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Koo BS, Eun S, Shin K, Yoon H, Hong CL, Kim DH, Hong S, Kim YG, Lee CK, Yoo B, Oh JS. OP0023 PREDICTION OF REMISSION FOR EACH BIOLOGICS BASED ON PATIENT’S CLINICAL INFORMATION BEFORE STARTING BIOLOGICS USING EXPLAINABLE ARTIFICIAL INTELLIGENCE: DATA FROM THE KOREAN COLLEGE OF RHEUMATOLOGY BIOLOGICS REGISTRY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Many studies have identified predictive factors of response to biologics in patients wirh rheumatoid arthritis (RA). However, there is still a lack in using them in daily clinical practice. Therefore, it is necessary to develop a method that can assist the physician in selecting effective biologics.Objectives:The purpose of this study is to establish machine learning model that predicts remission in patients treated with biologics using data of RA patients from the Korean College of Rheumatology Biologics (KOBIO) registry, and to identify the important features that have the most influence on the response to biologics using explainable artificial intelligence (AI).Methods:A total of 1,527 patients who started with biologics such as etanercept, adalimumab, golimumab, infliximab, abatacept, and tocilizumab from December 2012 to June 2019 were enrolled. Remission was predicted using 46 variables corresponding to baseline profiles at the starting of each biologics. We used five machine learning methods such as lasso, ridge, SVM, random forest, and XGBoost. For explainability of those models, we used Shapley plot to interpret the feature importance for each biologics.Results:In all machine learning methods, the accuracy and the area under the receiver operating characteristic (AUROC) were 57.2%~74.5%, 0.547~0.747, respectively (Table 1). The accuracy and AUROC of each biologics were similar between machine learning methods. Figure 2 showed interpretation of feature importance with the Shapley plot for remission. The most important feature was age in adalimumab (younger were closer to remission), daily corticosteroid dose in etanercept, golimumab, and all TNF inhibitors (using fewer doses daily were closer to remission), baseline erythrocyte sedimentation rate in infliximab (lower ESR were closer to remission), disease duration in abatacept (longer disease durations showed difficulty determining remission), baseline c-reactive protein in tocilizumab (higher CRP were closer to remission).Table.Predicting remission for all biologics in various machine learning method.MeasureLassoRidgeSVMRandom ForestXGBoostNo info rateSampleAbataceptAccuracy74.1%74.1%70.6%71.8%68.8%70.6%216AUROC0.7250.7420.7070.6770.6470.500AdalimumabAccuracy73.6%72.0%70.4%72.0%70.4%68.8%315AUROC0.7100.7290.7000.6750.6630.500EtanerceptAccuracy72.0%72.0%70.0%71.5%70.0%68.0%250AUROC0.7410.7470.7260.7190.7040.500GolimumabAccuracy71.3%68.5%66.7%68.5%68.5%68.5%138AUROC0.7460.7270.7010.6900.6550.500InfliximabAccuracy72.8%73.5%67.6%73.5%69.1%72.5%172AUROC0.6630.6830.6160.5970.5270.500TNF inhibitorsAccuracy73.9%74.5%73.9%74.2%73.6%70.3%875AUROC0.7390.7410.7260.7470.7240.500TocilizumabAccuracy62.4%63.6%62.4%59.5%57.2%59.5%436AUROC0.6330.6400.6330.6150.5470.500Figure 2.Shapley plots and SHAP values for the feature importance from clinical information in patients with RA.Conclusion:We developed machine learning models for predicting remission as a response to each biologics in active RA patients based on their clinical profiles, and found important clinical features using explainable AI. This approach may support clinical decisions to improve treatment outcomes in patients with RA.Disclosure of Interests:None declared
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Wu M, Zhao CL, Yang YX, Cao KH, Qiao XW, Hong CL. Ag−Co
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@ Nr GO Material Synthesized by One‐pot Hydrothermal Method for Carcinoembryonic Antigen (CEA) Detection of Enzyme‐mimetic Electrochemical Immunosensor. ELECTROANAL 2020. [DOI: 10.1002/elan.201900664] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M. Wu
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical EngineeringShihezi University Shihezi 832003 China
| | - C. L. Zhao
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical EngineeringShihezi University Shihezi 832003 China
| | - Y. X. Yang
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical EngineeringShihezi University Shihezi 832003 China
| | - K. H. Cao
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical EngineeringShihezi University Shihezi 832003 China
| | - X. W. Qiao
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical EngineeringShihezi University Shihezi 832003 China
| | - C. L. Hong
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical EngineeringShihezi University Shihezi 832003 China
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Zhou XL, Dong FQ, Hong CL, Chen DK, He F. A Novel Coordinated Polymer [Cu(En)2][(PzTp)Fe(CN)3]2: Synthesis, Crystal Structure, and Inhibiting Left Atrial Myxoma Cell Activity in vitro. RUSS J COORD CHEM+ 2018. [DOI: 10.1134/s1070328418030089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Hong CL, Jia YB, Yang XE, He ZL, Stoffella PJ. Assessing lead thresholds for phytotoxicity and potential dietary toxicity in selected vegetable crops. Bull Environ Contam Toxicol 2008; 80:356-361. [PMID: 18311529 DOI: 10.1007/s00128-008-9375-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Accepted: 01/29/2008] [Indexed: 05/26/2023]
Abstract
Lead tolerance and accumulation in shoots and edible parts varied with crop species and soil type. The critical Pb concentrations at 10% yield reduction were 24.71, 28.25, and 0.567 mg kg(-1) for pakchoi, celery, and hot pepper, respectively under hydroponic conditions, whereas were 13.1, 3.83, 0.734 mg kg(-1) grown in the Inceptisol and 31.7, 30.0, 0.854 mg kg(-1) in the Alluvial soil, respectively. Based on the threshold of human dietary toxicity for Pb, the critical levels of soil available Pb for pakchoi, celery, and hot pepper were 5.07, 8.06, and 0.48 mg kg(-1) for the Inceptisol, and 1.38, 1.47, and 0.162 mg kg(-1) for the Alluvial soil, respectively. Similarly, the total soil Pb thresholds were different from vegetable species and soil types.
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Affiliation(s)
- C L Hong
- College of Natural Resources and Environmental Science, Zhejiang University, Hangzhou, 310029, China
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Chen HJ, Lin TC, Hong CL, Chiang LC. Analysis of 3,N(4)-ethenocytosine in DNA and in human urine by isotope dilution gas chromatography/negative ion chemical ionization/mass spectrometry. Chem Res Toxicol 2001; 14:1612-9. [PMID: 11743744 DOI: 10.1021/tx015551x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [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: 11/30/2022]
Abstract
The promutagenic etheno DNA adducts have been detected in tissue DNA of rodents and humans from various exogenous and endogenous sources. While other etheno DNA adducts have been detected and quantified by isotope dilution gas chromatography/negative ion chemical ionization/mass spectrometry (GC/NICI/MS), similar analysis for 3,N(4)-ethenocytosine (epsilonCyt) has not been available. In this report, a GC/NICI/MS assay was developed for detection and quantification of epsilonCyt in DNA and in human urine samples. The stable isotope of epsilonCyt with 7 mass units higher than the normal epsilonCyt was synthesized and used as internal standard of the assay. The adduct-enriched fraction of DNA hydrolysate was derivatized with pentafluorobenzyl bromide before GC/NICI/MS analysis with selective ion monitoring at [M - 181](-) fragments of pentafluorobenzylated epsilonCyt and its isotope analogue. One femtogram (S/N > 40) of pentafluorobenzylated epsilonCyt was detected when injected on column with selective ion monitoring mode. The limit of quantification for the entire assay was 7.4 fmol of epsilonCyt, which was approximately one thousand times lower than that of the HPLC/fluorescence assay for the nucleoside 3,N(4)-etheno-2'-deoxycytidine in DNA. Analysis of chloroacetaldehyde-treated calf thymus DNA by both GC/NICI/MS and HPLC/fluorescence methods provided similar adduct levels and thus verified the assay. This GC/NICI/MS method was used for analysis of epsilonCyt in two smokers' urine samples and the average level of epsilonCyt was 101 +/- 17 pg/mL/g of creatinine. Thus, quantification of epsilonCyt in DNA and in urine by this highly specific and ultrasensitive isotope dilution GC/NICI/MS assay may facilitate research on the role of epsilonCyt in carcinogenesis and in cancer development.
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Affiliation(s)
- H J Chen
- Department of Chemistry, National Chung Cheng University, 160 San-Hsing, Ming-Hsiung, Chia-Yi 62142, Taiwan.
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Tso AS, Chung HS, Wu CY, Li JY, Hong CL, Yang MW, Lui PW. Anesthetic management of a patient with relapsing polychondritis--a case report. Acta Anaesthesiol Sin 2001; 39:189-94. [PMID: 11840586] [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: 02/23/2023]
Abstract
Relapsing polychondritis is a rare multisystem disorder of uncertain etiology. It is characterized by recurrent and progressive destruction of both elastic and hyaline cartilages as well as connective tissue. Respiratory tract involvement is associated with high mortality and morbidity. General anesthesia may be required in these patients for tracheostomy, bronchoscopy, nasal reconstruction, aortic valve replacement, and recent tracheobronchial stenting which they usually sustain. Tracheostomy was once the most likely surgical procedure in relapsing polychondritis. However, this procedure is only effective in patients with upper subglottic involvement. In cases of extensive tracheobronchial involvement, tracheostomy is ineffective because the distant tracheal collapse below the tracheostomy is still unresolved. We would like to report a case of relapsing polychondritis with tracheobronchial involvement, who underwent an emergent tracheostomy. Tracheostomy with continuous positive airway pressure (CPAP) effectively improved her airway collapse. Herein, we also discuss the anesthetic management after review of the current literature.
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Affiliation(s)
- A S Tso
- Department of Anesthesia, Chang Gung Memorial Hospital, Linkou, 5 Fu-Shin St., Kweishan, Taoyuan, Taiwan, R.O.C
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Hong CL, Ho AC, Liu HP, Chung HS, Chen CH, Tso AS, Yang MW. Diagnosis of progressive compression of the aortic true lumen with intraoperative transesophageal echocardiography during repair of dissection of thoracic aorta--a case report. Acta Anaesthesiol Sin 2001; 39:183-7. [PMID: 11840585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
We report an incident of progressive compression of the true lumen of aorta which happened immediately after cardiopulmonary bypass (CPB) and was diagnosed with intraoperative transesophageal echocardiography (TEE) in a patient undergoing an emergent repair of type A aortic dissection under femoral perfusion. During the CPB period, intraoperative TEE revealed gradual expansion of the false lumen which nearly obstructed the true lumen of the dissected aorta. The possible mechanism was related with distension of the false lumen by a dominant flow from retrograde femoral perfusion of CPB. With the application of intraoperative TEE, we could easily detect the hemodynamic changes of thoracic aorta and find the real causes so as to solve the perfusion abnormalities.
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Wang YL, Hong CL, Chung HS, Ho AC, Yu CL, Liu HP, Lee YH, Tan PP. Massive hemoptysis after the initiation of positive pressure ventilation in a patient with pulmonary tuberculosis. Anesthesiology 2000; 92:1480-2. [PMID: 10781296 DOI: 10.1097/00000542-200005000-00040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Y L Wang
- Department of Anesthesia, Chang Gung Memorial Hospital, Taiwan, Republic of China
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Chen CH, Hong CL, Kau YC, Lee HL, Chen CK, Shyr MH. Fatal hyperkalemia during rapid and massive blood transfusion in a child undergoing hip surgery--a case report. Acta Anaesthesiol Sin 1999; 37:163-6. [PMID: 10609352] [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: 02/14/2023]
Abstract
We report a girl who developed severe and fatal hyperkalemia following rapid and massive blood transfusion during surgery. She was 7-year-old, 20-kg in weight, and received wide resection of the femoral bone with custom prosthesis implant because of malignant femoral osteosarcoma. During the procedure, bleeding was active and profuse and amounted to about 3,000 mL in 4 h, eventuating in shock. Despite rapid transfusion with 15 units of packed red blood cells (RBC) still she remained hypotensive and hypovolemic. When we switched to give her whole blood, actually 100 mL having been given, widening of QRS complex followed immediately by cardiac arrest developed. Cardiopulmonary resuscitation although started at once was unsuccessful. At this juncture, arterial blood gas analysis showed acidosis and severe hyperkalemia (10.3 mmol/L), possibly resulting from transfusion of blood of older storage. The case reminded us once again the importance and necessity of the use of potassium-low blood component (fresh, saline-washed RBCs) in case of massive and rapid blood transfusion especially in pediatric patients with hypovolemia and low cardiac output.
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Affiliation(s)
- C H Chen
- Department of Anesthesia, Chang Gung Memorial Hospital, Taiwan, R.O.C
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Lin WT, Cheng KC, Liu HP, Hsieh JR, Hong CL, Wu RS, Tan PP. Alternation of one-lung and two-lung ventilations with the same single-lumen endobronchial tube during thoracoscopic surgery--a case report. Acta Anaesthesiol Sin 1998; 36:229-33. [PMID: 10399519] [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: 02/13/2023]
Abstract
One-lung ventilation is sometimes necessary for procedures performed through thoracotomy. Single lumen endobronchial tube has been used purposefully for one lung ventilation since 1931. However, there are no reports on intra-operative alternation of one-lung and two-lung ventilations through the same single lumen endobronchial tube as it can only provide unilateral lung ventilation. We present a case in whom a tube exchanger was used to readjust tube position so as to provide alternation of one-lung and two-lung ventilations in a thoracoscopic procedure.
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Affiliation(s)
- W T Lin
- Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, R.O.C
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Affiliation(s)
- F J Lu
- Department of Biochemistry, College of Medicine, National Taiwan University, Republic of China
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Abstract
A high incidence of bladder cancer (23.53/100,000 population per annum from 1981-1985) was found in an endemic area of peripheral vascular disease known as black foot disease (BFD) on the southwest coast of Taiwan. The average incidence of bladder cancer in the whole of the Taiwan area was 2.29/100,000 during the same period. The incidence of female bladder cancer (21.10/100,000) in this area was also high. The ratio of male to female bladder cancer in the BFD endemic area and the neighbouring area was 1.24 and 1.09, lower than that in the whole Taiwan area (2.75) and elsewhere around the world. The high content of arsenic and the high concentration of a "fluorescent substance" in artesian well water in this area are the only 2 related factors identified so far. Determination of the actual carcinogen requires further investigation.
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Affiliation(s)
- H S Chiang
- Department of Urology, Taipei Medical College, Taiwan, Republic of China
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Chi WO, Hong CL. A Rapid Synthesis of 2,3,11,11a-Tetrahydro-6H-pyrazino[1,2-b]isoquinoline-1,4-diones Through an Amido Iminium Ion Cyclization. Aust J Chem 1990. [DOI: 10.1071/ch9900773] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
7,10-Dimethoxy-6-methyl-2,3,11,11a-tetrahydro-6H-pyrazino[1,2-b]isoquinoline-1,4-diones (5) and (6) were synthesized from glycine anhydride and 2,5-dimethoxybenzaldehyde through an amido iminium ion cyclization reaction. This method for the construction of the tetrahydroisoquinoline ring will be useful for the synthesis of saframycins.
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Chiang HS, Hong CL, Guo HR, Lee EF, Chen TY. Comparative study on the high prevalence of bladder cancer in the blackfoot disease endemic area in Taiwan. Taiwan Yi Xue Hui Za Zhi 1988; 87:1074-80. [PMID: 3235966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Hong CL, Huang PC. Analysis of body weight gain and estimation of additional energy costs during normal pregnancy in Taiwan and Japan. Taiwan Yi Xue Hui Za Zhi 1987; 86:649-56. [PMID: 3655710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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