{-8.6}^{+9.5}(syst)±12.1(model) fb, whereas the measured fiducial cross section is 6.28±0.81(stat)±0.69(syst)±0.37(model) fb. The observed significance of the signal is 6.2 standard deviations above the background-only hypothesis.
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Chen D, Xu Q, Mao X, Zhang J, Wu L. Reproductive history does not compromise subsequent live birth and perinatal outcome following in-vitro fertilization: analysis of 25 329 first frozen-thawed embryo transfer cycles without preimplantation genetic testing for aneuploidy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 62:430-438. [PMID: 37058394 DOI: 10.1002/uog.26220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To investigate the effect of women's reproductive history on live-birth rate and perinatal outcome after first frozen-thawed embryo transfer (FET) without preimplantation genetic testing for aneuploidy. METHODS This was a retrospective cohort study of women who had undergone their first FET cycle between January 2014 and December 2020 at a university-affiliated fertility center. No transferred embryo underwent preimplantation genetic testing for aneuploidy. The women were categorized into five groups based on their reproductive history: no previous pregnancy; previous termination of pregnancy (TOP); previous pregnancy loss; previous ectopic pregnancy (EP); and previous live birth. The women with no previous pregnancy were considered as the reference group. The primary outcome was the live-birth rate and secondary endpoints included rates of positive pregnancy test, clinical pregnancy, pregnancy loss and EP as well as perinatal outcomes such as birth weight and preterm birth. Multivariable logistic regression analyses were used to control for a number of potential confounders, including age, body mass index, education level, duration and cause of infertility, insemination method, type of endometrial preparation, number of embryos transferred, embryo developmental stage, quality of the embryos transferred, year of treatment and endometrial thickness. Additionally, propensity score matching (PSM) was used to check the robustness of the main findings. RESULTS In total, 25 329 women were included in the final analysis. On univariate analysis, each reproductive-history type except for previous EP was significantly associated with worse pregnancy outcome following in-vitro fertilization (IVF), including rates of positive pregnancy test, clinical pregnancy, pregnancy loss and live birth, when compared with the group of women with no previous pregnancy. However, after correcting for several potential confounders, the differences in rates of live birth, pregnancy loss, positive pregnancy test and clinical pregnancy were no longer significant between the study and control groups on multivariable regression models, while the risk of EP after embryo transfer was elevated among women with a previous TOP or EP. There was no increased risk of adverse perinatal outcome associated with reproductive history compared with the control group. Notably, similar results were obtained from the PSM models, confirming the robustness of the main findings. CONCLUSION Relative to women without a previous pregnancy, those with a prior TOP, pregnancy loss, EP or live birth did not have compromised live-birth rate or perinatal outcomes following FET without preimplantation genetic testing for aneuploidy, with the exception of an increased risk of EP in those with prior TOP or EP. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Wu J, Liu Y, Zhang J, Wang X. Cloning, expression, purification and functional study of low-temperature chitinase PBCHI5 gene from marine-derived photobacteria. CRYO LETTERS 2023; 44:280-290. [PMID: 38032308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND Chitin is the second largest carbon source on the earth, and chitosan oligosaccharides produced by its degradation have good application prospects in medicine, cosmetics, and agricultural production. OBJECTIVE The discovery of a chitinase with high efficiency, high stability and clear degradation mechanism is of great help to promote the research of chitin derivatives and the development of the industrial chain. MATERIALS AND METHODS In this experiment, a low-temperature chitinase-producing strain Photobacterium sp. LG-29 was isolated from deep-sea mud in the Bohai Sea, and studied by means of molecular biology, biochemistry and bioinformatics. RESULTS Purification of chitinase yielded an enzyme solution with a concentration of 0.918 mg per mL and a specific activity of 21.036 U per mg. The optimum action temperature is 35 degree C, and it is still active at 4 degree C, showing low-temperature enzymatic activity, and also has certain thermal stability. The optimum pH is 8.0, and it maintains more than 70% of the enzyme activity at pH 11, which is very stable in an alkaline environment. Mn2+, Ca2+, and Mg2+ are the main activators of enzymes, while Fe2+, Zn2+, etc. have extremely significant inhibitory effects on enzymes. The Km and Kcat of chitinase were determined to be 269.05 μmol/L and 0.49 min-1, respectively. Chitinase PbCHI5 has both endonuclease and exonuclease activity. The theoretical pI of the enzyme is 4.16, which is a stable hydrophilic protein. CONCLUSION This experiment laid a theoretical foundation for the development and utilization of new low-temperature chitinases. Doi.org/10.54680/fr23510110212.
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