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Vallevik VB, Babic A, Marshall SE, Elvatun S, Brøgger HMB, Alagaratnam S, Edwin B, Veeraragavan NR, Befring AK, Nygård JF. Can I trust my fake data - A comprehensive quality assessment framework for synthetic tabular data in healthcare. Int J Med Inform 2024; 185:105413. [PMID: 38493547 DOI: 10.1016/j.ijmedinf.2024.105413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/17/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Ensuring safe adoption of AI tools in healthcare hinges on access to sufficient data for training, testing and validation. Synthetic data has been suggested in response to privacy concerns and regulatory requirements and can be created by training a generator on real data to produce a dataset with similar statistical properties. Competing metrics with differing taxonomies for quality evaluation have been proposed, resulting in a complex landscape. Optimising quality entails balancing considerations that make the data fit for use, yet relevant dimensions are left out of existing frameworks. METHOD We performed a comprehensive literature review on the use of quality evaluation metrics on synthetic data within the scope of synthetic tabular healthcare data using deep generative methods. Based on this and the collective team experiences, we developed a conceptual framework for quality assurance. The applicability was benchmarked against a practical case from the Dutch National Cancer Registry. CONCLUSION We present a conceptual framework for quality assuranceof synthetic data for AI applications in healthcare that aligns diverging taxonomies, expands on common quality dimensions to include the dimensions of Fairness and Carbon footprint, and proposes stages necessary to support real-life applications. Building trust in synthetic data by increasing transparency and reducing the safety risk will accelerate the development and uptake of trustworthy AI tools for the benefit of patients. DISCUSSION Despite the growing emphasis on algorithmic fairness and carbon footprint, these metrics were scarce in the literature review. The overwhelming focus was on statistical similarity using distance metrics while sequential logic detection was scarce. A consensus-backed framework that includes all relevant quality dimensions can provide assurance for safe and responsible real-life applications of synthetic data. As the choice of appropriate metrics are highly context dependent, further research is needed on validation studies to guide metric choices and support the development of technical standards.
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Affiliation(s)
- Vibeke Binz Vallevik
- University of Oslo, Boks 1072 Blindern, NO-0316 Oslo, Norway; DNV AS, Veritasveien 1, 1322 Høvik, Norway.
| | | | | | - Severin Elvatun
- Cancer Registry of Norway, Ullernchausseen 64, 0379 Oslo, Norway
| | - Helga M B Brøgger
- DNV AS, Veritasveien 1, 1322 Høvik, Norway; Oslo University Hospital, Sognsvannsveien 20, 0372 Oslo, Norway
| | | | - Bjørn Edwin
- University of Oslo, Boks 1072 Blindern, NO-0316 Oslo, Norway; The Intervention Centre and Department of HPB Surgery, Oslo University Hospital and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | | | - Jan F Nygård
- Cancer Registry of Norway, Ullernchausseen 64, 0379 Oslo, Norway; UiT - The Arctic University of Norway, Tromsø, Norway
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Koch E, Pardiñas AF, O'Connell KS, Selvaggi P, Camacho Collados J, Babic A, Marshall SE, Van der Eycken E, Angulo C, Lu Y, Sullivan PF, Dale AM, Molden E, Posthuma D, White N, Schubert A, Djurovic S, Heimer H, Stefánsson H, Stefánsson K, Werge T, Sønderby I, O'Donovan MC, Walters JTR, Milani L, Andreassen OA. How Real-World Data Can Facilitate the Development of Precision Medicine Treatment in Psychiatry. Biol Psychiatry 2024:S0006-3223(24)00003-9. [PMID: 38185234 DOI: 10.1016/j.biopsych.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/20/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
Precision medicine has the ambition to improve treatment response and clinical outcomes through patient stratification and holds great potential for the treatment of mental disorders. However, several important factors are needed to transform current practice into a precision psychiatry framework. Most important are 1) the generation of accessible large real-world training and test data including genomic data integrated from multiple sources, 2) the development and validation of advanced analytical tools for stratification and prediction, and 3) the development of clinically useful management platforms for patient monitoring that can be integrated into health care systems in real-life settings. This narrative review summarizes strategies for obtaining the key elements-well-powered samples from large biobanks integrated with electronic health records and health registry data using novel artificial intelligence algorithms-to predict outcomes in severe mental disorders and translate these models into clinical management and treatment approaches. Key elements are massive mental health data and novel artificial intelligence algorithms. For the clinical translation of these strategies, we discuss a precision medicine platform for improved management of mental disorders. We use cases to illustrate how precision medicine interventions could be brought into psychiatry to improve the clinical outcomes of mental disorders.
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Affiliation(s)
- Elise Koch
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Antonio F Pardiñas
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Kevin S O'Connell
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pierluigi Selvaggi
- Department of Translational Biomedicine and Neuroscience, University of Bari Aldo Moro, Bari, Italy
| | - José Camacho Collados
- CardiffNLP, School of Computer Science and Informatics, Cardiff University, Cardiff, United Kingdom
| | | | | | - Erik Van der Eycken
- Global Alliance of Mental Illness Advocacy Networks-Europe, Brussels, Belgium
| | - Cecilia Angulo
- Global Alliance of Mental Illness Advocacy Networks-Europe, Brussels, Belgium
| | - Yi Lu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Patrick F Sullivan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Anders M Dale
- Multimodal Imaging Laboratory, University of California San Diego, La Jolla, California; Departments of Radiology, Psychiatry, and Neurosciences, University of California, San Diego, La Jolla, California
| | - Espen Molden
- Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway
| | - Danielle Posthuma
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Nathan White
- CorTechs Laboratories, Inc., San Diego, California
| | | | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; The Norwegian Centre for Mental Disorders Research Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Hakon Heimer
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Nordic Society of Human Genetics and Precision Medicine, Copenhagen, Denmark
| | | | | | - Thomas Werge
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark; Lundbeck Foundation GeoGenetics Centre, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - Ida Sønderby
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Michael C O'Donovan
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - James T R Walters
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Lili Milani
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia; Genetics and Personalized Medicine Clinic, Tartu University Hospital, Tartu, Estonia
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Division of Mental Health and Addiction, Oslo University Hospital, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo and Oslo University Hospital, Oslo, Norway.
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3
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Haraldsen IH, Hatlestad-Hall C, Marra C, Renvall H, Maestú F, Acosta-Hernández J, Alfonsin S, Andersson V, Anand A, Ayllón V, Babic A, Belhadi A, Birck C, Bruña R, Caraglia N, Carrarini C, Christensen E, Cicchetti A, Daugbjerg S, Di Bidino R, Diaz-Ponce A, Drews A, Giuffrè GM, Georges J, Gil-Gregorio P, Gove D, Govers TM, Hallock H, Hietanen M, Holmen L, Hotta J, Kaski S, Khadka R, Kinnunen AS, Koivisto AM, Kulashekhar S, Larsen D, Liljeström M, Lind PG, Marcos Dolado A, Marshall S, Merz S, Miraglia F, Montonen J, Mäntynen V, Øksengård AR, Olazarán J, Paajanen T, Peña JM, Peña L, Peniche DL, Perez AS, Radwan M, Ramírez-Toraño F, Rodríguez-Pedrero A, Saarinen T, Salas-Carrillo M, Salmelin R, Sousa S, Suyuthi A, Toft M, Toharia P, Tveitstøl T, Tveter M, Upreti R, Vermeulen RJ, Vecchio F, Yazidi A, Rossini PM. Intelligent digital tools for screening of brain connectivity and dementia risk estimation in people affected by mild cognitive impairment: the AI-Mind clinical study protocol. Front Neurorobot 2024; 17:1289406. [PMID: 38250599 PMCID: PMC10796757 DOI: 10.3389/fnbot.2023.1289406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024] Open
Abstract
More than 10 million Europeans show signs of mild cognitive impairment (MCI), a transitional stage between normal brain aging and dementia stage memory disorder. The path MCI takes can be divergent; while some maintain stability or even revert to cognitive norms, alarmingly, up to half of the cases progress to dementia within 5 years. Current diagnostic practice lacks the necessary screening tools to identify those at risk of progression. The European patient experience often involves a long journey from the initial signs of MCI to the eventual diagnosis of dementia. The trajectory is far from ideal. Here, we introduce the AI-Mind project, a pioneering initiative with an innovative approach to early risk assessment through the implementation of advanced artificial intelligence (AI) on multimodal data. The cutting-edge AI-based tools developed in the project aim not only to accelerate the diagnostic process but also to deliver highly accurate predictions regarding an individual's risk of developing dementia when prevention and intervention may still be possible. AI-Mind is a European Research and Innovation Action (RIA H2020-SC1-BHC-06-2020, No. 964220) financed between 2021 and 2026. First, the AI-Mind Connector identifies dysfunctional brain networks based on high-density magneto- and electroencephalography (M/EEG) recordings. Second, the AI-Mind Predictor predicts dementia risk using data from the Connector, enriched with computerized cognitive tests, genetic and protein biomarkers, as well as sociodemographic and clinical variables. AI-Mind is integrated within a network of major European initiatives, including The Virtual Brain, The Virtual Epileptic Patient, and EBRAINS AISBL service for sensitive data, HealthDataCloud, where big patient data are generated for advancing digital and virtual twin technology development. AI-Mind's innovation lies not only in its early prediction of dementia risk, but it also enables a virtual laboratory scenario for hypothesis-driven personalized intervention research. This article introduces the background of the AI-Mind project and its clinical study protocol, setting the stage for future scientific contributions.
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Affiliation(s)
| | | | - Camillo Marra
- Memory Clinic, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy
| | - Hanna Renvall
- Department of Neuroscience and Biomedical Engineering, Aalto University, Helsinki, Finland
- BioMag Laboratory, HUS Medical Imaging Centre, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Fernando Maestú
- Centre for Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, Madrid, Spain
- Department of Experimental Psychology, Cognitive Psychology and Speech and Language Therapy, Universidad Complutense de Madrid, Pozuelo de Alarcón, Spain
- Institute of Sanitary Investigation (IdISSC), San Carlos University Hospital, Madrid, Spain
| | | | - Soraya Alfonsin
- Centre for Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, Madrid, Spain
- Department of Experimental Psychology, Cognitive Psychology and Speech and Language Therapy, Universidad Complutense de Madrid, Pozuelo de Alarcón, Spain
| | | | - Abhilash Anand
- Performance and Assurance Solutions, Digital Solutions, DNV, Oslo, Norway
| | | | - Aleksandar Babic
- Healthcare Programme, Group Research and Development, DNV, Oslo, Norway
| | - Asma Belhadi
- Department of Computer Science, OsloMet—Oslo Metropolitan University, Oslo, Norway
- NordSTAR—Nordic Center for Sustainable and Trustworthy AI Research, Oslo, Norway
| | | | - Ricardo Bruña
- Centre for Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, Madrid, Spain
- Institute of Sanitary Investigation (IdISSC), San Carlos University Hospital, Madrid, Spain
- Department of Radiology, Universidad Complutense de Madrid, Madrid, Spain
| | - Naike Caraglia
- Memory Clinic, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Claudia Carrarini
- Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele, Rome, Italy
| | | | - Americo Cicchetti
- The Graduate School of Health Economics and Management (ALTEMS), Catholic University of the Sacred Heart, Rome, Italy
| | - Signe Daugbjerg
- The Graduate School of Health Economics and Management (ALTEMS), Catholic University of the Sacred Heart, Rome, Italy
| | - Rossella Di Bidino
- The Graduate School of Health Economics and Management (ALTEMS), Catholic University of the Sacred Heart, Rome, Italy
| | | | - Ainar Drews
- IT Department, University of Oslo, Oslo, Norway
| | - Guido Maria Giuffrè
- Memory Clinic, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy
| | | | - Pedro Gil-Gregorio
- Department of Geriatric Medicine, Hospital Universitario Clínico San Carlos, Madrid, Spain
- Department of Geriatrics, Fundación para la Investigación Biomédica del Hospital Clínico San Carlos, Madrid, Spain
| | | | - Tim M. Govers
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands
| | - Harry Hallock
- Healthcare Programme, Group Research and Development, DNV, Oslo, Norway
| | - Marja Hietanen
- Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Lone Holmen
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Jaakko Hotta
- Department of Neurology, Helsinki University Hospital and Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, Finland
| | - Samuel Kaski
- Department of Computer Science, Helsinki Institute of Information Technology, Aalto University, Helsinki, Finland
- Department of Computer Science, University of Manchester, Manchester, United Kingdom
| | - Rabindra Khadka
- Department of Computer Science, OsloMet—Oslo Metropolitan University, Oslo, Norway
- NordSTAR—Nordic Center for Sustainable and Trustworthy AI Research, Oslo, Norway
| | - Antti S. Kinnunen
- BioMag Laboratory, HUS Medical Imaging Centre, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Anne M. Koivisto
- Department of Neurology, Helsinki University Hospital and Clinical Neurosciences, Neurology, University of Helsinki, Helsinki, Finland
- Department of Neurosciences, University of Helsinki, Helsinki, Finland
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Shrikanth Kulashekhar
- BioMag Laboratory, HUS Medical Imaging Centre, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Denis Larsen
- Department of Computer Science, OsloMet—Oslo Metropolitan University, Oslo, Norway
- NordSTAR—Nordic Center for Sustainable and Trustworthy AI Research, Oslo, Norway
| | - Mia Liljeström
- Department of Neuroscience and Biomedical Engineering, Aalto University, Helsinki, Finland
- BioMag Laboratory, HUS Medical Imaging Centre, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Pedro G. Lind
- Department of Computer Science, OsloMet—Oslo Metropolitan University, Oslo, Norway
- NordSTAR—Nordic Center for Sustainable and Trustworthy AI Research, Oslo, Norway
| | - Alberto Marcos Dolado
- Institute of Sanitary Investigation (IdISSC), San Carlos University Hospital, Madrid, Spain
- Neurology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - Serena Marshall
- Healthcare Programme, Group Research and Development, DNV, Oslo, Norway
| | - Susanne Merz
- Department of Neuroscience and Biomedical Engineering, Aalto University, Helsinki, Finland
| | - Francesca Miraglia
- Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele, Rome, Italy
| | - Juha Montonen
- BioMag Laboratory, HUS Medical Imaging Centre, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Ville Mäntynen
- BioMag Laboratory, HUS Medical Imaging Centre, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | | | - Javier Olazarán
- Neurology Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Teemu Paajanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | | | | | - Ana S. Perez
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Mohamed Radwan
- Department of Computer Science, OsloMet—Oslo Metropolitan University, Oslo, Norway
- NordSTAR—Nordic Center for Sustainable and Trustworthy AI Research, Oslo, Norway
| | - Federico Ramírez-Toraño
- Centre for Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, Madrid, Spain
- Department of Experimental Psychology, Cognitive Psychology and Speech and Language Therapy, Universidad Complutense de Madrid, Pozuelo de Alarcón, Spain
| | - Andrea Rodríguez-Pedrero
- Centre for Cognitive and Computational Neuroscience, Universidad Complutense de Madrid, Madrid, Spain
- Department of Experimental Psychology, Cognitive Psychology and Speech and Language Therapy, Universidad Complutense de Madrid, Pozuelo de Alarcón, Spain
| | - Timo Saarinen
- BioMag Laboratory, HUS Medical Imaging Centre, Helsinki University Hospital, Helsinki University and Aalto University School of Science, Helsinki, Finland
| | - Mario Salas-Carrillo
- Institute of Sanitary Investigation (IdISSC), San Carlos University Hospital, Madrid, Spain
- Memory Unit, Department of Geriatrics, Hospital Clínico San Carlos, Madrid, Spain
| | - Riitta Salmelin
- Department of Neuroscience and Biomedical Engineering, Aalto University, Helsinki, Finland
| | - Sonia Sousa
- School of Digital Technologies, Tallinn University, Tallinn, Estonia
| | - Abdillah Suyuthi
- Performance and Assurance Solutions, Digital Solutions, DNV, Oslo, Norway
| | - Mathias Toft
- Department of Neurology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pablo Toharia
- Center for Computational Simulation, Universidad Politécnica de Madrid, Madrid, Spain
| | | | - Mats Tveter
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Ramesh Upreti
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Robin J. Vermeulen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands
| | - Fabrizio Vecchio
- Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele, Rome, Italy
- Department of Theoretical and Applied Sciences, eCampus University, Como, Italy
| | - Anis Yazidi
- Department of Computer Science, OsloMet—Oslo Metropolitan University, Oslo, Norway
- NordSTAR—Nordic Center for Sustainable and Trustworthy AI Research, Oslo, Norway
| | - Paolo Maria Rossini
- Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele, Rome, Italy
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Brøgger HMB, Vallevik VB, Babic A, Agafonov O, Bach TA, Hallock H, Alagaratnam S. Kunstig intelligens i helsesektoren – en veileder. Tidsskr Nor Laegeforen 2023; 143:23-0443. [PMID: 37830956 DOI: 10.4045/tidsskr.23.0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
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Tanaskovic S, Ilijevski N, Koncar I, Matejevic D, Popovic M, Stefanovic Z, Babic A, Lazic A, Knezevic D, Damnjanovic Z, Pesic S, Stankovic J, Marjanovic I, Davidovic L. Analysis of Lower Extremity Amputations from the SerbVasc Registry. J Endovasc Ther 2023:15266028231199919. [PMID: 37727976 DOI: 10.1177/15266028231199919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
BACKGROUND Peripheral arterial disease (PAD) and diabetes are the major causes of lower extremity amputations (LEAs) worldwide. Morbidity and mortality in patients with LEAs are high with an associated significant burden on the global health system. The aim of this article is to report the overall morbidity and mortality rates after major and minor LEAs from the Serbian Vascular Registry (SerbVasc), with an analysis of predictive factors that influenced adverse outcomes. MATERIALS AND METHODS SerbVasc was created in 2019 as a part of the Vascunet collaboration that is aiming to include all vascular procedures from 21 hospitals in Serbia. Prevalence of diabetes among patients with LEAs, previous revascularization procedures, the degree and the type of foot infection and tissue loss, and overall morbidity and mortality rates were analyzed, with a special reference to mortality predictors. RESULTS In the period from January 2020 to December 2022, data on 702 patients with LEAs were extracted from the SerbVasc registry, mean age of 69.06±10.63 years. Major LEAs were performed in 59%, while minor LEAs in 41% of patients. Diabetes was seen in 65.1% of the patients, with 44% of them being on insulin therapy. Before LEA, only 20.3% of patients had previous peripheral revascularization. Soft tissue infection, irreversible acute ischemia, and Fontaine III and IV grade ischemia were the most common causes of above-the-knee amputations while diabetic foot was the most common cause of transphalangeal and toe amputations. The infection rate was 3.7%, the re-amputation rate was 5.7%, and the overall mortality rate was 6.9%, with intrahospital mortality in patients with above-the-knee amputation of 11.1%. The most significant intrahospital mortality predictors were age >65 years (p<0.001), chronic kidney disease (CKD) (p<0.001), ischemic heart disease (IHD) (p=0.001), previous myocardial revascularization (p=0.017), emergency type of admission (p<0.001), not using aspirin (p=0.041), using previous anticoagulation therapy (p=0.003), and postoperative complications (p<0.001). CONCLUSIONS The main predictors of increased mortality after LEAs from the SerbVasc registry are age >65 years, CKD, IHD, previous myocardial revascularization, emergency type of admission, not using aspirin, using previous anticoagulation therapy, and postoperative complications. Taking into account high mortality rates after LEAs and a small proportion of previous peripheral revascularization, the work should be done on early diagnosis and timely treatment of PAD hopefully leading to decreased number of LEAs and overall mortality. CLINICAL IMPACT Mortality after lower limb amputation from the SerbVasc register is high. A small number of previously revascularized patients is of particular clinical importance, bearing in mind that the main reasons for above-the-knee amputations were irreversible ischemia, Fontaine III and Fontaine IV grade ischemia. Lack of diagnostics procedures and late recognition of patients with PAD, led to subsequent threating limb ischemia and increased amputation rates. The work should be done on early diagnosis and timely treatment of PAD in Serbia, hopefully leading to an increased number of PAD procedures, decreased number of LEAs, and lower overall mortality.
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Affiliation(s)
- Slobodan Tanaskovic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
- School of Medicine, Belgrade University, Belgrade, Serbia
| | - Nenad Ilijevski
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
- School of Medicine, Belgrade University, Belgrade, Serbia
| | - Igor Koncar
- School of Medicine, Belgrade University, Belgrade, Serbia
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | - David Matejevic
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | | | | | - Aleksandar Babic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
| | | | | | | | | | | | | | - Lazar Davidovic
- School of Medicine, Belgrade University, Belgrade, Serbia
- Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia, Belgrade, Serbia
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Babic S, Babic A, Marinkovic M, Kovacevic V, Vucurevic B, Tanaskovic S, Sevkovic M, Gajin P, Matic P, Ilijevski N. Rare Cause of Leg Edema after Femoropopliteal Bypass Procedure in Patient with Previously Unrecognized Arteriovenous Fistulas: A Case Report. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.11009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND: Arteriovenous fistulas (AVFs) are pathological, congenital, or acquired communications between the arterial and venous vascular bed. Asymptomatic AVFs do not require surgical or endovascular treatment; however, if they are symptomatic, they must be treated to relieve the patient of symptoms and cardiovascular disorders.
CASE PRESENTATION: Our patient had an undiagnosed AVF that became symptomatic after femoropopliteal bypass surgery. We successfully treated these complications with four cover stents.
CONCLUSION: The presence of AVFs should be kept in mind in the case of rapidly developing leg edema after revascularization. Endovascular treatment of symptomatic AVF is a safe and effective treatment modality. Treatment of symptomatic AVFs is not only recommended for improving impaired arterial or venous blood flow, but also for preventing recurrent PE.
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Yuan C, Kim J, Wang QL, Lee AA, Babic A, Amundadottir LT, Klein AP, Li D, McCullough ML, Petersen GM, Risch HA, Stolzenberg-Solomon RZ, Perez K, Ng K, Giovannucci EL, Stampfer MJ, Kraft P, Wolpin BM. The age-dependent association of risk factors with pancreatic cancer. Ann Oncol 2022; 33:693-701. [PMID: 35398288 PMCID: PMC9233063 DOI: 10.1016/j.annonc.2022.03.276] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/04/2022] [Accepted: 03/31/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Pancreatic cancer presents as advanced disease in >80% of patients; yet, appropriate ages to consider prevention and early detection strategies are poorly defined. We investigated age-specific associations and attributable risks of pancreatic cancer for established modifiable and non-modifiable risk factors. PATIENTS AND METHODS We included 167 483 participants from two prospective US cohort studies with 1190 incident cases of pancreatic cancer during >30 years of follow-up; 5107 pancreatic cancer cases and 8845 control participants of European ancestry from a completed multicenter genome-wide association study (GWAS); and 248 893 pancreatic cancer cases documented in the US Surveillance, Epidemiology, and End Results (SEER) Program. Across different age categories, we investigated cigarette smoking, obesity, diabetes, height, and non-O blood group in the prospective cohorts; weighted polygenic risk score of 22 previously identified single nucleotide polymorphisms in the GWAS; and male sex and black race in the SEER Program. RESULTS In the prospective cohorts, all five risk factors were more strongly associated with pancreatic cancer risk among younger participants, with associations attenuated among those aged >70 years. The hazard ratios comparing participants with three to five risk factors with those with no risk factors were 9.24 [95% confidence interval (CI) 4.11-20.77] among those aged ≤60 years, 3.00 (95% CI 1.85-4.86) among those aged 61-70 years, and 1.46 (95% CI 1.10-1.94) among those aged >70 years (Pheterogeneity = 3×10-5). These factors together were related to 65.6%, 49.7%, and 17.2% of incident pancreatic cancers in these age groups, respectively. In the GWAS and the SEER Program, the associations with the polygenic risk score, male sex, and black race were all stronger among younger individuals (Pheterogeneity ≤0.01). CONCLUSIONS Established risk factors are more strongly associated with earlier-onset pancreatic cancer, emphasizing the importance of age at initiation for cancer prevention and control programs targeting this highly lethal malignancy.
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Affiliation(s)
- C Yuan
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA.
| | - J Kim
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Q L Wang
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
| | - A A Lee
- Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - A Babic
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
| | - L T Amundadottir
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA
| | - A P Klein
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins School of Medicine, Baltimore, USA; Department of Pathology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins School of Medicine, Baltimore, USA
| | - D Li
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M L McCullough
- Department of Population Science, American Cancer Society, Atlanta, USA
| | - G M Petersen
- Department of Quantitative Health Sciences, Mayo Clinic College of Medicine, Rochester, USA
| | - H A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, USA
| | | | - K Perez
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
| | - K Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
| | - E L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - M J Stampfer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | - P Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, USA
| | - B M Wolpin
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
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8
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Tanaskovic S, Sagic D, Radak D, Antonic Z, Kovacevic V, Vukovic M, Aleksic N, Radak S, Nenezic D, Cvetkovic S, Isenovic E, Vucurevic G, Lozuk B, Babic A, Babic S, Matic P, Gajin P, Unic-Stojanovic D, Ilijevski N. Carotid Restenosis Rate After Stenting for Primary Lesions Versus Restenosis After Endarterectomy With Creation of Risk Index. J Endovasc Ther 2022:15266028221091895. [PMID: 35466778 DOI: 10.1177/15266028221091895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Carotid artery stenting (CAS) is an option for carotid restenosis (CR) treatment with favorable outcomes. However, CAS has also emerged as an alternative to carotid endarterectomy (CEA) for the management of patients with primary carotid stenosis. This study aimed to report CR rates after CAS was performed in patients with primary lesions versus restenosis after CEA, to identify predictors of CR, and to report both neurological and overall outcomes. MATERIALS AND METHODS From January 2000 to September 2018, a total of 782 patients were divided into 2 groups: The CAS (prim) group consisted of 440 patients in whom CAS was performed for primary lesions, and the CAS (res) group consisted of 342 patients with CAS due to restenosis after CEA. Indications for CAS were symptomatic stenosis/restenosis >70% and asymptomatic stenosis/restenosis >85%. A color duplex scan (CDS) of carotid arteries was performed 6 months after CAS, after 1 year, and annually afterward. Follow-up ranged from 12 to 88 months, with a mean follow-up of 34.6±18.0 months. RESULTS There were no differences in terms of CR rate between the patients in the CAS (prim) and CAS (res) groups (8.7% vs 7.2%, χ2=0.691, p=0.406). The overall CR rate was 7.9%, whereas significant CR (>70%) rate needing re-intervention was 5.6%, but there was no difference between patients in the CAS (prim) and CAS (res) groups (6.4% vs 4.7%, p=0.351). Six independent predictors for CR were smoking, associated previous myocardial infarction and angina pectoris, plaque morphology, spasm after CAS, the use of FilterWire or Spider Fx cerebral protection devices, and time after stenting. A carotid restenosis risk index (CRRI) was created based on these predictors and ranged from -7 (minimal risk) to +10 (maximum risk); patients with a score >-4 were at increased risk for CR. There were no differences in terms of neurological and overall morbidity and mortality between the 2 groups. CONCLUSIONS There was no difference in CR rate after CAS between the patients with primary stenosis and restenosis after CEA. A CRRI score >-4 is a criterion for identifying high-risk patients for post-CAS CR that should be tested in future randomized trials.
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Affiliation(s)
- Slobodan Tanaskovic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dragan Sagic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Department for Interventional Radiology, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
| | - Djordje Radak
- Scientific Board, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
| | - Zelimir Antonic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Department for Interventional Radiology, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
| | - Vladimir Kovacevic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Department for Interventional Radiology, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
| | - Mira Vukovic
- Department of Healthcare Quality Assurance, General Hospital Valjevo, Valjevo, Serbia
| | - Nikola Aleksic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Department for Angiology, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
| | - Sandra Radak
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Department for Angiology, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
| | - Dragoslav Nenezic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Slobodan Cvetkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | - Esma Isenovic
- Department of Radiobiology and Molecular Genetics, "VINČA" Institute of Nuclear Sciences, National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Goran Vucurevic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Branko Lozuk
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
| | - Aleksandar Babic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
| | - Srdjan Babic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Predrag Matic
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Predrag Gajin
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dragana Unic-Stojanovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Anesthesiology and Intensive Care, "Dedinje" Cardiovascular Institute, Belgrade, Serbia
| | - Nenad Ilijevski
- Vascular Surgery Clinic, "Dedinje" Cardiovascular Institute, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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9
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Babic S, Babic A, Stojicic M, Gencic M, Tanaskovic S, Radoicic D, Gajin P, Atanasijevic I, Ilijevski N. Risk Factors and Incidence of Deep Venous Thrombosis in Non-severe Coronavirus Disease-19 Patients. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND: The coronavirus disease (COVID-19) is characterized by a high prevalence of deep vein thrombosis (DVT), particularly in its severe form, but the incidence of DVT and risk factors for DVT in non-severe patients are still unknown.
METHODS: The study enrolled 118 patients with non-severe COVID-19 infection which did not required hospital admittance. A duplex ultrasound and laboratory test were performed in all the patients after the first negative polymerase chain reaction SARS-CoV-2 test.
RESULTS: DVT was identified in 50 (42.4%) patients with a median age of 48 years (interquartile range 30–85 years). Symptomatic DVT was present in 40 (80%) patients and was commonly seen in the Class I calf vein thrombosis (38 patients, 76%) (χ2 = 51.71, p < 0.001). The most significant risk factors for DVT were as follows: Increased C-reactive protein (p = 0.000), fibrinogen (p = 0.000), low lymphocyte count (p = 0.002), obesity (p = 0.017), and neutrophil count (p = 0.042). The multivariable logistic regression analysis revealed that a D-dimer cutoff point of 1253.5 μg/L showed a sensitivity of 92% and a specificity of 71%.
CONCLUSION: Patients with increased inflammatory markers and obese patients after a non-severe COVID-19 infection should have an ultrasound examination to ensure early diagnosis of DVT and to prevent the occurrence of any complications.
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10
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Babic MD, Angelkov L, Tomovic M, Jovicic M, Boljevic D, Suluburic I, Babic A, Milosevic M, Bojic M, Djuranovic A. Severe pacemaker pocket infection during the COVID-19 pandemic, transvenous lead removal. J Infect Dev Ctries 2021; 15:1277-1280. [PMID: 34669596 DOI: 10.3855/jidc.15225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/19/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION The estimated infection rate after permanent endocardial lead implantation is between 1% and 2%. Pacemaker lead endocarditis is treated with total removal of the infected device and proper antibiotics. In this case report, we present a patient with delayed diagnosis and treatment due to the COVID-19 outbreak. CASE REPORT An 88-year-old, pacemaker dependent woman with diagnosed pacemaker pocket infection was admitted to the University Cardiovascular institute. The patient had a prolonged follow-up time due to the COVID-19 outbreak. She missed her routine checkup and came to her local hospital when the generator had already protruded completely, to the point where she held it in her own hand. Transthoracic echocardiogram showed possible vegetations on the lead. Transesophageal echocardiography was not performed due to the COVID-19 pandemic. On the day after the admission the patient underwent transvenous removal of the pacemaker lead using a 9 French gauge rotational extraction sheathe (Cook Medical). The extracted lead was covered in a thin layer of vegetations. Further follow-ups showed good recovery with no complications. CONCLUSIONS A case showing delayed treatment of pacemaker pocket infection, due to delayed follow-up time during the COVID-19 pandemic. This patient underwent successful transvenous removal of the infected pacemaker lead, along with adequate antibiotic therapy, which has proven to be the most effective method of treating cardiac device-related endocarditis.
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Affiliation(s)
| | - Lazar Angelkov
- Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
| | - Milosav Tomovic
- Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
| | - Mihailo Jovicic
- Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia.
| | - Darko Boljevic
- Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
| | - Ivana Suluburic
- Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
| | - Aleksandar Babic
- Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
| | - Maja Milosevic
- Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
| | - Milovan Bojic
- Institute for Cardiovascular Diseases, Dedinje, Belgrade, Serbia
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11
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Gilbert A, Holden M, Eikvil L, Rakhmail M, Babic A, Aase SA, Samset E, McLeod K. User-Intended Doppler Measurement Type Prediction Combining CNNs With Smart Post-Processing. IEEE J Biomed Health Inform 2021; 25:2113-2124. [PMID: 33027010 DOI: 10.1109/jbhi.2020.3029392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Spectral Doppler measurements are an important part of the standard echocardiographic examination. These measurements give insight into myocardial motion and blood flow, providing clinicians with parameters for diagnostic decision making. Many of these measurements are performed automatically with high accuracy, increasing the efficiency of the diagnostic pipeline. However, full automation is not yet available because the user must manually select which measurement should be performed on each image. In this work, we develop a pipeline based on convolutional neural networks (CNNs) to automatically classify the measurement type from cardiac Doppler scans. We show how the multi-modal information in each spectral Doppler recording can be combined using a meta parameter post-processing mapping scheme and heatmaps to encode coordinate locations. Additionally, we experiment with several architectures to examine the tradeoff between accuracy, speed, and memory usage for resource-constrained environments. Finally, we propose a confidence metric using the values in the last fully connected layer of the network and show that our confidence metric can prevent many misclassifications. Our algorithm enables a fully automatic pipeline from acquisition to Doppler spectrum measurements. We achieve 96% accuracy on a test set drawn from separate clinical sites, indicating that the proposed method is suitable for clinical adoption.
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12
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Babic A, Buchanan P, Gill A, Bloomquist J, Regan D, Bhatla D, Ferguson W. Analysis of outcomes of single-unit cord blood transplantation with umbilical cord blood units processed with two different red blood cell sedimentation reagents. Transfusion 2021; 61:1856-1866. [PMID: 34018206 DOI: 10.1111/trf.16428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 03/12/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Various processing methodologies are routinely used to reduce volume and red blood cell content of umbilical cord blood (UCB) units collected for hematopoietic stem cell transplantation. There is limited information regarding effects of UCB processing techniques on clinical outcomes. STUDY DESIGN AND METHODS Retrospective data analysis compared laboratory and clinical outcomes following single-unit UCB transplantation performed between 1999 and 2015. All UCB units were from St. Louis Cord Blood Bank and all were manually processed with either Hetastarch processed cord blood units (HCB) (n = 661) or PrepaCyte processed cord blood units (PCB) (n = 84). Additional sensitivity analysis focused on units transplanted from 2010 to 2015 and included 105 HCB and 84 PCB. RESULTS There were no significant differences in patient characteristics between the two groups. Pre-freeze total nucleated and CD34+ cell counts, cell doses/kg of recipient weight, and total colony-forming units (CFUs) were higher in PCB compared with HCB. Post-thaw, the PCB group had a significantly better total nucleated cell recovery, while there were no significant differences in cell viability, CFU recovery, or CD34+ cell recovery. Primary analysis demonstrated faster neutrophil and platelet engraftment for PCB but no differences in overall survival (OS), whereas sensitivity analysis found no effect of processing method on engraftment, but better OS in the HCB group compared with PCB group. CONCLUSION The UCB processing method had no significant impact on engraftment. However, we cannot completely exclude the effect of processing method on OS. Additional studies may be warranted to investigate the potential impact of the PCB processing method on clinical outcomes.
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Affiliation(s)
- Aleksandar Babic
- St. Louis Cord Blood Bank, SSM Health Cardinal Glennon Children's Hospital, St Louis, Missouri, USA.,Department of Pediatrics, St. Louis University School of Medicine, St Louis, Missouri, USA
| | - Paula Buchanan
- Center for Health Outcomes Research, St Louis University, St. Louis, Missouri, USA
| | - Ammara Gill
- Division of Hematology and Oncology, Adventist Health Rideout Cancer Center, Marysville, California, USA
| | - Jenni Bloomquist
- Clinical Data Quality, Center for International Blood and Marrow Transplant Research, Milwaukee, Wisconsin, USA.,Customer Ready Products, National Marrow Donor Program, Minneapolis, Minnesota, USA
| | - Donna Regan
- Customer Ready Products, National Marrow Donor Program, Minneapolis, Minnesota, USA
| | - Deepika Bhatla
- Department of Pediatrics, St. Louis University School of Medicine, St Louis, Missouri, USA
| | - William Ferguson
- St. Louis Cord Blood Bank, SSM Health Cardinal Glennon Children's Hospital, St Louis, Missouri, USA.,Department of Pediatrics, St. Louis University School of Medicine, St Louis, Missouri, USA
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13
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Mariette C, Lorenc M, Cailleau H, Collet E, Guérin L, Volte A, Trzop E, Bertoni R, Dong X, Lépine B, Hernandez O, Janod E, Cario L, Ta Phuoc V, Ohkoshi S, Tokoro H, Patthey L, Babic A, Usov I, Ozerov D, Sala L, Ebner S, Böhler P, Keller A, Oggenfuss A, Zmofing T, Redford S, Vetter S, Follath R, Juranic P, Schreiber A, Beaud P, Esposito V, Deng Y, Ingold G, Chergui M, Mancini GF, Mankowsky R, Svetina C, Zerdane S, Mozzanica A, Bosak A, Wulff M, Levantino M, Lemke H, Cammarata M. Strain wave pathway to semiconductor-to-metal transition revealed by time-resolved X-ray powder diffraction. Nat Commun 2021; 12:1239. [PMID: 33623010 PMCID: PMC7902810 DOI: 10.1038/s41467-021-21316-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 01/13/2021] [Indexed: 11/09/2022] Open
Abstract
One of the main challenges in ultrafast material science is to trigger phase transitions with short pulses of light. Here we show how strain waves, launched by electronic and structural precursor phenomena, determine a coherent macroscopic transformation pathway for the semiconducting-to-metal transition in bistable Ti3O5 nanocrystals. Employing femtosecond powder X-ray diffraction, we measure the lattice deformation in the phase transition as a function of time. We monitor the early intra-cell distortion around the light absorbing metal dimer and the long range deformations governed by acoustic waves propagating from the laser-exposed Ti3O5 surface. We developed a simplified elastic model demonstrating that picosecond switching in nanocrystals happens concomitantly with the propagating acoustic wavefront, several decades faster than thermal processes governed by heat diffusion.
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Affiliation(s)
- C Mariette
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France.
| | - M Lorenc
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France.
| | - H Cailleau
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - E Collet
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - L Guérin
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - A Volte
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - E Trzop
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - R Bertoni
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - X Dong
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - B Lépine
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France
| | - O Hernandez
- Univ Rennes, CNRS, ISCR (Institut des Sciences Chimiques de Rennes)-UMR 6226, Rennes, France
| | - E Janod
- Institut des Matériaux Jean Rouxel (IMN), Université de Nantes, CNRS, Nantes, France
| | - L Cario
- Institut des Matériaux Jean Rouxel (IMN), Université de Nantes, CNRS, Nantes, France
| | - V Ta Phuoc
- GREMAN-UMR 7347 CNRS, Université de Tours, Tours, France
| | - S Ohkoshi
- Department of Chemistry, School of Science, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - H Tokoro
- Department of Chemistry, School of Science, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Materials Science, Faculty of Pure and Applied Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - L Patthey
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Babic
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - I Usov
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - D Ozerov
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - L Sala
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - S Ebner
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - P Böhler
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Keller
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Oggenfuss
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - T Zmofing
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - S Redford
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - S Vetter
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - R Follath
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - P Juranic
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Schreiber
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - P Beaud
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - V Esposito
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland.,Institute for Materials and Energy Science, Stanford University and SLAC National Accelerator Laboratory, Menlo Park, CA, USA
| | - Y Deng
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - G Ingold
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - M Chergui
- Laboratory of Ultrafast Spectroscopy, Lausanne Center for Ultrafast Science (LACUS), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - G F Mancini
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland.,Laboratory of Ultrafast Spectroscopy, Lausanne Center for Ultrafast Science (LACUS), École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - R Mankowsky
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - C Svetina
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - S Zerdane
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Mozzanica
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - A Bosak
- European Synchrotron Radiation Facility, Grenoble, France
| | - M Wulff
- European Synchrotron Radiation Facility, Grenoble, France
| | - M Levantino
- European Synchrotron Radiation Facility, Grenoble, France
| | - H Lemke
- SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland
| | - M Cammarata
- Univ Rennes, CNRS, IPR (Institut de Physique de Rennes)-UMR 6251, Rennes, France. .,European Synchrotron Radiation Facility, Grenoble, France.
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14
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Akel S, Murray C, Ferguson W, Babic A. Outcomes of processing of bone marrow harvests for hematopoietic stem cell transplantation in pediatric patients utilizing a novel red blood cell sedimentation kit. Transfusion 2019; 59:2375-2381. [DOI: 10.1111/trf.15337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Salem Akel
- St. Louis Cord Blood Bank and Cellular Therapy LaboratorySSM Health Cardinal Glennon Children's Hospital St. Louis Missouri
- Department of PediatricsSt Louis University School of Medicine St Louis Missouri
- Department of Bone Marrow Transplantation & Cellular TherapySt Jude Children's Research Hospital Memphis Tennessee
| | - Christianna Murray
- St. Louis Cord Blood Bank and Cellular Therapy LaboratorySSM Health Cardinal Glennon Children's Hospital St. Louis Missouri
| | - William Ferguson
- St. Louis Cord Blood Bank and Cellular Therapy LaboratorySSM Health Cardinal Glennon Children's Hospital St. Louis Missouri
- Department of PediatricsSt Louis University School of Medicine St Louis Missouri
| | - Aleksandar Babic
- St. Louis Cord Blood Bank and Cellular Therapy LaboratorySSM Health Cardinal Glennon Children's Hospital St. Louis Missouri
- Department of PediatricsSt Louis University School of Medicine St Louis Missouri
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15
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Kamath M, Babic A. On being cancelled: a patient's perspective. Br J Anaesth 2019; 122:e16-e17. [DOI: 10.1016/j.bja.2018.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 10/24/2018] [Indexed: 11/26/2022] Open
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16
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Nordenfur T, Babic A, Bulatovic I, Giesecke A, Günyeli E, Ripsweden J, Samset E, Winter R, Larsson M. Method comparison for cardiac image registration of coronary computed tomography angiography and 3-D echocardiography. J Med Imaging (Bellingham) 2018; 5:014001. [PMID: 29322069 PMCID: PMC5753006 DOI: 10.1117/1.jmi.5.1.014001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/04/2017] [Indexed: 11/17/2022] Open
Abstract
Treatment decision for coronary artery disease (CAD) is based on both morphological and functional information. Image fusion of coronary computed tomography angiography (CCTA) and three-dimensional echocardiography (3DE) could combine morphology and function into a single image to facilitate diagnosis. Three semiautomatic feature-based methods for CCTA/3DE registration were implemented and applied on CAD patients. Methods were verified and compared using landmarks manually identified by a cardiologist. All methods were found feasible for CCTA/3DE fusion.
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Affiliation(s)
- Tim Nordenfur
- KTH Royal Institute of Technology, Department of Medical Engineering, Stockholm, Sweden.,Karolinska Institute, Department of Clinical Sciences, Stockholm, Sweden
| | - Aleksandar Babic
- GE Vingmed Ultrasound, Oslo, Norway.,University of Oslo, Department of Informatics, Oslo, Norway
| | - Ivana Bulatovic
- Karolinska Institute, Department of Molecular Medicine and Surgery, Stockholm, Sweden
| | - Anders Giesecke
- Karolinska Hospital, Department of Emergency Medicine, Stockholm, Sweden
| | - Elif Günyeli
- Danderyd Hospital, Department of Cardiology, Stockholm, Sweden
| | - Jonaz Ripsweden
- Karolinska Institute, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden
| | - Eigil Samset
- GE Vingmed Ultrasound, Oslo, Norway.,University of Oslo, Department of Informatics, Oslo, Norway
| | - Reidar Winter
- Karolinska Institute, Department of Clinical Sciences, Stockholm, Sweden.,Danderyd Hospital, Department of Cardiology, Stockholm, Sweden
| | - Matilda Larsson
- KTH Royal Institute of Technology, Department of Medical Engineering, Stockholm, Sweden
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17
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Bhandari R, Lindley A, Bhatla D, Babic A, Mueckl K, Rao R, Brooks P, Geiler V, Gross G, Al-Hosni M, Shenoy S. Awareness of cord blood collection and the impact on banking. Pediatr Blood Cancer 2017; 64. [PMID: 28111924 DOI: 10.1002/pbc.26412] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/02/2016] [Accepted: 11/21/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Umbilical cord blood (UCB) is an important source of hematopoietic stem cells for transplantation especially in minority populations with limited chances of finding a histocompatible volunteer donor in the registry. UCB has the advantages of early availability, successful outcomes despite some histocompatibility mismatch, and low incidence of chronic graft-versus-host disease. Public cord blood banks that disseminate UCB products for transplant depend on voluntary donation at participating hospitals and obstetrical providers for collection. PROCEDURE Using survey questionnaires, we evaluated attitudes toward UCB donation, the frequency of donation, and provider opinions on UCB collection in the greater St. Louis metropolitan area that caters to minority ethnicities in significant numbers. RESULTS Our data suggest that nervousness and lack of information regarding the donation and utility of the product were ubiquitous reasons for not donating. Additionally, irrespective of age or level of education, women relied on healthcare providers for information regarding UCB donation. Providers reported primarily time constraints to discussing UCB donation at prenatal visits (54%). Of the interviewees, 62% donated UCB. Fallout due to refusal or preferring private banking was miniscule. CONCLUSIONS These results suggest that dedicated personnel focused on disseminating information, obtaining consent, and collecting the UCB product at major hospitals can enrich cord blood banks especially with minority cords. Sustained and focused efforts could improve upon a relatively high wastage rate and ensure a robust supply of UCB products at local public banks.
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Affiliation(s)
- Rusha Bhandari
- Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri
| | - Amy Lindley
- Saint Louis University School of Medicine and SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri
| | - Deepika Bhatla
- Saint Louis University School of Medicine and SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri
| | - Aleksandar Babic
- Saint Louis University School of Medicine and SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri.,St. Louis Cord Blood Bank, St. Louis, Missouri
| | | | - Rakesh Rao
- Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri.,Missouri Baptist Hospital, St. Louis, Missouri
| | | | | | - Gilad Gross
- SSM Health St. Mary's Hospital, St. Louis, Missouri
| | - Mohamad Al-Hosni
- Saint Louis University School of Medicine and SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri.,SSM Health St. Mary's Hospital, St. Louis, Missouri
| | - Shalini Shenoy
- Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri
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18
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Ballen KK, Logan BR, Chitphakdithai P, Spellman S, Adams AJ, Drexler RJ, Duffy M, Kemp A, King RJ, Delaney C, Shpall EJ, Kurtzberg J, Babic A, Confer DL, Miller JP. Excellent Outcomes in 1589 Patients Receiving Umbilical Cord Blood Transplantation Using Unlicensed Units From a Centralized Cord Blood Registry. Biol Blood Marrow Transplant 2017. [DOI: 10.1016/j.bbmt.2016.12.282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Nadimpalli S, Buchanan P, Bloomquist J, Ferguson W, Regan D, Freter CE, Babic A, Lionberger JM. Comparison of Processing Reagents (Hespan and PrepaCyte-CB®) in Preparation of Cord Blood Units at the Saint Louis Cord Blood Bank. Biol Blood Marrow Transplant 2017. [DOI: 10.1016/j.bbmt.2016.12.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Babic A, Spinney S, Maloney DG, Walker JD. Residual neuromuscular blockade and tracheal extubation in recovery rooms – a reply. Anaesthesia 2015; 70:1464-5. [DOI: 10.1111/anae.13317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Terry KL, Babic A, Karlan BY, Goodman MT, Lambrechts D, Heitz F, Matsuo K, McNeish I, Pejovic T, Kjaer SK, Webb PM, Hogdall E, Goode EL, Cramer DW. Abstract AS13: Epidemiologic predictors of pre-treatment CA125 in women with ovarian cancer. Clin Cancer Res 2015. [DOI: 10.1158/1557-3265.ovcasymp14-as13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: CA125 is elevated in 80% of ovarian cancer cases and has proven utility in assessing response to therapy and prognosis. Unfortunately, CA125 is elevated in a variety of benign conditions and only in 50% of early stage ovarian cancers, resulting in a sensitivity and specificity unacceptable for population-based screening. Therefore, understanding factors that influence CA125 at presentation could provide important insights for interpreting CA125 values.
Methods: Using pre-treatment CA125 and detailed epidemiologic data from 12 studies participating in the Ovarian Cancer Association Consortium (OCAC), we evaluated factors previously reported to influence CA125 levels, including age, race, oral contraceptive use, parity, tubal ligation, endometriosis, body mass index (BMI), personal history of breast cancer, or a family history of breast or ovarian cancer. We used linear regression to estimate the association between each variable and CA125 probit scores, which we used to standardize values between studies. Secondary analyses included adjustment for histologic subtype. We also estimated the associations within each study using log-transformed CA125 as the outcome and estimated summary measures using random effects meta-analyses.
Results: Of the 4417 cases included in the analysis, 2918 (66%) were serous, 227 (5%) were mucinous, 484 (11%) were endometrioid, and 258 (6%) were clear cell carcinomas. Median CA125 values varied between studies with a high of 831 U/mL and a low of 271 U/mL. We observed no association between race, oral contraceptive use, tubal ligation, endometriosis, prior breast cancer, and family history of breast cancer and pre-treatment CA125. However, we observed increased pre-treatment CA125 levels with older age (>70 vs. < 50, p=0.03), parity (p=0.01), number of children (p=0.02), obesity (BMI>30 vs. 21-25, p=0.03), and family history of ovarian cancer (p=0.05). Results were similar but attenuated when we calculated summary estimates of the association using meta-analysis of study specific estimates of the association with log-transformed CA125 rather than probit scores. Age and BMI remained predictive of pre-treatment CA125 values after adjustment for histologic subtype. Our data are limited by between site variability in CA125 assays; therefore, validation of these findings is needed with adjustment for type of assay used or in a study population in which all cases had pre-treatment CA125 values measured with the same assay.
Conclusions: Despite these limitations, results from this analysis of over 4000 ovarian cancer cases suggest that age and body size may influence pre-treatment CA125 values.
Citation Format: KL Terry, A Babic, BY Karlan, MT Goodman, D Lambrechts, F Heitz, K Matsuo, I McNeish, T Pejovic, S Kruger Kjaer, PM Webb, E Hogdall, EL Goode, DW Cramer, for the Ovarian Cancer Association Consortium. Epidemiologic predictors of pre-treatment CA125 in women with ovarian cancer [abstract]. In: Proceedings of the 10th Biennial Ovarian Cancer Research Symposium; Sep 8-9, 2014; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(16 Suppl):Abstract nr AS13.
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Affiliation(s)
- KL Terry
- 1Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,
- 2Harvard School of Public Health, Boston, MA, USA,
| | - A Babic
- 2Harvard School of Public Health, Boston, MA, USA,
| | - BY Karlan
- 3Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA,
| | - MT Goodman
- 3Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA,
| | - D Lambrechts
- 4Vesalius Research Center, VIB, KU Leuven, Leuven, Belgium,
| | - F Heitz
- 5Dr. Horst Schmidt KlinikWiesbaden, Wiesbaden, Germany,
| | - K Matsuo
- 6Aichi Cancer Center Research Institute, Nagoya 464–8681, Japan,
| | - I McNeish
- 7Barts Cancer Institute, Queen Mary, University of London, London, England,
| | - T Pejovic
- 8Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA,
| | - S Kruger Kjaer
- 9Copenhagen University Hospital, Rigshospitalet, Denmark,
| | - PM Webb
- 10QIMR Berghofer Institute of Medical Research, Brisbane, Australia,
| | - E Hogdall
- 11Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark,
| | - EL Goode
- 12Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - DW Cramer
- 1Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,
- 2Harvard School of Public Health, Boston, MA, USA,
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22
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Babic A, Odland HH, Gérard O, Samset E. Parametric ultrasound and fluoroscopy image fusion for guidance of left ventricle lead placement in cardiac resynchronization therapy. J Med Imaging (Bellingham) 2015; 2:025001. [PMID: 26158110 DOI: 10.1117/1.jmi.2.2.025001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/13/2015] [Indexed: 11/14/2022] Open
Abstract
Recent studies show that the response rate to cardiac resynchronization therapy (CRT) could be improved if the left ventricle (LV) is paced at the site of the latest mechanical activation, but away from the myocardial scar. A prototype system for CRT lead placement guidance that combines LV functional information from ultrasound with live x-ray fluoroscopy was developed. Two mean anatomical models, each containing LV epi-, LV endo- and right ventricle endocardial surfaces, were computed from a database of 33 heart failure patients as a substitute for a patient-specific model. The sphericity index was used to divide the observed population into two groups. The distance between the mean and the patient-specific models was determined using a signed distance field metric (reported in mm). The average error values for LV epicardium were [Formula: see text] and for LV endocardium were [Formula: see text]. The validity of using average LV models for a CRT procedure was tested by simulating coronary vein selection in a group of 15 CRT candidates. The probability of selecting the same coronary branch, when basing the selection on the average model compared to a patient-specific model, was estimated to be [Formula: see text]. This was found to be clinically acceptable.
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Affiliation(s)
- Aleksandar Babic
- Center for Cardiological Innovation , Songsvannsveien 9, Oslo 0372, Norway ; GE Vingmed Ultrasound AS , Strandpromenaden 45, Horten 3183, Norway ; University of Oslo , Department of Informatics, Gaustadalléen 23 B, Oslo 0373, Norway
| | - Hans Henrik Odland
- Center for Cardiological Innovation , Songsvannsveien 9, Oslo 0372, Norway ; Oslo University Hospital , Department of Cardiology and Pediatrics, P.O. Box 1072, Blindern, Oslo 0316, Norway
| | - Olivier Gérard
- GE Vingmed Ultrasound AS , Strandpromenaden 45, Horten 3183, Norway
| | - Eigil Samset
- Center for Cardiological Innovation , Songsvannsveien 9, Oslo 0372, Norway ; GE Vingmed Ultrasound AS , Strandpromenaden 45, Horten 3183, Norway ; University of Oslo , Department of Informatics, Gaustadalléen 23 B, Oslo 0373, Norway
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23
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Snarski E, Mank A, Iacobelli S, Hoek J, Styczyński J, Babic A, Cesaro S, Johansson E. Current practices used for the prevention of central venous catheter-associated infection in hematopoietic stem cell transplantation recipients: a survey from the Infectious Diseases Working Party and Nurses' Group of EBMT. Transpl Infect Dis 2015; 17:558-65. [PMID: 25953418 DOI: 10.1111/tid.12399] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 04/01/2015] [Accepted: 04/17/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND Central line-associated bloodstream infection (CLABSI) is one of the most common infectious complications after hematopoietic stem cell transplantation. To prevent this complication, international guidelines recommend the implementation of the CLABSI 'prevention bundle' consisting of hand hygiene, full barrier precautions, cleaning the insertion site with chlorhexidine, avoiding femoral sites for insertion, and removing unnecessary catheters. The aim of this survey was to analyze to what extent European Group for Blood and Marrow Transplantation (EBMT) centers have included the CLABSI prevention bundle in practice. METHODS A questionnaire used for data collection was sent to the 545 EBMT centers worldwide, 103 of which responded. RESULTS All 5 components of the CLABSI prevention bundle were recorded in 28% of the centers' standard operating procedures (SOP), and 21% of the centers answered that they used all of the bundle components in clinical practice. The most common recommendation absent from the SOP was specification of all the components of full barrier precautions (43% of the centers did not include at least 1 component). Skin disinfection with chlorhexidine before catheter insertion was reported by 66% centers. CLABSI rates were monitored in 21% of centers. CONCLUSIONS Although most of the centers lacked 1 or more of the CLABSI prevention bundle components in their SOP, improvements could easily be made by updating the centers' SOP. The first important step is introduction of CLABSI rate monitoring in this high-risk patient population.
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Affiliation(s)
- E Snarski
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warszawa, Poland
| | - A Mank
- Department of Hematology, Academic Medical Center, Amsterdam, The Netherlands
| | - S Iacobelli
- Dipartimento di Medicina dei sistemi, Università degli Studi di Roma "Tor Vergata", Roma, Italy
| | - J Hoek
- Data Office, European Group for Blood and Marrow Transplantation (EBMT), Leiden, Belgium
| | - J Styczyński
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - A Babic
- European Institute of Oncology, Milano, Italy
| | - S Cesaro
- Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - E Johansson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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24
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Shahgaldi K, Hegner T, Da Silva C, Fukuyama A, Takeuchi M, Uema A, Kado Y, Nagata Y, Hayashi A, Otani K, Fukuda S, Yoshitani H, Otsuji Y, Morhy S, Lianza A, Afonso T, Oliveira W, Tavares G, Rodrigues A, Vieira M, Warth A, Deutsch A, Fischer C, Tezynska-Oniszk I, Turska-Kmiec A, Kawalec W, Dangel J, Maruszewski B, Bokiniec R, Burczynski P, Borszewska-Kornacka K, Ziolkowska L, Zuk M, Troshina A, Dzhalilova D, Poteshkina N, Hamitov F, Warita S, Kawasaki M, Tanaka R, Yagasaki H, Minatoguchi S, Wanatabe T, Ono K, Noda T, Wanatabe S, Minatoguchi S, Angelis A, Ageli K, Vlachopoulos C, Felekos I, Ioakimidis N, Aznaouridis K, Vaina S, Abdelrasoul M, Tsiamis E, Stefanadis C, Cameli M, Sparla S, D'ascenzi F, Fineschi M, Favilli R, Pierli C, Henein M, Mondillo S, Lindqvist P, Tossavainen E, Gonzalez M, Soderberg S, Henein M, Holmgren A, Strachinaru M, Catez E, Jousten I, Pavel O, Janssen C, Morissens M, Chatzistamatiou E, Moustakas G, Memo G, Konstantinidis D, Mpampatzeva Vagena I, Manakos K, Traxanas K, Vergi N, Feretou A, Kallikazaros I, Tsai WC, Sun YT, Lee WH, Yang LT, Liu YW, Lee CH, Li WT, Mizariene V, Bieseviciene M, Karaliute R, Verseckaite R, Vaskelyte J, Lesauskaite V, Chatzistamatiou E, Mpampatseva Vagena I, Manakos K, Moustakas G, Konstantinidis D, Memo G, Mitsakis O, Kasakogias A, Syros P, Kallikazaros I, Hristova K, Cornelissen G, Singh R, Shiue I, Coisne D, Madjalian AM, Tchepkou C, Raud Raynier P, Degand B, Christiaens L, Baldenhofer G, Spethmann S, Dreger H, Sanad W, Baumann G, Stangl K, Stangl V, Knebel F, Azzaz S, Kacem S, Ouali S, Risos L, Dedobbeleer C, Unger P, Sinem Cakal S, Elif Eroglu E, Baydar O, Beytullah Cakal B, Mehmet Vefik Yazicioglu M, Mustafa Bulut M, Cihan Dundar C, Kursat Tigen K, Birol Ozkan B, Ali Metin Esen A, Tournoux F, Chequer R, Sroussi M, Hyafil F, Rouzet F, Leguludec D, Baum P, Stoebe S, Pfeiffer D, Hagendorff A, Fang F, Lau M, Zhang Q, Luo X, Wang X, Chen L, Yu C, Zaborska B, Smarz K, Makowska E, Kulakowski P, Budaj A, Bengrid TM, Zhao Y, Henein MY, Caminiti G, D'antoni V, Cardaci V, Conti V, Volterrani M, Warita S, Kawasaki M, Yagasaki H, Minatoguchi S, Nagaya M, Ono K, Noda T, Watanabe S, Houle H, Minatoguchi S, Gillebert TC, Chirinos JA, Claessens TC, Raja MW, De Buyzere ML, Segers P, Rietzschel ER, Kim K, Cha J, Chung H, Kim J, Yoon Y, Lee B, Hong B, Rim S, Kwon H, Choi E, Pyankov V, Aljaroudi W, Matta S, Al-Shaar L, Habib R, Gharzuddin W, Arnaout S, Skouri H, Jaber W, Abchee A, Bouzas Mosquera A, Peteiro J, Broullon F, Constanso Conde I, Bescos Galego H, Martinez Ruiz D, Yanez Wonenburger J, Vazquez Rodriguez J, Alvarez Garcia N, Castro Beiras A, Gunyeli E, Oliveira Da Silva C, Shahgaldi K, Manouras A, Winter R, Meimoun P, Abouth S, Martis S, Boulanger J, Elmkies F, Zemir H, Detienne J, Luycx-Bore A, Clerc J, Rodriguez Palomares JF, Gutierrez L, Maldonado G, Garcia G, Galuppo V, Gruosso D, Teixido G, Gonzalez Alujas M, Evangelista A, Garcia Dorado D, Rechcinski T, Wierzbowska-Drabik K, Wejner-Mik P, Szymanska B, Jerczynska H, Lipiec P, Kasprzak J, El-Touny K, El-Fawal S, Loutfi M, El-Sharkawy E, Ashour S, Boniotti C, Carminati M, Fusini L, Andreini D, Pontone G, Pepi M, Caiani E, Oryshchyn N, Kramer B, Hermann S, Liu D, Hu K, Ertl G, Weidemann F, Ancona F, Miyazaki S, Slavich M, Figini F, Latib A, Chieffo A, Montorfano M, Alfieri O, Colombo A, Agricola E, Nogueira M, Branco L, Rosa S, Portugal G, Galrinho A, Abreu J, Cacela D, Patricio L, Fragata J, Cruz Ferreira R, Igual Munoz B, Erdociain Perales M, Maceira Gonzalez A, Estornell Erill Jordi J, Donate Bertolin L, Vazquez Sanchez Alejandro A, Miro Palau Vicente V, Cervera Zamora A, Piquer Gil M, Montero Argudo A, Girgis HYA, Illatopa V, Cordova F, Espinoza D, Ortega J, Khan U, Islam A, Majumder A, Girgis HYA, Bayat F, Naghshbandi E, Naghshbandi E, Samiei N, Samiei N, Malev E, Omelchenko M, Vasina L, Zemtsovsky E, Piatkowski R, Kochanowski J, Budnik M, Scislo P, Opolski G, Kochanowski J, Piatkowski R, Scislo P, Budnik M, Marchel M, Opolski G, Abid L, Ben Kahla S, Abid D, Charfeddine S, Maaloul I, Ben Jmaa M, Kammoun S, Hashimoto G, Suzuki M, Yoshikawa H, Otsuka T, Isekame Y, Yamashita H, Kawase I, Ozaki S, Nakamura M, Sugi K, Benvenuto E, Leggio S, Buccheri S, Bonura S, Deste W, Tamburino C, Monte IP, Gripari P, Fusini L, Muratori M, Tamborini G, Ghulam Ali S, Bottari V, Cefalu' C, Bartorelli A, Agrifoglio M, Pepi M, Zambon E, Iorio A, Di Nora C, Abate E, Lo Giudice F, Di Lenarda A, Agostoni P, Sinagra G, Timoteo AT, Galrinho A, Moura Branco L, Rio P, Aguiar Rosa S, Oliveira M, Silva Cunha P, Leal A, Cruz Ferreira R, Zemanek D, Tomasov P, Belehrad M, Kostalova J, Kara T, Veselka J, Hassanein M, El Tahan S, El Sharkawy E, Shehata H, Yoon Y, Choi H, Seo H, Lee S, Kim H, Youn T, Kim Y, Sohn D, Choi G, Mielczarek M, Huttin O, Voilliot D, Sellal J, Manenti V, Carillo S, Olivier A, Venner C, Juilliere Y, Selton-Suty C, Butz T, Faber L, Brand M, Piper C, Wiemer M, Noelke J, Sasko B, Langer C, Horstkotte D, Trappe H, Maysou L, Tessonnier L, Jacquier A, Serratrice J, Copel C, Stoppa A, Seguier J, Saby L, Verschueren A, Habib G, Petroni R, Bencivenga S, Di Mauro M, Acitelli A, Cicconetti M, Romano S, Petroni A, Penco M, Maceira Gonzalez AM, Cosin-Sales J, Igual B, Sancho-Tello R, Ruvira J, Mayans J, Choi J, Kim S, Almeida A, Azevedo O, Amado J, Picarra B, Lima R, Cruz I, Pereira V, Marques N, Chatzistamatiou E, Konstantinidis D, Manakos K, Mpampatseva Vagena I, Moustakas G, Memo G, Mitsakis O, Kasakogias A, Syros P, Kallikazaros I, Cho E, Kim J, Hwang B, Kim D, Jang S, Jeon H, Cho J, Chatzistamatiou E, Konstantinidis D, Memo G, Mpapatzeva Vagena I, Moustakas G, Manakos K, Traxanas K, Vergi N, Feretou A, Kallikazaros I, Jedrzejewska I, Konopka M, Krol W, Swiatowiec A, Dluzniewski M, Braksator W, Sefri Noventi S, Sugiri S, Uddin I, Herminingsih S, Arif Nugroho M, Boedijitno S, Caro Codon J, Blazquez Bermejo Z, Valbuena Lopez SC, Lopez Fernandez T, Rodriguez Fraga O, Torrente Regidor M, Pena Conde L, Moreno Yanguela M, Buno Soto A, Lopez-Sendon JL, Stevanovic A, Dekleva M, Kim M, Kim S, Kim Y, Shim J, Park S, Park S, Kim Y, Shim W, Kozakova M, Muscelli E, Morizzo C, Casolaro A, Paterni M, Palombo C, Bayat F, Nazmdeh M, Naghshbandi E, Nateghi S, Tomaszewski A, Kutarski A, Brzozowski W, Tomaszewski M, Nakano E, Harada T, Takagi Y, Yamada M, Takano M, Furukawa T, Akashi Y, Lindqvist G, Henein M, Backman C, Gustafsson S, Morner S, Marinov R, Hristova K, Geirgiev S, Pechilkov D, Kaneva A, Katova T, Pilosoff V, Pena Pena M, Mesa Rubio D, Ruiz Ortin M, Delgado Ortega M, Romo Penas E, Pardo Gonzalez L, Rodriguez Diego S, Hidalgo Lesmes F, Pan Alvarez-Ossorio M, Suarez De Lezo Cruz-Conde J, Gospodinova M, Sarafov S, Guergelcheva V, Vladimirova L, Tournev I, Denchev S, Mozenska O, Segiet A, Rabczenko D, Kosior D, Gao S, Eliasson M, Polte C, Lagerstrand K, Bech-Hanssen O, Morosin M, Piazza R, Leonelli V, Leiballi E, Pecoraro R, Cinello M, Dell' Angela L, Cassin M, Sinagra G, Nicolosi G, Savu O, Carstea N, Stoica E, Macarie C, Moldovan H, Iliescu V, Chioncel O, Moral S, Gruosso D, Galuppo V, Teixido G, Rodriguez-Palomares J, Gutierrez L, Evangelista A, Jansen Klomp WW, Peelen L, Spanjersberg A, Brandon Bravo Bruinsma G, Van 'T Hof A, Laveau F, Hammoudi N, Helft G, Barthelemy O, Michel P, Petroni T, Djebbar M, Boubrit L, Le Feuvre C, Isnard R, Bandera F, Generati G, Pellegrino M, Alfonzetti E, Labate V, Villani S, Gaeta M, Guazzi M, Gabriels C, Lancellotti P, Van De Bruaene A, Voilliot D, De Meester P, Buys R, Delcroix M, Budts W, Cruz I, Stuart B, Caldeira D, Morgado G, Almeida A, Lopes L, Fazendas P, Joao I, Cotrim C, Pereira H, Weissler Snir A, Greenberg G, Shapira Y, Weisenberg D, Monakier D, Nevzorov R, Sagie A, Vaturi M, Bando M, Yamada H, Saijo Y, Takagawa Y, Sawada N, Hotchi J, Hayashi S, Hirata Y, Nishio S, Sata M, Jackson T, Sammut E, Siarkos M, Lee L, Carr-White G, Rajani R, Kapetanakis S, Ciobotaru V, Yagasaki H, Kawasaki M, Tanaka R, Minatoguchi S, Sato N, Amano K, Warita S, Ono K, Noda T, Minatoguchi S, Breithardt OA, Razavi H, Nabutovsky Y, Ryu K, Gaspar T, Kosiuk J, John S, Prinzen F, Hindricks G, Piorkowski C, Nemchyna O, Tovstukha V, Chikovani A, Golikova I, Lutai M, Nemes A, Kalapos A, Domsik P, Lengyel C, Orosz A, Forster T, Nordenfur T, Babic A, Giesecke A, Bulatovic I, Ripsweden J, Samset E, Winter R, Larsson M, Blazquez Bermejo Z, Lopez Fernandez T, Caro Codon J, Valbuena S, Caro Codon J, Mori Junco R, Moreno Yanguela M, Lopez-Sendon J, Pinto-Teixeira P, Branco L, Galrinho A, Oliveira M, Cunha P, Silva T, Rio P, Feliciano J, Nogueira-Silva M, Ferreira R, Shkolnik E, Vasyuk Y, Nesvetov V, Shkolnik L, Varlan G, Bajraktari G, Ronn F, Ibrahimi P, Jashari F, Jensen S, Henein M, Kang MK, Mun HS, Choi S, Cho JR, Han S, Lee N, Cho IJ, Heo R, Chang H, Shin S, Shim C, Hong G, Chung N. Poster session 3: Thursday 4 December 2014, 14:00-18:00 * Location: Poster area. Eur Heart J Cardiovasc Imaging 2014. [DOI: 10.1093/ehjci/jeu253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Aleksić J, Ansoldi S, Antonelli LA, Antoranz P, Babic A, Bangale P, Barrio JA, González JB, Bednarek W, Bernardini E, Biasuzzi B, Biland A, Blanch O, Bonnefoy S, Bonnoli G, Borracci F, Bretz T, Carmona E, Carosi A, Colin P, Colombo E, Contreras JL, Cortina J, Covino S, Da Vela P, Dazzi F, De Angelis A, De Caneva G, De Lotto B, Wilhelmi EDO, Mendez CD, Prester DD, Dorner D, Doro M, Einecke S, Eisenacher D, Elsaesser D, Fonseca MV, Font L, Frantzen K, Fruck C, Galindo D, López RJG, Garczarczyk M, Terrats DG, Gaug M, Godinović N, Muñoz AG, Gozzini SR, Hadasch D, Hanabata Y, Hayashida M, Herrera J, Hildebrand D, Hose J, Hrupec D, Idec W, Kadenius V, Kellermann H, Kodani K, Konno Y, Krause J, Kubo H, Kushida J, La Barbera A, Lelas D, Lewandowska N, Lindfors E, Lombardi S, Longo F, López M, López-Coto R, López-Oramas A, Lorenz E, Lozano I, Makariev M, Mallot K, Maneva G, Mankuzhiyil N, Mannheim K, Maraschi L, Marcote B, Mariotti M, Martínez M, Mazin D, Menzel U, Miranda JM, Mirzoyan R, Moralejo A, Munar-Adrover P, Nakajima D, Niedzwiecki A, Nilsson K, Nishijima K, Noda K, Orito R, Overkemping A, Paiano S, Palatiello M, Paneque D, Paoletti R, Paredes JM, Paredes-Fortuny X, Persic M, Poutanen J, Moroni PGP, Prandini E, Puljak I, Reinthal R, Rhode W, Ribó M, Rico J, Garcia JR, Rügamer S, Saito T, Saito K, Satalecka K, Scalzotto V, Scapin V, Schultz C, Schweizer T, Shore SN, Sillanpää A, Sitarek J, Snidaric I, Sobczynska D, Spanier F, Stamatescu V, Stamerra A, Steinbring T, Storz J, Strzys M, Takalo L, Takami H, Tavecchio F, Temnikov P, Terzić T, Tescaro D, Teshima M, Thaele J, Tibolla O, Torres DF, Toyama T, Treves A, Uellenbeck M, Vogler P, Zanin R, Kadler M, Schulz R, Ros E, Bach U, Krauß F, Wilms J. Black hole lightning due to particle acceleration at subhorizon scales. Science 2014; 346:1080-4. [DOI: 10.1126/science.1256183] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- J. Aleksić
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
| | - S. Ansoldi
- Università di Udine and Istituto Nazionale di Fisica Nucleare (INFN) Trieste, I-33100 Udine, Italy, and Istituto Nazionale di Astrofisica (INAF)-Trieste, I-34127 Trieste, Italy
| | - L. A. Antonelli
- INAF National Institute for Astrophysics, I-00136 Rome, Italy
| | - P. Antoranz
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - A. Babic
- Croatian MAGIC Consortium, Rudjer Boskovic Institute, University of Rijeka and University of Split, HR-10000 Zagreb, Croatia
| | - P. Bangale
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | | | - J. Becerra González
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, Tenerife, Spain
- Present address: NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA, and Department of Physics and Department of Astronomy, University of Maryland, College Park, MD 20742, USA
| | | | - E. Bernardini
- Deutsches Elektronen-Synchrotron, D-15738 Zeuthen, Germany
| | - B. Biasuzzi
- Università di Udine and Istituto Nazionale di Fisica Nucleare (INFN) Trieste, I-33100 Udine, Italy, and Istituto Nazionale di Astrofisica (INAF)-Trieste, I-34127 Trieste, Italy
| | - A. Biland
- ETH Zurich, CH-8093 Zurich, Switzerland
| | - O. Blanch
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
| | - S. Bonnefoy
- Universidad Complutense, E-28040 Madrid, Spain
| | - G. Bonnoli
- INAF National Institute for Astrophysics, I-00136 Rome, Italy
| | - F. Borracci
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - T. Bretz
- Universität Würzburg, D-97074 Würzburg, Germany
- Present address: Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - E. Carmona
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, E-28040 Madrid, Spain
| | - A. Carosi
- INAF National Institute for Astrophysics, I-00136 Rome, Italy
| | - P. Colin
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - E. Colombo
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, Tenerife, Spain
| | | | - J. Cortina
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
| | - S. Covino
- INAF National Institute for Astrophysics, I-00136 Rome, Italy
| | - P. Da Vela
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - F. Dazzi
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - A. De Angelis
- Università di Udine and Istituto Nazionale di Fisica Nucleare (INFN) Trieste, I-33100 Udine, Italy, and Istituto Nazionale di Astrofisica (INAF)-Trieste, I-34127 Trieste, Italy
| | - G. De Caneva
- Deutsches Elektronen-Synchrotron, D-15738 Zeuthen, Germany
| | - B. De Lotto
- Università di Udine and Istituto Nazionale di Fisica Nucleare (INFN) Trieste, I-33100 Udine, Italy, and Istituto Nazionale di Astrofisica (INAF)-Trieste, I-34127 Trieste, Italy
| | | | - C. Delgado Mendez
- Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas, E-28040 Madrid, Spain
| | - D. Dominis Prester
- Croatian MAGIC Consortium, Rudjer Boskovic Institute, University of Rijeka and University of Split, HR-10000 Zagreb, Croatia
| | - D. Dorner
- Universität Würzburg, D-97074 Würzburg, Germany
| | - M. Doro
- Università di Padova and INFN, I-35131 Padova, Italy
| | - S. Einecke
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | | | | | | | - L. Font
- Unitat de Física de les Radiacions, Departament de Física, and Centro de Estudios e Investigación Espaciales-Institut d’Estudis Espacials de Catalunya, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - K. Frantzen
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - C. Fruck
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - D. Galindo
- Universitat de Barcelona, Institut de Ciències del Cosmos, Institut d’Estudis Espacials de Catalunya-Universitat de Barcelona, E-08028 Barcelona, Spain
| | - R. J. García López
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, Tenerife, Spain
| | - M. Garczarczyk
- Deutsches Elektronen-Synchrotron, D-15738 Zeuthen, Germany
| | - D. Garrido Terrats
- Unitat de Física de les Radiacions, Departament de Física, and Centro de Estudios e Investigación Espaciales-Institut d’Estudis Espacials de Catalunya, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - M. Gaug
- Unitat de Física de les Radiacions, Departament de Física, and Centro de Estudios e Investigación Espaciales-Institut d’Estudis Espacials de Catalunya, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Spain
| | - N. Godinović
- Croatian MAGIC Consortium, Rudjer Boskovic Institute, University of Rijeka and University of Split, HR-10000 Zagreb, Croatia
| | - A. González Muñoz
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
| | - S. R. Gozzini
- Deutsches Elektronen-Synchrotron, D-15738 Zeuthen, Germany
| | - D. Hadasch
- Institute of Space Sciences, E-08193 Barcelona, Spain
- Present address: Institut für Astro- und Teilchenphysik, Leopold-Franzens-Universität Innsbruck, A-6020 Innsbruck, Austria
| | - Y. Hanabata
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - M. Hayashida
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - J. Herrera
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, Tenerife, Spain
| | | | - J. Hose
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - D. Hrupec
- Croatian MAGIC Consortium, Rudjer Boskovic Institute, University of Rijeka and University of Split, HR-10000 Zagreb, Croatia
| | - W. Idec
- University of Łódz', PL-90236 Lodz, Poland
| | - V. Kadenius
- Finnish MAGIC Consortium, Tuorla Observatory, University of Turku and Department of Physics, University of Oulu, Finland
| | - H. Kellermann
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - K. Kodani
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - Y. Konno
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - J. Krause
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - H. Kubo
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - J. Kushida
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - A. La Barbera
- INAF National Institute for Astrophysics, I-00136 Rome, Italy
| | - D. Lelas
- Croatian MAGIC Consortium, Rudjer Boskovic Institute, University of Rijeka and University of Split, HR-10000 Zagreb, Croatia
| | | | - E. Lindfors
- Finnish MAGIC Consortium, Tuorla Observatory, University of Turku and Department of Physics, University of Oulu, Finland
- Present address: Finnish Centre for Astronomy with ESO (FINCA), Turku, Finland
| | - S. Lombardi
- INAF National Institute for Astrophysics, I-00136 Rome, Italy
| | - F. Longo
- Università di Udine and Istituto Nazionale di Fisica Nucleare (INFN) Trieste, I-33100 Udine, Italy, and Istituto Nazionale di Astrofisica (INAF)-Trieste, I-34127 Trieste, Italy
| | - M. López
- Universidad Complutense, E-28040 Madrid, Spain
| | - R. López-Coto
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
| | - A. López-Oramas
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
| | | | - I. Lozano
- Universidad Complutense, E-28040 Madrid, Spain
| | - M. Makariev
- Institute for Nuclear Research and Nuclear Energy, BG-1784 Sofia, Bulgaria
| | - K. Mallot
- Deutsches Elektronen-Synchrotron, D-15738 Zeuthen, Germany
| | - G. Maneva
- Institute for Nuclear Research and Nuclear Energy, BG-1784 Sofia, Bulgaria
| | - N. Mankuzhiyil
- Università di Udine and Istituto Nazionale di Fisica Nucleare (INFN) Trieste, I-33100 Udine, Italy, and Istituto Nazionale di Astrofisica (INAF)-Trieste, I-34127 Trieste, Italy
- Present address: Astrophysics Science Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - K. Mannheim
- Universität Würzburg, D-97074 Würzburg, Germany
| | - L. Maraschi
- INAF National Institute for Astrophysics, I-00136 Rome, Italy
| | - B. Marcote
- Universitat de Barcelona, Institut de Ciències del Cosmos, Institut d’Estudis Espacials de Catalunya-Universitat de Barcelona, E-08028 Barcelona, Spain
| | - M. Mariotti
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M. Martínez
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
| | - D. Mazin
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - U. Menzel
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - J. M. Miranda
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - R. Mirzoyan
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - A. Moralejo
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
| | - P. Munar-Adrover
- Universitat de Barcelona, Institut de Ciències del Cosmos, Institut d’Estudis Espacials de Catalunya-Universitat de Barcelona, E-08028 Barcelona, Spain
| | - D. Nakajima
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | | | - K. Nilsson
- Finnish MAGIC Consortium, Tuorla Observatory, University of Turku and Department of Physics, University of Oulu, Finland
- Present address: Finnish Centre for Astronomy with ESO (FINCA), Turku, Finland
| | - K. Nishijima
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - K. Noda
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - R. Orito
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - A. Overkemping
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - S. Paiano
- Università di Padova and INFN, I-35131 Padova, Italy
| | - M. Palatiello
- Università di Udine and Istituto Nazionale di Fisica Nucleare (INFN) Trieste, I-33100 Udine, Italy, and Istituto Nazionale di Astrofisica (INAF)-Trieste, I-34127 Trieste, Italy
| | - D. Paneque
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - R. Paoletti
- Università di Siena and INFN Pisa, I-53100 Siena, Italy
| | - J. M. Paredes
- Universitat de Barcelona, Institut de Ciències del Cosmos, Institut d’Estudis Espacials de Catalunya-Universitat de Barcelona, E-08028 Barcelona, Spain
| | - X. Paredes-Fortuny
- Universitat de Barcelona, Institut de Ciències del Cosmos, Institut d’Estudis Espacials de Catalunya-Universitat de Barcelona, E-08028 Barcelona, Spain
| | - M. Persic
- Università di Udine and Istituto Nazionale di Fisica Nucleare (INFN) Trieste, I-33100 Udine, Italy, and Istituto Nazionale di Astrofisica (INAF)-Trieste, I-34127 Trieste, Italy
| | - J. Poutanen
- Finnish MAGIC Consortium, Tuorla Observatory, University of Turku and Department of Physics, University of Oulu, Finland
| | | | | | - I. Puljak
- Croatian MAGIC Consortium, Rudjer Boskovic Institute, University of Rijeka and University of Split, HR-10000 Zagreb, Croatia
| | - R. Reinthal
- Finnish MAGIC Consortium, Tuorla Observatory, University of Turku and Department of Physics, University of Oulu, Finland
| | - W. Rhode
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - M. Ribó
- Universitat de Barcelona, Institut de Ciències del Cosmos, Institut d’Estudis Espacials de Catalunya-Universitat de Barcelona, E-08028 Barcelona, Spain
| | - J. Rico
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
| | | | - S. Rügamer
- Universität Würzburg, D-97074 Würzburg, Germany
| | - T. Saito
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - K. Saito
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | | | - V. Scalzotto
- Università di Padova and INFN, I-35131 Padova, Italy
| | - V. Scapin
- Universidad Complutense, E-28040 Madrid, Spain
| | - C. Schultz
- Università di Padova and INFN, I-35131 Padova, Italy
| | - T. Schweizer
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - S. N. Shore
- Università di Pisa and INFN Pisa, I-56126 Pisa, Italy
| | - A. Sillanpää
- Finnish MAGIC Consortium, Tuorla Observatory, University of Turku and Department of Physics, University of Oulu, Finland
| | - J. Sitarek
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
| | - I. Snidaric
- Croatian MAGIC Consortium, Rudjer Boskovic Institute, University of Rijeka and University of Split, HR-10000 Zagreb, Croatia
| | | | - F. Spanier
- Universität Würzburg, D-97074 Würzburg, Germany
| | - V. Stamatescu
- Institut de Física d’Altes Energies, Campus UAB, E-08193 Bellaterra, Spain
- Present address: School of Chemistry and Physics, University of Adelaide, Adelaide 5005, Australia
| | - A. Stamerra
- INAF National Institute for Astrophysics, I-00136 Rome, Italy
| | | | - J. Storz
- Universität Würzburg, D-97074 Würzburg, Germany
| | - M. Strzys
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - L. Takalo
- Finnish MAGIC Consortium, Tuorla Observatory, University of Turku and Department of Physics, University of Oulu, Finland
| | - H. Takami
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - F. Tavecchio
- INAF National Institute for Astrophysics, I-00136 Rome, Italy
| | - P. Temnikov
- Institute for Nuclear Research and Nuclear Energy, BG-1784 Sofia, Bulgaria
| | - T. Terzić
- Croatian MAGIC Consortium, Rudjer Boskovic Institute, University of Rijeka and University of Split, HR-10000 Zagreb, Croatia
| | - D. Tescaro
- Instituto de Astrofísica de Canarias, E-38200 La Laguna, Tenerife, Spain
| | - M. Teshima
- Max-Planck-Institut für Physik, D-80805 München, Germany
- Japanese MAGIC Consortium, Division of Physics and Astronomy, Kyoto University, Japan
| | - J. Thaele
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - O. Tibolla
- Universität Würzburg, D-97074 Würzburg, Germany
| | - D. F. Torres
- ICREA and Institute of Space Sciences, E-08193 Barcelona, Spain
| | - T. Toyama
- Max-Planck-Institut für Physik, D-80805 München, Germany
| | - A. Treves
- Università dell’Insubria and INFN Milano Bicocca, Como, I-22100 Como, Italy
| | - M. Uellenbeck
- Technische Universität Dortmund, D-44221 Dortmund, Germany
| | - P. Vogler
- ETH Zurich, CH-8093 Zurich, Switzerland
| | - R. Zanin
- Universitat de Barcelona, Institut de Ciències del Cosmos, Institut d’Estudis Espacials de Catalunya-Universitat de Barcelona, E-08028 Barcelona, Spain
| | - M. Kadler
- Universität Würzburg, D-97074 Würzburg, Germany
| | - R. Schulz
- Universität Würzburg, D-97074 Würzburg, Germany
- Dr. Remeis-Sternwarte Bamberg, Astronomisches Institut der Universität Erlangen-Nürnberg, ECAP, D-96049 Bamberg, Germany
| | - E. Ros
- Max-Planck-Institut für Radioastronomie, D-53121 Bonn, Germany
- Observatori Astronòmic, Universitat de València, E-46980 Paterna, València, Spain
- Departament d’Astronomia i Astrofísica, Universitat de València, E-46100 Burjassot, València, Spain
| | - U. Bach
- Max-Planck-Institut für Radioastronomie, D-53121 Bonn, Germany
| | - F. Krauß
- Universität Würzburg, D-97074 Würzburg, Germany
- Dr. Remeis-Sternwarte Bamberg, Astronomisches Institut der Universität Erlangen-Nürnberg, ECAP, D-96049 Bamberg, Germany
| | - J. Wilms
- Dr. Remeis-Sternwarte Bamberg, Astronomisches Institut der Universität Erlangen-Nürnberg, ECAP, D-96049 Bamberg, Germany
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Andreola G, Babic A, Perseghin P, Crovetti G, Marson P, Savignano C, Ipsevich F, Lanti A, Laszlo D. Extracorporeal photochemotherapy: an Italian panel perspective on indications, methodologies and clinical results. Drugs Cell Ther Hematol 2013. [DOI: 10.4081/dcth.2013.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Andreola G, Babic A, Perseghin P, Crovetti G, Marson P, Savignano C, Ipsevich F, Lanti A, Laszlo D. Extracorporeal photochemotherapy: an Italian panel perspective on indications, methodologies and clinical results. Drugs Cell Ther Hematol 2013. [DOI: 10.4081/dcth.2013.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Gardellini A, Gigli F, Babic A, Andreola G, Radice D, Sammassimo S, Martinelli G, Laszlo D. Filgrastim XM02 (Tevagrastim®) after autologous stem cell transplantation compared to lenograstim: favourable cost-efficacy analysis. Ecancermedicalscience 2013; 7:327. [PMID: 23818939 PMCID: PMC3694838 DOI: 10.3332/ecancer.2013.327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Granulocyte colony-stimulating factors (G-CSFs), filgrastim and lenograstim, are recognised to be useful in accelerating engraftment after autologous stem cell transplantation. Several forms of biosimilar non-glycosylated G-CSF have been approved by the European Medicines Agency, with limited published data supporting the clinical equivalence in peripheral blood stem cell mobilisation and recovery after autologous stem cell transplantation. METHOD With the aim of comparing cost-effective strategies in the use of G-CSF after autologous stem cell transplantation, we retrospectively evaluated 32 patients consecutively treated with biosimilar filgrastim XM02 (Tevagrastim) and 26 with lenograstim. All patients received G-CSF (biosimilar or lenograstim) at a dosage of 5 mcg/kg/day subcutaneously from day 5 to absolute neutrophil count of 1500/mmc for three days. RESULTS The median time to absolute neutrophil count engraftment was 11 days for the filgrastim XM02 group and 12 days for the lenograstim group. As for platelets recovery, the median time was 12 days in both groups. The median number of G-CSF vials used for patients was 9.5 for Tevagrastim and 10.5 for lenograstim, reflecting a mean estimated cost of about 556.1 euros for Tevagrastim versus 932.2 euros for lenograstim (p< 0.001). The median days of febrile neutropenia were 1.5 and 1 for filgrastim XM02 and lenograstim, respectively. No adverse event related to the use of XM02 filgrastim was recorded. CONCLUSION In our experience, filgrastim XM02 and lenograstim showed comparable efficacy in shortening the period of neutropenia after cytoreduction and autologous stem cell transplantation, with a favourable cost effect for filgrastim XM02.
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Affiliation(s)
- A Gardellini
- Division of Haematoncology, European Institute of Oncology, Milan, Italy
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Chen J, Burns KM, Babic A, Carrum G, Kennedy M, Segura FJ, Garcia S, Potts S, Leveque C. Donor body mass index is an important factor that affects peripheral blood progenitor cell yield in healthy donors after mobilization with granulocyte-colony-stimulating factor. Transfusion 2013; 54:203-10. [PMID: 23763340 DOI: 10.1111/trf.12238] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 03/26/2013] [Accepted: 03/28/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND The use of hematopoietic progenitor cell (HPC) transplantation has rapidly expanded in recent years. Currently, several sources of HPCs are available for transplantation including peripheral blood HPCs (PBPCs), cord blood cells, and marrow cells. Of these, PBPC collection has become the major source of HPCs. An important variable in PBPC collection is the response to PBPC mobilization, which varies significantly and sometime causes mobilization failure. STUDY DESIGN AND METHODS A retrospective study of 69 healthy donors who underwent PBPC donation by leukapheresis was performed. All of these donors received 10 μg/kg/day or more granulocyte-colony-stimulating factor (G-CSF) for 5 days before PBPC harvest. Donor factors were evaluated and correlated with mobilization responses, as indicated by the precollection CD34 count (pre-CD34). RESULTS Donors with a pre-CD34 of more than 100 × 10(6) /L had higher body mass index (BMI) compared with donors whose pre-CD34 was 38 × 10(6) to 99 × 10(6) /L or less than 38 × 10(6) /L (32.0 ± 1.04 kg/m(2) vs. 28.7 ± 0.93 kg/m(2) vs. 25.9 ± 1.27 kg/m(2) , respectively; p < 0.05). In addition, donors with high BMIs had higher pre-CD34 on a per-kilogram-of-body-weight basis compared with donors with low BMIs. CONCLUSION BMI is an important factor that affects donor's response to mobilization and consequently the HPC yield. This effect may be due to a relatively high dose of G-CSF administered to donors with higher BMI or due to the presence of unknown intrinsic factors affecting mobilization that correlate with the amount of adipose tissue in each donor.
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Affiliation(s)
- Jian Chen
- Department of Pathology and Genomic Medicine, Cell and Gene Therapy Department, Baylor College of Medicine, Houston, Texas; The Methodist Hospital, Houston, Texas; Gulf Coast Regional Blood Center, Houston, Texas
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Cannella L, Babic A, Andreola G, Elezi R, Rabascio C, Negri M, Calabrese L, Lionetti M, Laszlo D. O-26 G-CSF AND PLERIXAFOR AS NON-TOXIC AND EFFECTIVE FIRST-LINE MOBILIZING APPROACH IN PATIENTS WITH MULTIPLE MYELOMA CANDIDATE TO ASCT. Transfus Apher Sci 2012. [DOI: 10.1016/s1473-0502(12)70027-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Martin-Sanchez F, Iakovidis I, Nørager S, Maojo V, de Groen P, Van der Lei J, Jones T, Abraham-Fuchs K, Apweiler R, Babic A, Baud R, Breton V, Cinquin P, Doupi P, Dugas M, Eils R, Engelbrecht R, Ghazal P, Jehenson P, Kulikowski C, Lampe K, De Moor G, Orphanoudakis S, Rossing N, Sarachan B, Sousa A, Spekowius G, Thireos G, Zahlmann G, Zvárová J, Hermosilla I, Vicente FJ. Synergy between medical informatics and bioinformatics: facilitating genomic medicine for future health care. J Biomed Inform 2004; 37:30-42. [PMID: 15016384 DOI: 10.1016/j.jbi.2003.09.003] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2003] [Indexed: 11/29/2022]
Abstract
In this paper, we review the results of BIOINFOMED, a study funded by the European Commission (EC) with the purpose to analyse the different issues and challenges in the area where Medical Informatics and Bioinformatics meet. Traditionally, Medical Informatics has been focused on the intersection between computer science and clinical medicine, whereas Bioinformatics have been predominantly centered on the intersection between computer science and biological research. Although researchers from both areas have occasionally collaborated, their training, objectives and interests have been quite different. The results of the Human Genome and related projects have attracted the interest of many professionals, and introduced new challenges that will transform biomedical research and health care. A characteristic of the 'post genomic' era will be to correlate essential genotypic information with expressed phenotypic information. In this context, Biomedical Informatics (BMI) has emerged to describe the technology that brings both disciplines (BI and MI) together to support genomic medicine. In recognition of the dynamic nature of BMI, institutions such as the EC have launched several initiatives in support of a research agenda, including the BIOINFOMED study.
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Babic A, Ilas J, Pecar S. Synthesis of hydrophilic and amphiphilic spin probes. Pharmazie 2003; 58:599-600. [PMID: 12967044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Affiliation(s)
- A Babic
- Faculty of Pharmacy, University of Ljubljana, Slovenia
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Abstract
A potential cytological nuclear grading based on a semi-quantitative evaluation of three basic nuclear features, size of cell nuclei, anisonucleosis and the proportion of nucleoli-containing-nuclei, was tested on 74 Giemsa-stained fine needle aspiration of breast smears for its reliability in establishing the malignant potential of breast cancer. The prognostic impact of DNA-ploidy and S-phase fraction was also assessed. A good correlation between the three basic nuclear features, DNA-ploidy, S-phase fraction, cytological nuclear grade and histological grade, was shown. Using the cytological nuclear grade proposed, correct classification of cases between low histological grade (HG I) and high histological grade (HG II + HG III) was achieved in 79.73%. A statistically significant difference in 5-year survival rate was also observed between low malignancy grade and high malignancy grade breast cancer patients, regardless of the grading method used. DNA-ploidy and S-phase fraction were not statistically significant in establishing the malignant potential of breast cancer.
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MESH Headings
- Azure Stains
- Biopsy, Needle
- Breast Neoplasms/classification
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Breast Neoplasms/physiopathology
- Carcinoma, Ductal, Breast/classification
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/physiopathology
- Cell Nucleus/pathology
- DNA, Neoplasm/analysis
- Female
- Humans
- Ploidies
- Prognosis
- Survival Rate
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Affiliation(s)
- B Skrbínc
- Department for Medical Oncology, Institute of Oncology, Ljubljana, Slovenia
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Jonsson J, Babic A. Quantitative collagen as a golden standard in differential diagnosing of fibrotic changes in liver tissue. Stud Health Technol Inform 2000; 68:749-54. [PMID: 10724994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Determining a presence and degree of liver fibrosis provides means for diagnosing disease related processes. We have used two data mining methods, discriminant and regression analyses, to acquire knowledge from the data of 211 patients. We have shown and discussed that quantitative collagen has a distinguished discriminating power and can serve as a golden standard. We have additionally succeeded to obtain a formula consisting of standardised blood tests that can replace quantitative collagen. Practical implications of this is a non-invasive and cost efficient patient examination. All the results are now left for clinical evaluation and so is the current way of histopathological classifications.
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Affiliation(s)
- J Jonsson
- Linköpings Universitet, Department of Biomedical Engineering, Medical Informatics, Sweden
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Hedin K, Babic A, Frydén A. Take care: guidelines for patients with chronic hepatitis C. Stud Health Technol Inform 2000; 68:783-8. [PMID: 10725002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Alcohol consumption has significant impact on the condition of the liver, by itself, and even more in conjunction with other liver diseases such as chronic hepatitis C. Drinking habits might be delicate issues to address and could harm otherwise satisfying communication. Therefore, we intended to outline guidelines for advising hepatitis C patients concerning alcohol consumption. Analysis of a relatively limited knowledge base revealed the complexity of the disease rather than statistically significant findings regarding consumption. Thus, we instead chose to suggest a set of patient educational guidelines, which could be implemented on the Internet, hypothesizing that a better informed patient will be more able to comply with restrictions concerning alcohol consumption. A brief ad hoc evaluation pointed out Internet as a favourable media to present the information. We also suggest a tentative algorithm for further development of clinical decision support systems addressing monitoring of chronic hepatitis C patients.
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Affiliation(s)
- K Hedin
- Department of Infectious Diseases, Faculty of Health Sciences, Linkoping University, Sweden
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Babic A. Knowledge discovery for advanced clinical data management and analysis. Stud Health Technol Inform 2000; 68:409-13. [PMID: 10724916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Knowledge discovery is a broad research field in which methods are developed to support discovery of novel and potentially useful knowledge from clinical databases and registers in systems for patient care. However, the techniques available are not readily applicable in medical domains, due to, among other reasons, low user friendliness and lack of proper methodological background. Data mining approaches to be explored and improved are predictive modelling, segmentation, dependency modelling, summarization, and change and deviation detection/modelling (in data or knowledge). Another and original contribution of the research is to build up efficient feedback loops. Human experts and available domain expert systems could provide suggestions as how to improve all major steps in the knowledge discovery process such as evaluation of knowledge, choice of data mining methods and data input. A long tradition of collecting and maintaining clinical and administrative data could be found in fields of oncology, cardiology, coronary surgery, social and primary health care medicine. All these areas, that gather data over long periods of time, could benefit from knowledge discovery.
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Affiliation(s)
- A Babic
- Dept. of Biomedical Engineering, Linkoping University, Sweden
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Kircher A, Antonsson J, Babic A, Casimir-Ahn H. Quantitative data analysis for exploring outcomes in cardiac surgery. Stud Health Technol Inform 2000; 68:457-60. [PMID: 10724927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
The article focuses on possibilities of statistical knowledge exploration to predict outcomes of surgical treatments. The outcomes were defined in relation to the measured peri- and intraoperative data, as well as follow-up patient questionnaire. Clinical consequences are expected in terms of a smaller data set with a better ability to predict the surgery outcomes and a better cost performance. The important questions that could discriminate quality of life (QoL) were: Relief from surgery?, Has cardiac surgery effected earlier symptoms? Work capacity? Consultations after the surgery? The performed data analysis proved to be efficient in the complex data set that was collected. Pain relief was identified to be significant, while relations between measured blood laboratory profile and later QoL were weak.
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Affiliation(s)
- A Kircher
- Department of Biomed. Engineering, Linköping University, Sweden
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Kircher A, Granfeldt H, Babic A, Antonsson J, Lönn U, Ahn HC. Knowledge representation forms for data mining methodologies as applied in thoracic surgery. Proc AMIA Symp 2000:428-32. [PMID: 11079919 PMCID: PMC2243935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Typical ways of disseminating and using results of clinical research are scientific journals and reports. Presentation forms are condensed and comprehensible mainly to the experts following the specific topics. A vast amount of information remains unutilized due to the complex form of presenting the knowledge. Subject of this research is to explore possibilities of representation and also visualization of the results obtained using data mining methodologies. The intention is to formulate more than scientific ways to communicate facts that are of interest for the clinicians, medical students and even patients. Internet technologies as already widely established media support knowledge representation forms such as hypertext documents and structured knowledge components. The "Assist Me" decision support system for surgical treatment of cardiac patients integrates several forms of data mining and representation methodologies. We are showing a feasibility study in which scientific outcomes were forwarded to a broad group of potential users.
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Affiliation(s)
- A Kircher
- Department of Biomedical Engineering, Linköpings University, Sweden
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Hedin K, Babic A, Frydén A. Liver guide for monitoring of chronic hepatitis C. Proc AMIA Symp 2000:340-3. [PMID: 11079901 PMCID: PMC2243716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
The severity of chronic hepatitis C infection in the individual patient is monitored using blood laboratory findings and liver biopsy. If blood test results could be shown to provide sufficient information concerning the disease, the invasive procedure of liver biopsy could perhaps be avoided in some instances. This study assessed the clinical relevance of blood laboratory tests for detecting disease-related changes in the liver. Histopathological classification was used to assign class membership of the patients and data mining operations were performed in an elaborate way on 19 different data sets. Disease activity could be detected by a small set of blood tests. Extended sets could identify more severe changes, but failed to distinguish them. The extracted rules are implemented as a part of the knowledge base of a corresponding decision support system aimed at specialists and general practitioners.
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Affiliation(s)
- K Hedin
- Department of Infectious Diseases, Linköping University Hospital, Sweden
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Bergquist U, Babic A. Aspects of certainty in patient classification using a health-related quality-of-life instrument in inflammatory bowel disease. Proc AMIA Symp 1999:202-6. [PMID: 10566349 PMCID: PMC2232609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
The study has focused on deriving a certainty measure for the classification of disease activity in patients suffering from inflammatory bowel disease (IBD). The aim is to build an Internet-based health-related quality-of-life (HRQoL) questionnaire to continuously monitor a patient's condition. Data from 109 patients was collected four times in intervals of three months, using a standardized disease-specific quality-of-life questionnaire, the Rating Form of IBD Patient Concern (RFIPC), extended with 11 additional questions. Correlation analysis showed that the RFIPC items along with "general wellbeing" were highly correlated (significance < 0.001). Factor analysis confirmed this high correlation and only one factor was identified among those variables. Multivariate discriminant analysis was successful to 78.1% in classifying between cases of remission and relapse. Implementation of a smooth threshold function decreased the classification error. However, discrimination regarding change in disease activity over time has to be further improved.
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Affiliation(s)
- U Bergquist
- Department of Biomedical Engineering, Linkoping University, Sweden
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Babic A, Mathiesen U, Hedin K, Bodemar G, Wigertz O. Assessing an AI knowledge-base for asymptomatic liver diseases. Proc AMIA Symp 1998:513-7. [PMID: 9929272 PMCID: PMC2232391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Discovering not yet seen knowledge from clinical data is of importance in the field of asymptomatic liver diseases. Avoidance of liver biopsy which is used as the ultimate confirmation of diagnosis by making the decision based on relevant laboratory findings only, would be considered an essential support. The system based on Quinlan's ID3 algorithm was simple and efficient in extracting the sought knowledge. Basic principles of applying the AI systems are therefore described and complemented with medical evaluation. Some of the diagnostic rules were found to be useful as decision algorithms i.e. they could be directly applied in clinical work and made a part of the knowledge-base of the Liver Guide, an automated decision support system.
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Affiliation(s)
- A Babic
- Department of Medical Informatics, Linkoping University, Sweden
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Ivanusa T, Babic A, Petelin M. Diagnostic systems for assessing alveolar bone loss. Stud Health Technol Inform 1996; 43 Pt B:478-81. [PMID: 10179711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Radiological diagnostics serves as a basic monitoring technique for alveolar bone loss which is a severe consequence of periodontal disease. To evaluate efficacy of Conventional Visual Radiography (CVR), and to assess a complete clinical status, we had used two more diagnostic systems. These are Digital Subtraction Radiography (DSR) and Probing Pocket Depth (PPD). Experimental Periodontitis was studied in 20 beagle dogs based on the measurements taken in the beginning (baseline), and before (11th month) and after the medical treatment (12th month). Data analyses pointed out the same clinical trend, i.e. a significant bone loss prior to medical treatment and its recovery to the initial state. Differences in metrics and measurement errors could be identified as causes for discrepancies between the systems, but a relationship between the CVR and PPD is worth of further research, as these systems do not appear to be entirely compatible, but rather complementary to each other.
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Affiliation(s)
- T Ivanusa
- Veterinary Faculty, Institute Josef Stefan, University of Ljubeljana, Slovenia
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Babic A, Ster B, Pavesic N, Wigertz O. Machine learning for the quality of life in inflammatory bowel disease. Stud Health Technol Inform 1996; 43 Pt B:661-5. [PMID: 10179749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Presence of a chronic disease influences patients' lives and reinforces demands to accept and then cope with the illness. In the case of inflammatory bowel disease, quality of life greatly differs through phases of remissions and relapses. Could the quality of life questionnaire tell the difference? In this study we are disclosing possibilities of assessing patients' perspectives by analysing analogue scale statements regarding concerns and worries related to ulcerative colitis. Some two hundred Swedish patients, 3/4 in remission and 1/4 in relapse, filled out a booklet containing 36 statements. To characterise the disease activity, we have used multivariate discrimination. To structure and describe in details paths distinguishing the remission from relapse, we have used an artificial intelligence procedure. Applications of the CART (Classification And Regression Trees) algorithm resulted in a set of classifiers which are, based on the similar subsets of significant variables, i.e. statements. Best reached classification accuracy did not exceed 80% in any case. Other classifiers namely, K-nearest-neighbour (KNN), Learning Vector Quantization (LVQ) and Back Propagation Neural Network (BPNN) confirmed that outcome. An expectation that the disease activity should clearly speak throughout the questionnaire held for a certain number of the observations such as pain and suffering, loss of bowel control, dying early, feeling alone, ability to have children, being treated as different and concerns regarding the medication. To highlight the difference of incorrect 20%, K-means clustering was performed. The results settled a basis for a hypothesis that the studied quality of life instrument captures more than the disease activity.
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Affiliation(s)
- A Babic
- Faculty of Electrical Engineering, University of Ljubljana, Slovenia
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Abstract
BACKGROUND This study examined the use of the Hemopump to treat low cardiac output syndrome after cardiopulmonary bypass. METHODS We used the Hemopump temporary cardiac assist system in 29 patients with severe left ventricular dysfunction after open heart operations from September 1991 to November 1994. RESULTS Five patients were excluded from the study due to initial patient/device-related problems. Ten patients died in the operating room or early during the stay in the intensive care unit due to progressive biventricular failure. Fourteen patients (58.3%) were weaned from the device, and all of them were later discharged. In a subgroup of patients (54%) in whom we had a more aggressive approach for early insertion of the pump, the survival rate was 85%. Preoperative Higging risk score was significantly related to survival. CONCLUSIONS The Hemopump can effectively unload a failing left ventricle with preservation of multiorgan perfusion. A minor decrease in kidney function was observed in most patients, but none of the surviving patients needed hemodialysis. One patient required a short period of peritoneal dialysis to get rid of fluid overload. Hemolysis or platelet dysfunction was not a clinical problem.
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Affiliation(s)
- U Lönn
- Linköping Heart Center, University of Linköping, Sweden
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Babic A, Bodemar G, Mathiesen U, Ahlfeldt H, Franzen L, Wigertz O. Machine learning to support diagnostics in the domain of asymptomatic liver disease. Medinfo 1995; 8 Pt 1:809-813. [PMID: 8591335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Machine learning procedures, in unsupervised and supervised manner, can enable their users to achieve knowledge hardly comprehensible by even the best experts. This is true also if the clinical knowledge has been carefully assembled in a prospective way. A data set including 165 patients with elevated routine laboratory tests was extensively studied according to clinical history, laboratory profile and liver biopsy. Unsupervised learning by Kohonen feature map disclosed 4 groups of patients: the largest one with no or slight histopathological changes (116) and three smaller, more homogenous, with more diseased patients. Standardized histopathological scorings of the liver specimens defined patients into two groups. Fifty-eight of them were, according to the analysis, recommended for a liver biopsy, due to more severe degrees of inflammation and fibrosis. One-hundred and seven of the patients, in whom liver biopsy was retrospectively considered unnecessary, had only minor degrees of inflammation, fibrosis and/or steatosis. Supervised learning, using the inductive systems based on Quinlan's ID3 and CART algorithms, extracted knowledge in the form of decision trees. This approach could define a need for biopsy either with a very few significant findings or by pathways containing quotients and multiplications of the different basic items. These procedures were analyzed and compared for their theoretical and applicative performances. The cluster and Fischerian discriminant analyses were performed in order to compare the classification performance. The medical appropriateness of the obtained results is satisfying, therefore decision support systems, outlined in this study, should be evaluated in wider clinical practice. To achieve this goal, an example of a Medical Logical Module (MLM), based on the Arden Syntax, is given.
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Affiliation(s)
- A Babic
- Department of Medical Informatics, Linkoping University, Sweden
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46
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Krusinska E, Babic A, Mathiesen U, Chowdhury S, Wigertz O, Bodemar G, Franzén L. A statistically rule-based decision support system for the management of patients with suspected liver disease. Med Inform (Lond) 1993; 18:113-30. [PMID: 8231421 DOI: 10.3109/14639239309034474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The paper describes how a decision support system in liver diseases, mostly oriented to prediction of the necessity for liver biopsy, has been developed. The system designed is a hybrid one and consists of two parts: logical and statistical. The logical part contains rules, formulated on the basis of current medical knowledge, which enables recognition of clear cases; diseased or non-diseased. The unclear cases are classified on the basis of rules statistically extracted from databases. These rules have been reached after a comprehensive exploratory analysis of the sample of 165 patients with slightly to moderately raised levels of routine liver tests but without signs or symptoms of liver diseases. The extracted decision diagrams which simulate traditional medical diagnosis conduct have been found to be superior to discriminant analysis and probabilistic inductive learning. They use only a limited number of laboratory tests to detect the necessity for biopsy.
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Affiliation(s)
- E Krusinska
- Department of Mathematics and Informatics, Conservatoire National des Arts et Métiers, Paris, France
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47
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Abstract
We performed exploratory data analysis (EDA) to examine the hidden structure in liver disease data. The purpose was to demonstrate the potential of statistical techniques for extracting knowledge from an active HIS (hospital information system) database with decision support. The goal is to give strong support to the creation of new rules or "tuning" of old rules in the knowledge base. This would facilitate utilization of large patient databases, now commonly available, to help build/update decision support systems for improved patient care. Several statistical techniques were investigated. Stepwise discriminant analysis was found to be a good method in discriminating among different disease classes. Results showed that classification strength of a few (3) variables was similar to all the available (19) variables. Other important issues in the work are treatment of missing values as well as atypical values in medical databases. In estimating missing values we utilized both statistical methods and artificial intelligence approaches. Both these approaches were promising in the estimation of missing values. The study showed that several statistical approaches are possible for knowledge extraction from clinical data collected retrospectively.
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Affiliation(s)
- S Chowdhury
- Department of Medical Informatics, Linköping University, Sweden
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Krusinska E, Babic A, Chowdhury S, Wigertz O, Bodemar G, Mathiesen U. Integrated approach for designing medical decision support systems with knowledge extracted from clinical databases by statistical methods. Proc Annu Symp Comput Appl Med Care 1991:353-7. [PMID: 1807621 PMCID: PMC2247553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In clinical research data is often studied by a particular method without previous analysis of quality or semantic contents which could link clinical database and data analytical (e.g. statistical) procedures. In order to avoid bias caused by this situation, we propose that the analysis of medical data should be divided into two main steps. In the first one we concentrate on conducting the quality, semantic and structure analyses. In the second step our aim is to build an appropriate dictionary of data analysis methods for further knowledge extraction. Methods like robust statistical techniques, procedures for mixed continuous and discrete data, fuzzy linguistic approach, machine learning and neural networks can be included. The results may be evaluated both using test samples and applying other relevant data-analytical techniques to the particular problem under the study.
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Affiliation(s)
- E Krusinska
- Institute of Computer Science, University of Wroclaw, Poland
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