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Kaur K, Ai R, Perry AG, Riley B, Roberts EL, Montano EN, Han J, Roacho J, Lopez BG, Skelsey MK, Childs MV, Childs JN, Dobak J, Ibarra C, Jansen B, Clarke LE, Stone S, Whitaker JW. Skin Cancer Risk Is Increased by Somatic Mutations Detected Noninvasively in Healthy-Appearing Sun-Exposed Skin. J Invest Dermatol 2024:S0022-202X(24)00176-3. [PMID: 38513819 DOI: 10.1016/j.jid.2024.02.017] [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: 10/04/2023] [Revised: 01/08/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024]
Abstract
Skin cancer risk is increased by exposure to ultraviolet radiation (UVR). Because UVR exposure accumulates over time and lighter skin is more susceptible to UVR, age and skin tone are risk factors for skin cancer. However, measurements of somatic mutations in healthy-appearing skin have not been used to calculate skin cancer risk. In this study, we developed a noninvasive test that quantifies somatic mutations in healthy-appearing sun-exposed skin and applied it to a 1038-subject cohort. Somatic mutations were combined with other known skin cancer risk factors to train a model to calculate risk. The final model (DNA-Skin Cancer Assessment of Risk) was trained to predict personal history of skin cancer from age, family history, skin tone, and mutation count. The addition of mutation count significantly improved model performance (OR = 1.3, 95% confidence interval = 1.14-1.48; P = 5.3 × 10-6) and made a more significant contribution than skin tone. Calculations of skin cancer risk matched the known United States population prevalence, indicating that DNA-Skin Cancer Assessment of Risk was well-calibrated. In conclusion, somatic mutations in healthy-appearing sun-exposed skin increase skin cancer risk, and mutations capture risk information that is not accounted for by other risk factors. Clinical utility is supported by the noninvasive nature of skin sample collection through adhesive patches.
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Affiliation(s)
| | - Rizi Ai
- DermTech, San Diego, California, USA
| | | | - Bae Riley
- DermTech, San Diego, California, USA
| | | | | | | | | | | | - Maral K Skelsey
- Department of Dermatology, School of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Maria V Childs
- Department of Dermatology, Texas A&M University College of Medicine, Temple, Texas, USA
| | - James N Childs
- Department of Dermatology, Texas A&M University College of Medicine, Temple, Texas, USA
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Van Gestel F, Frantz T, Neuville Q, Klein S, Bruneau M, Jansen B, Scheerlinck T, Vandemeulebroucke J, Duerinck J. P07.02.B Neuro-oncological augmented reality planning (NOA-p). Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.134] [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: 11/12/2022] Open
Abstract
Abstract
Background
When preparing for the resection of an intracranial lesion, neuronavigation with a tracked pointer is most often used to determine lesion borders and the optimal approach. This can sometimes prove challenging, especially for deep-seated lesions. Augmented Reality (AR), directly displaying the lesion on the patient’s skin, can simplify and improve this step.
Material and Methods
We developed a system for inside-out infrared tracking that does not require an external tracking camera or external computer and allows for heads-up displaying an AR scene on the Microsoft HoloLens II. Twenty patients planned for the resection of an intracerebral lesion were included in our study. After patient registration, the lesion outlines were marked on the patient’s skin by different participants, consecutively using the Brainlab neuronavigation system and the HoloLens. Each registration on both systems provided a registration transform that was compared for accuracy and consistency. The performance of the participants was measured in terms of duration and accuracy and compared to expert registration and delineation.
Results
Both registration and delineation were significantly faster with AR (p=0.02 and p<0.001, respectively, and p<0.001 for the total duration), taking 79.23±17.48 and 39.58±39.10 seconds while neuronavigation required 96.61±24.54 and 90.80±44.09 seconds. AR had a registration offset of 3.3mm and 3.4°, and was more consistent compared to neuronavigation. AR facilitated more accurate and detailed lesion delineation, while neuronavigation often overestimated lesion size.
Conclusion
Augmented reality provides a faster and more accurate alternative for resection planning. Lesion delineation is more intuitive while remaining high in accuracy. Future research should focus on further intraoperative implementations.
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Affiliation(s)
- F Van Gestel
- Universitair Ziekenhuis Brussel, Department of Neurosurgery , Brussels , Belgium
- Vrije Universiteit Brussel, Research group Center For Neurosciences (C4N-NEUR) , Brussels , Belgium
| | - T Frantz
- Vrije Universiteit Brussel, Department of Electronics and Informatics (ETRO) , Brussels , Belgium
- imec , Leuven , Belgium
| | - Q Neuville
- Universitair Ziekenhuis Brussel, Department of Neurosurgery , Brussels , Belgium
- Vrije Universiteit Brussel, Research group Center For Neurosciences (C4N-NEUR) , Brussels , Belgium
| | - S Klein
- Universitair Ziekenhuis Brussel, Department of Neurosurgery , Brussels , Belgium
| | - M Bruneau
- Universitair Ziekenhuis Brussel, Department of Neurosurgery , Brussels , Belgium
| | - B Jansen
- Vrije Universiteit Brussel, Department of Electronics and Informatics (ETRO) , Brussels , Belgium
- imec , Leuven , Belgium
| | - T Scheerlinck
- Universitair Ziekenhuis Brussel, Department of Orthopedic Surgery and Traumatology , Brussels , Belgium
- Vrije Universiteit Brussel, Research group Beeldvorming en Fysische wetenschappen (BEFY-ORTHO) , Brussels , Belgium
| | - J Vandemeulebroucke
- Vrije Universiteit Brussel, Department of Electronics and Informatics (ETRO) , Brussels , Belgium
- imec , Leuven , Belgium
| | - J Duerinck
- Universitair Ziekenhuis Brussel, Department of Neurosurgery , Brussels , Belgium
- Vrije Universiteit Brussel, Research group Center For Neurosciences (C4N-NEUR) , Brussels , Belgium
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Rubin C, Skelsey M, Clarke L, Rock J, Jansen B, Arnold T, Wood J. 176 A non-invasive genomic assay for pigmented lesions to rule out primary cutaneous melanoma: Interim analysis of a national registry database. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.183] [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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Kaur K, Allen T, Hill K, Howell M, Jansen B, Rock J, Clarke L, Ibarra C. 629 Performance monitoring of a streamlined and scalable non-invasive gene expression assay for pigmented lesions. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.640] [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: 10/17/2022]
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Vo L, Ai R, Lee M, Holscher T, Rock J, Jansen B, Clarke L, Howell M, Whitaker J. 107 DermTech smart stickers can non-invasively detect RNAs that are associated with non-melanoma skin cancer. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.042] [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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Rigel DS, Whitaker JW, Skelsey MK, Peck G, Howell MD, Jansen B. Response to Marchetti et al. J Invest Dermatol 2021; 142:232-234. [PMID: 34273350 DOI: 10.1016/j.jid.2021.06.024] [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] [Received: 04/13/2021] [Revised: 05/22/2021] [Accepted: 06/02/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Darrell S Rigel
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
| | | | - Maral K Skelsey
- Department of Dermatology, School of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Gary Peck
- Dermatologic Surgery Center of DC, Chevy Chase, Maryland, USA
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Tripathi P, Kim M, Sokkam H, Rock J, Howell M, Jansen B, Yao Z. 073 A non-invasive genomic test for early assessment of UV damage in human skin. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.090] [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: 11/15/2022]
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Knoop V, Cloots B, Costenoble A, Debain A, Vella Azzopardi R, Vermeiren S, Jansen B, Scafoglieri A, Bautmans I. Fatigue and the prediction of negative health outcomes: A systematic review with meta-analysis. Ageing Res Rev 2021; 67:101261. [PMID: 33548508 DOI: 10.1016/j.arr.2021.101261] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/23/2020] [Accepted: 01/24/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Fatigue is a common complaint among older adults. Evidence grows that fatigue is linked to several negative health outcomes. A general overview of fatigue and its relationship with negative health outcomes still lacks in the existing literature. This brings complications for healthcare professionals and researchers to identify fatigue-related health risks. Therefore, this study gives an overview of the prospective predictive value of the main negative health outcomes for fatigue in community-dwelling older adults. METHODS PubMed, Web of Knowledge and PsycINFO were systematically screened for prospective studies regarding the relationship between fatigue and negative health outcomes resulting in 4595 articles (last search 5th March 2020). Meta-analyses were conducted in RevMan using Odds ratios (ORs), Hazard ratios (HRs) and relative risk ratios (RR) that were extracted from the included studies. Subgroup-analyses were performed based on (1) gender (male/female), (2) length of follow-up and (3) fatigue level (low, medium and high). RESULTS In total, thirty articles were included for this systematic review and meta-analysis encompassing 152 711 participants (age range 40-98 years), providing information on the relationship between fatigue and health outcomes. The results showed that fatigue is related to an increased risk for the occurrence of all studied health outcomes (range OR 1.299-3.094; HR/RR 1.038-1.471); for example, mortality OR 2.14 [1.74-2.63]; HR/RR 1.44 [1.28-1.62]), the development of disabilities in basic activities of daily living (OR 3.22 [2.05-5.38]), or the occurrence of physical decline (OR 1.42 [1.29-1.57]). CONCLUSION Overall fatigue increases the risk for developing negative health outcomes. The analyses presented in this study show that fatigue related physical decline occurs earlier than hospitalization, diseases and mortality, suggesting the importance of early interventions.
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Affiliation(s)
- V Knoop
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - B Cloots
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - A Costenoble
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - A Debain
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium
| | - R Vella Azzopardi
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium
| | - S Vermeiren
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium
| | - B Jansen
- Department of Electronics and Informatics ETRO, Vrije Universiteit Brussel (VUB), Elsene, Belgium; Imec, Leuven, Belgium
| | - A Scafoglieri
- Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Supporting Clinical Science Department and Research Department of Experimental Anatomy (EXAN), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - I Bautmans
- Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium.
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Moy R, Siegel D, Yao Z, Rock J, Howell M, Jansen B. Genomic Atypia of Lesions Clinically Suspicious for Melanoma Is Confined to Lesional Tissue Within Narrow Margins. J Drugs Dermatol 2021. [DOI: 10.36849/jdd.6005] [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: 11/09/2022]
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10
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Moy R, Siegel DM, Yao Z, Rock J, Howell MD, Jansen B. Genomic Atypia of Lesions Clinically Suspicious for Melanoma Is Confined to Lesional Tissue Within Narrow Margins. J Drugs Dermatol 2021; 20:480-481. [PMID: 33852234 DOI: 10.36849/jdd.2021.6005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Brouha B, Ferris L, Skelsey M, Peck G, Rock J, Nguyen A, Yao Z, Howell M, Jansen B, Cockerell C. Genomic Atypia to Enrich Melanoma Positivity in Biopsied Lesions: Gene Expression and Pathology Findings From a Large U.S. Registry Study. ACTA ACUST UNITED AC 2021. [DOI: 10.25251/skin.5.1.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Importance: Melanoma is diagnosed in approximately 200,000 people within the US each year and is responsible for more than 6,850 deaths. Currently, clinical suspicion guides biopsy decisions and melanoma is confirmed in approximately 4% of biopsied lesions. A non-invasive two-gene expression test (2-GEP) was shown to enhance the physical exam by evaluating genomic atypia to guide biopsy decisions. This study examines the corresponding histopathology of real-world 2-GEP-positive cases.
Methods: Cutaneous lesions suspicious for melanoma (n=3,418) were 2-GEP tested by 90 licensed clinicians in real-world practice. 2-GEP-positive lesions (genomically atypical as indicated by the detection of LINC and/or PRAME) were biopsied in 316 out of 324 (97.5%) cases and 313 pathology reports were available for analysis.
Results: Biopsied 2-GEP-positive lesions were separated into diagnostic subgroups based on corresponding pathology reports. The prevalence of melanoma in biopsies of 2-GEP-positive lesions was 18.7%. Gene expression of both LINC and PRAME was present in ever-increasing percentages of melanocytic lesions as pathology reports demonstrated increasing levels of atypia. Notably, 47.5% of the histopathologically-confirmed melanomas demonstrated this double positive genomic signature while 23.7% were single-positive for LINC and 28.8% were single-positive for PRAME.
Discussion: These data show that biopsied 2-GEP-positive lesions are enriched almost five-fold for advanced histopathologic features compared to those biopsied based solely on visual assessment criteria. The close correlation between genomic atypia and atypical pathology should be considered when planning treatment of a 2-GEP-positive lesion. Consideration of genomic atypia may be a superior approach to guide biopsy decisions and manage pigmented lesions.
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Rosenthal A, Kolli H, Moy R, Rock JA, Jansen B, Yao Z. 17057 Topical DNA Repair enzyme reversal of UVB-induced gene expression changes. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.398] [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: 10/22/2022]
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13
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Jackson Cullison SR, Yao Z, LaJolla, CA, Jansen B, Ferris LK. 16184 Risk stratification of severely dysplastic nevi with the use of noninvasively obtained gene expression and mutation analyses. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.309] [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: 11/25/2022]
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Brouha B, Ferris LK, Skelsey MK, Peck G, Moy R, Yao Z, Jansen B. Real-World Utility of a Non-Invasive Gene Expression Test to Rule Out Primary Cutaneous Melanoma: A Large US Registry Study. J Drugs Dermatol 2020; 19:257-262. [PMID: 32550693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Brouha B, Ferris L, Skelsey M, Peck G, Moy R, Yao Z, Jansen B. Real-World Utility of a Non-Invasive Gene Expression Test to Rule Out Primary Cutaneous Melanoma: A Large US Registry Study. J Drugs Dermatol 2020. [DOI: 10.36849/jdd.2020.4766] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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16
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Knoop V, Costenoble A, Vella Azzopardi R, Vermeiren S, Debain A, Jansen B, Scafoglieri A, Bautmans I, Bautmans I, Verté D, Beyer I, Petrovic M, De Donder L, Kardol T, Rossi G, Clarys P, Scafoglieri A, Cattrysse E, de Hert P, Jansen B. The operationalization of fatigue in frailty scales: a systematic review. Ageing Res Rev 2019; 53:100911. [PMID: 31136819 DOI: 10.1016/j.arr.2019.100911] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To identify the different fatigue items in existing frailty scales. METHODS PubMed, Web of Knowledge and PsycINFO were systematically screened for frailty scales. 133 articles were included, describing 158 frailty scales. Fatigue items were extracted and categorized in 4 fatigue constructs: "mood state related tiredness", "general feeling of tiredness", "activity based feeling of tiredness" and "resistance to physical tiredness". RESULTS 120 fatigue items were identified, of which 100 belonged to the construct "general feeling of tiredness" and only 9 to the construct "resistance to physical tiredness". 49,4% of the frailty scales included at least 1 fatigue item, representing 15 ± 9,3% of all items in these scales. Fatigue items have a significantly higher weight in single domain (dominantly physical frailty scales) versus multi domain frailty scales (21 ± 3.2 versus 10.6 ± 9.8%, p=<0,05). CONCLUSION Fatigue is prominently represented in frailty scales, covering a great diversity in fatigue constructs and underlying pathophysiological mechanisms by which fatigue relates to frailty. Although fatigue items were more prevalent and had a higher weight in physical frailty scales, the operationalization of fatigue leaned more towards psychological constructs. This review can be used as a reference for choosing a suitable frailty scale depending on the type of fatigue of interest.
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Ferris LK, Rigel DS, Siegel DM, Skelsey MK, Peck GL, Hren C, Gorman C, Frumento T, Jansen B, Yao Z, Rock J, Knezevich SR, Cockerell CJ. Corrigendum: Impact on clinical practice of a non-invasive gene expression melanoma rule-out test: 12-month followup of negative test results and utility data from a large US registry study. Dermatol Online J 2019; 25:13030/qt452297hk. [PMID: 31329399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 07/15/2019] [Indexed: 06/10/2023] Open
Abstract
The revised version of the article corrected Figure 2. This change appears in the revised online PDF copy of this article.
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Affiliation(s)
- Laura K Ferris
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA.
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Ferris LK, Rigel DS, Siegel DM, Skelsey MK, Peck GL, Hren C, Gorman C, Frumento T, Jansen B, Yao Z, Rock J, Knezevich SR, Cockerell CJ. Impact on clinical practice of a non-invasive gene expression melanoma rule-out test: 12-month follow-up of negative test results and utility data from a large US registry study. Dermatol Online J 2019; 25:13030/qt61w6h7mn. [PMID: 31220892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/10/2019] [Indexed: 06/09/2023] Open
Abstract
The Pigmented Lesion Assay (PLA, sensitivity 91-95%, specificity 69-91%, negative predictive value ?99%) is a commercially available, non-invasive gene expression test that helps dermatologists guide pigmented lesion management decisions and rule out melanoma. Earlier studies have demonstrated high clinical utility and no missed melanomas in a 3-6-month follow-up period. We undertook the current investigations to provide 12-month follow-up data on PLA(-) tests, and to further confirm utility. A 12-month chart review follow-up of 734 pigmented lesions that had negative PLA results from 5 US dermatology centers was performed. Thirteen of these lesions (1.8%) were biopsied in the follow-up period and submitted for histopathologic review. None of the lesions biopsied had a histopathologic diagnosis of melanoma. The test's utility was studied further in a registry (N=1575, 40 US dermatology offices, 62 participating providers), which demonstrated that 99.9% of PLA(-) lesions were clinically monitored, thereby avoiding a surgical procedure, and 96.5% of all PLA(+) lesions were appropriately biopsied, most commonly with a tangential shave. This long-term follow-up study confirms the PLA's high negative predictive value and high utility in helping guide the management of pigmented lesions to avoid unnecessary surgical procedures.
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Affiliation(s)
- Laura K Ferris
- Department of Dermatology, University of Pittsburgh, Pittsburgh, PA.
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Rock J, Jansen B, Yao Z, Talisha A, Maesa H, Dinh D, Cope J. 524 Evaluation of different skin collection methods for assessment of the skin microbiome. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ferris LK, Moy RL, Gerami P, Sligh JE, Jansen B, Yao Z, Cockerell CJ. Noninvasive Analysis of High-Risk Driver Mutations and Gene Expression Profiles in Primary Cutaneous Melanoma. J Invest Dermatol 2019; 139:1127-1134. [PMID: 30500343 DOI: 10.1016/j.jid.2018.10.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 04/11/2018] [Revised: 10/27/2018] [Accepted: 10/29/2018] [Indexed: 01/28/2023]
Abstract
Tools that help reduce the number of surgical biopsies performed on benign lesions have the potential to improve patient care. The pigmented lesion assay (PLA) is a noninvasive tool validated against histopathology that helps rule out melanoma and the need for surgical biopsies of atypical pigmented skin lesions. Genetic information is collected using adhesive patches and the expression of two genes, LINC and PRAME, is measured. By using genetic material collected noninvasively and to further validate the PLA, somatic hotspot mutations in genes known to be drivers of early melanoma development (BRAF other than V600E, NRAS, and the TERT promoter) can also be identified. The frequency of these hotspot mutations in samples of early melanoma was 77%, which is higher than the 14% found in nonmelanoma samples (P < 0.0001). TERT promoter mutations were the most prevalent mutation type in PLA-positive melanomas; 82% of PLA-negative lesions had no mutations, and 97% of histopathologically confirmed melanomas were PLA and/or mutation positive (cohort 1, n = 103). Mutation frequencies were similar in prospectively collected real-world PLA samples (cohort 2, n = 519), in which 88% of PLA-negative samples had no mutations. Combining gene expression and mutation analyses enhances the ability to noninvasively detect early cutaneous melanoma.
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Affiliation(s)
- Laura K Ferris
- Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
| | - Ronald L Moy
- RodeoDerm Moy Fincher Chips, Beverly Hills, California, USA
| | - Pedram Gerami
- Department of Dermatology, Northwestern University, Chicago, Illinois, USA
| | - James E Sligh
- Southern Arizona Veterans Affairs Healthcare System and University of Arizona, Tucson, Arizona, USA
| | | | - Zuxu Yao
- DermTech, Inc., La Jolla, California, USA
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Bonnechère B, Van Hove O, Jansen B, Van Sint Jan S. Validation of the Wii Balance Board to assess static balance during dual-task activity in healthy subjects. Medicine in Novel Technology and Devices 2019. [DOI: 10.1016/j.medntd.2019.100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Van Hove O, Van Muylem A, Leduc D, Legrand A, Jansen B, Feipel V, Van Sint Jan S, Bonnechère B. The use of cognitive mobile games to assess cognitive function of healthy subjects under various inspiratory loads. Medicine in Novel Technology and Devices 2019. [DOI: 10.1016/j.medntd.2019.100005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Van Hove O, Van Muylem A, Leduc D, Jansen B, Feipel V, Van Sint Jan S, Bonnechère B. Validation of the Wii Balance Board to assess balance modifications induced by increased respiratory loads in healthy subjects. Gait Posture 2019; 68:449-452. [PMID: 30597447 DOI: 10.1016/j.gaitpost.2018.12.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/18/2018] [Accepted: 12/25/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is a link between breathing and balance and posture. When the inspiratory loads are increased by pathologies, there is a decrease of postural control. The increase of the inspiratory load on respiratory muscles is a common feature in various chronic pulmonary pathologies. Consequently, the balance of those patients is likely affected. RESEARCH QUESTION The aim of this study is to validate the use of the Nintendo Wii Balance Board (WBB) to assess balance modifications induced by increased respiratory loads in healthy subjects. METHODS Thirty-seven healthy young participants (25 ± 4 years old, 17 women) participated in this study. Five different conditions were tested: without anything (control), throughout a mouthpiece, and throughout three inspiratory threshold loads (ITL) at 10% (low), 40% (mid) and 60% (high) of the maximal inspiratory pressure. Each trial lasted for 60 s. Nine parameters were extracted based on center of pressure displacement based on a previously-validated method. ANOVA tests were used to compare the different conditions followed by Bonferroni's corrections. RESULTS Highly statistically significant differences (all p < 0.01) and large effect sizes (all ω2 > 0.24) were obtained for all parameters between the different loads and the mouthpiece condition. There is a linear relationship between the load and balance perturbation. SIGNIFICANCE In this study, we demonstrated the validity of the WBB to detect the effect of the inspiratory load on balance in young healthy subjects. Further studies are needed to determine if such a kind of evaluation can be used in clinics with patients suffering from chronic respiratory disease.
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Affiliation(s)
- O Van Hove
- Chest and Thoracic Surgery Department, Erasme Hospital, Brussels, Belgium
| | - A Van Muylem
- Chest and Thoracic Surgery Department, Erasme Hospital, Brussels, Belgium
| | - D Leduc
- Chest and Thoracic Surgery Department, Erasme Hospital, Brussels, Belgium
| | - B Jansen
- Department of Electronics and Informatics - ETRO, Vrije Universiteit Brussel, Brussels, Belgium; imec, Leuven, Belgium
| | - V Feipel
- Laboratory of Functional Anatomy, Université Libre de Bruxelles, Brussels, Belgium
| | - S Van Sint Jan
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, Brussels, Belgium
| | - B Bonnechère
- Department of Electronics and Informatics - ETRO, Vrije Universiteit Brussel, Brussels, Belgium; imec, Leuven, Belgium; Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, Brussels, Belgium.
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Ferris LK, Rigel DS, Siegel DM, Skelsey MK, Peck GL, Hren C, Gorman C, Frumento T, Jansen B, Yao Z, Rock J, Knezevich SR, Cockerell CJ. Impact on clinical practice of a non-invasive gene expression melanoma rule-out test: 12-month follow-up of negative test results and utility data from a large US registry study. Dermatol Online J 2019. [DOI: 10.5070/d3255044059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Ferris LK, Rigel DS, Siegel DM, Skelsey MK, Peck GL, Hren C, Gorman C, Frumento T, Jansen B, Yao Z, Rock J, Knezevich SR, Cockerell CJ. Corrigendum: Impact on clinical practice of a non-invasive gene expression melanoma rule-out test: 12-month followup of negative test results and utility data from a large US registry study. Dermatol Online J 2019. [DOI: 10.5070/d3256044511] [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: 11/08/2022] Open
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Schmeh I, Kidszun A, Welk A, Schwanz T, Jansen B, Mildenberger E. Evaluation of microbiological screening in a neonatal intensive care unit to optimize empiric antibiotic use. J Hosp Infect 2018; 101:362-364. [PMID: 30292789 DOI: 10.1016/j.jhin.2018.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 09/24/2018] [Indexed: 11/29/2022]
Affiliation(s)
- I Schmeh
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Germany; Department of Neonatology, Karolinska University Hospital, Stockholm, Sweden.
| | - A Kidszun
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - A Welk
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - T Schwanz
- Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - B Jansen
- Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
| | - E Mildenberger
- Division of Neonatology, Department of Pediatrics, University Medical Center of the Johannes Gutenberg-University Mainz, Germany
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Jansen BHE, Disselhorst GW, Schutte T, Jansen B, Rissmann R, Richir MC, Keijsers CJPW, Vanmolkot FHM, van den Brink AM, Kramers C, Vondeling AM, Dumont GJH, de Waard-Siebinga I, Van Agtmael MA, Tichelaar J. Essential diseases in prescribing: A national Delphi study towards a core curriculum in pharmacotherapy education. Br J Clin Pharmacol 2018; 84:2645-2650. [PMID: 30076631 DOI: 10.1111/bcp.13730] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/18/2018] [Accepted: 07/29/2018] [Indexed: 11/28/2022] Open
Abstract
AIMS Prescribing is a core skill for junior doctors, yet 8-10% of their prescriptions contain errors. To ensure adequate training in prescribing, it is important to define the diseases for which junior doctors should be competent to prescribe. The aim of the present study was therefore to identify the essential diseases in prescribing for junior doctors. METHODS A two-round Delphi consensus study was conducted among medical specialists, general practitioners, junior doctors, pharmacists and pharmacotherapy teachers from all eight academic hospitals in the Netherlands. Using a five-point Likert scale, the participants indicated for each item on an initial questionnaire whether it should be considered an essential disease for junior doctors. The items for which ≥80% of all respondents agreed or strongly agreed were accepted as essential diseases. RESULTS Sixty-two participants completed the Delphi survey. In total, 63 of 220 items were considered to be essential diseases. CONCLUSION This is the first Delphi consensus study identifying exact conditions that junior doctors must be able to prescribe for. The essential diseases can be used for training in prescribing and assessment of junior doctors' prescribing competence.
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Affiliation(s)
- B H E Jansen
- Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam.,RECIPE (Research & Expertise Center In Pharmacotherapy Education), Amsterdam.,Department of Urology, VU University Medical Center, Amsterdam
| | - G W Disselhorst
- Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam.,RECIPE (Research & Expertise Center In Pharmacotherapy Education), Amsterdam
| | - T Schutte
- Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam.,RECIPE (Research & Expertise Center In Pharmacotherapy Education), Amsterdam
| | - B Jansen
- Department of General Practice & Elderly Care Medicine, VU University Medical Center, Amsterdam
| | - R Rissmann
- Centre for Human Drug Research, Leiden & Leiden University Medical Center
| | - M C Richir
- Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam.,RECIPE (Research & Expertise Center In Pharmacotherapy Education), Amsterdam
| | - C J P W Keijsers
- Department of Geriatrics, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch
| | | | - A Maassen van den Brink
- Department of Internal Medicine, Division of Pharmacology, Vascular and Metabolic Diseases, Erasmus MC, Rotterdam
| | - C Kramers
- Department of Pharmacology-Toxicology, Radboud MC, Nijmegen
| | - A M Vondeling
- Department of Geriatrics, Division of Internal Medicine and Dermatology, UMC, Utrecht
| | | | | | - M A Van Agtmael
- Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam.,RECIPE (Research & Expertise Center In Pharmacotherapy Education), Amsterdam
| | - J Tichelaar
- Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam.,RECIPE (Research & Expertise Center In Pharmacotherapy Education), Amsterdam
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Jansen B, Hansen D, Moy R, Hanhan M, Yao Z. Gene Expression Analysis Differentiates Melanomas from Spitz Nevi. J Drugs Dermatol 2018; 17:574-576. [PMID: 29742191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Pediatric Spitz nevi can pose significant diagnostic challenges to both clinicians and dermatopathologists when the current image-recognition based gold standard is employed. PRAME (preferentially expressed antigen in melanoma) and/or LINC (long intergeneic non-coding RNA 518) gene expression in adult patients in samples obtained non-invasively via adhesive patches differentiates primary melanomas from atypical nevi and other pigmented lesions with a NPV of over 99%, a sensitivity of 91%, and a specificity of 69%, to help clinicians rule out melanoma and the need for surgical biopsies of atypial pigmented lesions with suspicion for melanoma. Surgically obtained melanomas from adult patients show the same gene expression pattern. METHODS In this study, we investigate gene expression patterns of pigmented lesions from FFPE tissue block samples (n=23, 9 male, 14 female patients, median age 12) with a focus on differentiating Spitz nevi from melanomas in children and young adults. RESULTS PRAME levels were significantly (P less than 0.001) increased based on normalized Ct cycle counts (lower cycle counts indicate higher expression levels) in melanomas (mean Ct 33.83 + 0.54, 95% CI 32.85-34.80) when compared to Spitz nevi (mean Ct 37.21 + 0.98, 95% CI 35.41-39.01) or common nevi (mean Ct 36.94 + 0.80, 95% CI 35.47-38.40), respectively. LINC and 4 control genes showed similar expression levels in all 3 pigmented lesion groups investigated. Clinically and histopathologically complex pediatric Spitz nevi demonstrated gene expression signatures almost identical to gene expression signatures of common pediatric nevi but different from melanomas in children and young adults. DISCUSSION PRAME but not LINC gene expression can be a valuable molecular aid to differentiate melanomas from Spitz nevi, groups of pigmented lesions that can be particularly difficult to assess in children and young adults. J Drugs Dermatol. 2018;17(5):574-576.
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Abstract
The application of medical devices either for temporary or permanent use has become an indispensible part of almost all fields of medicine. However, foreign bodies are associated with a substantial risk of bacterial and fungal infections. Implant-associated infections significantly contribute to the still increasing problem of nosocomial infections. To reduce the incidence of such infections, specific guidelines providing evidence-based recommendations and comprising both technological and nontechnological strategies for prevention have been established. Strict adherence to hygienic rules during insertion or implantation of the device are aspects of particular importance. Besides such basic and indispensable aspects, the development of new materials which could withstand microbial adherence and colonization has become a major topic in recent years. Modification of surface by primarily physico-chemical methods may lead to a change in specific and unspecific interactions with microorganisms and, thus, to a reduction in microbial adherence. Medical devices made out of a material that would be ideally antiadhesive or at least colonization-resistant would be the most suitable candidates to avoid colonization and subsequent infection. However, it appears impossible to create a surface with an absolute “zero”-adherence due to thermodynamical reasons and due to the fact that a modified material surface is in vivo rapidly covered by plasma and connective tissue proteins. Therefore, another concept for the prevention of implant-associated infections involves the impregnation of devices with various antimicrobial substances such as antibiotics, antiseptics, and/or metals. In fact, already commercially available materials for clinical use such as antimicrobial catheters have been introduced, in part with considerable impact on subsequent infections. However, future studies are warranted to translate the knowledge on the pathogenesis of device-associated infections into applicable prevention strategies.
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Affiliation(s)
- C von Eiff
- Institute of Medical Microbiology, University of Münster Hospital and Clinics, Münster, Germany.
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Jansen B, Baart RIC. [Who does my leg belong to after amputation?; informed consent on amputation of body parts]. Ned Tijdschr Geneeskd 2018; 162:D2301. [PMID: 29493472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In the Netherlands, when body parts are amputated as part of a medical procedure the patient's consent is required if this body part is used for, or subjected to, medical tests. The patient's consent is, however, rarely obtained, when body parts are discarded as 'pathological waste'. This can raise concerns, as patients have good reasons and distinct rights to demand a different fate, such as a burial or cremation, for their amputated limb. This article analyses the legal status of an amputated body part. We conclude that, legally, the amputated part does not belong to the hospital or doctor and can therefore not be disposed of at whim, in accordance with the hospital's wishes. Doctors have an obligation to actively inform their patients of their property rights over the amputated limbs and of the alternatives to disposal that are available. Doctors might find themselves exposed to tortuous liability procedures if they dispose of amputated body parts without proper consent.
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Affiliation(s)
- B Jansen
- Universiteit Leiden, faculteit Rechtsgeleerdheid, Leiden
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Kopp C, Simonitsch I, Jilma B, Jansen B, Exner M, Speiser W, Kapiotis S, Chott A. Effect of Intradermal Tumor Necrosis Factor-α-induced Inflammation on Coagulation Factors in Dermal Vessel Endothelium. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1615693] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryInflammatory mediators were shown to exert procoagulant effects on cultured human endothelial cells (EC). In the present study the effect of intradermal application of tumor necrosis factor- (TNF-) on the expression of factors involved in regulation of coagulation at the EC surface, i. e. tissue factor (TF), thrombomodulin (TM) and tissue factor pathway inhibitor (TFPI) was studied in humans in vivo. The endothelial expression of these factors was evaluated immunohistochemically in biopsies taken after intradermal application of 5000 U TNF- in 8 healthy volunteers. After 6 and 22 h biopsies were taken from the injection sites. At TNF- injected sites typical inflammatory changes, e. g. EC upregulation of adhesion molecules and accumulation of leukocytes were detected. In parallel we could document EC expression of TF, downregulation of TM and depletion of tissue factor pathway inhibitor (TFPI) in inflamed areas. Early depletion of endothelial I B at the site of inflammation after application of TNF- points to an activation of the NF- B pathway. Our data suggest that, as shown in in vitro experiments, TNF- activates the NF- B pathway and induces specific procoagulant changes of EC due to expression of TF, down-regulation of TM and depletion of TFPI in vivo in humans. This procoagulant shift in the haemostatic balance on the cell surface, caused by TNF- -induced inflammation, is likely to contribute to thrombosis associated with tissue inflammation in humans.
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Sligh J, Yao Z, Jansen B. An Adhesive Patch Biopsy Based Gene Expression Test to Non-invasively Differentiate Basal Cell and Squamous Cell Carcinomas from Actinic Keratoses and Other Skin Lesions of Similar Appearance. ACTA ACUST UNITED AC 2017. [DOI: 10.25251/skin.1.supp.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Abstract Not Available Disclosure: Study supported by DermTech.
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Yao Z, Moy R, Allen T, Jansen B. An Adhesive Patch-Based Skin Biopsy Device for Molecular Diagnostics and Skin Microbiome Studies. J Drugs Dermatol 2017; 16:979-986. [PMID: 29036251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION A number of diagnoses in clinical dermatology are currently histopathologically confirmed and this image recognition-based confirmation generally requires surgical biopsies. The increasing ability of molecular pathology to corroborate or correct a clinical diagnosis based on objective gene expression, mutation analysis, or molecular microbiome data is on the horizon and would be further supported by a tool or procedure to collect samples non-invasively. This study characterizes such a tool in form of a 'bladeless' adhesive patch-based skin biopsy device. METHODS The performance of this device was evaluated through a variety of complementary technologies including assessment of sample biomass, electron microscopy demonstrating the harvesting of layers of epidermal tissue, and isolation of RNA and DNA from epidermal skin samples. Samples were obtained by application of adhesive patches to the anatomical area of interest. RESULTS Biomass assessment demonstrated collection of approximately 0.3mg of skin tissue per adhesive patch and electron microscopy confirmed the nature of the harvested epidermal skin tissue. The obtained tissue samples are stored in a stable fashion on adhesive patches over a wide range of temperatures (-80oC to +60oC) and for extended periods of time (7 days or more). Total human RNA, human genomic DNA and microbiome DNA yields were 23.35 + 15.75ng, 27.72 + 20.71ng and 576.2 + 376.8pg, respectively, in skin samples obtained from combining 4 full patches collected non-invasively from the forehead of healthy volunteers. DISCUSSION The adhesive patch skin sampling procedure is well tolerated and provides robust means to obtain skin tissue, RNA, DNA, and microbiome samples without involving surgical biopsies. The non-invasively obtained skin samples can be shipped cost effectively at ambient temperature by mail or standard courier service, and are suitable for a variety of molecular analyses of the skin microbiome as well as of keratinocytes, T cells, dendritic cells, melanocytes, and other skin cells involved in the pathology of various skin conditions and conditions where the skin can serve as a surrogate target organ. <p><em>J Drugs Dermatol. 2017;16(10):979-986.</em></p>.
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Ferris LK, Jansen B, Ho J, Busam KJ, Gross K, Hansen DD, Alsobrook JP, Yao Z, Peck GL, Gerami P. Utility of a Noninvasive 2-Gene Molecular Assay for Cutaneous Melanoma and Effect on the Decision to Biopsy. JAMA Dermatol 2017; 153:675-680. [PMID: 28445578 DOI: 10.1001/jamadermatol.2017.0473] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Expression of long intergenic non-protein coding RNA 518 (LINC00518) and preferentially expressed antigen in melanoma (PRAME) genes, obtained via noninvasive adhesive patch biopsy, is a sensitive and specific method for detection of cutaneous melanoma. However, the utility of this test in biopsy decisions made by dermatologists has not been evaluated. Objective To determine the utility of the pigmented lesion assay (PLA) for LINC00518/PRAME expression in decisions to biopsy a series of pigmented skin lesions. Design, Setting, and Participants In this secure web-based, multiple-reader-multiple-case study, 45 board-certified dermatologists each evaluated 60 clinical and dermoscopic images of clinically atypical pigmented lesions, first without and then with PLA gene expression information and were asked whether the lesions should be biopsied. Data were collected from March 24, 2014, through November 13, 2015. Interventions Participants were given a report for each lesion, which included the results of an assay for expression of LINC00518/PRAME and a PLA score with data on the predictive values of the information provided. Main Outcomes and Measures Biopsy sensitivity and specificity with vs without PLA data. Results Forty-five dermatologists (29 male and 16 female) performed the evaluation. After incorporating the PLA into their decision as to whether to biopsy a pigmented lesion suggestive of melanoma, dermatologists improved their mean biopsy sensitivity from 95.0% to 98.6% (P = .01); specificity increased from 32.1% to 56.9% (P < .001) with PLA data. Conclusions and Relevance The noninvasive PLA enables dermatologists to significantly improve biopsy specificity while maintaining or improving sensitivity. This result may increase the number of early melanomas biopsied and reduce the number of benign lesions biopsied, thereby improving patient outcomes and reducing health care costs.
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Affiliation(s)
- Laura K Ferris
- Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Jonhan Ho
- Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Doyle D Hansen
- East County Dermatology Medical Group, El Cajon, California
| | | | - Zuxu Yao
- DermTech, Inc, La Jolla, California
| | - Gary L Peck
- Dermatologic Surgery Center of Washington, Chevy Chase, Maryland
| | - Pedram Gerami
- Department of Dermatology, Northwestern University, Chicago, Illinois
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Gerami P, Yao Z, Polsky D, Jansen B, Busam K, Ho J, Martini M, Ferris LK. Development and validation of a noninvasive 2-gene molecular assay for cutaneous melanoma. J Am Acad Dermatol 2016; 76:114-120.e2. [PMID: 27707590 PMCID: PMC5599145 DOI: 10.1016/j.jaad.2016.07.038] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/14/2016] [Accepted: 07/19/2016] [Indexed: 11/26/2022]
Abstract
Background Clinical and histopathologic assessment of pigmented skin lesions remains challenging even for experts. Differentiated and accurate noninvasive diagnostic modalities are highly desirable. Objective We sought to provide clinicians with such a tool. Methods A 2-gene classification method based on LINC00518 and preferentially expressed antigen in melanoma (PRAME) gene expression was evaluated and validated in 555 pigmented lesions (157 training and 398 validation samples) obtained noninvasively via adhesive patch biopsy. Results were compared with standard histopathologic assessment in lesions with a consensus diagnosis among 3 experienced dermatopathologists. Results In 398 validation samples (87 melanomas and 311 nonmelanomas), LINC00518 and/or PRAME detection appropriately differentiated melanoma from nonmelanoma samples with a sensitivity of 91% and a specificity of 69%. We established LINC00518 and PRAME in both adhesive patch melanoma samples and underlying formalin fixed paraffin embedded (FFPE) samples of surgically excised primary melanomas and in melanoma lymph node metastases. Limitations This technology cannot be used on mucous membranes, palms of hands, and soles of feet. Conclusions This noninvasive 2-gene pigmented lesion assay classifies pigmented lesions into melanoma and nonmelanoma groups and may serve as a tool to help with diagnostic challenges that may be inherently linked to the visual image and pattern recognition approach.
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Affiliation(s)
- Pedram Gerami
- Department of Dermatology, Northwestern University, Chicago, Illinois.
| | - Zuxu Yao
- DermTech Inc, La Jolla, California
| | - David Polsky
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York University Langone Medical Center, New York, New York; Ronald O. Perelman Department of Pathology, New York University School of Medicine, New York University Langone Medical Center, New York, New York
| | | | - Klaus Busam
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Jonhan Ho
- Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mary Martini
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Laura K Ferris
- Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania
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Bonnechère B, Jansen B, Van Sint Jan S. Cost-effective (gaming) motion and balance devices for functional assessment: Need or hype? J Biomech 2016; 49:2561-2565. [DOI: 10.1016/j.jbiomech.2016.07.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/12/2016] [Accepted: 07/14/2016] [Indexed: 10/21/2022]
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Yao Z, Allen T, Oakley M, Samons C, Garrison D, Jansen B. Analytical Characteristics of a Noninvasive Gene Expression Assay for Pigmented Skin Lesions. Assay Drug Dev Technol 2016; 14:355-63. [PMID: 27505074 DOI: 10.1089/adt.2016.724] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We previously reported clinical performance of a novel noninvasive and quantitative PCR (qPCR)-based molecular diagnostic assay (the pigmented lesion assay; PLA) that differentiates primary cutaneous melanoma from benign pigmented skin lesions through two target gene signatures, LINC00518 (LINC) and preferentially expressed antigen in melanoma (PRAME). This study focuses on analytical characterization of this PLA, including qPCR specificity and sensitivity, optimization of RNA input in qPCR to achieve a desired diagnostic sensitivity and specificity, and analytical performance (repeatability and reproducibility) of this two-gene PLA. All target qPCRs demonstrated a good specificity (100%) and sensitivity (with a limit of detection of 1-2 copies), which allows reliable detection of gene expression changes of LINC and PRAME between melanomas and nonmelanomas. Through normalizing RNA input in qPCR, we converted the traditional gene expression analyses to a binomial detection of gene transcripts (i.e., detected or not detected). By combining the binomial qPCR results of the two genes, an improved diagnostic sensitivity (raised from 52%- 65% to 71% at 1 pg of total RNA input, and to 91% at 3 pg of total RNA input) was achieved. This two-gene PLA demonstrates a high repeatability and reproducibility (coefficient of variation <3%) and all required analytical performance characteristics for the commercial processing of clinical samples.
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Affiliation(s)
- Zuxu Yao
- DermTech, Inc. , La Jolla, California
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Wolthaus J, van Asselen B, Woodings S, van Soest T, Kok J, de Prez L, Jansen B, de Pooter J, Raaymakers B. TH-CD-BRA-03: Direct Measurement of Magnetic Field Correction Factors, KQB, for Application in Future Codes of Practice for Reference Dosimetry. Med Phys 2016. [DOI: 10.1118/1.4958146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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de Prez L, de Pooter J, Jansen B, Wolthaus J, van Asselen B, Woodings S, Soest T, Kok J, Raaymakers B. TH-CD-BRA-05: First Water Calorimetric Dw Measurement and Direct Measurement of Magnetic Field Correction Factors, KQ,B, in a 1.5 T B-Field of An MRI Linac. Med Phys 2016. [DOI: 10.1118/1.4958148] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Omelina L, Jansen B, Bonnechère B, Oravec M, Jarmila P, Van Sint Jan S. Interaction Detection with Depth Sensing and Body Tracking Cameras in Physical Rehabilitation. Methods Inf Med 2015; 55:70-8. [PMID: 26640833 DOI: 10.3414/me14-01-0120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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: 11/27/2014] [Accepted: 09/17/2015] [Indexed: 11/09/2022]
Abstract
INTRODUCTION This article is part of the Focus Theme of Methods of Information in Medicine on "Methodologies, Models and Algorithms for Patients Rehabilitation". OBJECTIVES This paper presents a camera based method for identifying the patient and detecting interactions between the patient and the therapist during therapy. Detecting interactions helps to discriminate between active and passive motion of the patient as well as to estimate the accuracy of the skeletal data. METHODS Continuous face recognition is used to detect, recognize and track the patient with other people in the scene (e.g. the therapist, or a clinician). We use a method based on local binary patterns (LBP). After identifying users in the scene we identify interactions between the patient and other people. We use a depth map/point cloud for estimating the distance between two people. Our method uses the association of depth regions to user identities and computes the minimal distance between the regions. RESULTS Our results show state-of-the-art performance of real-time face recognition using low-resolution images that is sufficient to use in adaptive systems. Our proposed approach for detecting interactions shows 91.9% overall recognition accuracy what is sufficient for applications in the context of serious games. We also discuss limitations of the proposed method as well as general limitations of using depth cameras for serious games. CONCLUSIONS We introduced a new method for frame-by-frame automated identification of the patient and labeling reliable sequences of the patient's data recorded during rehabilitation (games). Our method improves automated rehabilitation systems by detecting the identity of the patient as well as of the therapist and by detecting the distance between both over time.
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Affiliation(s)
- L Omelina
- Lubos Omelina, Department of Electronics and Informatics, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussel, Belgium, E-mail:
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Bonnechère B, Jansen B, Omelina L, Van Sint Jan S. Rehabilitation of neurologic patient using serious games, from theory to practice. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Schmeh I, Welk A, Schwanz T, Diefenbach A, Jansen B, Mildenberger E. Is the implementation of a microbiological surveillance screening beneficial in a neonatal intensive care unit? Mol Cell Pediatr 2015. [PMCID: PMC4715031 DOI: 10.1186/2194-7791-2-s1-a17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bonnechère B, Jansen B, Omelina L, Degelaen M, Wermenbol V, Rooze M, Van Sint Jan S. Can serious games be incorporated with conventional treatment of children with cerebral palsy? A review. Res Dev Disabil 2014; 35:1899-1913. [PMID: 24794289 DOI: 10.1016/j.ridd.2014.04.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [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: 01/14/2014] [Revised: 04/03/2014] [Accepted: 04/08/2014] [Indexed: 06/03/2023]
Abstract
The use of video games in rehabilitation is becoming more popular to clinicians. These games are embedded in off-the-shelf commercial entertainment applications or especially-developed for clinical purposes. Treatment of cerebral palsy (CP) children is a challenging task for clinicians. Lack of motivation and progress monitoring are two important factors clinicians need to deal with. The use of serious games (SG), sometimes referred to as Virtual Rehabilitation (VR), could therefore be an interesting adjuvant to conventional treatment for these patients. This is however a new discipline and many scientific issues remain to be solved. The aim of this paper is to describe available conventional treatment for CP children together with the level of evidence of each approach. A systematic review of the use of SG in rehabilitation is then conducted. 31 papers (7 randomized clinical trials, 16 cohort studies and 8 single-cases studies) were selected and analyzed, and their level of evidence compared to the conventional treatment. These studies reported outcomes for 352 patients. In summary, this review shows that it is difficult to compare those studies despite the large amount of patients. This is due to the lack of standardization in patient rehabilitation strategy and to the use of various clinical scales and scores. This non-standardization in patient follow-up between previously-published works make evidence-based conclusions difficult to obtain in order to support these techniques objectively. The use of SG for rehabilitation purposes currently meets similar issues. This paper proposes standardization strategies in order to improve treatment comparison and SG use in rehabilitation.
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Affiliation(s)
- B Bonnechère
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, Belgium.
| | - B Jansen
- Department of Electronics and Informatics - ETRO, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium; iMinds, Department of Future Media and Imaging (FMI), Gaston Crommenlaan 8 (Box 102), B-9050 Ghent, Belgium
| | - L Omelina
- Department of Electronics and Informatics - ETRO, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium
| | - M Degelaen
- Rehabilitation Hospital Inkendaal, Centrum voor bewegingsanalyse, Vlezenbeek, Belgium; Centre d'analyse du Mouvement, Hôpital Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - V Wermenbol
- Department of Paediatric Neurology - Hôpital Erasme, Belgium
| | - M Rooze
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, Belgium
| | - S Van Sint Jan
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, Belgium
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Trippolini MA, Dijkstra PU, Jansen B, Oesch P, Geertzen JHB, Reneman MF. Reliability of clinician rated physical effort determination during functional capacity evaluation in patients with chronic musculoskeletal pain. J Occup Rehabil 2014; 24:361-9. [PMID: 23975060 PMCID: PMC4000417 DOI: 10.1007/s10926-013-9470-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
INTRODUCTION Functional capacity evaluation (FCE) can be used to make clinical decisions regarding fitness-for-work. During FCE the evaluator attempts to assess the amount of physical effort of the patient. The aim of this study is to analyze the reliability of physical effort determination using observational criteria during FCE. METHODS Twenty-one raters assessed physical effort in 18 video-recorded FCE tests independently on two occasions, 10 months apart. Physical effort was rated on a categorical four-point physical effort determination scale (PED) based on the Isernhagen criteria, and a dichotomous submaximal effort determination scale (SED). Cohen's Kappa, squared weighted Kappa and % agreement were calculated. RESULTS Kappa values for intra-rater reliability of PED and SED for all FCE tests were 0.49 and 0.68 respectively. Kappa values for inter-rater reliability of PED for all FCE tests in the first and the second session were 0.51, and 0.72, and for SED Kappa values were 0.68 and 0.77 respectively. The inter-rater reliability of PED ranged from κ = 0.02 to κ = 0.99 between FCE tests. Acceptable reliability scores (κ > 0.60, agreement ≥80 %) for each FCE test were observed in 38 % of scores for PED and 67 % for SED. On average material handling tests had a higher reliability than postural tolerance and ambulatory tests. CONCLUSION Dichotomous ratings of submaximal effort are more reliable than categorical criteria to determine physical effort in FCE tests. Regular education and training may improve the reliability of observational criteria for effort determination.
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Affiliation(s)
- M A Trippolini
- Department of Work Rehabilitation, Rehaklinik Bellikon, Suva Care, 5454, Bellikon, Switzerland,
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De Prez L, De Pooter J, Jansen B. WE-G-17A-06: A Water Calorimeter for Use in MRI Linacs. Med Phys 2014. [DOI: 10.1118/1.4889508] [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: 11/07/2022] Open
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Schmidt FP, Peivandi AA, Kohnen W, Jansen B. Surgery for acquired cardiovascular disease: antiseptic treatment of contaminated vein grafts. J Cardiovasc Surg (Torino) 2014; 55:271-277. [PMID: 24131932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM Saphenous vein grafts harvested for use as bypass conduits can be contaminated intraoperatively, e.g. by being inadvertently dropped to the floor of the operating room (OR). This study was performed to investigate microorganisms most likely contaminating vein grafts and to assess the possible efficacy of measures to treat potentially contaminated vein grafts antiseptically for further use. METHODS In a first step we determined the microbiological flora of the OR using surface cultures and cultures from intentionally dropped vein grafts. Several antiseptic agents (PVP-iodine 10%, octenidinhydrochloride 0.1%, polyhexanide 1%) were evaluated for their in vitro efficacy to disinfect artificially contaminated vein segments. The most promising antiseptic regimen was tested on veins contaminated in a real OR setting. Finally, we tested for possible alterations in mechanical properties of the veins caused by antiseptic treatment. RESULTS Coagulase-negative staphylococci where the predominant bacteria recovered from the OR with 59.9%. Antiseptic treatment with a combination of octenidine and PVP-iodine resulted in a higher rate of negative cultures than any single agent. Treatment of 50 saphenous vein grafts contaminated in the OR with the combination regimen resulted in only 3 positive cultural results within 7 days. Mechanical tear-stress testing comparing antiseptically treated vein grafts with controls showed no difference in their resistance to tear stress. CONCLUSION Antiseptic treatment of contaminated vein grafts was shown to be effective in a high percentage of cases without altering mechanical properties of grafts and may be an option for the surgeon in case of a contamination.
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Affiliation(s)
- F P Schmidt
- Second Medical Department University Medical Center Johannes Gutenberg University, Mainz, Germany -
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Bonnechère B, Jansen B, Salvia P, Bouzahouene H, Sholukha V, Cornelis J, Rooze M, Van Sint Jan S. Determination of the precision and accuracy of morphological measurements using the Kinect™ sensor: comparison with standard stereophotogrammetry. Ergonomics 2014; 57:622-31. [PMID: 24646374 DOI: 10.1080/00140139.2014.884246] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 05/20/2023]
Abstract
The recent availability of the Kinect™ sensor, a low-cost Markerless Motion Capture (MMC) system, could give new and interesting insights into ergonomics (e.g. the creation of a morphological database). Extensive validation of this system is still missing. The aim of the study was to determine if the Kinect™ sensor can be used as an easy, cheap and fast tool to conduct morphology estimation. A total of 48 subjects were analysed using MMC. Results were compared with measurements obtained from a high-resolution stereophotogrammetric system, a marker-based system (MBS). Differences between MMC and MBS were found; however, these differences were systematically correlated and enabled regression equations to be obtained to correct MMC results. After correction, final results were in agreement with MBS data (p = 0.99). Results show that measurements were reproducible and precise after applying regression equations. Kinect™ sensors-based systems therefore seem to be suitable for use as fast and reliable tools to estimate morphology. Practitioner Summary: The Kinect™ sensor could eventually be used for fast morphology estimation as a body scanner. This paper presents an extensive validation of this device for anthropometric measurements in comparison to manual measurements and stereophotogrammetric devices. The accuracy is dependent on the segment studied but the reproducibility is excellent.
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Affiliation(s)
- B Bonnechère
- a Laboratory of Anatomy, Biomechanics and Organogenesis (LABO) , Université Libre de Bruxelles , Brussels , Belgium
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Bonnechère B, Jansen B, Salvia P, Bouzahouene H, Omelina L, Moiseev F, Sholukha V, Cornelis J, Rooze M, Van Sint Jan S. Validity and reliability of the Kinect within functional assessment activities: comparison with standard stereophotogrammetry. Gait Posture 2013; 39:593-8. [PMID: 24269523 DOI: 10.1016/j.gaitpost.2013.09.018] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [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: 01/31/2013] [Revised: 06/27/2013] [Accepted: 09/25/2013] [Indexed: 02/02/2023]
Abstract
The recent availability of the Kinect™ sensor, a cost-effective markerless motion capture system (MLS), offers interesting possibilities in clinical functional analysis and rehabilitation. However, neither validity nor reproducibility of this device is known yet. These two parameters were evaluated in this study. Forty-eight volunteers performed shoulder abduction, elbow flexion, hip abduction and knee flexion motions; the same protocol was repeated one week later to evaluate reproducibility. Movements were simultaneously recorded by the Kinect (with Microsoft Kinect SDK v.1.5) MLS and a traditional marker-based stereophotogrammetry system (MBS). Considering the MBS as reference, discrepancies between MLS and MBS were evaluated by comparing the range of motion (ROM) between both systems. MLS reproducibility was found to be statistically similar to MBS results for the four exercises. Measured ROMs however were found different between the systems.
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Affiliation(s)
- B Bonnechère
- Laboratory of Anatomy, Biomechanics and Organogenesis (LABO), Université Libre de Bruxelles, CP 610, Lennik Street 808, 1070 Brussels, Belgium.
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Trippolini MA, Reneman MF, Jansen B, Dijkstra PU, Geertzen JHB. Reliability and safety of functional capacity evaluation in patients with whiplash associated disorders. J Occup Rehabil 2013; 23. [PMID: 23179744 PMCID: PMC3734606 DOI: 10.1007/s10926-012-9403-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 05/08/2023]
Abstract
INTRODUCTION Whiplash-associated disorders (WAD) are a burden for both individuals and society. It is recommended to evaluate patients with WAD at risk of chronification to enhance rehabilitation and promote an early return to work. In patients with low back pain (LBP), functional capacity evaluation (FCE) contributes to clinical decisions regarding fitness-for-work. FCE should have demonstrated sufficient clinimetric properties. Reliability and safety of FCE for patients with WAD is unknown. METHODS Thirty-two participants (11 females and 21 males; mean age 39.6 years) with WAD (Grade I or II) were included. The FCE consisted of 12 tests, including material handling, hand grip strength, repetitive arm movements, static arm activities, walking speed, and a 3 min step test. Overall the FCE duration was 60 min. The test-retest interval was 7 days. Interclass correlations (model 1) (ICCs) and limits of agreement (LoA) were calculated. Safety was assessed by a Pain Response Questionnaire, observation criteria and heart rate monitoring. RESULTS ICCs ranged between 0.57 (3 min step test) and 0.96 (short two-handed carry). LoA relative to mean performance ranged between 15 % (50 m walking test) and 57 % (lifting waist to overhead). Pain reactions after WAD FCE decreased within days. Observations and heart rate measurements fell within the safety criteria. CONCLUSIONS The reliability of the WAD FCE was moderate in two tests, good in five tests and excellent in five tests. Safety-criteria were fulfilled. Interpretation at the patient level should be performed with care because LoA were substantial.
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Affiliation(s)
- M A Trippolini
- Department of Work Rehabilitation, Rehaklinik Bellikon, Suva Care, 5454 Bellikon, Switzerland.
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Jansen B, Böhme C, Schön-Hölz K, Schwartz T, Obst U, Kohnen W. Occurence of vancomycin-resistant Enterococcus faecium in patient isolates and aquatic environment during a period between 2004 and 2010. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.579] [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: 10/28/2022] Open
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