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Lu A, Li KY, Su GN, Yang PZ. [Literature data mining on the current research status of uveitis in China]. Zhonghua Yan Ke Za Zhi 2024; 60:359-369. [PMID: 38583060 DOI: 10.3760/cma.j.cn112142-20230929-00121] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
Objective: To analyze the current research status of uveitis in China. Methods: It was a bibliometric analysis study. Using search formulas covering uveitis and its multiple subtypes, uveitis-related literature in English with publication dates from 2013 to 2022 was retrieved in Web of Science core databases through certain search strategies. This study used the latent Dirichlet allocation (LDA) algorithm to build topic models and analyzed the trends of research topics in recent years. Bibliometric analysis was used to analyze and visualize the bibliometric indicators (e.g., number of publications, citations, and H-index) of the included literature using tools such as VOSviewer software. Results: Over the past decade, China has published 1 657 papers on uveitis, ranking second globally. However, there is still room for improvement in terms of the H-index (58) and citation (12.28 per publication). Countries such as the USA (43.04%) and the United Kingdom (62.54%) were engaged in more international collaboration. We identified ten optimal LDA topics for uveitis literature in China such as immunotherapy, Behçet's disease, and Vogt-Koyanagi-Harada syndrome. Research on uveitis in China was mostly published in Ocular Immunology and Inflammation (92). Conclusions: China has made remarkable progress in uveitis research. Nonetheless, there is still untapped potential to enhance our global academic influence. It is encouraged to promote international collaborations, harness our expertise in areas like Behçet's disease and VKH syndrome, and publish our scientific achievements in high-impact journals.
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Affiliation(s)
- A Lu
- Department of Ophthalmology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - K Y Li
- Department of Ophthalmology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - G N Su
- Department of Ophthalmology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - P Z Yang
- Department of Ophthalmology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
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Long Z, Hesley GK, Lu A, Hangiandreou NJ, Gorny KR, Tiegs-Heiden CA. MRgFUS ablation of a recurrent tenosynovial giant cell tumor in the foot using ExAblate 2100 system in combination with patient immobilization device. Radiography (Lond) 2024; 30:840-842. [PMID: 38574580 DOI: 10.1016/j.radi.2024.03.010] [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: 12/20/2023] [Revised: 03/04/2024] [Accepted: 03/19/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION Magnetic Resonance-guided Focused Ultrasound (MRgFUS) treatment for certain anatomy locations can be extremely challenging due to patient positioning and potential motion. This present study describes the treatment of a recurrent tenosynovial giant cell tumor of the plantar forefoot using the ExAblate 2100 system in combination with patient immobilization device. METHODS Prior to the treatment, several patient immobilization devices were investigated. Vacuum cushions were selected and tested for safety and compatibility with the treatment task and the MR environment. RESULTS During the treatment, one vacuum cushion immobilized the patient's right leg in knee flexion and allowed the bottom of the foot to be securely positioned on the treatment window. Another vacuum cushion supported the patient upper body extended outside the scanner bore. 19 sonications were successfully executed. The treatment was judged to be successful. No immediate complications were observed. CONCLUSIONS MRgFUS treatment of a recurrent tenosynovial giant cell tumor of the right plantar forefoot was successful with the use of patient immobilization vacuum cushions. IMPLICATIONS FOR PRACTICE The immobilization system could be utilized to aid future MRgFUS treatment of lesions in challenging anatomic locations. Various sizes of the vacuum cushions are available to potentially better accommodate other body parts and treatment configurations.
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Affiliation(s)
- Z Long
- Department of Radiology, Mayo Clinic, MN, USA.
| | - G K Hesley
- Department of Radiology, Mayo Clinic, MN, USA
| | - A Lu
- Department of Radiology, Mayo Clinic, MN, USA
| | | | - K R Gorny
- Department of Radiology, Mayo Clinic, MN, USA
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Ledda V, George C, Glasbey J, Labib P, Li E, Lu A, Kudrna L, Nepogodiev D, Picciochi M, Williams I, Bhangu A. Uncertainties and opportunities in delivering environmentally sustainable surgery: the surgeons' view. Anaesthesia 2024; 79:293-300. [PMID: 38207004 DOI: 10.1111/anae.16195] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Accepted: 11/08/2023] [Indexed: 01/13/2024]
Abstract
Surgery is a carbon-heavy activity and creates a high volume of waste. Surgical teams around the world want to deliver more environmentally sustainable surgery but are unsure what to do and how to create change. There are many interventions available, but resources and time are limited. Capital investment into healthcare and engagement of senior management are challenging. However, frontline teams can change behaviours and drive wider change. Patients have a voice here too, as they would like to ensure their surgery does not harm their local community but are concerned about the effects on them when changes are made. Environmentally sustainable surgery is at the start of its journey. Surgeons need to rapidly upskill their generic knowledge base, identify which measures they can implement locally and take part in national research programmes. Surgical teams in the NHS have the chance to create a world-leading programme that can bring change to hospitals around the world. This article provides an overview of how surgeons see the surgical team being involved in environmentally sustainable surgery.
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Affiliation(s)
- V Ledda
- NIHR Programme Grant for Environmentally Sustainable Surgery, Institute of Applied Health Research, University of Birmingham, UK
| | - C George
- Department of Anaesthesia, Christian Medical College and Hospital, Ludhiana, India
| | - J Glasbey
- NIHR Programme Grant for Environmentally Sustainable Surgery, Institute of Applied Health Research, University of Birmingham, UK
| | - P Labib
- NIHR Programme Grant for Environmentally Sustainable Surgery, Institute of Applied Health Research, University of Birmingham, UK
| | - E Li
- NIHR Programme Grant for Environmentally Sustainable Surgery, Institute of Applied Health Research, University of Birmingham, UK
| | - A Lu
- Department of Anaesthesia, North West School of Anaesthesia, Manchester, UK
| | - L Kudrna
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - D Nepogodiev
- NIHR Programme Grant for Environmentally Sustainable Surgery, Institute of Applied Health Research, University of Birmingham, UK
| | - M Picciochi
- NIHR Programme Grant for Environmentally Sustainable Surgery, Institute of Applied Health Research, University of Birmingham, UK
| | - I Williams
- School of Social Policy, University of Birmingham, Birmingham, UK
| | - A Bhangu
- NIHR Programme Grant for Environmentally Sustainable Surgery, Institute of Applied Health Research, University of Birmingham, UK
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Tseng J, Su J, Chang K, Chang A, Chuang L, Lu A, Lee R, Lee E. Electrophoresis of a dielectric droplet with constant surface charge density. Electrophoresis 2023; 44:1810-1817. [PMID: 37439369 DOI: 10.1002/elps.202300077] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/15/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023]
Abstract
Electrophoresis of a dielectric fluid droplet with constant surface charge density is investigated theoretically in this study. A pseudo-spectral method based on Chebyshev polynomials is adopted to solve the governing electrokinetic equations. It is found, among other things, that the larger the electrolyte strength in the ambient solution is, the slower the droplet moves in general. This is due to the strong screening effect of the large amount of indifferent counterions in the neighborhood of the droplet, with no reinforcement of potential-determining ions adsorbing to the droplet surface. The droplet comes to a complete halt eventually. Critical points are discovered for highly charged droplets, at which the droplet surface becomes immobile and the interior fluid stops recirculating. The droplet moves like a rigid particle with constant mobility regardless of its viscosity, a situation referred to as the "solidification phenomenon." The deadlock between the spinning motions on the charged droplet surface induced by the electric driving force and the hydrodynamic driving force respectively is responsible for this peculiar phenomenon. This is also observed for a dielectric droplet with constant surface electric potential. We demonstrate here that it occurs in the constant surface charge density situation as well.
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Affiliation(s)
- Jessica Tseng
- Department of Chemical Engineering, National Taiwan University, Taipei, Taiwan
| | - Judy Su
- Department of Chemical Engineering, National Taiwan University, Taipei, Taiwan
| | - Kevin Chang
- Department of Chemical Engineering, National Taiwan University, Taipei, Taiwan
| | - Amy Chang
- Department of Chemical Engineering, National Taiwan University, Taipei, Taiwan
| | - Lily Chuang
- Department of Chemical Engineering, National Taiwan University, Taipei, Taiwan
| | - Amanda Lu
- Taipei First Girls' High School, Taipei, Taiwan
| | - Rose Lee
- Taipei First Girls' High School, Taipei, Taiwan
| | - Eric Lee
- Department of Chemical Engineering, National Taiwan University, Taipei, Taiwan
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Buhagiar R, Lu A, Liu S, Sahadevan S, Schulz LM, Ghosh J, Yeoh A. A pilot study to assess the impact of aboriginal and torres strait islander cultural humility webinars on australian medical school students. BMC Med Educ 2023; 23:626. [PMID: 37661272 PMCID: PMC10476379 DOI: 10.1186/s12909-023-04612-7] [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] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND The Aboriginal and Torres Strait Islander Health Curriculum Framework helps higher education providers to deliver safe and well-informed cultural humility education. However, there is currently a scarcity of evidence surrounding the efficacy and impact of cultural humility education. This study will use qualitative and quantitative research methods to evaluate learning outcomes from an Indigenous health educational webinar aimed at Australian medical students. METHODS A pilot study was conducted following a group of Australian medical students who attended an educational Indigenous health (IH) culturally responsive webinar. Recruitment was conducted via the webinar hosts' social media pages. Quantitative methods involved sending one pre- and two post-webinar questionnaires to attendees. To assess participants' retention of information, one post-webinar survey was sent out immediately after the webinar and another three months after the webinar. These questionnaires were designed to reflect pre-determined learning objectives for the webinar. Qualitative methods involved a focus group discussion to identify common themes from participant feedback. RESULTS Twenty-six participants were included in the final quantitative analysis. Most of the participants were clinical students between 18 and 24 years old who did not identify as Aboriginal and/or Torres Strait Islander. There was a significant increase (p = 0.007) between pre-intervention (M = 0.35, SD = 0.26) and post-webinar knowledge for the learning outcome exploring the links between health and education (M = 047, SD = 0.25). No results were obtained from the three months post-intervention questionnaire. The qualitative analysis synthesized feedback from three participants and identified presenter delivery style as an important mediator of webinar effectiveness. CONCLUSIONS There was a significant increase in knowledge and understanding for the learning outcome that explored the links between health and education. We attribute this partly to the engaging and conversational delivery style of the webinar presenters. The importance of Indigenous facilitators that encourage reflective teaching should not be understated. Our results suggest that cultural humility webinars can have a positive impact on medical students' understanding of the Aboriginal and/or Torres Strait Islander health landscape. This pilot study warrants further research on a larger population.
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Affiliation(s)
- R Buhagiar
- School of Medicine, Deakin University, 75 Pigdons Road, Waurn Ponds, VIC, 3216, Australia.
| | - A Lu
- School of Medicine, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - S Liu
- School of Medicine, Monash University, Wellington Road, Clayton, VIC, 3800, Australia
| | - S Sahadevan
- School of Medicine, University of Queensland, St Lucia, QLD, 4072, Australia
| | - L M Schulz
- School of Medicine, Western Sydney University, 255 Elizabeth Street, Sydney, NSW, 2000, Australia
| | - J Ghosh
- School of Medicine, Deakin University, 75 Pigdons Road, Waurn Ponds, 3216, VIC, Australia
| | - A Yeoh
- Institute of Evidence-Based Healthcare, Bond University, 14 University Drive, Robina, QLD, 4226, Australia
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Bayer JMM, Spark J, Krcmar M, Formica M, Gwyther K, Srivastava A, Selloni A, Cotter M, Hartmann J, Polari A, Bilgrami ZR, Sarac C, Lu A, Yung AR, McGowan A, McGorry P, Shah JL, Cecchi GA, Mizrahi R, Nelson B, Corcoran CM. The SPEAK study rationale and design: A linguistic corpus-based approach to understanding thought disorder. Schizophr Res 2023; 259:80-87. [PMID: 36732110 PMCID: PMC10387495 DOI: 10.1016/j.schres.2022.12.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/27/2022] [Accepted: 12/30/2022] [Indexed: 02/04/2023]
Abstract
AIM Psychotic symptoms are typically measured using clinical ratings, but more objective and sensitive metrics are needed. Hence, we will assess thought disorder using the Research Domain Criteria (RDoC) heuristic for language production, and its recommended paradigm of "linguistic corpus-based analyses of language output". Positive thought disorder (e.g., tangentiality and derailment) can be assessed using word-embedding approaches that assess semantic coherence, whereas negative thought disorder (e.g., concreteness, poverty of speech) can be assessed using part-of-speech (POS) tagging to assess syntactic complexity. We aim to establish convergent validity of automated linguistic metrics with clinical ratings, assess normative demographic variance, determine cognitive and functional correlates, and replicate their predictive power for psychosis transition among at-risk youths. METHODS This study will assess language production in 450 English-speaking individuals in Australia and Canada, who have recent onset psychosis, are at clinical high risk (CHR) for psychosis, or who are healthy volunteers, all well-characterized for cognition, function and symptoms. Speech will be elicited using open-ended interviews. Audio files will be transcribed and preprocessed for automated natural language processing (NLP) analyses of coherence and complexity. Data analyses include canonical correlation, multivariate linear regression with regularization, and machine-learning classification of group status and psychosis outcome. CONCLUSIONS This prospective study aims to characterize language disturbance across stages of psychosis using computational approaches, including psychometric properties, normative variance and clinical correlates, important for biomarker development. SPEAK will create a large archive of language data available to other investigators, a rich resource for the field.
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Affiliation(s)
- J M M Bayer
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
| | - J Spark
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - M Krcmar
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - M Formica
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - K Gwyther
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - A Srivastava
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Selloni
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Cotter
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Hartmann
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - A Polari
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | | | - C Sarac
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Lu
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison R Yung
- Orygen, Parkville, Victoria, Australia; Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Australia; School of Health Sciences, University of Manchester, United Kingdom
| | - A McGowan
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - P McGorry
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - J L Shah
- McGill Department of Psychiatry & Douglas Research Hospital, Montreal, Canada
| | - G A Cecchi
- IBM TJ Watson Research Center, Yorktown Heights, NY, USA
| | - R Mizrahi
- McGill Department of Psychiatry & Douglas Research Hospital, Montreal, Canada
| | - B Nelson
- Orygen, Parkville, Victoria, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - C M Corcoran
- Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters Veterans Administration, Bronx, NY, USA
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Oliver AA, Koons EK, Trester PS, Kleinow JE, Jonsgaard RS, Vercnocke AJ, Bilgin C, Kadirvel R, Leng S, Lu A, Dragomir-Daescu D, Kallmes DF. Medical Imaging Compatibility of Magnesium- and Iron-Based Bioresorbable Flow Diverters. AJNR Am J Neuroradiol 2023; 44:668-674. [PMID: 37169543 PMCID: PMC10249688 DOI: 10.3174/ajnr.a7873] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 04/16/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND AND PURPOSE Bioresorbable flow diverters are under development to mitigate complications associated with conventional flow-diverter technology. One proposed advantage is the ability to reduce metal-induced artifacts in follow-up medical imaging. In the current work, the medical imaging compatibility of magnesium- and iron-based bioresorbable flow diverters is assessed relative to an FDA-approved control in phantom models. MATERIALS AND METHODS Bioresorbable flow diverters, primarily composed of braided magnesium or antiferromagnetic iron alloy wires, were compared with an FDA-approved control flow diverter. The devices were assessed for MR imaging safety in terms of magnetically induced force and radiofrequency heating using 1.5T, 3T, and 7T field strength clinical scanners. The devices were deployed in phantom models, and metal-induced image artifacts were assessed in the 3 MR imaging scanners and a clinical CT scanner following clinical scan protocols; device visibility was assessed under fluoroscopy. RESULTS The magnesium-based bioresorbable flow diverter, iron-based bioresorbable flow diverter, and the control device all demonstrated MR imaging safety in terms of magnetically induced force and radiofrequency heating at all 3 field strengths. The bioresorbable flow diverters did not elicit excessive MR imaging artifacts at any field strength relative to the control. Furthermore, the bioresorbable flow diverters appeared to reduce blooming artifacts in CT relative to the control. The iron-based bioresorbable flow diverter and control device were visible under standard fluoroscopy. CONCLUSIONS We have demonstrated the baseline medical imaging compatibility of magnesium and antiferromagnetic iron alloy bioresorbable flow diverters. Future work will evaluate the medical imaging characteristics of the bioresorbable flow diverters in large-animal models.
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Affiliation(s)
- A A Oliver
- From the Department of Biomedical Engineering and Physiology (A.A.O., E.K.K., S.L., D.D.-D, D.F.K.), Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minnesota
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
- Physiology and Biomedical Engineering (A.A.O., D.D.-D.)
| | - E K Koons
- From the Department of Biomedical Engineering and Physiology (A.A.O., E.K.K., S.L., D.D.-D, D.F.K.), Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minnesota
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
| | - P S Trester
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
| | - J E Kleinow
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
| | - R S Jonsgaard
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
| | - A J Vercnocke
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
| | - C Bilgin
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
| | - R Kadirvel
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
- Neurosurgery (R.K.), Mayo Clinic, Rochester, Minnesota
| | - S Leng
- From the Department of Biomedical Engineering and Physiology (A.A.O., E.K.K., S.L., D.D.-D, D.F.K.), Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minnesota
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
| | - A Lu
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
| | - D Dragomir-Daescu
- From the Department of Biomedical Engineering and Physiology (A.A.O., E.K.K., S.L., D.D.-D, D.F.K.), Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minnesota
- Physiology and Biomedical Engineering (A.A.O., D.D.-D.)
| | - D F Kallmes
- From the Department of Biomedical Engineering and Physiology (A.A.O., E.K.K., S.L., D.D.-D, D.F.K.), Mayo Clinic Graduate School of Biomedical Sciences, Rochester, Minnesota
- Departments of Radiology (A.A.O., E.K.K., P.S.T., J.E.K., R.S.J., A.J.V., C.B., R.K. S.L., A.L., D.F.K.)
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Zhang M, Lu A, Wang H, Yang J. Quercetin downregulates the expression of IL15 in cancer cells through DNA methylation. Eur Rev Med Pharmacol Sci 2023; 27:2580-2590. [PMID: 37013776 DOI: 10.26355/eurrev_202303_31795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect of quercetin on cellular immunity (via IL15 expression) against cancer and to elucidate its regulatory mechanism. MATERIALS AND METHODS HeLa cells and A549 cells were cultured in vitro and were divided into control (DMSO treated) and experimental groups (treated with different concentrations of quercetin). Transcript levels of IL15 and DNA methyltransferase (DNMTS) were measured using quantitative reverse transcription polymerase chain reaction (qRT-PCR). Genomic DNA was extracted, treated with bisulfite, and the promoter region of IL15 was cloned. Finally, Sanger sequencing was used to detect the degree of promoter methylation. RESULTS Following quercetin treatment, the expression of IL15 was significantly downregulated in HeLa and A549 cells. The methylation level of IL15 promoter in HeLa cells was about twice that of the control group, and the methylation level of IL15 promoter in A549 cells was about three times that of the control group. CONCLUSIONS Quercetin inhibits cancer cell proliferation while downregulating IL15 expression, and this regulation is achieved by increasing the methylation of the IL15 promoter.
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Affiliation(s)
- M Zhang
- Shanghai Key Laboratory of Plant Functional Genomics and Resources, Shanghai Chenshan Botanical Garden, Shanghai, China.
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Mushtaq A, Woodrum D, Thompson S, Adamo D, Lomas D, Favazza C, Lu A, Kwon E. Abstract No. 91 MRI-Guided Cryoablation of Oligo-Metastatic Prostate Cancer to the Pelvic Lymph Nodes. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.138] [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: 02/27/2023] Open
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Huang H, Siewerdsen JH, Lu A, Hu Y, Zbijewski W, Unberath M, Weiss CR, Sisniega A. Multi-Stage Adaptive Spline Autofocus (MASA) with a Learned Metric for Deformable Motion Compensation in Interventional Cone-Beam CT. Proc SPIE Int Soc Opt Eng 2023; 12463:1246314. [PMID: 37937146 PMCID: PMC10629227 DOI: 10.1117/12.2654361] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Purpose Cone-beam CT (CBCT) is widespread in abdominal interventional imaging, but its long acquisition time makes it susceptible to patient motion. Image-based autofocus has shown success in CBCT deformable motion compensation, via deep autofocus metrics and multi-region optimization, but it is challenged by the large parameter dimensionality required to capture intricate motion trajectories. This work leverages the differentiable nature of deep autofocus metrics to build a novel optimization strategy, Multi-Stage Adaptive Spine Autofocus (MASA), for compensation of complex deformable motion in abdominal CBCT. Methods MASA poses the autofocus problem as a multi-stage adaptive sampling strategy of the motion trajectory, sampled with Hermite spline basis with variable amplitude and knot temporal positioning. The adaptive method permits simultaneous optimization of the sampling phase, local temporal sampling density, and time-dependent amplitude of the motion trajectory. The optimization is performed in a multi-stage schedule with increasing number of knots that progressively accommodates complex trajectories in late stages, preconditioned by coarser components from early stages, and with minimal increase in dimensionality. MASA was evaluated in controlled simulation experiments with two types of motion trajectories: i) combinations of slow drifts with sudden jerk (sigmoid) motion; and ii) combinations of periodic motion sources of varying frequency into multi-frequency trajectories. Further validation was obtained in clinical data from liver CBCT featuring motion of contrast-enhanced vessels, and soft-tissue structures. Results The adaptive sampling strategy provided successful motion compensation in sigmoid trajectories, compared to fixed sampling strategies (mean SSIM increase of 0.026 compared to 0.011). Inspection of the estimated motion showed the capability of MASA to automatically allocate larger sampling density to parts of the scan timeline featuring sudden motion, effectively accommodating complex motion without increasing the problem dimension. Experiments on multi-frequency trajectories with 3-stage MASA (5, 10, and 15 knots) yielded a twofold SSIM increase compared to single-stage autofocus with 15 knots (0.076 vs 0.040, respectively). Application of MASA to clinical datasets resulted in simultaneous improvement on the delineation of both contrast-enhanced vessels and soft-tissue structures in the liver. Conclusion A new autofocus framework, MASA, was developed including a novel multi-stage technique for adaptive temporal sampling of the motion trajectory in combination with fully differentiable deep autofocus metrics. This novel adaptive sampling approach is a crucial step for application of deformable motion compensation to complex temporal motion trajectories.
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Affiliation(s)
- H Huang
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA
| | - J H Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA
- Russell H. Morgan Department of Radiology, Johns Hopkins University, Baltimore, MD USA
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston TX USA
| | - A Lu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA
| | - Y Hu
- Department of Computer Science, Johns Hopkins University, Baltimore, MD USA
| | - W Zbijewski
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA
| | - M Unberath
- Department of Computer Science, Johns Hopkins University, Baltimore, MD USA
| | - C R Weiss
- Russell H. Morgan Department of Radiology, Johns Hopkins University, Baltimore, MD USA
| | - A Sisniega
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA
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11
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Vijayan R, Sheth N, Mekki L, Lu A, Uneri A, Sisniega A, Magaraggia J, Kleinszig G, Vogt S, Thiboutot J, Lee H, Yarmus L, Siewerdsen JH. 3D-2D image registration in the presence of soft-tissue deformation in image-guided transbronchial interventions. Phys Med Biol 2022; 68. [PMID: 36317269 DOI: 10.1088/1361-6560/ac9e3c] [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: 05/31/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
Purpose. Target localization in pulmonary interventions (e.g. transbronchial biopsy of a lung nodule) is challenged by deformable motion and may benefit from fluoroscopic overlay of the target to provide accurate guidance. We present and evaluate a 3D-2D image registration method for fluoroscopic overlay in the presence of tissue deformation using a multi-resolution/multi-scale (MRMS) framework with an objective function that drives registration primarily by soft-tissue image gradients.Methods. The MRMS method registers 3D cone-beam CT to 2D fluoroscopy without gating of respiratory phase by coarse-to-fine resampling and global-to-local rescaling about target regions-of-interest. A variation of the gradient orientation (GO) similarity metric (denotedGO') was developed to downweight bone gradients and drive registration via soft-tissue gradients. Performance was evaluated in terms of projection distance error at isocenter (PDEiso). Phantom studies determined nominal algorithm parameters and capture range. Preclinical studies used a freshly deceased, ventilated porcine specimen to evaluate performance in the presence of real tissue deformation and a broad range of 3D-2D image mismatch.Results. Nominal algorithm parameters were identified that provided robust performance over a broad range of motion (0-20 mm), including an adaptive parameter selection technique to accommodate unknown mismatch in respiratory phase. TheGO'metric yielded median PDEiso= 1.2 mm, compared to 6.2 mm for conventionalGO.Preclinical studies with real lung deformation demonstrated median PDEiso= 1.3 mm with MRMS +GO'registration, compared to 2.2 mm with a conventional transform. Runtime was 26 s and can be reduced to 2.5 s given a prior registration within ∼5 mm as initialization.Conclusions. MRMS registration via soft-tissue gradients achieved accurate fluoroscopic overlay in the presence of deformable lung motion. By driving registration via soft-tissue image gradients, the method avoided false local minima presented by bones and was robust to a wide range of motion magnitude.
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Affiliation(s)
- R Vijayan
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - N Sheth
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - L Mekki
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - A Lu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - A Uneri
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - A Sisniega
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | | | | | - S Vogt
- Siemens Healthineers, Erlangen, Germany
| | - J Thiboutot
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institution, Baltimore, MD, United States of America
| | - H Lee
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institution, Baltimore, MD, United States of America
| | - L Yarmus
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institution, Baltimore, MD, United States of America
| | - J H Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America.,Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
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12
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Chowdhury D, Yip HF, Lam K, Zhu H, Tai XC, Lu A. Dynamic expression of Ddc mediates the melatonin biosynthesis rhythms in the mouse: a virtual knockout approach. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.139] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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13
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Garcia L, Jaradeh K, Ornelas-Dorian C, Lu A, Stark N, Peabody C. 262 Developing Novel Tools for Clinicians to Discuss Immigration for Resource Referral in the Emergency Department. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.289] [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: 11/28/2022]
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14
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Nelson J, Lu A, Maestre J, Palmer E, Jarma D, Kinney K, Grubesic T, Kirisits M. Space-time analysis of COVID-19 cases and SARS-CoV-2 wastewater loading: A geodemographic perspective. Spat Spatiotemporal Epidemiol 2022; 42:100521. [PMID: 35934330 PMCID: PMC9142176 DOI: 10.1016/j.sste.2022.100521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/05/2022]
Abstract
Severe acute respiratory syndrome - coronavirus 2 (SARS-CoV-2) continues to effect communities across the world. One way to combat these effects is to enhance our collective ability to remotely monitor community spread. Monitoring SARS-CoV-2 in wastewater is one approach that enables researchers to estimate the total number of infected people in a region; however, estimates are often made at the sewershed level which may mask the geographic nuance required for targeted interdiction efforts. In this work, we utilize an apportioning method to compare the spatial and temporal trends of daily case count with the temporal pattern of viral load in the wastewater at smaller units of analysis within Austin, TX. We find different lag-times between wastewater loading and case reports. Daily case reports for some locations follow the temporal trend of viral load more closely than others. These findings are then compared to socio-demographic characteristics across the study area.
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15
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Sisniega A, Lu A, Huang H, Zbijewski W, Unberath M, Siewerdsen JH, Weiss CR. Targeted Deformable Motion Compensation for Vascular Interventional Cone-Beam CT Imaging. Proc SPIE Int Soc Opt Eng 2022; 12031:120311H. [PMID: 36381563 PMCID: PMC9654751 DOI: 10.1117/12.2613232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Purpose Cone-beam CT has become commonplace for 3D guidance in interventional radiology (IR), especially for vascular procedures in which identification of small vascular structures is crucial. However, its long image acquisition time poses a limit to image quality due to soft-tissue deformable motion that hampers visibility of small vessels. Autofocus motion compensation has shown promising potential for soft-tissue deformable motion compensation, but it lacks specific target to the imaging task. This work presents an approach for deformable motion compensation targeted at imaging of vascular structures. Methods The proposed method consists on a two-stage framework for: i) identification of contrast-enhanced blood vessels in 2D projection data and delineation of an approximate region covering the vascular target in the volume space, and, ii) a novel autofocus approach including a metric designed to promote the presence of vascular structures acting solely in the region of interest. The vesselness of the image is quantified via evaluation of the properties of the 3D image Hessian, yielding a vesselness filter that gives larger values to voxels candidate to be part of a tubular structure. A cost metric is designed to promote large vesselness values and spatial sparsity, as expected in regions of fine vascularity. A targeted autofocus method was designed by combining the presented metric with a conventional autofocus term acting outside of the region of interest. The resulting method was evaluated on simulated data including synthetic vascularity merged with real anatomical features obtained from MDCT data. Further evaluation was obtained in two clinical datasets obtained during TACE procedures with a robotic C-arm (Artis Zeego, Siemens Healthineers). Results The targeted vascular autofocus effectively restored the shape and contrast of the contrast-enhanced vascularity in the simulation cases, resulting in improved visibility and reduced artifacts. Segmentations performed with a single threshold value on the target vascular regions yielded a net increase of up to 42% in DICE coefficient computed against the static reference. Motion compensation in clinical datasets resulted in improved visibility of vascular structures, observed in maximum intensity projections of the contrast-enhanced liver vessel tree. Conclusion Targeted motion compensation for vascular imaging showed promising performance for increased identification of small vascular structures in presence of motion. The development of autofocus metrics and methods tailored to vascular imaging opens the way for reliable compensation of deformable motion while preserving the integrity of anatomical structures in the image.
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Affiliation(s)
- A Sisniega
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA
| | - A Lu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA
| | - H Huang
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA
| | - W Zbijewski
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA
| | - M Unberath
- Department of Computer Science, Johns Hopkins University, Baltimore, MD USA
| | - J H Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD USA
- Russell H. Morgan Department of Radiology, Johns Hopkins University, Baltimore, MD USA
| | - C R Weiss
- Russell H. Morgan Department of Radiology, Johns Hopkins University, Baltimore, MD USA
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16
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Li HG, Zhao LH, Lu A, Liu JB, Su ZJ, Wang XB, Gao YJ. [The mechanism of circ_0023990/miR-873-5p/ANXA2 axis regulating radiosensitivity and development of thyroid carcinoma]. Zhonghua Yi Xue Za Zhi 2021; 101:3329-3337. [PMID: 34758534 DOI: 10.3760/cma.j.cn112137-20210207-00379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the effect and possible mechanism of circ_0023990 on the radiosensitivity of thyroid cancer cells. Methods: qRT-PCR was used to detect the expression of circ_0023990 in the cancer tissues of 55 patients with thyroid cancer and thyroid cancer cell lines (TPC-1, KTC-1, FTC-133 and CAL-62), and the relationship between the expression of circ_0023990 in cancer tissues and the clinical characteristics of the patients were analyzed. Thyroid cancer cells TPC-1 and KTC-1 were divided into sh-circ_0023990 group, sh-NC group, sh-circ_0023990+anti-miR-873-5p group, sh-circ_0023990+anti-miR-NC group, miR-873-5p group, miR-NC group, miR-873-5p+pcDNA-ANXA2 group and miR-873-5p+pcDNA group, and then clone formation experiment was used to detect cell radiosensitivity. After each group of cells was irradiated with 4Gy radiation, the expression of γH2AX protein in the cells was detected by Western Blot. The dual luciferase reporter gene experiment verified the targeting relationship between circ_0023990 and miR-873-5p or miR-873-5p and ANXA2. Results: The expression of circ_0023990 in thyroid cancer tissues was higher than that in normal tissues (2.15±0.09 vs. 0.97±0.05, P<0.05), and its expression was closely related to tumor size, lymph node metastasis and TNM staging of patients with thyroid cancer (P<0.05). The expression of circ_0023990 in thyroid cancer cell lines (TPC-1, KTC-1, FTC-133 and CAL-62) were higher than that of normal thyroid cells HTori-3 (3.16±0.38, 2.63±0.28, 1.82±0.24, 1.71±0.22 vs. 1.00±0.10, all P<0.05). The survival scores of TPC-1 and KTC-1 cells in the sh-circ_0023990 group were significantly lower than those in the sh-NC group (P<0.05), and the sensitization ratios were 2.482, 1.643; The survival scores of TPC-1 and KTC-1 cells in the sh-circ_0023990+anti-miR-873-5p group were higher than those in the sh-circ_0023990+anti-miR-NC group (P<0.05), and the sensitization ratios were 0.305, 0.441, respectively. The survival scores of TPC-1 and KTC-1 cells in the miR-873-5p group were lower than those in the miR-NC group (P<0.05), and the sensitization ratios were 2.044, 1.653 respectively. The survival scores of TPC-1 and KTC-1 cells in the miR-873-5p+pcDNA-ANXA2 group was higher than that in the miR-873-5p+pcDNA group (P<0.05), and the sensitization ratios were 0.496, 0.686, respectively. The expression of γH2AX protein in TPC-1 and KTC-1 cells of the 4 Gy+sh-circ_0023990 group were higher than that in the 4 Gy+sh-NC group (2.68±0.27 vs. 1.87±0.25, 2.46±0.19 vs. 1.77±0.14; all P<0.05), but the expression of γH2AX protein in TPC-1 and KTC-1 cells of the 4 Gy+sh-circ_0023990+anti-miR-873-5p group were lower than that in the 4 Gy+sh-circ_0023990+anti-miR-NC group (1.13±0.09 vs. 1.69±0.09, 1.11±0.08 vs. 1.60±0.08; both P<0.05). The expression of γH2AX protein in TPC-1 and KTC-1 cells in the 4 Gy+miR-873-5p group were higher than that in the 4 Gy+miR-NC group (2.35±0.16 vs. 1.84±0.14, 2.26±0.12 vs. 1.77±0.13; both P<0.05), but the expression of γH2AX protein in TPC-1 and KTC-1 cells of the 4 Gy+miR-873-5p+pcDNA-ANXA2 group were lower than that in the 4 Gy+miR-873-5p+pcDNA group (1.96±0.12 vs. 2.41±0.12, 1.92±0.07 vs. 2.28±0.12; both P<0.05). circ_0023990 targeted the negative regulation of miR-873-5p, and ANXA2 was the target gene of miR-873-5p. Conclusion: circ_0023990 was highly expressed in thyroid cancer tissues and cell lines, and it may promote the radiotherapy resistance of thyroid cancer cells in vivo through regulating miR-873-5p/ANXA2 axis.
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Affiliation(s)
- H G Li
- Department of Thyroid Surgery,Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - L H Zhao
- Department of Disinfection Supply Center,Fuwai Central China Cardiovascular Hospital, Zhengzhou, 450003, China
| | - A Lu
- Department of Thyroid Surgery,Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - J B Liu
- Department of Radiotherapy,Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Z J Su
- Department of Thyroid Surgery,Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - X B Wang
- Department of Nuclear Medicine,Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Y J Gao
- Department of Nuclear Medicine,Henan Provincial People's Hospital, Zhengzhou, 450003, China
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17
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Zakharevich M, Kippenhan M, Lu A, Mark Courtney D, McCarthy D, Kim H. 238 Antibiotic and Opioid Antitussive Prescribing Among Urgent Care and Emergency Department Visits for Respiratory Diagnoses. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.250] [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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18
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Grade M, Stark N, Emanuels D, Lu A, Leung S, Peabody C. 13 Impact of an Electronic Decision Tool for Social Resources upon Discharge. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.021] [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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Lu A, Gunzburger E, Glorioso T, Smith W, Whooley M, Ho M. Impact of Longitudinal Virtual Primary Care on Diabetes Quality of Care. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13443] [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] Open
Affiliation(s)
- A. Lu
- San Francisco Veterans Affairs Health Care System San Francisco CA United States
- University of California San Francisco San Francisco CA United States
| | - E. Gunzburger
- VA Eastern Colorado Health Care System Aurora CO United States
| | - T. Glorioso
- Denver‐Seattle Center of Innovation (COIN) Denver CO United States
| | - W. Smith
- San Francisco Veterans Affairs Health Care System San Francisco CA United States
- University of California San Francisco San Francisco CA United States
| | - M. Whooley
- San Francisco Veterans Affairs Health Care System San Francisco CA United States
- University of California San Francisco San Francisco CA United States
| | - M. Ho
- University of Colorado Hospital Denver CO United States
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20
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Abstract
Zero TE MR imaging is a novel technique that achieves a near-zero time interval between radiofrequency excitation and data acquisition, enabling visualization of short-T2 materials such as cortical bone. Zero TE offers a promising radiation-free alternative to CT with rapid, high-resolution, silent, and artifact-resistant imaging, as well as the potential for "pseudoCT" reconstructions. In this report, we will discuss our preliminary experience with zero TE, including technical principles and a clinical case series demonstrating emerging applications in neuroradiology.
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Affiliation(s)
- A Lu
- Department of Medical Physics (A.L., K.R.G.), Mayo Clinic, Rochester, Minnesota
| | - K R Gorny
- Department of Medical Physics (A.L., K.R.G.), Mayo Clinic, Rochester, Minnesota
| | - M-L Ho
- From the Department of Radiology, Nationwide Children's Hospital (M.-L.H.), The Ohio State University College of Medicine, Columbus, Ohio
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21
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Chowdhury D, Wang C, Lu A, Zhu H. Quantitatively decoding the circadian transcriptional regulations: an advanced approach in sleep medicine. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.205] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Liang W, Lu A, Chu C, Wang J, Davis D, Liang W. REGULATION OF VOLTAGE-GATED SODIUM CURRENT BY WNT SIGNALLING IN HEALTHY AND BRUGADA SYNDROME HUMAN CARDIOMYOCYTES. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.303] [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] Open
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23
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Wu Z, Zhong M, Li M, Huang H, Liao J, Lu A, Guo K, Ma N, Lin J, Duan J, Liu L, Xu F, Zhong Z, Chen J. Mutation Analysis of Pre-mRNA Splicing Genes PRPF31, PRPF8, and SNRNP200 in Chinese Families with Autosomal Dominant Retinitis Pigmentosa. Curr Mol Med 2019; 18:287-294. [PMID: 30360737 DOI: 10.2174/1566524018666181024160452] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 08/04/2018] [Revised: 09/28/2018] [Accepted: 09/28/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND To screen variants in pre-mRNA Splicing genes in 95 Chinese autosomal dominant retinitis pigmentosa (adRP) families. METHODS Clinical examination and pedigree analysis were performed. Targeted exome sequencing (TES) and / or Sanger sequencing were performed to detect the variants in genes of Splicing factors and conduct intra-familiar segregation analysis with DNA available. In silico analysis was performed to predict pathogenicity of variants in protein level and in vitro splicing assays were performed to compare splicing variants with their corresponding wildtype about their splicing effect. RESULTS In this study, total nine different variants were identified in PRPF31, SNRNP200, and PRPF8 respectively, including six PRPF31 variants [five novel variants 322+1G>A, c.527+2T>G, c.590T>C(p.Leu197Pro), c.1035_1036insGC (p.Pro346Argfs X18), and c.1224dupG (p.Gln409AlafsX66) plus one reported variant c.1060C>T (p.Arg354X)], a recurrent PRPF8 variant c.6930G>T (p.Arg2310Ser), two SNRNP200 variants [one heterozygous and homozygous SNRNP200 recurrent variant c.3260G>A (p.Ser1087Leu), and a reported heterozygous c.2042G>A(p.Arg681His)]. In family 20009, incomplete penetrance was observed. A novel PRPF31 missense variant c.590T>C (p.Leu197Pro) was predicted to be pathogenic in protein level via in silico analysis and in vitro splicing assay demonstrated that two novel splicing PRPF31 variants c.322+1G>A and c.527+2T>G affect splicing compared with the wildtype. CONCLUSIONS In our studies, RP-causing variants of pre-mRNA Splicing genes (PRPF31, PRPF8 and SNRNP200) were identified in nine of the ninety-five adRP families respectively, which extend the spectra of RP variant and phenotype. And we provide the first example that SNRNP200-related RP can be caused by both heterozygous and homozygous variants of this gene.
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Affiliation(s)
- Z Wu
- Department of Ophthalmology of Shanghai Tenth People's Hospital, and Tongji Eye Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Genetics, Tongji University School of Medicine, Shanghai, China
| | - M Zhong
- Department of Ophthalmology of Pingxiang People's Hospital, Pingxiang, Jiangxi, China
| | - M Li
- Department of Ophthalmology of The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - H Huang
- Department of Ophthalmology of The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - J Liao
- Department of Ophthalmology of Shanghai Tenth People's Hospital, and Tongji Eye Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Genetics, Tongji University School of Medicine, Shanghai, China
| | - A Lu
- Department of Bioinformatics, School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - K Guo
- Department of Ophthalmology of Shanghai Tenth People's Hospital, and Tongji Eye Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Genetics, Tongji University School of Medicine, Shanghai, China
| | - N Ma
- Department of Ophthalmology of Shanghai Tenth People's Hospital, and Tongji Eye Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Genetics, Tongji University School of Medicine, Shanghai, China
| | - J Lin
- Department of Ophthalmology of Shanghai Tenth People's Hospital, and Tongji Eye Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Genetics, Tongji University School of Medicine, Shanghai, China
| | - J Duan
- Maternity and Child Health Care Hospital, Jiujiang, Jiangxi Province, China
| | - L Liu
- Department of Ophthalmology of The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - F Xu
- Department of Ophthalmology of The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Z Zhong
- Department of Ophthalmology of Shanghai Tenth People's Hospital, and Tongji Eye Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Genetics, Tongji University School of Medicine, Shanghai, China
| | - J Chen
- Department of Ophthalmology of Shanghai Tenth People's Hospital, and Tongji Eye Institute, Tongji University School of Medicine, Shanghai, China.,Department of Medical Genetics, Tongji University School of Medicine, Shanghai, China
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24
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VASQUEZ C, Lu A. MON-285 BROWN TUMOR IN A DIALYSIS PATIENT WHO RESPONDED TO PARATHYROIDECTOMY: A CASE REPORT. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.1091] [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: 10/26/2022] Open
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25
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Lu J, Zhao J, Jia C, Zhou L, Cai Y, Ni J, Ma J, Zheng M, Lu A. FPR2 enhances colorectal cancer progression by promoting EMT process. Neoplasma 2019; 66:785-791. [PMID: 31288528 DOI: 10.4149/neo_2018_181123n890] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 05/02/2019] [Indexed: 11/08/2022]
Abstract
Formyl peptide receptor-2 (FPR2) has been shown to promote various tumors, but its role in colorectal cancer (CRC) has not been clearly illuminated. The aim of this study was to investigate the effect of FPR2 interference on cell proliferation, migration, invasion, apoptosis, pro-angiogenesis of CRC cells, and also the mechanisms involved. Quantitative PCR assays were applied to assess the expression levels of FPR2 in CRC tissues. CRC cell line SW1116 was chosen to perform this study. We knocked down FPR2 gene by sh-RNA. Then, the cell proliferation was assayed by soft agar colony formation assay, the cell migration capacity was checked by wound healing assay, and cell invasion ability was detected by transwell assay. In addition, flow cytometric analysis was used to detect apoptosis, while endothelial tube formation assay was used to evaluate the effects of FPR2 on pro-angiogenesis in vitro. Tumorigenesis experiment in vivo was performed in nude mice. EMT-related proteins were studied by western blotting. Quantitative PCR demonstrated that FPR2 mRNA was highly expressed in the colorectal cancer tissues. SW1116 cells' capacities of proliferation, migration, invasion, anti-apoptosis and pro-angiogenesis were distinctly suppressed after silencing FPR2 in SW1116 by sh-RNA. Suppression FPR2 mRNA in SW1116 cells suppressed tumorigenicity in nude mice. The expression of proteins related to epithelial-mesenchymal transition (EMT) such as E-cadherin, N-cadherin, Snail, Slug and vimentin was changed after suppressing FPR2. In conclusion, our study demonstrated that FPR2 could promote CRC cells progression in vitro and in vivo that may relate to promoting EMT.
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Affiliation(s)
- J Lu
- Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - J Zhao
- Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - C Jia
- Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - L Zhou
- Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Y Cai
- Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - J Ni
- Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - J Ma
- Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - M Zheng
- Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - A Lu
- Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Inwards-Breland DJ, DiVall S, Salehi P, Crouch JM, Negaard M, Lu A, Kantor A, Albertson K, Ahrens KR. Youth and Parent Experiences in a Multidisciplinary Gender Clinic. Transgend Health 2019; 4:100-106. [PMID: 30949585 PMCID: PMC6447995 DOI: 10.1089/trgh.2018.0046] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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] [Indexed: 11/13/2022] Open
Abstract
Purpose: To assess youth and parent/caregiver satisfaction with care at a pediatric multidisciplinary gender clinic. Methods: Transgender/gender nonconforming youth (n=33) and their parent/caregiver (n=29) completed self-report questionnaires and individual interviews (n=20) about experiences and satisfaction with care. Results: Quantitatively, participants reported being extremely satisfied with care experiences (parents 97%; youth 94%). Qualitatively, main themes included (1) affirmation due to use of preferred name/pronouns, (2) access barriers due to scheduling and readiness assessments, and (3) positive interactions with Care Navigator. Conclusion: Youth and parents/caregivers are highly satisfied with multidisciplinary, coordinated health care for transgender/gender nonconforming youth; however, some challenges remain.
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Affiliation(s)
- David J Inwards-Breland
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington.,Division of Adolescent Medicine, Seattle Children's Hospital, Seattle, Washington.,Division of Endocrinology, Seattle Children's Hospital, Seattle, Washington.,Department of Pediatrics and Adolescent Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Sara DiVall
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington.,Division of Endocrinology, Seattle Children's Hospital, Seattle, Washington.,Department of Pediatrics and Adolescent Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Parisa Salehi
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington.,Division of Endocrinology, Seattle Children's Hospital, Seattle, Washington.,Department of Pediatrics and Adolescent Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Julia M Crouch
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Morgan Negaard
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Amanda Lu
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Alena Kantor
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Katie Albertson
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Kym R Ahrens
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington.,Division of Adolescent Medicine, Seattle Children's Hospital, Seattle, Washington.,Department of Pediatrics and Adolescent Medicine, School of Medicine, University of Washington, Seattle, Washington
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Salehi P, Herzig L, Capone G, Lu A, Oron AP, Kim SJ. Comparison of Aberrant Behavior Checklist profiles across Prader-Willi syndrome, Down syndrome, and autism spectrum disorder. Am J Med Genet A 2018; 176:2751-2759. [DOI: 10.1002/ajmg.a.40665] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 03/12/2018] [Accepted: 09/04/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Parisa Salehi
- Seattle Children's Hospital, Division of Endocrine; University of Washington; Seattle Washington
| | - Lisa Herzig
- Seattle Children's Hospital, Division of Developmental Medicine; University of Washington; Seattle Washington
| | - George Capone
- Kennedy Krieger Institute, Johns Hopkins University School of Medicine; Baltimore Maryland
| | - Amanda Lu
- Seattle Children's Hospital; University of Washington; Seattle Washington
| | - Assaf P. Oron
- Epidemiology Section; Institute for Disease Modeling; Bellevue Washington
| | - Soo-Jeong Kim
- Seattle Children's Hospital, Division of Psychiatry; University of Washington; Seattle Washington
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Levine M, Lu A, Quach A, Chen B, Baccarelli A, Whitsel E, Ferrucci L, Horvath S. AN EPIGENETIC CLOCK FOR AGING AND LIFE EXPECTANCY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.231] [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: 11/14/2022] Open
Affiliation(s)
- M Levine
- Yale School of Medicine, New Haven, Connecticut, United States
| | - A Lu
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - A Quach
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - B Chen
- LIFE Epigenetics, Los Angeles, CA, USA
| | - A Baccarelli
- Laboratory of Environmental Epigenetics, Departments of Environmental Health Sciences Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - E Whitsel
- Dept. of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - L Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, USA. Baltimore, MD, USA
| | - S Horvath
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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29
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Lu A, Adamo M, Warren O. 271EMF Understanding High Utilization of the Emergency Department: An Interview Study. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.276] [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: 11/16/2022]
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Tan L, Jiang W, Lu A, Cai H, Kong L. miR-155 Aggravates Liver Ischemia/reperfusion Injury by Suppressing SOCS1 in Mice. Transplant Proc 2018; 50:3831-3839. [PMID: 30577275 DOI: 10.1016/j.transproceed.2018.08.060] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 05/20/2018] [Accepted: 08/16/2018] [Indexed: 01/23/2023]
Abstract
Liver ischemia/reperfusion injury (IRI) occurs during partial liver resection and liver transplantation. Activation of Toll-like receptors (TLRs) is a key event triggered by a range of proinflammatory cytokines during liver I/R. Although it has been reported that miR-155 takes part in both innate and adaptive immune responses, the potential role of miR-155 in liver IRI remains unknown. In this study, we found that expression of miR-155 was upregulated during liver I/R by many inflammatory cytokines, and forced expression of miR-155 aggravated hepatocyte injury following liver I/R both in vivo and in vitro. Mice transfected with Ago-miR-155-a chemically modified miR-155-showed enhanced liver severity compared to those transfected with negative control miRNA by inhibiting the expression of SOCS1, the target of miR-155. Thus by the inhibition of SOCS1, the overexpression of miR-155 promoted activation of NF-κB, and elevating the production of proinflammatory cytokines, such TNF-α and IL-6. In conclusion, miR-155 aggravates liver I/R injury in vivo and hepatocyte hypoxia/reoxygenation injury by suppressing the expression of SOCS1.
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Affiliation(s)
- L Tan
- Surgical Intensive Care Unit, The First Affiliated Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - W Jiang
- Department of Neonatal Surgery, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - A Lu
- Surgical Intensive Care Unit, The First Affiliated Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - H Cai
- Surgical Intensive Care Unit, The First Affiliated Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - L Kong
- Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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31
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Hsiang W, Ghabili K, Lu A, Syed J, Nguyen K, Suarez-Sarmiento A, Leapman M, Sprenkle P. MP17-12 UTILITY OF SERIAL MRI/ULTRASOUND FUSION TARGETED BIOPSY IN MEN WITH LOW RISK PROSTATE CANCER MANAGED WITH ACTIVE SURVEILLANCE. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.567] [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: 11/17/2022]
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Lu A, Amirkhiz KG, Nguyen K, Leapman M, Sprenkle P. MP77-07 HOW MANY CORES ARE NEEDED TO DETECT CLINICALLY SIGNIFICANT PROSTATE CANCER ON TARGETED MRI-ULTRASOUND FUSION BIOPSY? J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2595] [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: 11/30/2022]
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Lu A, Amirkhiz KG, Nguyen K, Hsiang W, Leapman M. MP34-07 DISPARITIES IN THE DIAGNOSIS AND MANAGEMENT OF METASTATIC PROSTATE CANCER IN YOUNG MEN. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1099] [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: 10/17/2022]
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Lu A, Ghabili K, Nguyen K, Leapman M, Sprenkle P. How many cores are needed to detect clinically significant prostate cancer on targeted MRI-ultrasound fusion biopsy? J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.134] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
134 Background: The optimal number of MRI-US fusion biopsy cores to adequately sample regions of interest (ROI) remains unknown. To better understand the optimal approach to lesion targeting, we aimed to examine the cancer detection rate based on sequential number of cores obtained. Methods: Of 744 patients undergoing MRI-US fusion biopsy between 2012 and 2016 at our institution, we identified 628 men with targets on multi-parametric MRI (mpMRI) who underwent targeted and systematic fusion biopsy using the Artemis platform for clinical suspicion (n=465) or known history of PCa (n=163). mpMRI studies were reviewed by genitourinary radiologists using a 3-tiered Likert scale and PI-RADS classification schema. Biopsy was performed by two urologists performing a high volume of fusion biopsies (PS and RD). Cores were taken sequentially from each ROI with an even distribution. The primary outcome was the proportion of high-grade (Gleason ≥3+4) cancers missed on a 2-core lesion biopsy. Results: We biopsied 1,233 ROI with a median of 5 cores (IQR 3-5) from each ROI. A total of 581 ROI (47%) were positive for any Gleason grade PCa, in 380 (61%) patients. On a per-lesion basis, 84% of any Gleason score cancers were detected with a two-core biopsy and 77% of Gleason ≥3+4 tumors. Cancer detection rates improved with increasing number of cores (Table 1). For any Gleason grade PCa, additional cores beyond 5 cores had no significance. For G≥3+4 cancer, there was no significance with additional sampling from 3 to 4 cores, but improved detection from 3 to 5 cores (P<0.05). For PI-RADs 4 and 5 lesions, additional sampling up to 4 cores significantly improves G≥3+4 detection, while for PI-RADs 1-3 lesions sampling up to 2 cores improves detection. Conclusions: On a per-lesion basis, sampling two cores of mpMRI-evident lesions at the time of fusion biopsy misses nearly one-quarter of clinically significant PCa that would be detected on additional sampling. [Table: see text]
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Affiliation(s)
- Amanda Lu
- Yale School of Medicine, New Haven, CT
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35
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Lu A, Ghabili K, Nguyen K, Sprenkle P. Role of core location in targeted MRI-ultrasound fusion biopsy of prostate lesions. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.136] [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: 11/20/2022] Open
Abstract
136 Background: Targeted mpMRI fusion biopsy has gained adoption with superior clinically significant cancer detection rates and accuracy over template biopsy. We sought to establish the role of biopsy location within a prostate lesion to detect clinically significant prostate cancer. Methods: From Nov 2016-Aug 2017, 110 patients with positive multiparametric-MRI (mpMRI) underwent targeted and systematic MRI-US fusion biopsy at our institution for clinical suspicion or known history of prostate cancer. Lesions were scored by Prostate imaging reporting and data system (PI-RADS) classification schema by experienced genitourinary radiologists. Biopsy was performed by an oncology-trained urologist (PS) performing a high volume of fusion biopsies. 5 cores were taken from each lesion, each corresponding to a predetermined location (central, medial, lateral, apex, and base of the lesion). Cancer detection rates (CDR) were calculated on a per lesion basis from biopsy histology. Results: 154 prostate lesions were identified and biopsied with an average volume of 1.31 mL. Detection of clinically significant cancer (G>3+4) did not differ significantly among the 5 locations (Table 1). The central core detected slightly more G≥3+4 cancers than the apex core. No concordance of pathology grade was found between the central core and location of the peripheral core (medial, lateral, apex, or base). In 32% (50/154) of lesions, the peripheral cores had a higher Gleason score than the central core. Biopsy of only the central core missed 40% (21/52) of G≥3+4 cancers and 17% (4/24) of G>3+4 cancers. Lesions with higher PIRADs score were more likely to detect cancer in both the central and peripheral cores, but lesion volume was not a significant predictor. Conclusions: Location of biopsy cores within mpMRI-identified prostate lesions has little correlation with detection of clinically significant cancer. However, targeted biopsy of only the center of a lesion can miss 17% of Gleason >3+4 cancers. [Table: see text]
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Affiliation(s)
- Amanda Lu
- Yale School of Medicine, New Haven, CT
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36
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Ghabili K, Nguyen K, Lu A, Hsiang W, Shuch BM, Leapman M. Heterogeneity in early oncologic outcomes among men with NCCN intermediate-risk prostate cancer treated with radical prostatectomy. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.144] [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: 11/20/2022] Open
Abstract
144 Background: The National Comprehensive Cancer Network (NCCN) risk classification scheme for prostate cancer (PCa) encompasses several definitions and has been shown to contain significant heterogeneity. Because patients possessing a single intermediate-risk (IR) feature may be regarded as ineligible for active surveillance (AS), we aimed to compare pathologic and early oncologic outcomes between those with low-risk (LR) and IR features based on the number of criteria met. Methods: We queried the National Cancer Database (NCDB) to identify men with NCCN LR (cT1-T2a, prostate-specific antigen [PSA] < 10 ng/mL, and Gleason score (GS)≤6) and IR PCa diagnosed from 2010-2014 who were treated with radical prostatectomy (RP). Patients with IR PCa were stratified based on a single factor: clinical stage (cT2b-T2c), PSA (10-20 ng/mL), GS 3+4, or GS 4+3 alone. The pathologic outcomes including any Gleason upgrade, and adverse pathology (primary Gleason 4 or ≥pT3 at RP), and receipt of adjuvant radiation therapy (RT) were compared between the LR and IR groups. Odds ratios for pathologic outcomes and receipt of adjuvant RT were computed using logistic regression analyses. Results: Of 181,847 men treated with RP, we identified 30.7% and 37.1% with LR and IR PCa, respectively. Of 67,623 with IR PCa, 4,075 (6%) were due to clinical stage alone, 5,004 (7.4%) by PSA, 43,409 (64.2%) by GS 3+4, and 15,135 (22.4%) by GS 4+3. Patients meeting IR by clinical stage alone had similar risks of adverse pathology as LR patients (OR 1.03, 95%CI 0.94-1.13, p = 0.49). In contrast, those meeting IR by PSA alone had higher risks of adverse pathology compared with LR individuals (OR 2.20, 95%CI 2.05-2.36, p < 0.001). Moreover, receipt of adjuvant RT was similar among LR and IR patients by clinical stage alone (p = 0.62), and higher among patients meeting IR by PSA alone (OR 2.99, 95% CI 2.43-3.69, p < 0.001). Conclusions: Based on national cancer registry data, early outcomes among men meeting the NCCN IR definition for PCa are heterogeneous. IR patients by clinical stage alone had similar rates of adverse pathology as did LR group. Broadened eligibility for AS should be considered to include those meeting favorable IR definitions.
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Affiliation(s)
| | | | - Amanda Lu
- Yale School of Medicine, New Haven, CT
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Lu A, Nguyen K, Nolte AC, Alimi O, Hsiang W, Ghabili K, Syed J, Shuch BM, Leapman M. National determinants of active surveillance among patients with clinical stage 1A kidney tumors. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.694] [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: 11/20/2022] Open
Abstract
694 Background: Active surveillance (AS) has been increasingly recognized as a viable management strategy for patients with small renal masses (SRM). To better understand the contemporary management landscape of SRMs we examined practice patterns in a nationally representative cancer database. Methods: We identified patients with clinical T1a renal masses within the National Cancer Database (NCDB) between 2010 to 2014. Patients were classified according to initial management received including AS, surgery, ablation, or other treatment. We characterized time trends in the use of surveillance versus definitive therapy and examined clinical and socio-demographic determinants of AS among patients with small renal masses using multivariate logistic regression models. Results: We identified 59,189 patients who satisfied the inclusion criteria. Of the total cohort, 1,733 (2.9%) individuals received initial management with AS, while 57,456 (97.1%) received definitive treatment. There was a slight increase in initial management with surveillance however rates remained less than 5% in all years. On multivariate analysis, patient age (OR: 1.08, 95% CI 1.08-1.09), treatment at an academic center vs. community center (OR: 2.05, 95% CI: 1.83-2.29), and African American vs. Caucasian race (OR: 1.56, 95% CI:1.35-1.80) were independently associated with use of active surveillance. Moreover, regional-level differences were observed with the highest utilization of AS in the West North Central census division. Conclusions: Based on cancer registry data, national utilization of AS for SRMs remains very low, and we observed clinical and facility-level differences. Further investigation is warranted to better understand the factors underlying management for patients with SRMs.
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Affiliation(s)
- Amanda Lu
- Yale School of Medicine, New Haven, CT
| | | | - Adam C Nolte
- Yale University School of Medicine, New Haven, CT
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Ghanem M, Wang L, Zhang Y, Edwards S, Lu A, Ley D, El-Gazzar M. Core Genome Multilocus Sequence Typing: a Standardized Approach for Molecular Typing of Mycoplasma gallisepticum. J Clin Microbiol 2018; 56:JCM.01145-17. [PMID: 29070657 PMCID: PMC5744223 DOI: 10.1128/jcm.01145-17] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 07/18/2017] [Accepted: 10/14/2017] [Indexed: 02/07/2023] Open
Abstract
Mycoplasma gallisepticum is the most virulent and economically important Mycoplasma species for poultry worldwide. Currently, M. gallisepticum strain differentiation based on sequence analysis of 5 loci remains insufficient for accurate outbreak investigation. Recently, whole-genome sequences (WGS) of many human and animal pathogens have been successfully used for microbial outbreak investigations. However, the massive sequence data and the diverse properties of different genes within bacterial genomes results in a lack of standard reproducible methods for comparisons among M. gallisepticum whole genomes. Here, we proposed the development of a core genome multilocus sequence typing (cgMLST) scheme for M. gallisepticum strains and field isolates. For development of this scheme, a diverse collection of 37 M. gallisepticum genomes was used to identify cgMLST targets. A total of 425 M. gallisepticum conserved genes (49.85% of M. gallisepticum genome) were selected as core genome targets. A total of 81 M. gallisepticum genomes from 5 countries on 4 continents were typed using M. gallisepticum cgMLST. Analyses of phylogenetic trees generated by cgMLST displayed a high degree of agreement with geographical and temporal information. Moreover, the high discriminatory power of cgMLST allowed differentiation between M. gallisepticum strains of the same outbreak. M. gallisepticum cgMLST represents a standardized, accurate, highly discriminatory, and reproducible method for differentiation among M. gallisepticum isolates. cgMLST provides stable and expandable nomenclature, allowing for comparison and sharing of typing results among laboratories worldwide. cgMLST offers an opportunity to harness the tremendous power of next-generation sequencing technology in applied avian mycoplasma epidemiology at both local and global levels.
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Affiliation(s)
- Mostafa Ghanem
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
- Faculty of Veterinary Medicine, Alexandria University, Rasheed El-Mahmoudeya, Markaz Rasheed, El Beheira Governorate, Egypt
| | - Leyi Wang
- Animal Disease Diagnostic Laboratory, Ohio Department of Agriculture, Reynoldsburg, Ohio, USA
| | - Yan Zhang
- Animal Disease Diagnostic Laboratory, Ohio Department of Agriculture, Reynoldsburg, Ohio, USA
| | - Scott Edwards
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Amanda Lu
- Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | - David Ley
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Mohamed El-Gazzar
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
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Syed JS, Lu A, Nguyen KA, Sprenkle PC, Weinreb JC. Author Reply. Urology 2017; 105:122. [DOI: 10.1016/j.urology.2017.01.050] [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: 01/09/2023]
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40
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Feng B, Lu J, Zhang S, Yan X, Li J, Xue P, Wang M, Lu A, Ma J, Zang L, Dong F, He Z, Yue F, Sun J, Hong X, Zheng M. Laparoscopic abdominoperineal excision with trans-abdominal individualized levator transection: interim analysis of a randomized controlled trial. Colorectal Dis 2017; 19:O246-O252. [PMID: 28477432 DOI: 10.1111/codi.13711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/13/2016] [Accepted: 02/24/2017] [Indexed: 02/08/2023]
Abstract
AIM Extralevator abdominoperineal excision (ELAPR) is challenging 'conventional' abdominoperineal excision (APR), yet the safety and efficacy of ELAPR is still under debate. We therefore developed a laparoscopic APR with trans-abdominal individualized levator transection (LAPR-TILT) approach and compared the outcome with a conventional laparoscopic APR (CLAPR). METHOD All eligible patients were entered a single-centre randomized controlled trial to compare CLAPR and LAPR-TILT. We assessed the first 185 patients, including operative findings, complications, histopathology and urogenital function. RESULTS Ninety-three patients in the CLAPR group and 92 patients in the APR-TILT group were included for analysis. The APR-TILT procedure took less time [137 (101-175) min vs 146 (102-187) min; P = 0.03], mainly owing to faster perineal dissection. APR-TILT resulted in a reduced rate of bowel perforation (1.1% vs 8.6%; P = 0.04), circumferential resection margin positivity (1.1% vs 10.8%; P = 0.01) and postoperative wound complications (5.4% vs 16.2%; P = 0.02) compared with the CLAPR procedure. At a median follow-up of 19 months after surgery, three patients (3.2%) in the CLAPR group had tumour recurrence while no tumour recurrence occurred in the LAPR-TILT group. Patients who underwent LAPR-TILT reported fewer urinary or sexual problems (LAPR-TILT vs CLAPR, 10.9% vs 24.7% and 17.4% vs 38.7%, respectively). CONCLUSION Compared with CLAPR, LAPR-TILT achieved better pathological results for factors that are surrogate parameters for local recurrence. LAPR-TILT could also reduce the risk of urogenital dysfunction.
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Affiliation(s)
- B Feng
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - J Lu
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - S Zhang
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - X Yan
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - J Li
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - P Xue
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - M Wang
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - A Lu
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - J Ma
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - L Zang
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - F Dong
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - Z He
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - F Yue
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - J Sun
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - X Hong
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
| | - M Zheng
- Department of Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, and Shanghai Minimally Invasive Surgery Center, Shanghai, China
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Han F, Lu A, Yuan Y, Huang W, Beerntsen BT, Huang J, Ling E. Characterization of an entomopathogenic fungi target integument protein, Bombyx mori single domain von Willebrand factor type C, in the silkworm, Bombyx mori. Insect Mol Biol 2017; 26:308-316. [PMID: 28168773 DOI: 10.1111/imb.12293] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The insect cuticle works as the first line of defence to protect insects from pathogenic infections and water evaporation. However, the old cuticle must be shed in order to enter the next developmental stage. During each ecdysis, moulting fluids are produced and secreted into the area among the old and new cuticles. In a previous study, the protein Bombyx mori single domain von Willebrand factor type C (BmSVWC; BGIBMGA011399) was identified in the moulting fluids of Bo. mori and demonstrated to regulate ecdysis. In this study we show that in Bo. mori larvae, BmSVWC primarily locates to the integument (epidermal cells and cuticle), wing discs and head. During the moulting stage, BmSVWC is released into the moulting fluids, and is then produced again by epidermal cells after ecdysis. Fungal infection was shown to decrease the amount of BmSVWC in the cuticle, which indicates that BmSVWC is a target protein of entomopathogenic fungi. Thus, BmSVWC is mainly involved in maintaining the integrity of the integument structure, which serves to protect insects from physical damage and pathogenic infection.
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Affiliation(s)
- F Han
- College of Life Sciences, Shanghai University, Shanghai, China
- Key Laboratory of Insect Developmental and Evolutionary Biology, Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, Shanghai, China
| | - A Lu
- Key Laboratory of Insect Developmental and Evolutionary Biology, Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, Shanghai, China
- Key Laboratory of Medical Reprogramming Technology, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Y Yuan
- Key Laboratory of Insect Developmental and Evolutionary Biology, Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, Shanghai, China
| | - W Huang
- Key Laboratory of Insect Developmental and Evolutionary Biology, Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, Shanghai, China
| | - B T Beerntsen
- Veterinary Pathobiology, University of Missouri, Columbia, MO, USA
| | - J Huang
- College of Life Sciences, Shanghai University, Shanghai, China
| | - E Ling
- Key Laboratory of Insect Developmental and Evolutionary Biology, Institute of Plant Physiology and Ecology, Chinese Academy of Sciences, Shanghai, China
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Huard J, Mu X, Lu A. Evolving paradigms in clinical pharmacology and therapeutics for the treatment of Duchenne muscular dystrophy. Clin Pharmacol Ther 2016; 100:142-6. [DOI: 10.1002/cpt.379] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 04/06/2016] [Indexed: 11/10/2022]
Affiliation(s)
- J Huard
- Department of Orthopedic Surgery, McGovern Medical School; University of Texas Health Science Center at Houston; Houston Texas USA
- Steadman Philippon Research Institute; Vail Colorado USA
- Brown Foundation Institute of Molecular Medicine; Center for Tissue Engineering and Aging Research; Houston Texas USA
| | - X Mu
- Department of Orthopedic Surgery, McGovern Medical School; University of Texas Health Science Center at Houston; Houston Texas USA
- Steadman Philippon Research Institute; Vail Colorado USA
- Brown Foundation Institute of Molecular Medicine; Center for Tissue Engineering and Aging Research; Houston Texas USA
| | - A Lu
- Department of Orthopedic Surgery, McGovern Medical School; University of Texas Health Science Center at Houston; Houston Texas USA
- Steadman Philippon Research Institute; Vail Colorado USA
- Brown Foundation Institute of Molecular Medicine; Center for Tissue Engineering and Aging Research; Houston Texas USA
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Su J, Lu A, Bryson C, Rosoff J, Honig S. 125 Initial Peyronie’s Disease Questionnaire Bother Scores do not Correlate with Degree of Penile Curvature in Patients with Peyronie’s Disease. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.131] [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: 10/21/2022]
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Lu A, Nawaf C, Rosoff J, Weinreb J, Humphrey P, Levi A, Huber S, Sprenkle P. PD15-11 SHOULD WE STILL BIOPSY NEGATIVE MP-MRIS? J Urol 2016. [DOI: 10.1016/j.juro.2016.02.1137] [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: 10/22/2022]
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Lu A, Fang Y, Du X, Li Y, Cai Z, Yu K, Zhao L, Wang B, Wu J, Cheng Y, Zuo Y, Jia Y, Tan F, Ding L, Lu J, Zhang L, Huang X. Efficacy, safety and pharmacokinetics of clofarabine in Chinese pediatric patients with refractory or relapsed acute lymphoblastic leukemia: a phase II, multi-center study. Blood Cancer J 2016; 6:e400. [PMID: 26918364 PMCID: PMC4771971 DOI: 10.1038/bcj.2016.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- A Lu
- Department of Pediatrics, Peking University People's Hospital, Beijing, China
| | - Y Fang
- Department of Phase 1 Clinical Trial, Peking University People's Hospital, Beijing, China
| | - X Du
- Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Y Li
- The First Hospital of China Medical University, Shenyang, China
| | - Z Cai
- The First Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - K Yu
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - L Zhao
- Department of Phase 1 Clinical Trial, Peking University People's Hospital, Beijing, China
| | - B Wang
- Department of Pediatrics, Peking University People's Hospital, Beijing, China
| | - J Wu
- Department of Pediatrics, Peking University People's Hospital, Beijing, China
| | - Y Cheng
- Department of Pediatrics, Peking University People's Hospital, Beijing, China
| | - Y Zuo
- Department of Pediatrics, Peking University People's Hospital, Beijing, China
| | - Y Jia
- Department of Pediatrics, Peking University People's Hospital, Beijing, China
| | - F Tan
- Betta Pharmaceuticals Co., Ltd, Hangzhou, China
| | - L Ding
- Betta Pharmaceuticals Co., Ltd, Hangzhou, China
| | - J Lu
- Institute of Hematology, Peking University People's Hospital, Beijing, China
| | - L Zhang
- Department of Pediatrics, Peking University People's Hospital, Beijing, China
| | - X Huang
- Institute of Hematology, Peking University People's Hospital, Beijing, China
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Nawaf C, Lu A, Rosoff J, Weinreb J, Schulam P, Humphrey P, Levi A, Sprenkle P. MRI-US fusion targeted biopsy results in patients with a history of a prior negative biopsy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.2_suppl.90] [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: 11/20/2022] Open
Abstract
90 Background: Patients with an elevated PSA but negative prostate biopsy present a diagnostic and management dilemma. We evaluated the capability of multi-parametric (MP) MRI and MRI-USG Fusion prostate biopsy to detect clinically significant (CS) prostate cancer in men who have had a prior negative 12-core standard biopsy. Methods: Between 12/2012 and 06/2015, 374 men with an indication for prostate biopsy underwent pre-biopsy mpMRI followed by 12-core standard trans-rectal mapping biopsy (Mbx) and MRI-Ultrasound fusion targeted biopsy (Tbx) of lesions identified on mpMRI. The combination of Mbx and Tbx, when both occurred, constitutes a fusion biopsy (Fbx). Men who underwent both Mbx with or without Tbx using the Artemis/Pro-Fuse system with a previous biopsy but no diagnosis of prostate cancer were included. Patients without a lesion on MRI underwent Mbx only. Maximum Gleason scores (GS) was assigned on a per patient basis with Mbx GS available for all patients in the cohort and Tbx GS available only for patients with a lesion visible on MP-MRI. CS cancer was defined as GS ≥ 3+4. GS per patient was compared by chi-square and McNemar’s test. Results: 138 men (mean age = 64.0, mean psa = 11.6) met inclusion criteria. Fbx cancer detection rate in this population was 42%. 17 men (12%) were missed by Mbx but picked up on Tbx. Of these 17 men, 13 had Gleason ≥ 7.In comparison, 15 men were missed by Tbx, but only 2 were Gleason ≥ 7. Tbx had a higher rate of detection of CS cancer than Mbx, but this did not reach statistical significance (86% vs 68%, p = 0.09). MRI suspicion level correlated with the detection of CS cancer (p = 0.012). None of the 20 men with a negative MRI had GS ≥ 7 cancer detected on Mbx. The number of prior negative biopsies was not related to the likelihood of finding CS cancer on Fbx (p = 0.47). Conclusions: MRI suspicion score predicts detection of CS prostate cancer when paired with MRI-USG Fbx of the prostate, with a negative MRI correlating with no evidence of CS cancer on biopsy. MRI is a biomarker in this population that may, with more corroborative data, allow for men with a negative MRI to avoid repeat biopsies. [Table: see text]
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Affiliation(s)
| | - Amanda Lu
- Yale School of Medicine, New Haven, CT
| | | | | | - Peter Schulam
- Department of Urology, Yale University, New Haven, CT
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Nawaf C, Rosoff J, Lu A, Weinreb J, Humphrey P, Levi A, Schulam P, Sprenkle P. MRI-US fusion targeted biopsy results in men with a history of prior cancer. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.2_suppl.88] [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: 11/20/2022] Open
Abstract
88 Background: Appropriate risk stratification of men on active surveillance for prostate cancer is essential to identify men in whom it is safe to take this deferred treatment approach. This study evaluates upstaging rates using MRI-US fusion targeted biopsy in men who have had a prior positive standard 12-core biopsy. Methods: Between 12/2012 and 06/2015, 374 men with an indication for prostate biopsy underwent pre-biopsy mpMRI followed by 12-core standard trans-rectal mapping biopsy (Mbx) and MRI-Ultrasound fusion targeted biopsy (Tbx) of lesions identified on mpMRI. The combination of Mbx and Tbx, when both occurred, constitutes a fusion biopsy (Fbx). Men who underwent both Mbx with or without Tbx using the Artemis/Pro-Fuse system with a previous non-MRI-guided biopsy and a diagnosis of prior Gleason 6 prostate cancer were included. Patients without a lesion on MRI underwent Mbx only. Maximum Gleason scores (GS) were assigned on a per patient basis with Mbx GS available for all patients in the cohort and Tbx GS available only for patients with a lesion visible on MP-MRI. Clinically significant (CS) cancer was defined as GS ≥ 3+4. GS per patient was compared by chi-square and McNemar’s test. Results: 118 patients met inclusion criteria (Mean PSA = 6.9, Mean age = 62.5). 40 patients (34%) were upstaged by Fbx to Gleason ≥ 7. Of those upstaged, 17 men (14%) would have been missed by Mbx alone, in comparison to 7 (6%) that were missed by Tbx alone. Total number of prior biopsies (p = 0.28) and number of years on Active Surveillance (p = 0.22) were not related to upgrade on Fbx. Older men (65.3 vs. 60.9, p = 0.033) and those with higher PSA (8.7 vs 5.8, p = 0.002) were more likely to be upgraded on Fbx. Tbx was more likely to identify CS cancer than Mbx (85% vs 56%; p < 0.012). Conclusions: MP-MRI Fusion biopsy more accurately stratifies men with a previous prostate biopsy than those receiving a template mapping 12-core biopsy alone. Tbx should be strongly considered before enrolling a patient in active surveillance since up 14% of clinically significant cancer would have been missed with a 12-core biopsy alone. [Table: see text]
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Affiliation(s)
| | | | - Amanda Lu
- Yale School of Medicine, New Haven, CT
| | | | | | | | - Peter Schulam
- Department of Urology, Yale University, New Haven, CT
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Nawaf C, Rosoff J, Weinreb J, Lu A, Levi A, Humphrey P, Schulam P, Sprenkle P. MRI-US fusion targeted biopsy results in patients without history of prostate biopsy. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.2_suppl.150] [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: 11/20/2022] Open
Abstract
150 Background: Results from 12-core template mapping biopsy (Mbx) and concurrent MRI-US fusion targeted biopsy (Tbx) were compared in 118 men without prior biopsy. Methods: Between 12/2012 and 06/2015, 374 men with an indication for prostate biopsy presented to our institution and underwent pre-biopsy mpMRI followed by 12-core standard trans-rectal mapping biopsy (Mbx) and MRI-Ultrasound fusion targeted biopsy (Tbx) of lesions identified on mpMRI. The combination of Mbx and Tbx, when both occurred, constitutes a fusion biopsy (Fbx). Men who underwent both Mbx with or without Tbx using the Artemis/Pro-Fuse system with no previous biopsy were included. Patients without a lesion on MRI underwent Mbx only. Maximum Gleason scores (GS) was assigned on a per patient basis with Mbx GS available for all patients in the cohort and Tbx GS available only for patients with a lesion visible on MP-MRI. Clinically significant (CS) was defined as GS ≥3+4. GS per patient was compared by chi-square and McNemar’s test. Results: 118 men met inclusion criteria (mean age=64.9, mean PSA=11.5). Prostate cancer was detected in 64 (54%) Fbx cases. Cancer detection rates for Mbx and Tbx were 54% and 57%, respectively. In patients where Fbx identified CS cancer, Tbx was more likely to have identified the cancer than Mbx (96% vs 72%; p < 0.001). Fewer GS 6 cancers were detected by Tbx (n=7) than by Mbx (n=25), and Tbx alone would have prevented the detection of 21 (18%) cases of GS 6 disease. Conversely, more GS≥ 7 (50% of men) was detected on Tbx than on Mbx (33% of men). In total, there were 16 patients (13.5%) that were missed or understaged by Tbx, but only 4 of these patients (3%) were GS≥ 7. In contrast, there were 19 (16%) patients that were missed or understaged by Mbx, but 17 (14%) of these 19 patients harbored GS≥ 7 disease. Conclusions: In biopsy-naive men who are suspected to have prostate cancer, Tbx provides improved detection of CS prostate cancer compared with Mbx while decreasing the detection of low-grade disease. Tbx alone in biopsy-naive men should be considered if missing 3% of CS disease is acceptable. [Table: see text]
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Affiliation(s)
| | | | | | - Amanda Lu
- Yale School of Medicine, New Haven, CT
| | | | | | - Peter Schulam
- Department of Urology, Yale University, New Haven, CT
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Abstract
91 Background: Increased lesion suspicion score on MRI is known to be associated with increased grade of prostate cancer. However, the negative predictive value (NPV) of MRI is still being investigated. To determine the NPV of mpMRI, we evaluated the frequency of prostate cancer (CaP) detection by 12-core template mapping biopsy (Mbx) in men whose mpMRI showed no suspicious regions. Methods: 374 men undergoing MRI-US fusion biopsy from 12/2012 to 06/2015 were enrolled in an IRB-approved database and met inclusion criteria for this study. The mpMRI sequences T2-weighted, diffusion-weighted imaging, and dynamic contrast enhancement were used to identify and classify targets as low, medium, and high suspicion. Men with negative mpMRI received a template 12-core template mapping biopsy. Only patients with complete mpMRI sequences were included. Results: 53 men with a negative MRI were identified (mean age=63.5 years, PSA=7.53 ng/mL, mean prostate volume=67.2 mL). The NPV of negative MRI was 64.2% for any cancer and 96.2% for clinically significant cancer (Gleason≥7). Men on active surveillance had the highest CDR 56.3%, compared to 38.9% for biopsy-naive men, and 15.8% for men with prior negative biopsy (Figure 1). Clinically significant CaP was found in two patients: Gleason 4+3 in a patient on Active Surveillance, and 4+4 in a biopsy naïve patient. Conclusions: Negative MRI has a high NPV (96%) for clinically significant CaP found in 12-core template mapping biopsy. If we did not biopsy mpMRI negative men, we would have missed 16 patients with Gleason 6 and 2 patients with ≥ Gleason 7. Clinicians can use this information in patient counseling to discuss the likelihood of detecting significant cancer – though these findings should be reproduced widely before a negative MRI is used to recommend against biopsy. Sources of funding: NIH-National Institute of Diabetes and Digestive and Kidney Diseases [Table: see text]
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Affiliation(s)
- Amanda Lu
- Yale School of Medicine, New Haven, CT
| | | | | | | | - Peter Schulam
- Department of Urology, Yale University, New Haven, CT
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