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Gao Y, Ma C, Guo L, Liu G, Zhang X, Ji X. Adversarial learning-based domain adaptation algorithm for intracranial artery stenosis detection on multi-source datasets. Comput Biol Med 2024; 170:108001. [PMID: 38280254 DOI: 10.1016/j.compbiomed.2024.108001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/26/2023] [Accepted: 01/13/2024] [Indexed: 01/29/2024]
Abstract
Intracranial arterial stenosis (ICAS) is characterized by the pathological narrowing or occlusion of the inner lumen of intracranial blood vessels. However, the retina can indirectly react to cerebrovascular disease. Therefore, retinal fundus images (RFI) serve as valuable noninvasive and easily accessible screening tools for early detection and diagnosis of ICAS. This paper introduces an adversarial learning-based domain adaptation algorithm (ALDA) specifically designed for ICAS detection in multi-source datasets. The primary objective is to achieve accurate detection and enhanced generalization of ICAS based on RFI. Given the limitations of traditional algorithms in meeting the accuracy and generalization requirements, ALDA overcomes these challenges by leveraging RFI datasets from multiple sources and employing the concept of adversarial learning to facilitate feature representation sharing and distinguishability learning. In order to evaluate the performance of the ALDA algorithm, we conducted experimental validation on multi-source datasets. We compared its results with those obtained from other deep learning algorithms in the ICAS detection task. Furthermore, we validated the potential of ALDA for detecting diabetic retinopathy. The experimental results clearly demonstrate the significant improvements achieved by the ALDA algorithm. By leveraging information from diverse datasets, ALDA learns feature representations that exhibit enhanced generalizability and robustness. This makes it a reliable auxiliary diagnostic tool for clinicians, thereby facilitating the prevention and treatment of cerebrovascular diseases.
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Affiliation(s)
- Yuan Gao
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, 100191, Beijing, China; Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, 100053, Beijing, China.
| | - Chenbin Ma
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, 100191, Beijing, China; Shen Yuan Honors College, Beihang University, 100191, Beijing, China.
| | - Lishuang Guo
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, 100191, Beijing, China.
| | - Guiyou Liu
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, 100050, Beijing, China.
| | - Xuxiang Zhang
- Beijing Institute for Brain Disorders, Capital Medical University, 100069, Beijing, China.
| | - Xunming Ji
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, 100191, Beijing, China.
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Ma C, Zhang Y, Cao Y, Hu CH, Zheng CX, Jin Y, Sui BD. Autonomic neural regulation in mediating the brain-bone axis: mechanisms and implications for regeneration under psychological stress. QJM 2024; 117:95-108. [PMID: 37252831 DOI: 10.1093/qjmed/hcad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Indexed: 06/01/2023] Open
Abstract
Efficient regeneration of bone defects caused by disease or significant trauma is a major challenge in current medicine, which is particularly difficult yet significant under the emerging psychological stress in the modern society. Notably, the brain-bone axis has been proposed as a prominent new concept in recent years, among which autonomic nerves act as an essential and emerging skeletal pathophysiological factor related to psychological stress. Studies have established that sympathetic cues lead to impairment of bone homeostasis mainly through acting on mesenchymal stem cells (MSCs) and their derivatives with also affecting the hematopoietic stem cell (HSC)-lineage osteoclasts, and the autonomic neural regulation of stem cell lineages in bone is increasingly recognized to contribute to the bone degenerative disease, osteoporosis. This review summarizes the distribution characteristics of autonomic nerves in bone, introduces the regulatory effects and mechanisms of autonomic nerves on MSC and HSC lineages, and expounds the crucial role of autonomic neural regulation on bone physiology and pathology, which acts as a bridge between the brain and the bone. With the translational perspective, we further highlight the autonomic neural basis of psychological stress-induced bone loss and a series of pharmaceutical therapeutic strategies and implications toward bone regeneration. The summary of research progress in this field will add knowledge to the current landscape of inter-organ crosstalk and provide a medicinal basis for the achievement of clinical bone regeneration in the future.
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Affiliation(s)
- C Ma
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Y Zhang
- Department of Medical Rehabilitation, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Y Cao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
- Department of Orthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - C-H Hu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
- Xi'an Institute of Tissue Engineering and Regenerative Medicine, Xi'an, Shaanxi 710032, China
| | - C-X Zheng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Y Jin
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
- Xi'an Institute of Tissue Engineering and Regenerative Medicine, Xi'an, Shaanxi 710032, China
| | - B-D Sui
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, China
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Wang L, Ma C, Shen Y, Haugen TW, He Y, Sun J. Application of tensor fascia lata perforator flap in head and neck reconstruction. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00005-5. [PMID: 38228464 DOI: 10.1016/j.ijom.2024.01.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024]
Abstract
The aim of this study was to describe the authors' experience in head and neck reconstruction with the tensor fascia lata perforator flap (TFLPF). Between April 2009 and August 2020, 16 patients underwent head and neck reconstruction with a TFLPF. The flaps were designed in a vertical or transverse fashion based on perforators traveling along the medial or lateral aspect of the posterior edge of the tensor fascia lata muscle. Clinical details and postoperative results were recorded and analyzed. The size of the flap ranged from 7 × 5 cm2 to 25 × 9 cm2. The perforators were mostly septocutaneous (11 patients), allowing a simple and straightforward dissection of the perforator and TFLPF in most patients. There were either one or two perforators in all cases. The overall flap survival rate was 100%. All of the flaps healed uneventfully with no delayed wound healing or donor site dysfunction. Follow-up ranged from 18 to 120 months, during which all patients experienced satisfactory functional and aesthetic results, without serious complications at either the recipient or donor site. The TFLPF is a pliable and reliable flap that could be a first choice in selected head and neck reconstruction cases.
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Affiliation(s)
- L Wang
- Department of Oral and Maxillofacial - Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - C Ma
- Department of Oral and Maxillofacial - Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Y Shen
- Department of Oral and Maxillofacial - Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - T W Haugen
- Department of Otolaryngology - Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Y He
- Department of Oral and Maxillofacial - Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Sun
- Department of Oral and Maxillofacial - Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Xia CD, Xue JD, Xing PP, Di HP, Shi JJ, Zhang J, Cao DY, Xiao HT, Liu L, Ma C. [Clinical effects of scalp flaps pedicled with superficial temporal artery parietal branch in repairing facial destructive burn wounds]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:919-925. [PMID: 37899556 DOI: 10.3760/cma.j.cn501225-20230312-00077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Objective: To explore the clinical effects of scalp flaps pedicled with superficial temporal artery parietal branch in repairing facial destructive burn wounds. Methods: A retrospective observational study was conducted. From January 2016 to December 2021, 15 patients with facial destructive burns who met the inclusion criteria were admitted to Zhengzhou First People's Hospital, including 11 males and 4 females, aged 22 to 79 years. Two patients were complicated with unilateral eyeball destructive burns, two patients were complicated with unilateral auricle defects, eight patients were complicated with lip and cheek defects, and three patients were complicated with lip, cheek, and unilateral nasal alar defects. The burn wound areas ranged from 9 cm×6 cm to 13 cm×10 cm. The scalp flaps pedicled with superficial temporal artery parietal branch, with the area of 10 cm×7 cm to 15 cm×11 cm, were designed, excised, and transferred for repairing burn wounds. The secondary wounds at the donor sites were repaired with medium-thickness scalp grafts. According to patient's needs, the hairs grew at the facial transplanted flap were removed by laser at 2 weeks after the flap was completely viable, or the expanded scalp flap was used to treat the secondary alopecia in the flap donor area of the head at 3 months after the primary wound repair. The survival of the flap/skin graft and the wound healing of the donor and recipient areas after the primary wound repair were recorded. During the follow-up, the appearance of the flap, the scar hyperplasia at the suture site, the repair effect of facial functional parts, the treatment effects of laser hair removal and secondary alopecia treatment at the flap donor site were observed; the patient's satisfaction with the overall repair effect was inquired. Results: After the primary wound repair, all the flaps transplanted to the burn wounds and the skin grafts transplanted to the secondary wounds of the flap donor sites survived well, and the wounds at the donor and recipient sites of flap healed well. The color, texture, and thickness of flap were basically the same as those of normal facial skin, and the scar at the suture site was slight during 3 to 18 months of follow-up period after the primary wound repair. In 11 patients complicated with lip defects, the oral integrity, and the opening and closing functions of mouth were restored with the mouth opening being 2.0-2.5 cm and no microstomia; all the patients could carry out basic language communication, 8 of them could take regular food, and 3 of them could take soft food. The wounds in two patients with unilateral eyeball destructive burns were repaired. In 2 patients complicated with auricle defects, the wounds were repaired, and the external auditory canals were normal. In 3 patients complicated with unilateral nasal alar defects, their noses had poor appearance with reduced nostrils. No hair growth was observed in the facial flap sites after treatment of laser hair removal in 8 patients. Five patients were successfully treated with expanded scalp flaps for secondary alopecia in the flap donor area of the head. The patients were all satisfied with the overall repair effect. Conclusions: The scalp flap pedicled with superficial temporal artery parietal branch has abundant blood supply and is suitable for repairing the wounds in facial destructive burns. It is easy to transfer and can better restore the appearance and function of the recipient area with minimal damage to the flap donor area, which is worthy of clinical promotion.
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Affiliation(s)
- C D Xia
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - J D Xue
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - P P Xing
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - H P Di
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - J J Shi
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - J Zhang
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - D Y Cao
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - H T Xiao
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - L Liu
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - C Ma
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
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Ma C, Xu Y, Zhang P, Song F, Sun Y, Feng Y, He Y, Zhang G. PPG-based Continuous BP Waveform Estimation Using Polarized Attention-guided Conditional Adversarial Learning Model. IEEE J Biomed Health Inform 2023; PP:1-13. [PMID: 37831570 DOI: 10.1109/jbhi.2023.3324319] [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: 10/15/2023]
Abstract
The blood pressure (BP) waveform is a vital source of physiological and pathological information concerning the cardiovascular system. This study proposes a novel attention-guided conditional generative adversarial network (cGAN), named PPG2BP-cGAN, to estimate BP waveforms based on photoplethysmography (PPG) signals. The proposed model comprises a generator and a discriminator. Specifically, the UNet3+-based generator integrates a full-scale skip connection structure with a modified polarized self-attention module based on a spatial-temporal attention mechanism. Additionally, its discriminator comprises PatchGAN, which augments the discriminative power of the generated BP waveform by increasing the perceptual field through fully convolutional layers. We demonstrate the superior BP waveform prediction performance of our proposed method compared to state-of-the-art (SOTA) techniques on two independent datasets. Our approach first pre-trained on a dataset containing 683 subjects and then tested on a public dataset. Experimental results from the Multi-parameter Intelligent Monitoring in Intensive Care dataset show that the proposed method achieves a root mean square error of 3.54, mean absolute error of 2.86, and Pearson coefficient of 0.99 for BP waveform estimation. Furthermore, the estimation errors (mean error ± standard deviation error) for systolic BP and diastolic BP are 0.72 ± 4.34 mmHg and 0.41 ± 2.48 mmHg, respectively, meeting the American Association for the Advancement of Medical Instrumentation standard. Our approach exhibits significant superiority over SOTA techniques on independent datasets, thus highlighting its potential for future applications in continuous cuffless BP waveform measurement.
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Jhaveri K, Eli LD, Wildiers H, Hurvitz SA, Guerrero-Zotano A, Unni N, Brufsky A, Park H, Waisman J, Yang ES, Spanggaard I, Reid S, Burkard ME, Vinayak S, Prat A, Arnedos M, Bidard FC, Loi S, Crown J, Bhave M, Piha-Paul SA, Suga JM, Chia S, Saura C, Garcia-Saenz JÁ, Gambardella V, de Miguel MJ, Gal-Yam EN, Rapael A, Stemmer SM, Ma C, Hanker AB, Ye D, Goldman JW, Bose R, Peterson L, Bell JSK, Frazier A, DiPrimeo D, Wong A, Arteaga CL, Solit DB. Neratinib + fulvestrant + trastuzumab for HR-positive, HER2-negative, HER2-mutant metastatic breast cancer: outcomes and biomarker analysis from the SUMMIT trial. Ann Oncol 2023; 34:885-898. [PMID: 37597578 DOI: 10.1016/j.annonc.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND HER2 mutations are targetable alterations in patients with hormone receptor-positive (HR+) metastatic breast cancer (MBC). In the SUMMIT basket study, patients with HER2-mutant MBC received neratinib monotherapy, neratinib + fulvestrant, or neratinib + fulvestrant + trastuzumab (N + F + T). We report results from 71 patients with HR+, HER2-mutant MBC, including 21 (seven in each arm) from a randomized substudy of fulvestrant versus fulvestrant + trastuzumab (F + T) versus N + F + T. PATIENTS AND METHODS Patients with HR+ HER2-negative MBC with activating HER2 mutation(s) and prior cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) therapy received N + F + T (oral neratinib 240 mg/day with loperamide prophylaxis, intramuscular fulvestrant 500 mg on days 1, 15, and 29 of cycle 1 then q4w, intravenous trastuzumab 8 mg/kg then 6 mg/kg q3w) or F + T or fulvestrant alone. Those whose disease progressed on F + T or fulvestrant could cross-over to N + F + T. Efficacy endpoints included investigator-assessed objective response rate (ORR), clinical benefit rate (RECIST v1.1), duration of response, and progression-free survival (PFS). Plasma and/or formalin-fixed paraffin-embedded tissue samples were collected at baseline; plasma was collected during and at end of treatment. Extracted DNA was analyzed by next-generation sequencing. RESULTS ORR for 57 N + F + T-treated patients was 39% [95% confidence interval (CI) 26% to 52%); median PFS was 8.3 months (95% CI 6.0-15.1 months). No responses occurred in fulvestrant- or F + T-treated patients; responses in patients crossing over to N + F + T supported the requirement for neratinib in the triplet. Responses were observed in patients with ductal and lobular histology, 1 or ≥1 HER2 mutations, and co-occurring HER3 mutations. Longitudinal circulating tumor DNA sequencing revealed acquisition of additional HER2 alterations, and mutations in genes including PIK3CA, enabling further precision targeting and possible re-response. CONCLUSIONS The benefit of N + F + T for HR+ HER2-mutant MBC after progression on CDK4/6is is clinically meaningful and, based on this study, N + F + T has been included in the National Comprehensive Cancer Network treatment guidelines. SUMMIT has improved our understanding of the translational implications of targeting HER2 mutations with neratinib-based therapy.
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Affiliation(s)
- K Jhaveri
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York; Weill Cornell Medical College, New York.
| | - L D Eli
- Clinical Development, Puma Biotechnology, Los Angeles, USA
| | - H Wildiers
- University Hospitals Leuven, Leuven, Belgium
| | - S A Hurvitz
- David Geffen School of Medicine, UCLA, Los Angeles, Santa Monica, USA
| | - A Guerrero-Zotano
- Medical Oncology Department, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - N Unni
- UT Southwestern Medical Center, Dallas
| | - A Brufsky
- Magee-Womens Hospital of UPMC, Pittsburgh
| | - H Park
- Washington University School of Medicine, St. Louis
| | - J Waisman
- City of Hope Comprehensive Cancer Center, Duarte
| | - E S Yang
- University of Alabama at Birmingham, Birmingham, USA
| | - I Spanggaard
- Department of Oncology, Rigshospitalet - Copenhagen University Hospital, Copenhagen, Denmark
| | - S Reid
- Division of Hematology/Oncology (Breast Oncology), The Vanderbilt-Ingram Cancer Center, Nashville
| | - M E Burkard
- Division of Hematology/Oncology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison
| | - S Vinayak
- Seattle Cancer Care Alliance, Seattle, USA
| | - A Prat
- Hospital Clínic de Barcelona, Barcelona, Spain
| | - M Arnedos
- Department of Medical Oncology, Gustave Roussy, Villejuif
| | - F-C Bidard
- Department of Medical Oncology, UVSQ/Paris-Saclay University, Institut Curie, Saint Cloud, France
| | - S Loi
- Division of Cancer Research, Peter MacCallum Cancer Centre, Melbourne; The Sir Peter MacCallum Department of Medical Oncology, The University of Melbourne, Parkville, Australia
| | - J Crown
- St. Vincent's University Hospital, Dublin, Ireland
| | - M Bhave
- Department of Hematology/Oncology, Emory University, Winship Cancer Institute, Atlanta
| | - S A Piha-Paul
- Department of Investigational Cancer Therapeutics, University of Texas MD Anderson Cancer Center, Houston
| | - J M Suga
- Kaiser Permanente, Department of Medical Oncology, Vallejo, USA
| | - S Chia
- Department of Medical Oncology, British Columbia Cancer Agency, Vancouver, Canada
| | - C Saura
- Medical Oncology Service, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology (VHIO), Barcelona
| | - J Á Garcia-Saenz
- Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), CIBERONC, Madrid
| | - V Gambardella
- Hospital Clínico de Valencia, Instituto de Investigación Sanitaria INCLIVA, Valencia
| | - M J de Miguel
- START Madrid - Hospital Universitario Madrid Sanchinarro, Madrid, Spain
| | - E N Gal-Yam
- Institute of Breast Oncology, Sheba Medical Center, Ramat Gan
| | - A Rapael
- Sourasky Medical Center, Tel Aviv
| | - S M Stemmer
- Davidoff Cancer Center, Rabin Medical Center, Petah Tikva; Tel Aviv University, Tel Aviv, Israel
| | - C Ma
- Division of Medical Oncology, Department of Medicine and Siteman Cancer Center, Washington University, St. Louis
| | - A B Hanker
- UT Southwestern Simmons Comprehensive Cancer Center, Dallas
| | - D Ye
- UT Southwestern Simmons Comprehensive Cancer Center, Dallas
| | | | - R Bose
- Division of Medical Oncology, Department of Medicine and Siteman Cancer Center, Washington University, St. Louis
| | - L Peterson
- Division of Medical Oncology, Department of Medicine and Siteman Cancer Center, Washington University, St. Louis
| | | | - A Frazier
- Clinical Development, Puma Biotechnology, Los Angeles, USA
| | - D DiPrimeo
- Clinical Development, Puma Biotechnology, Los Angeles, USA
| | - A Wong
- Clinical Development, Puma Biotechnology, Los Angeles, USA
| | - C L Arteaga
- UT Southwestern Simmons Comprehensive Cancer Center, Dallas
| | - D B Solit
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
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Cao J, Qi X, Wang N, Chen Y, Xie B, Ma C, Chen Z, Xiong W. Ceruloplasmin regulating fibrosis in orbital fibroblasts provides a novel therapeutic target for Graves' orbitopathy. J Endocrinol Invest 2023; 46:2005-2016. [PMID: 36849849 DOI: 10.1007/s40618-023-02033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/03/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE In diagnosing the pathogenesis of Graves' orbitopathy (GO), there is a growing interest in fibrosis generated by orbital fibroblasts (OFs); nevertheless, the involvement of ceruloplasmin (CP) in OFs remains unknown. METHODS Differentially expressed genes (DEGs) were identified through bioinformatic analysis. OFs were isolated from orbital tissue and identified with immunofluorescent staining. The levels of DEGs were validated in GO tissue samples and TGF-β-challenged OFs, and CP was selected for the following laboratory investigations. CP overexpression or knockdown was achieved, and cell viability and fibrosis-associated proteins were investigated to assess the cell phenotype and function. Signaling pathways were subsequently investigated to explore the mechanism of CP function in OFs. RESULTS CP and cathepsin C (CTSC) are two overlapped DEGs in GSE58331 and GSE105149. OFs were isolated and identified through fibrotic biomarkers. CP and CTSC were downregulated in GO tissue samples and TGF-β-challenged OFs. CP overexpression or knockdown was achieved in OFs by transducing a CP overexpression vector or small interfering RNA against CP (si1-CP or si2-CP) and verified using a qRT-PCR. CP overexpression inhibited cell viability and reduced the levels of α-SMA, vimentin, fibronectin, and collagen I, whereas CP knockdown exerted opposite effects on OFs. CP overexpression inhibited the phosphorylation of Smad3, Erk1/2, p38, JNK, and AKT; conversely, CP knockdown exerted opposite effects on the phosphorylation of factors mentioned above. CONCLUSION CP was downregulated in GO and suppressed the expression of fibrosis-associated proteins in both GO and normal OFs. CP might serve as a promising therapeutic agent in the treatment regimens for GO.
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Affiliation(s)
- J Cao
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - X Qi
- Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, China
| | - N Wang
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - Y Chen
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - B Xie
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - C Ma
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - Z Chen
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
| | - W Xiong
- Department of Ophthalmology, Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.
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Yu DM, Ma C, Hua GD, Li Q, Liu LW. [Discussion on the history of Pinelliae Rhizoma Praeparatum(Fa banxia) Processing]. Zhonghua Yi Shi Za Zhi 2023; 53:259-267. [PMID: 37935508 DOI: 10.3760/cma.j.cn112155-20220617-00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Before the Song Dynasty, the main processing method of Pinelliae Rhizoma was soup washing. The "new method" in Taiping Huimin Heji JuFang is a processing method that concocted with Ginger,white alum and starter-making.The "Fa Banxia" in the Yuan Dynasty's Yuyuan Yaofang comes from the Taiping Huimin Heji JuFang, and the Fa Wen Banxia, Fa Bai Banxia, and Fa Hong Banxia are the processing methods of patent medicine with a variety of other herbs.Fa Banxia appeared in the Ming Dynasty, and its auxiliary materials were ginger and white alum, and medical formulary began to include formulas containing Fa Banxia. Bencao Gangmu abbreviates the Yuan Dynasty's Fabai Banxia as "Fa Banxia", and is elaborated under the item attached "prescription" item instead of the "treatment". In the literature of Materia Medica, it is recorded that the preparation of auxiliary materials in Fa Banxia increased, including lime, licorice, soap horn, and simple nitro.After Daoguang in the Qing Dynasty, the Fa Banxia in famous medical cases was more used, and at that time, Fa Banxia was Xian Banxia. There are two recipes for Xian Banxia: one is made with seven processes, and the other is soaked in alum licorice water. During the Republican period, Zhang Cigong also pointed out that Fa Banxia was sliced Xian Banxia after rinsing and boiling, while the preparation method of Xian Banxia was Banxia made of ginger and white alum.Ye Juquan pointed out that the so-called "fa" is neither an ancient method nor a new method, questioning the process of repeated immersion in Banxia. After 1949, the questioning of Fa Banxia continued unceasing.Influenced by this, the 1960 edition Beijing Traditional Chinese Medicine Slice Cutting Experience included the method of soaking alum, licorice ,lime water, and was included in the 1963 edition of the Pharmacopoeia of the People's Republic of China.The 1985 version reduced the soaking time and eliminated the soaking process of alum based on the 1963 version, and this method is still used today.
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Affiliation(s)
- D M Yu
- Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700 China
| | - C Ma
- Academic Affairs Office of Beijing Vocational College of Health,Beijing 101101,China
| | - G D Hua
- Pharmacy Department of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100700,China
| | - Q Li
- Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700 China
| | - L W Liu
- Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700 China
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Di HP, Xing PP, Zheng JJ, Ma C, Huang WX, Liu L, Xue JD, Guo HN, Yang GY, Xia CD, Zhou C. [Curative effects of ultrathin anterolateral femoral flap in one-stage split-finger repair of palmar combined with multiple finger wounds]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:835-841. [PMID: 37805799 DOI: 10.3760/cma.j.cn501225-20221129-00514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To explore the curative effects of ultrathin anterolateral femoral flap in one-stage split-finger repair of palmar combined with multiple finger wounds. Methods: A retrospective observational study was conducted. From October 2016 to June 2018, 20 patients with wounds on palms and multiple fingers who met the inclusion criteria were admitted to Zhengzhou First People's Hospital, including 15 males and 5 females, aged 18 to 77 years. After debridement, the wound area was 8 cm×4 cm-17 cm×12 cm. The wound was repaired by ultrathin anterolateral femoral flap with area of 9 cm×5 cm to 19 cm×13 cm. According to the wound condition of finger, the finger division was performed in one stage, and the length-to-width ratio of the split-finger flap was 2.0:1.0-2.5:1.0. During the surgery, the descending branches of lateral circumflex femoral artery and accompanying vein of flap were anastomosed end-to-end to the radial artery and vein in the recipient area, respectively, and the anterolateral femoral cutaneous nerve of flap was bridged with the superficial branch of radial nerve in the recipient area. The wounds in the donor area of flap in 14 patients were sutured directly, the wounds in the donor area of flap in 3 patients were repaired by relay superficial iliac circumflex artery perforator flap, and the wounds in the donor area of flap in 3 patients were covered by free trunk medium-thick skin graft. The survival of flap, occurrence of vascular crisis and other complications, and healing of wounds in the donor area of flap were recorded. The appearance of flap, scar hyperplasia in the donor and recipient areas and the patients' satisfaction with the shape and function of the donor and recipient areas were followed up. In 1 year after surgery, the two-point discrimination distance of the flap was measured, and the recovery of hand function was evaluated by the trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association. Results: The flaps of 17 patients survived without vascular crisis or other complications after surgery. The flap of 1 patient had poor blood circulation and partial necrosis, and the wound was healed 14 days after dressing change and grafting of split-thickness skin graft from head. Two patients had mild cyanosis at the margin of flap after surgery, which disappeared spontaneously 5 days later. Incisions at donor site, relay flaps, and skin grafts of all patients survived well. After surgery, the color and texture of flap were basically the same as that of the normal skin of hand, and linear scars were observed in the donor and recipient areas. The patients were satisfied with the recovery of appearance and function of donor and recipient areas. After 1 year of follow-up, the patients' hand sensory function recovered well, the two-point discrimination distance of flap was 4-6 mm, and the recovery of hand function was evaluated as excellent in 18 cases and good in 2 cases. Conclusions: The ultrathin anterolateral femoral flap in repairing the palmar combined with multiple finger wounds in one-stage split-finger can significantly reduce the number of surgeries and improve the function and beauty of the hand, so it is worthy of clinical promotion.
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Affiliation(s)
- H P Di
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - P P Xing
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - J J Zheng
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - C Ma
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - W X Huang
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - L Liu
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - J D Xue
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - H N Guo
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - G Y Yang
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - C D Xia
- Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China
| | - C Zhou
- Institute of Biomedical Engineering and Health Sciences, Changzhou University, Changzhou 213164, China
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Feng SM, Luo X, Xue C, Chen J, Wang K, Shao CQ, Ma C. [Effect of hollow compression screw internal fixation in treating McCrory-Bladin type Ⅱ lateral process fracture of the talus: open versus arthroscopy surgery]. Zhonghua Yi Xue Za Zhi 2023; 103:2808-2812. [PMID: 37723056 DOI: 10.3760/cma.j.cn112137-20230403-00541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
In order to explore the clinical efficacy of hollow compression screw internal fixation in the treatment of lateral process fracture of the talus under open surgery versus arthroscopy procedure, a retrospective cohort study was conducted to analyze the clinical data of 33 patients with lateral process fracture of the talus admitted to Xuzhou Central Hospital from January 2019 to December 2021. There were 19 males (19 feet) and 14 females (14 feet), aged 18 to 50 years, with an average age of (32.2±9.3) years. According to the modified McCrory-Bladin classification, all patients were classified as type Ⅱ. Based on the different surgical methods, the patients were divided into the arthroscopy group (21 cases, treated with double-tunnel subtalar arthroscopy combined with hollow compression screw internal fixation) and the open group (12 cases, treated with open reduction and internal fixation with hollow compression screw). The operation time was observed and the surgical effects were evaluated using the visual analogue scale (VAS) of pain, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, the Foot Function Index (FFI), and the Foot and Ankle Ability Measure (FAAM), which includes the FAAM-ADL (activity of daily living subscale) and the FAAM-S (sport subscale). All the patients of the two groups achieved stage Ⅰ wound healing. On the first day after the operation, the mean VAS score of the arthroscopy group was 2.4±0.7, which was significantly lower than that of the open group (3.4±1.6) (P=0.020). No significant difference was observed in terms of the follow-up time, operation time and AOFAS score between the two groups (all P>0.05). The FFI score of the arthroscopy group was significantly lower than that of the open group, and the FAAM-ADL and FAAM-S scores were significantly higher than those in the open group (all P<0.05). Two cases of dorsal foot numbness occurred in the open group after the operation, and the incidence of complications was not significantly different from that of the arthroscopy group (P=0.054). For McCrory-Bladin type Ⅱ lateral process fracture of the talus, the use of compression screw internal fixation could achieve reliable results, however, compared to open surgery, arthroscopy procedure obtained mini trauma and better functions.
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Affiliation(s)
- S M Feng
- Department of Orthopedics, Xuzhou Central Hospital (Xuzhou Medical University Xuzhou Clinical College), Xuzhou 221009, China
| | - X Luo
- Department of Orthopedics, Xuzhou Central Hospital (Xuzhou Medical University Xuzhou Clinical College), Xuzhou 221009, China
| | - C Xue
- Department of Orthopedics, Xuzhou Central Hospital (Xuzhou Medical University Xuzhou Clinical College), Xuzhou 221009, China
| | - J Chen
- Department of Orthopedics, Xuzhou Central Hospital (Xuzhou Medical University Xuzhou Clinical College), Xuzhou 221009, China
| | - K Wang
- Department of Orthopedics, Xuzhou Central Hospital (Xuzhou Medical University Xuzhou Clinical College), Xuzhou 221009, China
| | - C Q Shao
- Department of Orthopedics, Xuzhou Central Hospital (Xuzhou Medical University Xuzhou Clinical College), Xuzhou 221009, China
| | - C Ma
- Department of Orthopedics, Xuzhou Central Hospital (Xuzhou Medical University Xuzhou Clinical College), Xuzhou 221009, China
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Gao Y, Ma C, Guo L, Zhang X, Ji X. CLRD: Collaborative Learning for Retinopathy Detection Using Fundus Images. Bioengineering (Basel) 2023; 10:978. [PMID: 37627863 PMCID: PMC10451343 DOI: 10.3390/bioengineering10080978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Retinopathy, a prevalent disease causing visual impairment and sometimes blindness, affects many individuals in the population. Early detection and treatment of the disease can be facilitated by monitoring the retina using fundus imaging. Nonetheless, the limited availability of fundus images and the imbalanced datasets warrant the development of more precise and efficient algorithms to enhance diagnostic performance. This study presents a novel online knowledge distillation framework, called CLRD, which employs a collaborative learning approach for detecting retinopathy. By combining student models with varying scales and architectures, the CLRD framework extracts crucial pathological information from fundus images. The transfer of knowledge is accomplished by developing distortion information particular to fundus images, thereby enhancing model invariance. Our selection of student models includes the Transformer-based BEiT and the CNN-based ConvNeXt, which achieve accuracies of 98.77% and 96.88%, respectively. Furthermore, the proposed method has 5.69-23.13%, 5.37-23.73%, 5.74-23.17%, 11.24-45.21%, and 5.87-24.96% higher accuracy, precision, recall, specificity, and F1 score, respectively, compared to the advanced visual model. The results of our study indicate that the CLRD framework can effectively minimize generalization errors without compromising independent predictions made by student models, offering novel directions for further investigations into detecting retinopathy.
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Affiliation(s)
- Yuan Gao
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Chenbin Ma
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
- Shen Yuan Honors College, Beihang University, Beijing 100191, China
| | - Lishuang Guo
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Xuxiang Zhang
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Xunming Ji
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
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Gao Y, Ma C, Guo L, Zhang X, Ji X. MIL-CT: Multiple Instance Learning via a Cross-Scale Transformer for Enhanced Arterial Light Reflex Detection. Bioengineering (Basel) 2023; 10:971. [PMID: 37627856 PMCID: PMC10451897 DOI: 10.3390/bioengineering10080971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
One of the early manifestations of systemic atherosclerosis, which leads to blood circulation issues, is the enhanced arterial light reflex (EALR). Fundus images are commonly used for regular screening purposes to intervene and assess the severity of systemic atherosclerosis in a timely manner. However, there is a lack of automated methods that can meet the demands of large-scale population screening. Therefore, this study introduces a novel cross-scale transformer-based multi-instance learning method, named MIL-CT, for the detection of early arterial lesions (e.g., EALR) in fundus images. MIL-CT utilizes the cross-scale vision transformer to extract retinal features in a multi-granularity perceptual domain. It incorporates a multi-head cross-scale attention fusion module to enhance global perceptual capability and feature representation. By integrating information from different scales and minimizing information loss, the method significantly improves the performance of the EALR detection task. Furthermore, a multi-instance learning module is implemented to enable the model to better comprehend local details and features in fundus images, facilitating the classification of patch tokens related to retinal lesions. To effectively learn the features associated with retinal lesions, we utilize weights pre-trained on a large fundus image Kaggle dataset. Our validation and comparison experiments conducted on our collected EALR dataset demonstrate the effectiveness of the MIL-CT method in reducing generalization errors while maintaining efficient attention to retinal vascular details. Moreover, the method surpasses existing models in EALR detection, achieving an accuracy, precision, sensitivity, specificity, and F1 score of 97.62%, 97.63%, 97.05%, 96.48%, and 97.62%, respectively. These results exhibit the significant enhancement in diagnostic accuracy of fundus images brought about by the MIL-CT method. Thus, it holds potential for various applications, particularly in the early screening of cardiovascular diseases such as hypertension and atherosclerosis.
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Affiliation(s)
- Yuan Gao
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
- Department of Ophthalmology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Chenbin Ma
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
- Shen Yuan Honors College, Beihang University, Beijing 100191, China
| | - Lishuang Guo
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
| | - Xuxiang Zhang
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Xunming Ji
- Department of Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, China
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Ma C, Zhang J, Xiao M, Kang N, Chen YH, Dai XC. [Value of contrast-enhanced ultrasonography in detection of endoleak after endovascular repair of infrarenal abdominal aortic aneurysm]. Zhonghua Yi Xue Za Zhi 2023; 103:2106-2111. [PMID: 37455129 DOI: 10.3760/cma.j.cn112137-20230214-00202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Objective: To investigate the value of contrast-enhanced ultrasound in detecting endoleak after endovascular repair of infrarenal abdominal aortic aneurysm (EVAR). Methods: The postoperative follow-up data of 102 patients with infrarenal abdominal aortic aneurysm treated with EVAR in Tianjin Medical University General Hospital from August 2015 to December 2021 were retrospectively analyzed. There were 79 males and 23 females, aged 50-91 (69.6±7.6) years old. Using CT angiography (CTA) as the gold standard for diagnosing endoleaks, the effectiveness of contrast-enhanced ultrasound and CDUS in detecting endoleaks was evaluated by paired design chi-square test, and the Kappa value was calculated for consistency test. Patients were divided into groups according to body mass index (BMI), and the number of false-negative endoleaks detected by contrast-enhanced ultrasound in each group was calculated, and its ratio to the actual number of endoleaks was calculated to evaluate whether BMI was related to false-negative ultrasound-enhanced ultrasound. Results: A total of 203 follow-up visits met the inclusion criteria. Endoleaks were detected 36 times (17.7%) by CTA, 31 times (15.3%) by contrast-enhanced ultrasound, 16 times (7.9%) by CDUS, and they all detected type Ⅰ, type Ⅱ and type Ⅲ endoleaks. There was no significant difference between contrast-enhanced ultrasound and CTA in endoleak detection rate and determination of endoleak types (endoleak detection rate: 15.3% vs 17.7%; determination of endoleak types: type Ⅰ 4 vs 4, type Ⅱ 26 vs 31, type Ⅲ 1 vs 1; all P>0.05). CDUS and CTA had statistically significant differences in the detection rate of endoleaks and determination of endoleak types (endoleak detection rate: 7.9% vs 17.7%; determination of endoleak types: type Ⅰ 4 vs 4, type Ⅱ 11 vs 31, type Ⅲ 1 vs 1; all P<0.001). Compared with CTA, contrast-enhanced ultrasound has a sensitivity of 83.3%, a specificity of 99.4%, a Youden index of 0.827, a coincidence rate of 96.6%, a positive predictive value of 96.8%, a negative predictive value of 96.5%, and a Kappa value of 0.875(P<0.001). The two showed excellent diagnostic consistency. All 6 endoleaks not detected by contrast-enhanced ultrasound were type Ⅱ endoleak that did not require treatment, and 3(15.8%) occurred in obese patients with a BMI≥32 kg/m2. Compared with CTA, CDUS had a sensitivity of 38.9%, a specificity of 98.8%, a Youden index of 0.377, a coincidence rate of 88.2%, a positive predictive value of 87.5%, a negative predictive value of 88.2%, and a Kappa value of 0.482 (P<0.001). The two showed moderate diagnostic agreement. The correlation coefficient of the maximum diameter of aneurysms measured by ultrasound and CT was r=0.873(P<0.001). Conclusions: Contrast-enhanced ultrasound is accurate in detecting endoleak after infrarenal EVAR, and its sensitivity to endoleak detection in obese patients with BMI≥32 kg/m2 will be reduced. CDUS is not suitable for detection of endoleak after infrarenal EVAR, but it can be used to monitor the change of the largest diameter of aneurysm after EVAR.
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Affiliation(s)
- C Ma
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - J Zhang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - M Xiao
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - N Kang
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Y H Chen
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - X C Dai
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
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Huo R, Zheng L, Li SL, Wang SK, Ma C, Shi HY, Xie XP, Wang NW, Zhang XM, Liu B, Peng L, He QZ, Jiang F. Early adjunctive diagnostic value of contrast-enhanced ultrasound-related quantitative parameter and its relationship with micro-perfusion of nontraumatic necrosis of femoral head. Eur Rev Med Pharmacol Sci 2023; 27:6545-6553. [PMID: 37522666 DOI: 10.26355/eurrev_202307_33125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
OBJECTIVE The aim of this study is to explore the early diagnostic value of contrast-enhanced ultrasound (CEUS)-related quantitative parameter and its relationship with the micro-perfusion of nontraumatic necrosis of the femoral head. PATIENTS AND METHODS According to the random and double-blind method, the patients with non-traumatic femoral head necrosis diagnosed and treated in our hospital from July 2019 to January 2022 were selected as the subjects (the research group). According to the staging of the International Society of Bone Circulation for Femoral Head Necrosis, 89 patients with stage Ⅱ and Ⅲ A were included (39 patients with stage Ⅱ and 50 patients with stage Ⅲ A). 25 patients who conducted physical examination in our hospital during the same time were taken as the control group. Quantitative parameters of CEUS were analyzed. The content of serum vascular endothelial growth factor (VEGF) and bone morphogenetic protein-2 (BMP-2) were evaluated. The relationship among the quantitative parameters of CEUS, the expression of VEGF and BMP-2 in serum and the patient's condition, and the value for assisting the early diagnosis of nontraumatic femoral head necrosis were analyzed. RESULTS The body mass, body mass index (BMI), blood lipid, and cholesterol levels were much higher in the research group than in the control group (p < 0.05). The research group had a markedly higher slope of ascending branch (AS), strength enhancement index (EI), and VEGF and obviously lower decay slope (DS), mean transit time (MTT), and time to peak (TTP) than the control group (p < 0.05). In the research group, compared to stage Ⅱ, the levels of AS, EI, and VEGF in stage Ⅲ A patients were memorably higher, and the levels of DS, MTT, TTP and BMP-2 were dramatically lower (p < 0.05). Pearson's correlation test showed that AS, EI, and VEGF were positively correlated with the patients' condition, while DS, MTT, TTP and BMP-2 were negatively correlated with the patients' condition (p < 0.05). The receiver operating characteristic (ROC) curve analysis showed that the diagnostic area under the curve (AUC) of quantitative parameters of CEUS was 0.961, with sensitivity and specificity of 88.0% and 97.4%, respectively. The AUC of the combined detection of VEGF and BMP-2 was 0.945 with sensitivity and specificity of 82.3% and 87.5%, respectively, and the combined detection had a high diagnostic value (p < 0.05). CONCLUSIONS The quantitative parameters of CEUS were of great value in the early diagnosis of nontraumatic necrosis of the femoral head with microvascular perfusion and the patients' condition, and provided a reference for the clinical treatment of non-traumatic necrosis of the femoral head. These parameters were expected to be useful indicators for judging the efficacy before and after treatment.
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Affiliation(s)
- R Huo
- Department of Imaging, Affiliated Hospital of Traditional Chinese Medicine, Southwest Medical University, Luzhou City, Sichuan Province, China.
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Song F, Tian J, Zhang P, Ma C, Sun Y, Feng Y, Zhang T, Lei Y, He Y, Cai Z, Cheng Y, Zhang G. A Novel Feature Engineering Method Based on Latent Representation Learning for Radiomics: Application in NSCLC Subtype Classification. IEEE J Biomed Health Inform 2023; PP:1-11. [PMID: 37368801 DOI: 10.1109/jbhi.2023.3290006] [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: 06/29/2023]
Abstract
Radiomics refers to the high-throughput extraction of quantitative features from medical images, and is widely used to construct machine learning models for the prediction of clinical outcomes, while feature engineering is the most important work in radiomics. However, current feature engineering methods fail to fully and effectively utilize the heterogeneity of features when dealing with different kinds of radiomics features. In this work, latent representation learning is first presented as a novel feature engineering approach to reconstruct a set of latent space features from original shape, intensity and texture features. This proposed method projects features into a subspace called latent space, in which the latent space features are obtained by minimizing a unique hybrid loss function including a clustering-like loss and a reconstruction loss. The former one ensures the separability among each class while the latter one narrows the gap between the original features and latent space features. Experiments were performed on a multi-center non-small cell lung cancer (NSCLC) subtype classification dataset from 8 international open databases. Results showed that compared with four traditional feature engineering methods (baseline, PCA, Lasso and L2,1-norm minimization), latent representation learning could significantly improve the classification performance of various machine learning classifiers on the independent test set (all p<0.001). Further on two additional test sets, latent representation learning also showed a significant improvement in generalization performance. Our research shows that latent representation learning is a more effective feature engineering method, which has the potential to be used as a general technology in a wide range of radiomics researches.
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Bohannon D, Janopaul-Naylor J, Rudra S, Yang X, Chang CW, Wang Y, Ma C, Patel SA, McDonald MW, Zhou J. Prediction of plan adaptation in head and neck cancer proton therapy using clinical, radiographic, and dosimetric features. Acta Oncol 2023:1-8. [PMID: 37335043 DOI: 10.1080/0284186x.2023.2224050] [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: 01/23/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE Because proton head and neck (HN) treatments are sensitive to anatomical changes, plan adaptation (re-plan) during the treatment course is needed for a significant portion of patients. We aim to predict re-plan at plan review stage for HN proton therapy with a neural network (NN) model trained with patients' dosimetric and clinical features. The model can serve as a valuable tool for planners to assess the probability of needing to revise the current plan. METHODS AND MATERIALS Mean beam dose heterogeneity index (BHI), defined as the ratio of the maximum beam dose to the prescription dose, plan robustness features (clinical target volume (CTV), V100 changes, and V100 > 95% passing rates in 21 robust evaluation scenarios), as well as clinical features (e.g., age, tumor site, and surgery/chemotherapy status) were gathered from 171 patients treated at our proton center in 2020, with a median age of 64 and stages from I-IVc across 13 HN sites. Statistical analyses of dosimetric parameters and clinical features were conducted between re-plan and no-replan groups. A NN was trained and tested using these features. Receiver operating characteristic (ROC) analysis was conducted to evaluate the performance of the prediction model. A sensitivity analysis was done to determine feature importance. RESULTS Mean BHI in the re-plan group was significantly higher than the no-replan group (p < .01). Tumor site (p < .01), chemotherapy status (p < .01), and surgery status (p < .01) were significantly correlated to re-plan. The model had sensitivities/specificities of 75.0%/77.4%, respectively, and an area under the ROC curve of .855. CONCLUSION There are several dosimetric and clinical features that correlate to re-plans, and NNs trained with these features can be used to predict HN re-plans, which can be used to reduce re-plan rate by improving plan quality.
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Affiliation(s)
- D Bohannon
- Department of Nuclear and Radiological Engineering, Georgia institute of Technology, Atlanta, GA, USA
| | - J Janopaul-Naylor
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - S Rudra
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - X Yang
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - C W Chang
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - Y Wang
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - C Ma
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - S A Patel
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - M W McDonald
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
| | - J Zhou
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
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Ni WY, Wang JL, Yun J, Xie WQ, Ma C, Su SH. [The status and influencing factors of presenteeism among clinical nurses: a systematic review]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:286-293. [PMID: 37248183 DOI: 10.3760/cma.j.cn121094-20220617-00326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Objective: To systematically review the status and factors influencing presenteeism among clinical nurses. Methods: In December 2021, CNKI, CBM, Wanfang, VIP, Web of Science, PubMed, Embase, The Cochrane Library, CINAHL, PsyclNFO and other databases were electronically searched to cross sectional studies on the current situation and factors influencing the occurrence of presenteeism among clinical nurses. The search terms mainly included presenteeism, sick at work, Stanford Presenteeism Scale, nurse, level, risk factor, influence, et al. And the search time was from the establishment of the database to November 30, 2021. Literature screening, data extraction and evaluation of the risk of bias in the included literature were done independently by two researchers, and meta-analysis was performed using Stata 15.1 software. Results: A total of 29 studies involving 13 535 clinical nurses were included.The results of the meta-analysis showed that the score of presenteeism was 17.99 [95% CI (17.02-18.95), P =0.000]. Subgroup analysis showed that presenteeism scores were higher in articles published before 2020 (ES=19.28, 95%CI: 18.41-20.15, P=0.000) and in the group of nurses aged 36 to 40 years (ES=19.27, 95%CI: 17.35~21.19, P=0.000), female (ES= 17.04, 95%CI: 14.70-19.39, P=0.000), secondary school education (ES=21.01, 95%CI: 17.76-24.26, P= 0.007), married (ES=17.49, 95%CI: 15.13-19.85, P=0.000), working for 5 to 10 years (ES=17.78, 95%CI: 16.54-19.02, P=0.000), contract (ES=17.05, 95%CI: 15.23-18.87, P=0.000), working in pediatrics (ES= 16.65, 95% CI: 15.31-17.99, P=0.000) and European region (ES =21.21, 95% CI: 20.50-21.93, P=0.000) . Conclusion: Current evidence suggests that clinical nurses are at high risk of presenteeism, which is affected by variety of factors. The managers should pay attention to the physical and mental health of nurses, identify high-risk factors as early as possible and take measures to reduce the occurrence of presenteeism and improve the quality of nursing.
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Affiliation(s)
- W Y Ni
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - J L Wang
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - J Yun
- Chengdu University of Traditional Chinese Medicine Hospital, Chengdu 610032, China
| | - W Q Xie
- Department of Hospital Infection Control Disinfection Supply Room, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - C Ma
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - S H Su
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
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Hua J, Li Z, Ma C, Zhang X, Li Q, Duan X, Xiao T, Geng X. [Erratum to "Risk factors analysis and establishment of predictive nomogram of extranodal B-cell lymphoma of mucosal-associated lymphoid tissue" [Cancer Radiother 27 (2023) 126-135]]. Cancer Radiother 2023; 27:266. [PMID: 37062656 DOI: 10.1016/j.canrad.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Affiliation(s)
- J Hua
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - Z Li
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - C Ma
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Zhang
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - Q Li
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Duan
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - T Xiao
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Geng
- Department of Radiotherapy, Liaocheng People's Hospital, 252000 Shan Dong, China.
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Hurvitz S, Schott A, Ma C, Hamilton E, Nanda R, Zahrah G, Hunter N, Tan A, Telli M, Mesias J, Jeselsohn R, Munster P, Lu H, Gedrich R, Mather C, Parameswaran J, Han H, Wirth S. P253 ARV-471, a PROTAC® estrogen receptor (ER) degrader in advanced ER+/human epidermal growth factor receptor 2 (HER2)- breast cancer: phase 2 expansion (VERITAC) of a phase 1/2 study. Breast 2023. [DOI: 10.1016/s0960-9776(23)00371-5] [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: 03/16/2023] Open
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Zhang P, Ma C, Song F, Sun Y, Feng Y, He Y, Zhang T, Zhang G. D2AFNet: A dual-domain attention cascade network for accurate and interpretable atrial fibrillation detection. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Xing L, Yu J, Zhao R, Yang W, Guo Y, Li J, Xiao C, Ren Y, Dong L, Lv D, Zhao L, Lin Y, Zhang X, Chen L, Zhang A, Wang Y, Jiang D, Liu A, Ma C. 125P Real-world treatment patterns in stage III NSCLC patients: Interim results of a prospective, multicenter, non-interventional study (MOOREA). J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00380-5] [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: 04/03/2023]
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Hamilton PG, Buhler K, Kaplan G, Lu C, Seow C, Novak K, Panaccione R, Ma C. A180 PLACEBO RATES IN MICROSCOPIC COLITIS RANDOMIZED TRIALS: APPLICATIONS FOR FUTURE DRUG DEVELOPMENT USING A HISTORICAL CONTROL ARM. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991156 DOI: 10.1093/jcag/gwac036.180] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background There remains a need to develop effective medical therapies for patients with microscopic colitis (MC) who do not respond, are intolerant, or relapse on budesonide. Conducting randomized trials in MC is logistically and ethically challenging: budesonide is highly effective, and therefore, some institutional review boards have not allowed trials that randomize MC patients to placebo. However, comparing an investigational drug to budesonide is statistically infeasible: powering a non-inferiority study against a budesonide comparator arm with 90% power for a 10% non-inferiority margin would require over 700 subjects, yet fewer than 400 patients have been randomized in all historical MC trials. Therefore, alternative trial designs should be explored in MC, including the use of a historical control arm. Purpose To conduct a systematic review and meta-analysis to determine the proportion of placebo responders in MC trials that will inform future trials using a historical placebo comparator, and evaluate factors associated with placebo response. Method EMBASE, MEDLINE, and CENTRAL were searched from inception to January 7, 2022, and supplemented with conference abstracts to identify randomized controlled trials (RCTs) using a placebo comparator in adult patients with confirmed MC (either lymphocytic, collagenous, or mixed populations but excluding incomplete MC). The proportion of clinical and histologic responders in the placebo arms were pooled using random-effect models, statistical heterogeneity was evaluated using the I2 method, and the Freeman-Tukey double arcsine transformation was used to compute 95% confidence intervals (CI) using the score statistic and exact binomial method. All analyses were conducted in Stata 17.0. Result(s) Twelve placebo controlled RCTs were included, evaluating a total of 391 patients (163 randomized to placebo). The pooled placebo clinical response rate was 24.4% [95% CI 12.4%, 38.4%] (Figure 1), with substantial heterogeneity (I2=60.8%, p<0.01). The pooled histologic response rate was 19.9% [95% CI: 5.3%, 39.0%], with substantial heterogeneity (I2=66.4%, p<0.01). Subgroup analysis demonstrated higher placebo responses in lymphocytic colitis (39.9% [95% CI: 23.9%, 56.7%]) compared to collagenous colitis (19.8% [95% CI: 5.9%, 37.8%]), but not by allowance of baseline anti-diarrheals. Leave-one-out meta-analysis showed a reduction in heterogeneity after removal of Miehlke et al. 2014 (placebo response 21.0% [95% CI: 11.5%, 32.1%], I2=28.6%, p=0.17). Image ![]()
Conclusion(s) Approximately 1 in 4 patients in MC trials will respond clinically to placebo and 1 in 5 will demonstrate a histologic response, although with substantial heterogeneity. T his highlights the need for standardized outcome definitions in MC trials and can serve to inform a Bayesian prior estimate for future trials that may consider using a historical placebo comparator. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest P. Hamilton: None Declared, K. Buhler: None Declared, G. Kaplan Grant / Research support from: Ferring, Janssen, AbbVie, GlaxoSmith Kline, Merck, and Shire, Consultant of: AbbVie, Janssen, Pfizer, Amgen, Takeda, and Gilead, C. Lu Consultant of: Abbvie, Janssen, Ferring, and Takeda, Speakers bureau of: Janssen and Abbvie, C. Seow Consultant of: Advisory Boards: Janssen, Abbvie, Takeda, Ferring, Shire, Pfizer, Sandoz, Pharmascience, Fresenius Kabi, Amgen, Speakers bureau of: Janssen, Abbvie, Takeda, Ferring, Shire, Pfizer, Pharmascience, K. Novak Grant / Research support from: AbbVie and Janssen, Consultant of: Advisory board fees from AbbVie, Janssen, Pfizer, Ferring, and Takeda, speaker’s fees from AbbVie, Janssen, and Pfizer, R. Panaccione Consultant of: Abbott, AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Celltrion, Cosmos Pharmaceuticals, Eisai, Elan, Eli Lilly, Ferring, Galapagos, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JAMP Bio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pendopharm, Pfizer, Progenity, Protagonist Therapeutics, Roche, Sandoz, Satisfai Health, Shire, Sublimity Therapeutics, Takeda Pharmaceuticals, Theravance Biopharma, Trellus, Viatris, UCB. Advisory Boards for: AbbVie, Alimentiv (formerly Robarts), Amgen, Arena Pharmaceuticals, AstraZeneca, Biogen, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Genentech, Gilead Sciences, Glaxo-Smith Kline, JAMP Bio, Janssen, Merck, Mylan, Novartis, Oppilan Pharma, Organon, Pandion Pharma, Pfizer, Progenity, Protagonist Therapeutics, Roche, SandozShire, Sublimity Therapeutics, Takeda Pharmaceuticals, Speakers bureau of: AbbVie, Amgen, Arena Pharmaceuticals, Bristol-Myers Squibb, Celgene, Eli Lilly, Ferring, Fresenius Kabi, Gilead Sciences, Janssen, Merck, Organon, Pfizer, Roche, Sandoz, Shire, Takeda Pharmaceuticals, C. Ma Grant / Research support from: Ferring, Pfizer, Consultant of: AbbVie, Alimentiv, American College of Gastroenterology, Amgen, AVIR Pharma Inc, BioJAMP, Bristol Myers Squibb, Celltrion, Ferring, Fresenius Kabi, Janssen, McKesson, Mylan, Sanofi/Regeneron, Takeda, Pendopharm, Pfizer, Roche, Speakers bureau of: : AbbVie, Amgen, AVIR Pharma Inc, Alimentiv, Bristol Myers Squibb, Ferring, Fresenius Kabi, Janssen, Takeda, Pendopharm, and Pfizer
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Affiliation(s)
- P G Hamilton
- Internal Medicine Residency Program, Cumming School of Medicine - University of Calgary
| | - K Buhler
- University of Calgary, Calgary , Canada
| | - G Kaplan
- Gastroenterology and Hepatology, University of Calgary, Calgary , Canada
| | - C Lu
- Gastroenterology and Hepatology, University of Calgary, Calgary , Canada
| | - C Seow
- Gastroenterology and Hepatology, University of Calgary, Calgary , Canada
| | - K Novak
- Gastroenterology and Hepatology, University of Calgary, Calgary , Canada
| | - R Panaccione
- Gastroenterology and Hepatology, University of Calgary, Calgary , Canada
| | - C Ma
- Gastroenterology and Hepatology, University of Calgary, Calgary , Canada
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St-Pierre J, Rosentreter R, Kiraly A, Hart Szostakiwskyj J, Novak K, Panaccione R, Kaplan G, Devlin S, Seow C, Ingram R, Ma C, Wilson S, Medellin A, Lu C. A192 EFFICACY OF USTEKINUMAB IN SMALL BOWEL STRICTURES OF FIBROSTENOTIC CROHN'S DISEASE AS ASSESSED BY INTESTINAL ULTRASOUND. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991175 DOI: 10.1093/jcag/gwac036.192] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Small bowel Crohn’s disease (CD) strictures can lead to debilitating obstructive symptoms and the deterioration of quality of life. Imaging modalities such as intestinal ultrasound (IUS) are invaluable in the diagnosis of strictures. The use of IUS in CD is rapidly growing, is cost-effective, easily repeatable, and similar in accuracy to magnetic resonance enterography. Evidence for medical management of fibrostenotic CD has been limited to anti-tumor necrosis factor biologics. Studies on the efficacy of other biologic therapies for strictures such as ustekinumab, a p40/interleukin 12 and 23 inhibitor, are lacking. Purpose The objective of this study was to evaluate the efficacy of ustekinumab in the treatment of small bowel strictures on IUS. Method This retrospective cohort study evaluated the IUS changes of terminal ileal (TI) CD strictures at baseline and 12 months following ustekinumab initiation from 2016 to 2020 at a single tertiary care center. Strictures identified were defined as 1) increased bowel wall thickness (BWT) > 3mm, 2) narrowed luminal apposition, and 3) presence of pre-stenotic dilation (PSD) or the inability to pass the colonoscope through the narrowed area. Changes in sonographic parameters (BWT, luminal size, PSD, length, hyperemia, inflammatory fat, dysfunctional peristalsis) were recorded at baseline prior to initiation of ustekinumab and compared 12 months after treatment. Differences from baseline to 12 months were paired within-person and statistical analysis was performed using paired T-tests for continuous variables and McNemar’s test for categorical variables. Result(s) Of the 18 patients identified, 55% (n = 10) were male, median age was 49 years (Q1-Q3: 33-63 years) at initial scan, with median CD duration of 10 years (Q1-Q3: 8-20 years). The majority of TI strictures were surgically naïve (67%, n = 12). Between pre- and 12-month post ustekinumab therapy scans, there was significant improvement in BWT [8.2 mm vs 7.2 mm, p = 0.048], however there was no significant difference in the presence of peri-enteric inflammatory fat (p = 0.10), mean stricture length (17.7 vs 21.7 cm, p = 0.18), and mean stricture lumen diameter (3.3 mm vs 2.7 mm, p = 0.44) (Table 1). There was also no significant difference in the presence of stricture-associated peri-enteric fat (89% vs 67%, p = 0.10), stricture-associated hyperemia (83% vs 89%, p = 0.65) or dysfunctional peristalsis (50% vs 61%, p = 0.41) (Table 1). Image ![]()
Conclusion(s) Our study is the first to report the efficacy of ustekinumab in small bowel CD strictures using IUS at baseline and 12 months. This study shows that although ustekinumab leads to improvement in overall sonographic appearance of bowel thickness, it does not improve luminal narrowing nor PSD, two hallmark criteria of fibrostenosis. More extensive studies with larger sample sizes evaluating ustekinumab, or combination therapies, are required to identify their role in stricturing CD. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
| | | | | | - J Hart Szostakiwskyj
- Methods and Analytics, Clinical Research Unit, University of Calgary, Calgary, Canada
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Hua J, Lia Z, Ma C, Zhang X, Li Q, Duan X, Xiao T, Geng X. Risk factors analysis and establishment of predictive nomogram of extranodal B-cell lymphoma of mucosal-associated lymphoid tissue. Cancer Radiother 2023; 27:126-135. [PMID: 36894407 DOI: 10.1016/j.canrad.2022.08.006] [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: 06/21/2022] [Revised: 08/05/2022] [Accepted: 08/09/2022] [Indexed: 03/09/2023]
Abstract
PURPOSE The role of radiation therapy in mucosa-associated lymphoid tissue (MALT) lymphoma is poorly defined. The objective of this study was to explore the factors associated with the performance of radiotherapy and to assess its prognostic impact in patients with MALT lymphoma. PATIENTS AND METHODS Patients with MALT lymphoma diagnosed between 1992 and 2017 were identified in the US Surveillance, Epidemiology, and End Results database (SEER). Factors associated with the delivery of radiotherapy were assessed by chi-square test. Overall survival (OS) and lymphoma-specific survival (LSS) were compared between patients with and without radiotherapy, using Cox proportional hazard regression models, in patients with early stage as well as those with advanced stage. RESULTS Of the 10,344 patients identified with a diagnosis of MALT lymphoma, 33.6% had received radiotherapy; this rate was 38.9% for stage I/II patients and 12.0% for stage III/IV patients, respectively. Older patients and those who already received primary surgery or chemotherapy had a significantly lower rate of receiving radiotherapy, regardless of lymphoma stage. After univariate and multivariate analysis, radiotherapy was associated with improved OS and LSS in patients with stage I/II (HR=0.71 [0.65-0.78]) and (HR=0.66 [0.59-0.74]), respectively, but not in patients with stage III/IV (HR=1.01 [0.80-1.26]) and (HR=0.93 [0.67-1.29]). The nomogram built from the significant prognostic factors associated with overall survival of stage I/II patients had a good concordance (C-index=0.749±0.002). CONCLUSION This cohort study shows that radiotherapy is significantly associated with a better prognosis in patients with early but not advanced MALT lymphoma. Prospective studies are needed to confirm the prognostic impact of radiotherapy in patients with MALT lymphoma.
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Affiliation(s)
- J Hua
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - Z Lia
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - C Ma
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Zhang
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - Q Li
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Duan
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - T Xiao
- Department of Hematology, Liaocheng People's Hospital, Shan Dong, China
| | - X Geng
- Department of Radiotherapy, Liaocheng People's Hospital, 252000 Shan Dong, China.
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Markovinovic A, Herauf M, Quan J, Hracs L, Windsor JW, Sharifi N, Coward S, Caplan L, Gorospe J, Ma C, Panaccione R, Ingram R, Kanji J, Tipples G, Holodinsky J, Berstein C, Mahoney D, Bernatsky S, Benchimol E, Kaplan GG. A170 ADVERSE EVENTS & SEROLOGICAL RESPONSES FOLLOWING SARS-COV-2 VACCINATION IN INDIVIDUALS WITH INFLAMMATORY BOWEL DISEASE. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991202 DOI: 10.1093/jcag/gwac036.170] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background The rapid development and distribution of SARS-CoV-2 vaccines has raised concerns surrounding vaccine safety in immunocompromised populations, such as those with inflammatory bowel disease (IBD). Purpose We described adverse events (AEs) following SARS-CoV-2 vaccination in those with IBD and determined relationships between AEs to post-vaccination antibody titres. Method Individuals with IBD from a prospective cohort in Calgary, Canada (n=670) who received a 1st, 2nd, 3rd, and/or 4th dose of a SARS-CoV-2 vaccine (Pfizer-BioNTech, Moderna, and/or AstraZeneca) were interviewed via telephone for AEs using the Adverse Events Following Immunization form. Subsequently, we assessed injection site reaction as a specific AE outcome. Multivariable logistic regression models were used to assess the association between anti-SARS-CoV-2 spike protein antibody (anti-S) levels within 1–12 weeks of vaccination and injection site reaction following 1st, 2nd, and 3rd dose vaccination. Models were adjusted for age, sex, IBD type, IBD medications, vaccine type, and prior COVID-19 infection. Additionally, we evaluated the risk of flare of IBD within 30 days of vaccination via chart review. Result(s) Table 1 describes AEs in individuals with IBD following 1st dose (n=331), 2nd dose (n=331), 3rd dose (n=195), and 4th dose (n=100) of a SARS-CoV-2 vaccine. AEs were reported in 83.3% of participants after 1st dose, 79.1% after 2nd dose, 77.4% after 3rd dose, and 67.0% after 4th dose. Injection site reaction (pain, redness, etc.) was the most common AE (50.8% of AEs), with fatigue and malaise (18.1%), headache and migraine (8.6%), musculoskeletal discomfort (8.2%), and fever and chills (6.5%) also commonly reported. Multivariable logistic regression determined no associations between anti-S concentration and injection site reaction for all doses. Age above 65 years was associated with decreased injection site reaction following 1st and 3rd doses, while female sex and mRNA vaccine type were associated with increased injection site reaction following 1st and 2nd doses. Prior COVID-19 infection, IBD type, and medication class were not associated with injection site reaction with any dose. Only one participant was diagnosed with a severe AE requiring hospitalization: Immune thrombocytopenic purpura (ITP) following 2nd dose of a Pfizer vaccination. No cases of IBD flare occurred within 30 days of vaccination. Image ![]()
Conclusion(s) AEs following SARS-CoV-2 vaccination are generally mild and become less common with each consecutive dose. Antibody levels following each dose of the vaccine were not associated with injection site reactions. Females, those under 65 years of age, and those administered mRNA vaccines were more likely to experience an injection site reaction. Prior COVID-19 infection, IBD type, and IBD medication class did not predict injection site reactions. Vaccination was not associated with IBD flare within 30 days of vaccination. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding; Helmsley Disclosure of Interest A. Markovinovic: None Declared, M. Herauf: None Declared, J. Quan: None Declared, L. Hracs: None Declared, J. Windsor: None Declared, N. Sharifi: None Declared, S. Coward: None Declared, L. Caplan: None Declared, J. Gorospe: None Declared, C. Ma Grant / Research support from: Ferring, Pfizer, , Consultant of: AbbVie, Alimentiv, Amgen, Ferring, Pfizer, Takeda, , Speakers bureau of: AbbVie, Alimentiv, Amgen, Ferring, Pfizer, Takeda, R. Panaccione Grant / Research support from: AbbVie, Ferring, Janssen, Pfizer, Takeda, Consultant of: Abbott, AbbVie, Alimentiv, Amgen, Arena, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Celgene, Celltrion, Cosmos Pharmaceuticals, Eisai, Elan, Eli Lilly, Ferring, Galapagos, Genentech, Gilead Sciences, GlaxoSmithKline, Janssen, Merck, Mylan, Oppilan Pharma, Pandion Therapeutics, Pandion Pharma, Pfizer, Progenity, Protagonist, Roche, Sandoz, Satisfai Health, Schering-Plough, Shire, Sublimity Therapeutics, Takeda, Theravance, UCB, Speakers bureau of: AbbVie, Arena, Celgene, Eli Lilly, Ferring, Gilead Sciences, Janssen, Merck, Pfizer, Roche, Sandoz, Shire, Takeda, R. Ingram: None Declared, J. Kanji: None Declared, G. Tipples: None Declared, J. Holodinsky: None Declared, C. Berstein Grant / Research support from: AbbVie, Amgen, Janssen, Pfizer, Takeda, Speakers bureau of: AbbVie, Janssen, Pfizer, Takeda, D. Mahoney: None Declared, S. Bernatsky: None Declared, E. Benchimol: None Declared, G. Kaplan Grant / Research support from: Ferring, Speakers bureau of: AbbVie, Janssen, Pfizer
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Affiliation(s)
| | | | - J Quan
- University of Calgary, Calgary
| | - L Hracs
- University of Calgary, Calgary
| | | | | | | | | | | | - C Ma
- University of Calgary, Calgary
| | | | | | - J Kanji
- University of Calgary, Calgary
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Rosentreter R, Cheng E, Shen H, Ma C, Bhayana D, Panaccione R, Raman M, Medellin A, Lu C. A107 VISCERAL ADIPOSE TISSUE VOLUME DIFFERENTIATES BETWEEN FIBROSTENOTIC AND INFLAMMATORY CROHN’S DISEASE. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991293 DOI: 10.1093/jcag/gwac036.107] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Creeping fat, a form of visceral adipose tissue (VAT) that wraps the intestinal wall, influences the formation of Crohn’s disease (CD) strictures. The degree of fat wrapping from intestinal stricture resections is correlated with the extent of chronic inflammation, fibrosis, stricture formation, and response to biologic therapy. VAT and subcutaneous adipose tissue (SAT) ratios from CTE (computed tomography) scans are elevated in CD strictures. However, the definition of strictures in these studies has been poorly defined and not included current well-recognized criteria: 1) bowel wall thickness (BWT), 2) narrowed luminal diameter, and 3) pre-stenotic dilation. (PSD). Purpose The objective of this pilot study was to assess the relationship of 2D and 3D VAT:SAT ratios with CT stricture parameters in patients with terminal ileal (TI) CD strictures. Method 2D VAT:SAT ratios from CT’s of CD patients with TI strictures defined as increased BWT, narrowed luminal diameter (< 50% relative to normal adjacent distended loop), and PSD greater than the stricture diameter were retrospectively obtained from a database and chart review. CT’s from fibrostenotic CD patients were sex and BMI matched to patients with only TI inflammatory behaviour. Patient demographics, medication, smoking, and surgical history were also obtained. Analyses were adjusted for age, sex, and BMI covariates. Unpaired t-tests and multi-variable logistic regression analyses were conducted. Result(s) Twenty-eight patients with stricturing CD had a significantly greater mean VAT:SAT volume ratio than 29 non-stricturing CD (41.5 cm3 vs 34.2 cm3, p=0.03). Thirty-six percent (10/28) of CD stricture patients had prior ileocolic resection with a mean disease duration of 13.5 years (range 0-48). The median ileal BWT (7.0 mm, range 4.0-13.0 mm) for the stricturing group was significantly greater than those with inflammatory behaviour (BWT 2.0 mm, p<0.0001). The median luminal diameter and PSD for the stricture group was 2.0 mm (range 0 - 14.0 mm), and 3.0 cm (range 1.0 - 7.3 cm), respectively. Image ![]()
Conclusion(s) Fibrostenotic TI CD patients have increased VAT:SAT ratios in comparison to those with only inflammatory behaviour. These pilot VAT:SAT results provide an initial foundation for further studies to assess its predictive role in responsiveness of medical or surgical therapies in stricturing CD. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
| | | | - H Shen
- Department of Mathematics and Statistics
| | - C Ma
- Department of Medicine,Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | | | | | - M Raman
- Department of Medicine,Department of Community Health Sciences, University of Calgary, Calgary, Canada
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Caplan LN, Sharifi N, Markovinovic A, Herauf M, Quan J, Hracs L, Windsor JW, Coward S, Ma C, Panaccione R, Hagel B, Kaplan GG. A193 DEMOGRAPHIC, SOCIAL AND OCCUPATIONAL FACTORS THAT PREVENTED EXPOSURE TO SARS-COV-2 IN INFLAMMATORY BOWEL DISEASE PATIENTS DURING THE COVID-19 PANDEMIC: A PROSPECTIVE COHORT STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991122 DOI: 10.1093/jcag/gwac036.193] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background The COVID-19 pandemic caused by the SARS-CoV-2 virus is a rapidly evolving public health emergency in which mundane behaviors such as grocery shopping or restaurant dining are considered high-risk for some, such as persons with inflammatory bowel disease (IBD) who are often immunodeficient due to medications. Research on the behavioral exposures experienced by populations with IBD during the COVID-19 pandemic are lacking. Purpose We aim to better understand how the behaviors of persons with IBD are associated with COVID-19 diagnoses. Method We conducted a prospective serosurveillance cohort study in Calgary to assess exposure to SARS-CoV-2 from Nov. 1, 2020 to Aug. 8, 2022 in 485 individuals with IBD. A diagnosis of SARS-CoV-2 was defined as a molecular-confirmed PCR test, a self-report home antigen test, or a positive nucleocapsid antibody level. Participants completed a self-report electronic questionnaire on social and occupational risk activities stratified across two time periods: Jan. 2020 to Mar. 2020 (before lockdown) and post-Jun. 2020 (post lockdown). Univariate analyses (χ2 and Fischer’s exact if n≤5) were performed on social activities that occurred following the lockdown among those with IBD who were and were not diagnosed with COVID-19. Occupational exposures were compared across essential workers (EW) (i.e., frontline workers at high risk of COVID) and non-EWs. Result(s) Overall, 37.5% (n=182) of our cohort was diagnosed with COVID-19. Seniors were less likely to be infected with COVID-19 (22.7%) compared to those under the age of 65 (40.8%) (p=0.002). A greater proportion of females (42.6 %) compared to males (32.5%) were COVID positive (p=0.02). Those with Crohn’s disease (38.3%) were as likely to test positive for COVID-19 as those with ulcerative colitis (36%) (p=0.65). COVID positive patients were less likely to have 4 vaccine doses (28.5%) compared to those who tested negative (71.5%) (p=0.4). Statistically significant decreases (p<0.001) in engagement post-Jun. 2020 were observed for: bar use (11.6% to 2.1%), visiting a friend (44.5% to 15.2%), having visitors over (38.7% to 12.1%), restaurant dining (38% to 9%), indoor fitness (31.9% to 8.4%), and transit use (11% to 1.3%). There was an increase in regular use of outdoor fitness (31.9% to 67.1%, p<0.003). Persons with IBD who tested positive for COVID-19 were more likely to regularly dine in a restaurant (16.8% vs. 4.7% for COVID negative, p<0.001), engage in indoor fitness activities (14% vs. 5.1%, p<0.001), and travel outside Calgary (21% vs. 11.2%, p=0.004) post-lockdown. Post-lockdown, a greater proportion of EW were COVID positive (50.4%) compared to non-EW (38.6%) (p=0.04). Image ![]()
Conclusion(s) Over a two-year period, two-thirds of our cohort did not test positive for COVID-19. Those with IBD who avoided COVID tended to be older, male, have 4 doses of vaccine, and reduce their risk of exposure through social and occupational modifications, perhaps in response to public health guidance. Disclosure of Interest None Declared
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Affiliation(s)
- L N Caplan
- Community Health Sciences,IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
| | - N Sharifi
- Community Health Sciences,IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
| | - A Markovinovic
- IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
| | - M Herauf
- IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
| | - J Quan
- IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
| | - L Hracs
- IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
| | - J W Windsor
- IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
| | - S Coward
- IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
| | - C Ma
- IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
| | - R Panaccione
- IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
| | | | - G G Kaplan
- Community Health Sciences,IBD Clinic- Department of Medicine, University of Calgary, Calgary, Canada
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Yang H, Han X, Ma C, Yu H, Vallance B. A15 GENETIC OR DIET-ASSOCIATED DEFECTS IN MUCUS FACILITATE ULCERATIVE COLITIS PATHOBIONT-DRIVEN COLITIS. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991288 DOI: 10.1093/jcag/gwac036.015] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background The Inflammatory Bowel Diseases (IBD), Crohn’s Disease (CD) and ulcerative colitis (UC) affect > 270,000 Canadians and are increasing in incidence. Ileal CD has been linked to the overgrowth of mucosal adherent E. coli. Recent studies have also implicated the adherence of Escherichia coli pathobionts to the colonic mucosa of UC patients. Using the representative UC E. coli pathobiont p19A, we recently demonstrated it aggravated chemical-induced colitis in susceptible mice, through the actions of the toxin alpha-hemolysin, and by adhering to the inflamed colonic mucosa via the adhesin FimH. It is less clear what host factors control susceptibility to the UC pathobionts. One of the potential candidates is the glycosylated mucin (Muc2) which forms the mucus layer that covers the colonic epithelium and is often impaired in UC patients. Purpose To define the role of mucus structure and function in determining susceptibility to the p19A pathobiont, and its ability to cause colitis in mice. Method In vitro growth was assessed to test p19A’s ability to utilize mucin-derived sugars as nutrients. Susceptibility to p19A was tested in two mouse models of colonic mucus impairment. The first is a mouse strain deficient in core 1 derived O-glycans in their intestinal epithelial cells (IEC C1galt1-/-), resulting in reduced Muc2 glycosylation, and thus a thin and impaired mucus barrier. The second model involves feeding wildtype (WT) C57BL/6CR mice a fiber-free (FF) diet, resulting in a significantly thinner colonic mucus layer. The mice were subsequently orally gavaged with p19A and their susceptibility determined by p19A burdens, intestinal histopathology, inflammatory cytokine and short chain fatty acid (SCFA) production. Result(s) When tested in vitro, the p19A pathobiont was found to use an array of mucin-derived sugars as sole carbon source to proliferate. Following oral gavage of WT mice fed a normal diet, immunostaining identified p19A within the colonic mucus but it did not reach the colonic mucosa or cause disease. In contrast, p19A was found at the colonic mucosal surface of mucus-defective IEC C1galt1-/- mice (as compared to IEC C1galt1flox/flox mice) and in WT mice fed a fiber-free diet. This mucosal adherence was associated with increased body weight loss during the course of infection, as well as increased p19A burdens, colonic pathology and pro-inflammatory cytokine expression. Especially fiber-free diet-fed mice showed reduced SCFA levels in their feces at baseline. When the mice were given exogenous SCFA (tributyrin) orally, p19A infection was reduced. Conclusion(s) Our results indicate that UC E. coli pathobionts are able to dwell within colonic mucus and utilize mucin sugars as nutrients. Moreover, they can reach the mucosal surface and induce colitis in hosts suffering genetic or diet-based mucus dysfunction. In part, this susceptibility reflects the important role played by mucus in the production of SCFA, suggesting potential therapeutic approaches for patients suffering UC. Please acknowledge all funding agencies by checking the applicable boxes below CCC, CIHR Disclosure of Interest None Declared
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Affiliation(s)
- H Yang
- Pediatrics, BC Children's Hospital, Vancouver, Canada
| | - X Han
- Pediatrics, BC Children's Hospital, Vancouver, Canada
| | - C Ma
- Pediatrics, BC Children's Hospital, Vancouver, Canada
| | - H Yu
- Pediatrics, BC Children's Hospital, Vancouver, Canada
| | - B Vallance
- Pediatrics, BC Children's Hospital, Vancouver, Canada
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29
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Guo H, Hamilton P, Enns E, Gupta M, Andrews C, Nasser Y, Bredenoord A, Dellon E, Ma C. A142 APPROPRIATENESS OF POST-ENDOSCOPY CARE IN PATIENTS PRESENTING WITH FOOD BOLUS IMPACTIONS OVERNIGHT: A POPULATION-BASED MULTICENTER COHORT STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991086 DOI: 10.1093/jcag/gwac036.142] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Appropriate management of esophageal food bolus impactions includes endoscopic evaluation and follow-up for potential underlying esophageal pathology. Patients who present with impactions at night may not receive optimal long-term post-endoscopy care due to patient-, physician-, or system-related factors. Purpose We aimed to evaluate the appropriateness of care for patients who present with food bolus impactions after regular daytime hours. Method We conducted a retrospective, population-based, multi-center cohort study of adult patients undergoing endoscopy for food impaction between 19:00-06:59 from 2016-2018 in the Calgary Health Zone, Canada. Appropriate post-endoscopy care was defined by a composite of a follow-up clinic visit, repeat endoscopy, other appropriate investigations (e.g., manometry), or appropriate medical treatment (e.g., proton pump inhibitor). Predictors of inappropriate care were assessed using multivariable logistic regression, expressed as adjusted odds ratios (aOR) with 95% confidence intervals (CI). Result(s) A total of 323 patients underwent an after-hours or overnight endoscopy for food bolus impaction. 25.4% (82/323) of patients did not receive appropriate post-endoscopy care. Predictors of inappropriate care included rural residence (aOR 2.66 [95% CI: 1.18-6.01], p=0.02), first food bolus presentation (aOR 2.38 [95% CI: 1.04-5.44], p=0.04), and absence of a specific pathology during the index procedure (aOR 3.01 [95% CI: 0.97-9.29], p=0.05), suggesting a potential association with clinician cognitive bias. Among patients who were followed, 18.9% (35/185) had a change in the original diagnosis. Image ![]()
Conclusion(s) One quarter of patients presenting with a food bolus impaction at night do not receive appropriate post-endoscopy care. System-based interventions should target this high-risk population as the diagnosis and management may change with follow-up. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
- H Guo
- Division of Gastroenterology and Hepatology
| | - P Hamilton
- Department of Medicine, University of Calgary
| | - E Enns
- Department of Medicine, Alberta Health Services
| | - M Gupta
- Division of Gastroenterology and Hepatology
| | - C Andrews
- Division of Gastroenterology and Hepatology
| | - Y Nasser
- Division of Gastroenterology and Hepatology,Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Canada
| | - A Bredenoord
- Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, Netherlands
| | - E Dellon
- Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, United States
| | - C Ma
- Department of Medicine, Alberta Health Services,Department of Community Health Sciences, University of Calgary, Calgary, Canada
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30
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Sharifi N, Ma C, Seow C, Quan J, Hracs L, Caplan L, Markovinović A, Herauf M, Windsor J, Coward S, Buie M, Gorospe J, Panaccione R, Kaplan G. A195 DURABILITY OF SEROLOGICAL RESPONSES AFTER SECOND, THIRD AND FOURTH DOSE OF SARS-COV-2 VACCINATION IN INFLAMMATORY BOWEL DISEASE: A PROSPECTIVE COHORT STUDY. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991316 DOI: 10.1093/jcag/gwac036.195] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Adequate serological responses following two-dose regimens and additional doses of SARS-CoV-2 vaccination have been demonstrated for the vast majority of those with IBD. However, antibody levels following 2nd, 3rd, and 4th dose SARS-CoV-2 vaccination may decrease over time in the IBD population. Purpose We assessed the durability of serological responses to 2nd, 3rd, and 4th dose SARS-CoV-2 vaccination over time in a cohort of IBD patients. Method Adults with IBD who received at least one dose of a SARS-CoV-2 vaccine (n=559) were evaluated for serological response to the spike protein of SARS-CoV-2 using the Abbott IgG II Quant assay with a seroconversion threshold of ≥ 50 AU/mL. The geometric mean titer (GMT) with 95% confidence intervals (CI) were calculated and stratified by weeks (1–8, 8–16, 16–24, 24+ weeks) after each vaccine dose. We compared stratified GMTs with Mann–Whitney U tests using a significance level of 0.05. Result(s) Our cohort (n=559) comprised the following patient characteristics: 82.8% were 18–65 years-old (n = 463), 53.1% were female (n =297), and 71.6% had Crohn’s disease (n =400). IBD medications were classified in the following mutually exclusive groups: No immunosuppressives 10.5% (n = 59), anti-TNF monotherapy 35.8% (n = 200), immunomodulatory monotherapy 2.1% (n =12 ), vedolizumab 11.8% (n =66 ), ustekinumab 20.4% (n =114 ), tofacitinib 1.2% (n =7 ), combination therapy 15.9% (n = 89), and prednisone 2.1% (n =12). For vaccine type, 85.6% and 82.3% had Pfizer for 3rd and 4th dose, respectively, while the remainder had Moderna. Seroconversion rates 1–8 weeks after 3rd and 4th dose were both 99.9%. Figure 1 compares GMTs with 95% CI by weeks after each vaccine dose. GMTs are highest 1–8 weeks after 2nd dose (4053 AU/mL; 95% CI: 3468, 4737 AU/mL; n=337), 3rd dose (12116 AU/mL; 10413, 14098 AU/mL; n=256), and 4th dose (14337 AU/mL; 10429, 19710 AU/mL; n=67). Subsequently, antibody levels decay from 1–8 weeks to 8–16 weeks (p<0.001) for 2nd dose (mean difference: –2224 AU/mL), 3rd dose (mean difference: –7526 AU/mL), and 4th dose (mean difference: –9715 AU/mL). Compared to 16–24 weeks after 2nd dose, antibody levels 24+ weeks after were similar (GMTs: 795 AU/mL vs. 1043 AU/mL, p=0.52). For third dose, antibody levels 8–16 weeks and 16–24 weeks after vaccination were similar (4590 AU/mL vs. 4073 AU/mL, p=0.73) along with 16–24 weeks compared to 24+ weeks after vaccination (4073 AU/mL vs. 5876 AU/mL, p=0.18). Image ![]()
Conclusion(s) Within 1–8 weeks after each dose of vaccine, serological responses spikes with each subsequent dose yielding a higher GMT. While antibody levels decay 8–16 weeks after each dose, similar GMT levels beyond 16 weeks may indicate durability of antibody levels over a longer duration of time. Disclosure of Interest None Declared
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Affiliation(s)
- N Sharifi
- Department of Medicine, University of Calgary, Calgary, Canada
| | - C Ma
- Department of Medicine, University of Calgary, Calgary, Canada
| | - C Seow
- Department of Medicine, University of Calgary, Calgary, Canada
| | - J Quan
- Department of Medicine, University of Calgary, Calgary, Canada
| | - L Hracs
- Department of Medicine, University of Calgary, Calgary, Canada
| | - L Caplan
- Department of Medicine, University of Calgary, Calgary, Canada
| | - A Markovinović
- Department of Medicine, University of Calgary, Calgary, Canada
| | - M Herauf
- Department of Medicine, University of Calgary, Calgary, Canada
| | - J Windsor
- Department of Medicine, University of Calgary, Calgary, Canada
| | - S Coward
- Department of Medicine, University of Calgary, Calgary, Canada
| | - M Buie
- Department of Medicine, University of Calgary, Calgary, Canada
| | - J Gorospe
- Department of Medicine, University of Calgary, Calgary, Canada
| | - R Panaccione
- Department of Medicine, University of Calgary, Calgary, Canada
| | - G Kaplan
- Department of Medicine, University of Calgary, Calgary, Canada
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31
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Ma C, Sheng S, Gao W, Haugen T, Zhu Y, Shen Y. Clinical comparison of superior thyroid artery perforator flap and sternocleidomastoid myocutaneous flap for intraoral reconstruction. Int J Oral Maxillofac Surg 2023; 52:318-327. [PMID: 35835682 DOI: 10.1016/j.ijom.2022.06.017] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 06/02/2022] [Accepted: 06/30/2022] [Indexed: 11/18/2022]
Abstract
The aim was to evaluate the techniques and outcomes of superior thyroid artery perforator flaps (STAPF) for intraoral reconstruction and to compare them with those of the sternocleidomastoid myocutaneous flap (SCMMF). The cases of 43 patients who underwent reconstruction with either a SCMMF or STAPF for the repair of a medium-sized intraoral defect, between January 2013 and December 2020, were reviewed retrospectively. Although both flaps are based on the superior thyroid artery, their specific harvesting techniques largely differ. All SCMMF (n = 23) were superiorly-based rotational flaps with myocutaneous designs. The STAPF cases (n = 20) included 18 septocutaneous flaps and two chimeric flaps. The flap size was larger in the STAPF group (P = 0.008), while incomplete level IIB dissection (oncological safety) was more frequent in the SCMMF group (P = 0.002). The flap necrosis rate was lower in the STAPF group (STAPF 15% vs SCMMF 34.8%, though this was not statistically significant). Cox multivariate analysis showed that the postoperative flap outcome (total flap necrosis vs flap survival; hazard ratio 27, 95% confidence interval 2.149-336.05; P = 0.001) and complications (excluding fistula) (hazard ratio 14, 95% confidence interval 1.314-142.767; P = 0.029) were associated with overall patient survival. Both speech (P < 0.001) and neck mobility (P < 0.001) functions were superior with STAPF reconstruction. Compared with the traditional SCMMF, the STAPF was found to have a lower necrosis rate with uncompromised oncological safety during harvesting. The STAPF is a good alternative for the repair of medium-sized head and neck defects.
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Affiliation(s)
- C Ma
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - S Sheng
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - W Gao
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - T Haugen
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, PA, USA
| | - Y Zhu
- Department of CT Clinical Research, CT Business Unit, Canon Medical Systems (China) Co., Ltd, Beijing, China
| | - Y Shen
- Department of Oral Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
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32
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Nakamura T, Matsumoto M, Amano K, Enokido Y, Zolensky ME, Mikouchi T, Genda H, Tanaka S, Zolotov MY, Kurosawa K, Wakita S, Hyodo R, Nagano H, Nakashima D, Takahashi Y, Fujioka Y, Kikuiri M, Kagawa E, Matsuoka M, Brearley AJ, Tsuchiyama A, Uesugi M, Matsuno J, Kimura Y, Sato M, Milliken RE, Tatsumi E, Sugita S, Hiroi T, Kitazato K, Brownlee D, Joswiak DJ, Takahashi M, Ninomiya K, Takahashi T, Osawa T, Terada K, Brenker FE, Tkalcec BJ, Vincze L, Brunetto R, Aléon-Toppani A, Chan QHS, Roskosz M, Viennet JC, Beck P, Alp EE, Michikami T, Nagaashi Y, Tsuji T, Ino Y, Martinez J, Han J, Dolocan A, Bodnar RJ, Tanaka M, Yoshida H, Sugiyama K, King AJ, Fukushi K, Suga H, Yamashita S, Kawai T, Inoue K, Nakato A, Noguchi T, Vilas F, Hendrix AR, Jaramillo-Correa C, Domingue DL, Dominguez G, Gainsforth Z, Engrand C, Duprat J, Russell SS, Bonato E, Ma C, Kawamoto T, Wada T, Watanabe S, Endo R, Enju S, Riu L, Rubino S, Tack P, Takeshita S, Takeichi Y, Takeuchi A, Takigawa A, Takir D, Tanigaki T, Taniguchi A, Tsukamoto K, Yagi T, Yamada S, Yamamoto K, Yamashita Y, Yasutake M, Uesugi K, Umegaki I, Chiu I, Ishizaki T, Okumura S, Palomba E, Pilorget C, Potin SM, Alasli A, Anada S, Araki Y, Sakatani N, Schultz C, Sekizawa O, Sitzman SD, Sugiura K, Sun M, Dartois E, De Pauw E, Dionnet Z, Djouadi Z, Falkenberg G, Fujita R, Fukuma T, Gearba IR, Hagiya K, Hu MY, Kato T, Kawamura T, Kimura M, Kubo MK, Langenhorst F, Lantz C, Lavina B, Lindner M, Zhao J, Vekemans B, Baklouti D, Bazi B, Borondics F, Nagasawa S, Nishiyama G, Nitta K, Mathurin J, Matsumoto T, Mitsukawa I, Miura H, Miyake A, Miyake Y, Yurimoto H, Okazaki R, Yabuta H, Naraoka H, Sakamoto K, Tachibana S, Connolly HC, Lauretta DS, Yoshitake M, Yoshikawa M, Yoshikawa K, Yoshihara K, Yokota Y, Yogata K, Yano H, Yamamoto Y, Yamamoto D, Yamada M, Yamada T, Yada T, Wada K, Usui T, Tsukizaki R, Terui F, Takeuchi H, Takei Y, Iwamae A, Soejima H, Shirai K, Shimaki Y, Senshu H, Sawada H, Saiki T, Ozaki M, Ono G, Okada T, Ogawa N, Ogawa K, Noguchi R, Noda H, Nishimura M, Namiki N, Nakazawa S, Morota T, Miyazaki A, Miura A, Mimasu Y, Matsumoto K, Kumagai K, Kouyama T, Kikuchi S, Kawahara K, Kameda S, Iwata T, Ishihara Y, Ishiguro M, Ikeda H, Hosoda S, Honda R, Honda C, Hitomi Y, Hirata N, Hirata N, Hayashi T, Hayakawa M, Hatakeda K, Furuya S, Fukai R, Fujii A, Cho Y, Arakawa M, Abe M, Watanabe S, Tsuda Y. Formation and evolution of carbonaceous asteroid Ryugu: Direct evidence from returned samples. Science 2023; 379:eabn8671. [PMID: 36137011 DOI: 10.1126/science.abn8671] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Samples of the carbonaceous asteroid Ryugu were brought to Earth by the Hayabusa2 spacecraft. We analyzed 17 Ryugu samples measuring 1 to 8 millimeters. Carbon dioxide-bearing water inclusions are present within a pyrrhotite crystal, indicating that Ryugu's parent asteroid formed in the outer Solar System. The samples contain low abundances of materials that formed at high temperatures, such as chondrules and calcium- and aluminum-rich inclusions. The samples are rich in phyllosilicates and carbonates, which formed through aqueous alteration reactions at low temperature, high pH, and water/rock ratios of <1 (by mass). Less altered fragments contain olivine, pyroxene, amorphous silicates, calcite, and phosphide. Numerical simulations, based on the mineralogical and physical properties of the samples, indicate that Ryugu's parent body formed ~2 million years after the beginning of Solar System formation.
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Affiliation(s)
- T Nakamura
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - M Matsumoto
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - K Amano
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Y Enokido
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - M E Zolensky
- NASA Johnson Space Center; Houston, TX 77058, USA
| | - T Mikouchi
- The University Museum, The University of Tokyo, Tokyo 113-0033, Japan
| | - H Genda
- Earth-Life Science Institute, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - S Tanaka
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - M Y Zolotov
- School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287, USA
| | - K Kurosawa
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan
| | - S Wakita
- Department of Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - R Hyodo
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - H Nagano
- Department of Mechanical Systems Engineering, Nagoya University, Nagoya 464-8603, Japan
| | - D Nakashima
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - Y Takahashi
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan.,Isotope Science Center, The University of Tokyo, Tokyo 113-0032, Japan
| | - Y Fujioka
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - M Kikuiri
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - E Kagawa
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - M Matsuoka
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique (LESIA), Observatoire de Paris, Meudon 92195 France.,Geological Survey of Japan, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, 305-8567, Japan
| | - A J Brearley
- Department of Earth and Planetary Sciences, University of New Mexico, Albuquerque, NM 87131, USA
| | - A Tsuchiyama
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu 525-8577, Japan.,Key Laboratory of Mineralogy and Metallogeny, Guangdong Provincial Key Laboratory of Mineral Physics and Materials, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences (CAS), Guangzhou 510640, China.,Center for Excellence in Deep Earth Science, CAS, Guangzhou 510640, China
| | - M Uesugi
- Scattering and Imaging Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - J Matsuno
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu 525-8577, Japan
| | - Y Kimura
- Institute of Low Temperature Science, Hokkaido University, Sapporo 060-0819, Japan
| | - M Sato
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - R E Milliken
- Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, RI 02912, USA
| | - E Tatsumi
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan.,Instituto de Astrofísica de Canarias, University of La Laguna, Tenerife 38205, Spain
| | - S Sugita
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan.,Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - T Hiroi
- Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, RI 02912, USA
| | - K Kitazato
- Aizu Research Center for Space Informatics, The University of Aizu, Aizu-Wakamatsu 965-8580, Japan
| | - D Brownlee
- Department of Astronomy, University of Washington, Seattle, WA 98195 USA
| | - D J Joswiak
- Department of Astronomy, University of Washington, Seattle, WA 98195 USA
| | - M Takahashi
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - K Ninomiya
- Institute for Radiation Sciences, Osaka University, Toyonaka 560-0043, Japan
| | - T Takahashi
- Kavli Institute for the Physics and Mathematics of the Universe, The University of Tokyo, Kashiwa 277-8583, Japan.,Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - T Osawa
- Materials Sciences Research Center, Japan Atomic Energy Agency, Tokai 319-1195, Japan
| | - K Terada
- Department of Earth and Space Science, Osaka University, Toyonaka 560-0043, Japan
| | - F E Brenker
- Institute of Geoscience, Goethe University, Frankfurt, 60438 Frankfurt am Main, Germany
| | - B J Tkalcec
- Institute of Geoscience, Goethe University, Frankfurt, 60438 Frankfurt am Main, Germany
| | - L Vincze
- Department of Chemistry, Ghent University, Krijgslaan 281 S12, Ghent, Belgium
| | - R Brunetto
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - A Aléon-Toppani
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - Q H S Chan
- Department of Earth Sciences, Royal Holloway, University of London, Egham TW20 0EX, UK
| | - M Roskosz
- Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Muséum National d'Histoire Naturelle, Centre national de la recherche scientifique (CNRS), Sorbonne Université, Paris, France
| | - J-C Viennet
- Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Muséum National d'Histoire Naturelle, Centre national de la recherche scientifique (CNRS), Sorbonne Université, Paris, France
| | - P Beck
- Institut de Planétologie et d'Astrophysique de Grenoble, CNRS, Université Grenoble Alpes, 38000 Grenoble, France
| | - E E Alp
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, USA
| | - T Michikami
- Faculty of Engineering, Kindai University, Higashi-Hiroshima 739-2116, Japan
| | - Y Nagaashi
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan.,Department of Planetology, Kobe University, Kobe 657-8501, Japan
| | - T Tsuji
- Department of Earth Resources Engineering, Kyushu University, Fukuoka 819-0395, Japan.,School of Engineering, The University of Tokyo, Tokyo 113-0033, Japan
| | - Y Ino
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Physics, Kwansei Gakuin University, Sanda 669-1330, Japan
| | - J Martinez
- NASA Johnson Space Center; Houston, TX 77058, USA
| | - J Han
- Department of Earth and Atmospheric Sciences, University of Houston, Houston, TX 77204, USA
| | - A Dolocan
- Texas Materials Institute, The University of Texas at Austin, Austin, TX 78712, USA
| | - R J Bodnar
- Department of Geoscience, Virginia Tech, Blacksburg, VA 24061, USA
| | - M Tanaka
- Materials Analysis Station, National Institute for Materials Science, Tsukuba 305-0047, Japan
| | - H Yoshida
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - K Sugiyama
- Institute for Materials Research, Tohoku University, Sendai 980-8577, Japan
| | - A J King
- Department of Earth Science, Natural History Museum, London SW7 5BD, UK
| | - K Fukushi
- Institute of Nature and Environmental Technology, Kanazawa University, Kanazawa 920-1192, Japan
| | - H Suga
- Spectroscopy Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - S Yamashita
- Department of Materials Structure Science, The Graduate University for Advanced Studies (SOKENDAI), Tsukuba, Ibaraki 305-0801, Japan.,Institute of Materials Structure Science, High-Energy Accelerator Research Organization, Tsukuba 305-0801, Japan
| | - T Kawai
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - K Inoue
- Institute of Nature and Environmental Technology, Kanazawa University, Kanazawa 920-1192, Japan
| | - A Nakato
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - T Noguchi
- Division of Earth and Planetary Sciences, Kyoto University, Kyoto 606-8502, Japan.,Faculty of Arts and Science, Kyushu University, Fukuoka 819-0395, Japan
| | - F Vilas
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - A R Hendrix
- Planetary Science Institute, Tucson, AZ 85719, USA
| | | | - D L Domingue
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - G Dominguez
- Department of Physics, California State University, San Marcos, CA 92096, USA
| | - Z Gainsforth
- Space Sciences Laboratory, University of California, Berkeley, CA 94720, USA
| | - C Engrand
- Laboratoire de Physique des 2 Infinis Irène Joliot-Curie, Université Paris-Saclay, CNRS, 91405 Orsay, France
| | - J Duprat
- Institut de Minéralogie, Physique des Matériaux et Cosmochimie, Muséum National d'Histoire Naturelle, Centre national de la recherche scientifique (CNRS), Sorbonne Université, Paris, France
| | - S S Russell
- Department of Earth Science, Natural History Museum, London SW7 5BD, UK
| | - E Bonato
- Institute for Planetary Research, Deutsches Zentrum für Luftund Raumfahrt, Rutherfordstraße 2 12489 Berlin, Germany
| | - C Ma
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena CA 91125, USA
| | - T Kawamoto
- Department of Geosciences, Shizuoka University, Shizuoka 422-8529, Japan
| | - T Wada
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - S Watanabe
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Kavli Institute for the Physics and Mathematics of the Universe, The University of Tokyo, Kashiwa 277-8583, Japan
| | - R Endo
- Department of Materials Science and Engineering, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - S Enju
- Graduate School of Science and Engineering, Ehime University, Matsuyama 790-8577, Japan
| | - L Riu
- European Space Astronomy Centre, 28692 Villanueva de la Cañada, Spain
| | - S Rubino
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - P Tack
- Department of Chemistry, Ghent University, Krijgslaan 281 S12, Ghent, Belgium
| | - S Takeshita
- High Energy Accelerator Research Organization, Tokai 319-1106, Japan
| | - Y Takeichi
- Department of Materials Structure Science, The Graduate University for Advanced Studies (SOKENDAI), Tsukuba, Ibaraki 305-0801, Japan.,Institute of Materials Structure Science, High-Energy Accelerator Research Organization, Tsukuba 305-0801, Japan.,Department of Applied Physics, Osaka University, Suita 565-0871, Japan
| | - A Takeuchi
- Scattering and Imaging Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - A Takigawa
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - D Takir
- NASA Johnson Space Center; Houston, TX 77058, USA
| | | | - A Taniguchi
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Kumatori 590-0494, Japan
| | - K Tsukamoto
- Department of Earth Sciences, Tohoku University, Sendai 980-8578, Japan
| | - T Yagi
- National Metrology Institute of Japan, AIST, Tsukuba 305-8565, Japan
| | - S Yamada
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - K Yamamoto
- Japan Fine Ceramics Center, Nagoya 456-8587, Japan
| | - Y Yamashita
- National Metrology Institute of Japan, AIST, Tsukuba 305-8565, Japan
| | - M Yasutake
- Scattering and Imaging Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - K Uesugi
- Scattering and Imaging Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - I Umegaki
- High Energy Accelerator Research Organization, Tokai 319-1106, Japan.,Toyota Central Research and Development Laboratories, Nagakute 480-1192, Japan
| | - I Chiu
- Institute for Radiation Sciences, Osaka University, Toyonaka 560-0043, Japan
| | - T Ishizaki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - S Okumura
- Division of Earth and Planetary Sciences, Kyoto University, Kyoto 606-8502, Japan
| | - E Palomba
- Istituto di Astrofisica e Planetologia Spaziali, Istituto Nazionale di Astrofisica, Rome 00133, Italy
| | - C Pilorget
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France.,Institut Universitaire de France, Paris, France
| | - S M Potin
- Laboratoire d'Etudes Spatiales et d'Instrumentation en Astrophysique (LESIA), Observatoire de Paris, Meudon 92195 France.,Faculty of Aerospace Engineering, Delft University of Technology, Delft, Netherlands
| | - A Alasli
- Department of Mechanical Systems Engineering, Nagoya University, Nagoya 464-8603, Japan
| | - S Anada
- Japan Fine Ceramics Center, Nagoya 456-8587, Japan
| | - Y Araki
- Department of Physical Sciences, Ritsumeikan University, Shiga 525-0058, Japan
| | - N Sakatani
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - C Schultz
- Department of Earth, Environmental, and Planetary Sciences, Brown University, Providence, RI 02912, USA
| | - O Sekizawa
- Spectroscopy Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - S D Sitzman
- Physical Sciences Laboratory, The Aerospace Corporation, CA 90245, USA
| | - K Sugiura
- Earth-Life Science Institute, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - M Sun
- Key Laboratory of Mineralogy and Metallogeny, Guangdong Provincial Key Laboratory of Mineral Physics and Materials, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences (CAS), Guangzhou 510640, China.,Center for Excellence in Deep Earth Science, CAS, Guangzhou 510640, China.,University of Chinese Academy of Sciences, Beijing 100049, China
| | - E Dartois
- Institut des Sciences Moléculaires d'Orsay, Université Paris-Saclay, CNRS, 91405 Orsay, France
| | - E De Pauw
- Department of Chemistry, Ghent University, Krijgslaan 281 S12, Ghent, Belgium
| | - Z Dionnet
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - Z Djouadi
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - G Falkenberg
- Deutsches Elektronen-Synchrotron Photon Science, 22603 Hamburg, Germany
| | - R Fujita
- Department of Mechanical Systems Engineering, Nagoya University, Nagoya 464-8603, Japan
| | - T Fukuma
- Nano Life Science Institute, Kanazawa University, Kanazawa 920-1192, Japan
| | - I R Gearba
- Texas Materials Institute, The University of Texas at Austin, Austin, TX 78712, USA
| | - K Hagiya
- Graduate School of Life Science, University of Hyogo, Hyogo 678-1297, Japan
| | - M Y Hu
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, USA
| | - T Kato
- Japan Fine Ceramics Center, Nagoya 456-8587, Japan
| | - T Kawamura
- Institut de Physique du Globe de Paris, Université de Paris, Paris 75205, France
| | - M Kimura
- Department of Materials Structure Science, The Graduate University for Advanced Studies (SOKENDAI), Tsukuba, Ibaraki 305-0801, Japan.,Institute of Materials Structure Science, High-Energy Accelerator Research Organization, Tsukuba 305-0801, Japan
| | - M K Kubo
- Division of Natural Sciences, International Christian University, Mitaka 181-8585, Japan
| | - F Langenhorst
- Institute of Geosciences, Friedrich-Schiller-Universität Jena, 07745 Jena, Germany
| | - C Lantz
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - B Lavina
- Center for Advanced Radiation Sources, University of Chicago, Chicago, IL 60637, USA
| | - M Lindner
- Institute of Geoscience, Goethe University, Frankfurt, 60438 Frankfurt am Main, Germany
| | - J Zhao
- Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, USA
| | - B Vekemans
- Department of Chemistry, Ghent University, Krijgslaan 281 S12, Ghent, Belgium
| | - D Baklouti
- Institut d'Astrophysique Spatiale, Université Paris-Saclay, Orsay 91405, France
| | - B Bazi
- Department of Chemistry, Ghent University, Krijgslaan 281 S12, Ghent, Belgium
| | - F Borondics
- Optimized Light Source of Intermediate Energy to LURE (SOLEIL) L'Orme des Merisiers, Gif sur Yvette F-91192, France
| | - S Nagasawa
- Kavli Institute for the Physics and Mathematics of the Universe, The University of Tokyo, Kashiwa 277-8583, Japan.,Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - G Nishiyama
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - K Nitta
- Spectroscopy Division, Japan Synchrotron Radiation Research Institute, Sayo 679-5198, Japan
| | - J Mathurin
- Institut Chimie Physique, Université Paris-Saclay, CNRS, 91405 Orsay, France
| | - T Matsumoto
- Division of Earth and Planetary Sciences, Kyoto University, Kyoto 606-8502, Japan
| | - I Mitsukawa
- Division of Earth and Planetary Sciences, Kyoto University, Kyoto 606-8502, Japan
| | - H Miura
- Graduate School of Science, Nagoya City University, Nagoya 467-8501, Japan
| | - A Miyake
- Division of Earth and Planetary Sciences, Kyoto University, Kyoto 606-8502, Japan
| | - Y Miyake
- High Energy Accelerator Research Organization, Tokai 319-1106, Japan
| | - H Yurimoto
- Department of Natural History Sciences, Hokkaido University, Sapporo 060-0810, Japan
| | - R Okazaki
- Department of Earth and Planetary Sciences, Kyushu University, Fukuoka 819-0395, Japan
| | - H Yabuta
- Graduate School of Advanced Science and Engineering, Hiroshima University, Higashi-Hiroshima 739-8526, Japan
| | - H Naraoka
- Department of Earth and Planetary Sciences, Kyushu University, Fukuoka 819-0395, Japan
| | - K Sakamoto
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - S Tachibana
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - H C Connolly
- Department of Geology, Rowan University, Glassboro, NJ 08028, USA
| | - D S Lauretta
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - M Yoshitake
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - M Yoshikawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - K Yoshikawa
- Research and Development Directorate, JAXA, Sagamihara 252-5210, Japan
| | - K Yoshihara
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - Y Yokota
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - K Yogata
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - H Yano
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - Y Yamamoto
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - D Yamamoto
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - M Yamada
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan
| | - T Yamada
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - T Yada
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - K Wada
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan
| | - T Usui
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - R Tsukizaki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - F Terui
- Department of Mechanical Engineering, Kanagawa Institute of Technology, Atsugi 243-0292, Japan
| | - H Takeuchi
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - Y Takei
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - A Iwamae
- Marine Works Japan, Yokosuka 237-0063, Japan
| | - H Soejima
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Marine Works Japan, Yokosuka 237-0063, Japan
| | - K Shirai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - Y Shimaki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - H Senshu
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan
| | - H Sawada
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - T Saiki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - M Ozaki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - G Ono
- Research and Development Directorate, JAXA, Sagamihara 252-5210, Japan
| | - T Okada
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Chemistry, The University of Tokyo, Tokyo 113-0033, Japan
| | - N Ogawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - K Ogawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - R Noguchi
- Faculty of Science, Niigata University, Niigata 950-2181, Japan
| | - H Noda
- National Astronomical Observatory of Japan, Mitaka 181-8588, Japan
| | - M Nishimura
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - N Namiki
- Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan.,National Astronomical Observatory of Japan, Mitaka 181-8588, Japan
| | - S Nakazawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - T Morota
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - A Miyazaki
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - A Miura
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - Y Mimasu
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - K Matsumoto
- Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan.,National Astronomical Observatory of Japan, Mitaka 181-8588, Japan
| | - K Kumagai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Marine Works Japan, Yokosuka 237-0063, Japan
| | - T Kouyama
- Digital Architecture Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo 135-0064, Japan
| | - S Kikuchi
- Planetary Exploration Research Center, Chiba Institute of Technology, Narashino 275-0016, Japan.,National Astronomical Observatory of Japan, Mitaka 181-8588, Japan
| | - K Kawahara
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - S Kameda
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - T Iwata
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - Y Ishihara
- JAXA Space Exploration Center, JAXA, Sagamihara 252-5210, Japan
| | - M Ishiguro
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Korea
| | - H Ikeda
- Research and Development Directorate, JAXA, Sagamihara 252-5210, Japan
| | - S Hosoda
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - R Honda
- Department of Information Science, Kochi University, Kochi 780-8520, Japan.,Center for Data Science, Ehime University, Matsuyama 790-8577, Japan
| | - C Honda
- Aizu Research Center for Space Informatics, The University of Aizu, Aizu-Wakamatsu 965-8580, Japan
| | - Y Hitomi
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Marine Works Japan, Yokosuka 237-0063, Japan
| | - N Hirata
- Department of Planetology, Kobe University, Kobe 657-8501, Japan
| | - N Hirata
- Aizu Research Center for Space Informatics, The University of Aizu, Aizu-Wakamatsu 965-8580, Japan
| | - T Hayashi
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - M Hayakawa
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - K Hatakeda
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Marine Works Japan, Yokosuka 237-0063, Japan
| | - S Furuya
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - R Fukai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - A Fujii
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
| | - Y Cho
- Department of Earth and Planetary Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - M Arakawa
- Department of Planetology, Kobe University, Kobe 657-8501, Japan
| | - M Abe
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan.,Department of Space and Astronautical Science, The Graduate University for Advanced Studies (SOKENDAI), Hayama 240-0193, Japan
| | - S Watanabe
- Department of Earth and Environmental Sciences, Nagoya University, Nagoya 464-8601, Japan
| | - Y Tsuda
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (JAXA), Sagamihara 252-5210, Japan
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Xu J, Li Y, Zhong G, Fang Z, Liu C, Ma C, Wang C, Guo Y, Liu C. [Directed differentiation of human induced pluripotent stem cells into midbrain]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:175-182. [PMID: 36946035 PMCID: PMC10034547 DOI: 10.12122/j.issn.1673-4254.2023.02.03] [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] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To establish an efficient protocol for directed differentiation of human induced pluripotent stem cells (hiPSCs) into functional midbrain dopaminergic progenitor cells (DAPs) in vitro. METHODS hiPSCs were induced to differentiate into DAPs in two developmental stages. In the first stage (the first 13 days), hiPSCs were induced into intermediate cells morphologically similar to primitive neuroepithelial cells (NECs) in neural induction medium containing a combination of small molecule compounds. In the second stage, the intermediate cells were further induced in neural differentiation medium until day 28 to obtain DAPs. After CM-DiI staining, the induced DAPs were stereotactically transplanted into the right medial forebrain bundle (MFB) of rat models of Parkinson's disease (PD). Eight weeks after transplantation, the motor behaviors of PD rats was evaluated. Immunofluorescence assay of brain sections of the rats was performed at 2 weeks after transplantation to observe the survival, migration and differentiation of the transplanted cells in the host brain microenvironment. RESULTS hiPSCs passaged stably on Matrigel showed a normal diploid karyotype, expressed the pluripotency markers OCT4, SOX2, and Nanog, and were positive for alkaline phosphatase. The primitive neuroepithelial cells obtained on day 13 formed dense cell colonies in the form of neural rosettes and expressed the neuroepithelial markers (SOX2, Nestin, and PAX6, 91.3%-92.8%). The DAPs on day 28 highly expressed the specific markers (TH, FOXA2, LMX1A and NURR1, 93.3-96.7%). In rat models of PD, the hiPSCs-DAPs survived and differentiated into TH+, FOXA2+ and Tuj1+ neurons at 2 weeks after transplantation. Eight weeks after transplantation, the motor function of PD rats was significantly improved as shown by water maze test (P < 0.0001) and apomorphine-induced rotation test (P < 0.0001) compared with rats receiving vehicle injection. CONCLUSION HiPSCs can be effectively induced to differentiate into DAPs capable of differentiating into functional neurons both in vivo and in vitro. In rat models of PD, the transplanted hiPSCs-DAPs can survive for more than 8 weeks in the MFB and differentiate into multiple functional neurocytes to ameliorate neurological deficits of the rats, suggesting the potential value of hiPSCs-DAPs transplantation for treatment of neurological diseases.
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Affiliation(s)
- J Xu
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - Y Li
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - G Zhong
- School of Laboratory Medicine, Bengbu Medical College, Bengbu 233000, China
| | - Z Fang
- School of Laboratory Medicine, Bengbu Medical College, Bengbu 233000, China
| | - C Liu
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - C Ma
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - C Wang
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
| | - Y Guo
- School of Laboratory Medicine, Bengbu Medical College, Bengbu 233000, China
| | - C Liu
- School of Life Sciences, Bengbu Medical College, Bengbu 233000, China
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Zhang P, Song F, Ma C, Liu Z, Wu H, Sun Y, Feng Y, He Y, Zhang G. Robust reconstruction of fluorescence molecular tomography based on adaptive adversarial learning strategy. Phys Med Biol 2023; 68. [PMID: 36696695 DOI: 10.1088/1361-6560/acb638] [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: 08/22/2022] [Accepted: 01/25/2023] [Indexed: 01/26/2023]
Abstract
Objective.Fluorescence molecular tomography (FMT) is a promising molecular imaging modality for quantifying the three-dimensional (3D) distribution of tumor probes in small animals. However, traditional deep learning reconstruction methods that aim to minimize the mean squared error (MSE) and iterative regularization algorithms that rely on optimal parameters are typically influenced by strong noise, resulting in poor FMT reconstruction robustness.Approach.In this letter, we propose an adaptive adversarial learning strategy (3D-UR-WGAN) to achieve robust FMT reconstructions. Unlike the pixel-based MSE criterion in traditional CNNs or the regularization strategy in iterative solving schemes, the reconstruction strategy can greatly facilitate the performance of the network models through alternating loop training of the generator and the discriminator. Second, the reconstruction strategy combines the adversarial loss in GANs with the L1 loss to significantly enhance the robustness and preserve image details and textual information.Main results.Both numerical simulations and physical phantom experiments demonstrate that the 3D-UR-WGAN method can adaptively eliminate the effects of different noise levels on the reconstruction results, resulting in robust reconstructed images with reduced artifacts and enhanced image contrast. Compared with the state-of-the-art methods, the proposed method achieves better reconstruction performance in terms of target shape recovery and localization accuracy.Significance.This adaptive adversarial learning reconstruction strategy can provide a possible paradigm for robust reconstruction in complex environments, and also has great potential to provide an alternative solution for solving the problem of poor robustness encountered in other optical imaging modalities such as diffuse optical tomography, bioluminescence imaging, and Cherenkov luminescence imaging.
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Affiliation(s)
- Peng Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, People's Republic of China
| | - Fan Song
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, People's Republic of China
| | - Chenbin Ma
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, People's Republic of China
| | - Zeyu Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, People's Republic of China
| | - Huijie Wu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, People's Republic of China
| | - Yangyang Sun
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, People's Republic of China
| | - Youdan Feng
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, People's Republic of China
| | - Yufang He
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, People's Republic of China
| | - Guanglei Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, People's Republic of China
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Zhang P, Ma C, Song F, Zhang T, Sun Y, Feng Y, He Y, Liu F, Wang D, Zhang G. D2-RecST: Dual-domain joint reconstruction strategy for fluorescence molecular tomography based on image domain and perception domain. Comput Methods Programs Biomed 2023; 229:107293. [PMID: 36481532 DOI: 10.1016/j.cmpb.2022.107293] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Fluorescence molecular tomography (FMT) is a promising molecular imaging modality for quantifying the three-dimensional (3D) distribution of fluorescent probes in small animals. Over the past few years, learning-based FMT reconstruction methods have achieved promising results. However, these methods typically attempt to minimize the mean-squared error (MSE) between the reconstructed image and the ground truth. Although signal-to-noise ratios (SNRs) are improved, they are susceptible to non-uniform artifacts and loss of structural detail, making it extremely challenging to obtain accurate and robust FMT reconstructions under noisy measurements. METHODS We propose a novel dual-domain joint strategy based on the image domain and perception domain for accurate and robust FMT reconstruction. First, we formulate an explicit adversarial learning strategy in the image domain, which greatly facilitates training and optimization through two enhanced networks to improve anti-noise ability. Besides, we introduce a novel transfer learning strategy in the perceptual domain to optimize edge details by providing perceptual priors for fluorescent targets. Collectively, the proposed dual-domain joint reconstruction strategy can significantly eliminate the non-uniform artifacts and effectively preserve the structural edge details. RESULTS Both numerical simulations and in vivo mouse experiments demonstrate that the proposed method markedly outperforms traditional and cutting-edge methods in terms of positioning accuracy, image contrast, robustness, and target morphological recovery. CONCLUSIONS The proposed method achieves the best reconstruction performance and has great potential to facilitate precise localization and 3D visualization of tumors in in vivo animal experiments.
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Affiliation(s)
- Peng Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Chenbin Ma
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Fan Song
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Tianyi Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Yangyang Sun
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Youdan Feng
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Yufang He
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Fei Liu
- Advanced information & Industrial Technology Research Institute, Beijing Information Science & Technology University, Beijing, 100192, China
| | - Daifa Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Guanglei Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
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Zhang T, Feng Y, Zhao Y, Fan G, Yang A, Lyu S, Zhang P, Song F, Ma C, Sun Y, Feng Y, Zhang G. MSHT: Multi-stage Hybrid Transformer for the ROSE Image Analysis of Pancreatic Cancer. IEEE J Biomed Health Inform 2023; PP. [PMID: 37018254 DOI: 10.1109/jbhi.2023.3234289] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Pancreatic cancer is one of the most malignant cancers with high mortality. The rapid on-site evaluation (ROSE) technique can significantly accelerate the diagnostic workflow of pancreatic cancer by immediately analyzing the fast-stained cytopathological images with on-site pathologists. However, the broader expansion of ROSE diagnosis has been hindered by the shortage of experienced pathologists. Deep learning has great potential for the automatic classification of ROSE images in diagnosis. But it is challenging to model the complicated local and global image features. The traditional convolutional neural network (CNN) structure can effectively extract spatial features, while it tends to ignore global features when the prominent local features are misleading. In contrast, the Transformer structure has excellent advantages in capturing global features and long-range relations, while it has limited ability in utilizing local features. We propose a multi-stage hybrid Transformer (MSHT) to combine the strengths of both, where a CNN backbone robustly extracts multi-stage local features at different scales as the attention guidance, and a Transformer encodes them for sophisticated global modeling. Going beyond the strength of each single method, the MSHT can simultaneously enhance the Transformer global modeling ability with the local guidance from CNN features. To evaluate the method in this unexplored field, a dataset of 4240 ROSE images is collected where MSHT achieves 95.68% in classification accuracy with more accurate attention regions. The distinctively superior results compared to the state-of-the-art models make MSHT extremely promising for cytopathological image analysis. The codes and records are available at: https://github.com/sagizty/ Multi-Stage-Hybrid-Transformer.
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Affiliation(s)
- Tianyi Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Yunlu Feng
- Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China
| | - Yu Zhao
- Department of Pathology, Peking Union Medical College Hospital, Beijing, China
| | - Guangda Fan
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Aiming Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Beijing, China
| | - Shangqing Lyu
- School of Electronics & Computer Science, University of Southampton, Southampton, United Kingdom
| | - Peng Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Fan Song
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Chenbin Ma
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Yangyang Sun
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Youdan Feng
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Guanglei Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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Zhao X, Zhang P, Song F, Ma C, Fan G, Sun Y, Feng Y, Zhang G. Prior Attention Network for Multi-Lesion Segmentation in Medical Images. IEEE Trans Med Imaging 2022; 41:3812-3823. [PMID: 35939461 DOI: 10.1109/tmi.2022.3197180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The accurate segmentation of multiple types of lesions from adjacent tissues in medical images is significant in clinical practice. Convolutional neural networks (CNNs) based on the coarse-to-fine strategy have been widely used in this field. However, multi-lesion segmentation remains to be challenging due to the uncertainty in size, contrast, and high interclass similarity of tissues. In addition, the commonly adopted cascaded strategy is rather demanding in terms of hardware, which limits the potential of clinical deployment. To address the problems above, we propose a novel Prior Attention Network (PANet) that follows the coarse-to-fine strategy to perform multi-lesion segmentation in medical images. The proposed network achieves the two steps of segmentation in a single network by inserting a lesion-related spatial attention mechanism in the network. Further, we also propose the intermediate supervision strategy for generating lesion-related attention to acquire the regions of interest (ROIs), which accelerates the convergence and obviously improves the segmentation performance. We have investigated the proposed segmentation framework in two applications: 2D segmentation of multiple lung infections in lung CT slices and 3D segmentation of multiple lesions in brain MRIs. Experimental results show that in both 2D and 3D segmentation tasks our proposed network achieves better performance with less computational cost compared with cascaded networks. The proposed network can be regarded as a universal solution to multi-lesion segmentation in both 2D and 3D tasks. The source code is available at https://github.com/hsiangyuzhao/PANet.
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Zhai ZG, Jia XD, Ma C, Wang C. [Consolidate the foundation, steadily promote and comprehensively improve the quality control in prevention and management of venous thromboembolism in China]. Zhonghua Yi Xue Za Zhi 2022; 102:3333-3337. [PMID: 36372766 DOI: 10.3760/cma.j.cn112137-20220903-01866] [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: 06/16/2023]
Abstract
Hospital-associated venous thromboembolism (HA-VTE) has become a public health problem that seriously affects the quality of medical care and patient safety. Many countries regarded VTE prevention as a key element of medical quality management, carried out quality improvement work in VTE prevention and achieved remarkable results. In China, there is also unremitting efforts and explorations in the field of VTE prevention and management. The national program for prevention and management of pulmonary embolism and deep vein thrombosis was officially launched. Through a series of measures such as excellent center construction, regional alliance, and strengthening of quality control and informatization, the national program has greatly promoted the construction of VTE prevention and management system in hospitals across the country. Strengthening the prevention and treatment of VTE has become the common will of the government, hospital administrators, clinical medical staff and the public. In the future, we need to continue to steadily promote the prevention and management of VTE, and comprehensively improve the quality control management level of VTE prevention and management in hospitals.
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Affiliation(s)
- Z G Zhai
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital/National Center for Respiratory Medicine/Institute of Respiratory Medicine, Chinese Academy of Medical Sciences/National Clinical Research Center for Respiratory Diseases, Beijing 100029, China
| | - X D Jia
- General Office, China-Japan Friendship Hospital, Beijing 100029, China
| | - C Ma
- Department of Healthcare Quality Evaluation, Bureau of Medical Administration, National Health Commission of the People's Republic of China, Beijing 100044, China
| | - Chen Wang
- Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing 100730, China
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Zhang Q, Huang ZS, Hu QQ, Qin W, Liang LL, Cui F, Wang Y, Pan F, Liu XL, Tang L, Ma C, Yin ZD, Wang FZ. [Quality of life and risk factors in patients with herpes zoster]. Zhonghua Yi Xue Za Zhi 2022; 102:3395-3400. [PMID: 36372770 DOI: 10.3760/cma.j.cn112137-20220627-01416] [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: 06/16/2023]
Abstract
Objective: To evaluate the quality of life and influencing factors of patients with herpes zoster (HZ) seen in hospitals. Methods: Based on Zoster Brief Pain Inventory (ZBPI) and Five-level EuroQol Five-dimensional Questionnaire (EQ-5D-5L), a cross-sectional survey was conducted to evaluate the pain severity and quality of life of 332 HZ cases seen in 22 hospitals of Lu'an City (Anhui Province), Zibo City (Shandong Province) and Tongchuan City (Shaanxi Province) from October to December 2021. The censored least absolute deviations (CLAD) model was used to analyze the related factors affecting the changes of patients' health utility values. Results: The 45.5% of 332 HZ cases were male. The median (Q1,Q3) age was 59 (50, 68) years. 59.64% of them assessed by ZBPI had moderate to severe pain in the past 24 hours (worst pain score≥5), and that of PHN cases was 84.8%(39/46). 77.7% (258/332), 77.4% (257/332) and 74.1% (246/332) of all patients reported that pain interfered with sleep, mood and general activities, respectively. Aging [β40-49y (95%CI)=-0.11 (-0.15, -0.08); β50-59y (95%CI)=-0.03 (-0.05, 0.00); β60-69y (95%CI)=-0.09 (-0.12, -0.06); β70-90y(95%CI)=-0.16 (-0.19, -0.12)], working status (unemployed) [βfarmer (95%CI)=0.15 (0.13, 0.18); βretirees(95%CI)=0.21 (0.18, 0.24); βemployee (95%CI)=0.13 (0.10, 0.16) ], complications[βPHN (95%CI)=-0.08 (-0.13, -0.04); βother complications (95%CI)=-0.12 (-0.15, -0.08)], within 30 days after onset [β(95%CI)=-0.01 (-0.03, 0.01)] and treatment [βother complications (95%CI)=-0.09 (-0.11, -0.06)] were related factors for the decline of health utility value (all P values <0.05). Conclusions: More than half of the patients with HZ had moderate to severe pain in the past 24 hours, which had a serious negative impact on the physical and mental health of the patients. Elderly patients, acute patients and patients with complications had lower health utility values and worse health status. We suggest that eligible people be vaccinated with HZ vaccine as soon as possible.
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Affiliation(s)
- Q Zhang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Z S Huang
- Department of Immunization Program, Zibo Municipal Center for Disease Control and Prevention, Zibo 255026, China
| | - Q Q Hu
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - W Qin
- Department of Immunization Program, Lu'an Municipal Center for Disease Control and Prevention, Lu'an 237000, China
| | - L L Liang
- Department of Immunization Program, Tongchuan Municipal Center for Disease Control and Prevention, Tongchuan 727031, China
| | - F Cui
- Zibo Municipal Center for Disease Control and Prevention, Zibo 255026, China
| | - Y Wang
- Department of Immunization Program, Lu'an Municipal Center for Disease Control and Prevention, Lu'an 237000, China
| | - F Pan
- Department of Immunization Program, Lu'an Municipal Center for Disease Control and Prevention, Lu'an 237000, China
| | - X L Liu
- Tongchuan Municipal Center for Disease Control and Prevention, Tongchuan 727031, China
| | - L Tang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - C Ma
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Z D Yin
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - F Z Wang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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Shang X, Wang T, Chen G, Ma C, Wang H, Jia X, Mei J. 300P Real-world efficacy and safety of anlotinib in combination with PD-1/PD-L1 inhibitors as first-line or second-line treatment in advanced non-small cell lung cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.328] [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: 12/07/2022] Open
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Ma C, Cheng YJ, Xiao N. [Research progress of mesenchymal stem cell in the treatment of diabetic bladder dysfunction]. Zhonghua Wai Ke Za Zhi 2022; 60:1035-1040. [PMID: 36323586 DOI: 10.3760/cma.j.cn112139-20220530-00245] [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: 06/16/2023]
Abstract
Diabetic bladder dysfunction (DBD) is a common complication in the lower urinary tract of diabetes. In recent years, mesenchymal stem cell (MSC) have broad application prospects in the treatment of DBD. MSC can migrate to damaged bladder tissue and differentiate into various cell types, such as urothelial cells, myofibroblasts, smooth muscle cells and nerve cells, promote bladder tissue repair and regeneration through paracrine effects. In addition, MSC also intervene in the pathological process of DBD, reverse disease progression, and restore partial bladder function through immune regulation, improvement of oxidative stress, and regulation of blood glucose. At present, the treatment of DBD with MSC is limited to preclinical animal experiments, clinical research and application should be pursued further.
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Affiliation(s)
- C Ma
- Department of Urology, Lanzhou University Sencond Hospital, Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou 730030, China
| | - Y J Cheng
- Department of Urology, Lanzhou University Sencond Hospital, Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou 730030, China
| | - N Xiao
- Department of Urology, Lanzhou University Sencond Hospital, Key Laboratory of Gansu Province for Urological Diseases, Gansu Nephro-Urological Clinical Center, Lanzhou 730030, China
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Ma C, Xu D, Hui Q, Gao X, Peng M. Quantitative Intracerebral Iodine Extravasation in Risk Stratification for Intracranial Hemorrhage in Patients with Acute Ischemic Stroke. AJNR Am J Neuroradiol 2022; 43:1589-1596. [PMID: 36202552 PMCID: PMC9731239 DOI: 10.3174/ajnr.a7671] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/07/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Intracerebral hemorrhage poses a severe threat to the outcomes in patients with postthrombectomy acute stroke. We aimed to compare the absolute intracerebral iodine concentration and normalized iodine concentration ratio in predicting intracerebral hemorrhage in patients postthrombectomy. MATERIALS AND METHODS Patients with acute anterior circulation large-vessel occlusion who underwent mechanical thrombectomy and had successful recanalization were retrospectively included in the study. Dual-energy CT was performed within 1 hour after mechanical thrombectomy. Postprocessing was performed to measure the absolute intracerebral iodine concentration and the normalized iodine concentration ratio. The correlation between the absolute intracerebral iodine concentration and the normalized iodine concentration ratio was analyzed using the Spearman rank correlation coefficient. We compared the area under the receiver operating characteristic curve of the absolute intracerebral iodine concentration and the normalized iodine concentration ratio using the DeLong test. RESULTS We included 138 patients with successful recanalization. Of 43 patients who did not have parenchymal contrast staining on postthrombectomy dual-energy CT, 5 (11.6%) developed intracerebral hemorrhage. Among patients (95/138, 68.8%) with parenchymal contrast staining, 37 (38.9%, 37/95) developed intracerebral hemorrhage. The absolute intracerebral iodine concentration was significantly correlated with the normalized iodine concentration ratio (ρ = 0.807; 95% CI, 0.718-0.867; P < .001). The cutoffs of the normalized iodine concentration ratio and absolute intracerebral iodine concentration for identifying patients with intracerebral hemorrhage development were 222.8%, with a sensitivity of 67.6% and specificity of 76.4%, and 2.7 mg I/mL, with a sensitivity of 75.7% and specificity of 65.5%, respectively. No significant difference was found between the areas under the receiver operating characteristic curve for the absolute intracerebral iodine concentration and the normalized iodine concentration ratio (0.753 versus 0.738) (P = .694). CONCLUSIONS The hemorrhagic transformation predictive power of the normalized iodine concentration ratio is similar to that of the absolute intracerebral iodine concentration in patients with successful recanalization.
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Affiliation(s)
- C Ma
- From the Departments of Radiology (C.M., Q.H., X.G.)
| | | | - Q Hui
- From the Departments of Radiology (C.M., Q.H., X.G.)
| | - X Gao
- From the Departments of Radiology (C.M., Q.H., X.G.)
| | - M Peng
- Neurology (M.P.), Deyang People's Hospital, Deyang, Sichuan, China
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Li J, Song F, Zhang P, Ma C, Zhang T, Sun Y, Feng Y, Song X, Lyu S, Zhang G. A multi-classification model for non-small cell lung cancer subtypes based on independent subtask learning. Med Phys 2022; 49:6960-6974. [PMID: 35715882 DOI: 10.1002/mp.15808] [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: 03/22/2022] [Revised: 05/16/2022] [Accepted: 05/31/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The non-small cell lung cancer (NSCLC) can be divided into adenocarcinoma (ADC), squamous cell carcinoma (SCC), large cell carcinoma (LCC), and not otherwise specified (NOS), which is crucial for clinical decision-making. However, current related researches are rare for the complex multi-classification of NSCLC, mainly due to the serious data imbalance, the difficulty to unify the feature space, and the complicated decision boundary among multiple subtypes. The machine learning method of traditional "one-vs-one" (OVO) is difficult to solve these problems and achieve good results. METHODS To this end, we propose a novel independent subtask learning (ISTL) method to better carry out the multi-classification task. Specifically, it includes four pertinent strategies: (1) independent data expansion; (2) independent feature selection (IFS); (3) independent model construction; and (4) a novel voting strategy: majority voting combined with Bayesian prior. We performed experiments using 1036 CT scans (ADC:SCC:LCC:NOS = 600:268:105:63) collected from eight international databases, and the data acquisition was highly complex and diverse. RESULTS The experimental results showed that the ISTL method obtained an accuracy of 0.812 on the independent test cohort, which significantly improved the performance of multi-classification compared with the traditional OVO-support vector machine (0.691) and OVO-random forest (0.710) models. After the IFS, six selected feature sets of six binary tasks are obviously different, indicating that the ISTL method has better interpretability to distinguish the multiple NSCLC subtypes. The results of a further auxiliary contrast experiment showed that four pertinent strategies were all effective. CONCLUSION Our work indicates that the ISTL method can effectively perform multi-classification of NSCLC subtypes with better interpretability for clinical computer-aided detection and has the potential to be applied in a wide range of multi-classification studies.
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Affiliation(s)
- Jinkai Li
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.,School of General Engineering, Beihang University, Beijing, China
| | - Fan Song
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Peng Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Chenbin Ma
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Tianyi Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Yangyang Sun
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Youdan Feng
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xiao Song
- School of Medical Imaging, Shanxi Medical University, Taiyuan, China
| | - Shangqing Lyu
- School of Electronics & Computer Science, University of Southampton, Southampton, UK
| | - Guanglei Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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Zhang P, Ma C, Song F, Liu Z, Feng Y, Sun Y, He Y, Liu F, Wang D, Zhang G. Multi-branch attention prior based parameterized generative adversarial network for fast and accurate limited-projection reconstruction in fluorescence molecular tomography. Biomed Opt Express 2022; 13:5327-5343. [PMID: 36425627 PMCID: PMC9664898 DOI: 10.1364/boe.469505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
Limited-projection fluorescence molecular tomography (FMT) allows rapid reconstruction of the three-dimensional (3D) distribution of fluorescent targets within a shorter data acquisition time. However, the limited-projection FMT is severely ill-posed and ill-conditioned due to insufficient fluorescence measurements and the strong scattering properties of photons in biological tissues. Previously, regularization-based methods, combined with the sparse distribution of fluorescent sources, have been commonly used to alleviate the severe ill-posed nature of the limited-projection FMT. Due to the complex iterative computations, time-consuming solution procedures, and less stable reconstruction results, the limited-projection FMT remains an intractable challenge for achieving fast and accurate reconstructions. In this work, we completely discard the previous iterative solving-based reconstruction themes and propose multi-branch attention prior based parameterized generative adversarial network (MAP-PGAN) to achieve fast and accurate limited-projection FMT reconstruction. Firstly, the multi-branch attention can provide parameterized weighted sparse prior information for fluorescent sources, enabling MAP-PGAN to effectively mitigate the ill-posedness and significantly improve the reconstruction accuracy of limited-projection FMT. Secondly, since the end-to-end direct reconstruction strategy is adopted, the complex iterative computation process in traditional regularization algorithms can be avoided, thus greatly accelerating the 3D visualization process. The numerical simulation results show that the proposed MAP-PGAN method outperforms the state-of-the-art methods in terms of localization accuracy and morphological recovery. Meanwhile, the reconstruction time is only about 0.18s, which is about 100 to 1000 times faster than the conventional iteration-based regularization algorithms. The reconstruction results from the physical phantoms and in vivo experiments further demonstrate the feasibility and practicality of the MAP-PGAN method in achieving fast and accurate limited-projection FMT reconstruction.
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Affiliation(s)
- Peng Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering,
Beihang University, Beijing, 100191, China
- These authors contributed equally to this work
| | - Chenbin Ma
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering,
Beihang University, Beijing, 100191, China
- Shenyuan Honors College, Beihang University, 100191, Beijing, China
- These authors contributed equally to this work
| | - Fan Song
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering,
Beihang University, Beijing, 100191, China
| | - Zeyu Liu
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering,
Beihang University, Beijing, 100191, China
| | - Youdan Feng
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering,
Beihang University, Beijing, 100191, China
| | - Yangyang Sun
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering,
Beihang University, Beijing, 100191, China
| | - Yufang He
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering,
Beihang University, Beijing, 100191, China
| | - Fei Liu
- Advanced Information & Industrial Technology Research Institute, Beijing Information Science & Technology University, Beijing, 100192, China
| | - Daifa Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering,
Beihang University, Beijing, 100191, China
| | - Guanglei Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering,
Beihang University, Beijing, 100191, China
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Shi M, Ma Z, Tian Y, Ma C, Li Y, Zhang X. Effects of corn straw treated with CaO on rumen degradation characteristics and fermentation parameters and their correlation with microbial diversity in rumen. Anim Feed Sci Technol 2022. [DOI: 10.1016/j.anifeedsci.2022.115403] [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: 11/17/2022]
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Guo J, Wang X, Zheng F, Zhao G, Wang Y, Hu Y, Liu P, Ma C. 1004P Efficacy and safety of anlotinib monotherapy or combination therapy as second-line therapy in EGFR-wild-type non-small cell lung cancer (NSCLC) patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1130] [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: 12/01/2022] Open
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47
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Ma C, Lan K, Wang J, Yang Z, Zhang Z. Arrhythmia detection based on multi-scale fusion of hybrid deep models from single lead ECG recordings: A multicenter dataset study. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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48
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Liu F, Zhang P, Liu Z, Song F, Ma C, Sun Y, Feng Y, He Y, Zhang G. In vivo accurate detection of the liver tumor with pharmacokinetic parametric images from dynamic fluorescence molecular tomography. J Biomed Opt 2022; 27:070501. [PMID: 35810324 PMCID: PMC9270690 DOI: 10.1117/1.jbo.27.7.070501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
SIGNIFICANCE Pharmacokinetic parametric images in dynamic fluorescence molecular tomography (FMT) can describe three-dimensional (3D) physiological and pathological information inside biological tissues, potentially providing quantitative assessment tools for biological research and drug development. AIM In vivo imaging of the liver tumor with pharmacokinetic parametric images from dynamic FMT based on the differences in metabolic properties of indocyanine green (ICG) between normal liver cells and tumor liver cells inside biological tissues. APPROACH First, an orthotopic liver tumor mouse model was constructed. Then, with the help of the FMT/computer tomography (CT) dual-modality imaging system and the direct reconstruction algorithm, 3D imaging of liver metabolic parameters in nude mice was achieved to distinguish liver tumors from normal tissues. Finally, pharmacokinetic parametric imaging results were validated against in vitro anatomical results. RESULTS This letter demonstrates the ability of dynamic FMT to monitor the pharmacokinetic delivery of the fluorescent dye ICG in vivo, thus, enabling the distinction between normal and tumor tissues based on the pharmacokinetic parametric images derived from dynamic FMT. CONCLUSIONS Compared with CT structural imaging technology, dynamic FMT combined with compartmental modeling as an analytical method can obtain quantitative images of pharmacokinetic parameters, thus providing a more powerful research tool for organ function assessment, disease diagnosis and new drug development.
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Affiliation(s)
- Fei Liu
- Beijing Information Science & Technology University, Advanced Information and Industrial Technology Research Institute, Beijing, China
| | - Peng Zhang
- Beihang University, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beijing, China
| | - Zeyu Liu
- Beihang University, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beijing, China
| | - Fan Song
- Beihang University, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beijing, China
| | - Chenbin Ma
- Beihang University, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beijing, China
| | - Yangyang Sun
- Beihang University, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beijing, China
| | - Youdan Feng
- Beihang University, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beijing, China
| | - Yufang He
- Beihang University, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beijing, China
| | - Guanglei Zhang
- Beihang University, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beijing, China
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Feng Y, Song F, Zhang P, Fan G, Zhang T, Zhao X, Ma C, Sun Y, Song X, Pu H, Liu F, Zhang G. Prediction of EGFR Mutation Status in Non–Small Cell Lung Cancer Based on Ensemble Learning. Front Pharmacol 2022; 13:897597. [PMID: 35833032 PMCID: PMC9271946 DOI: 10.3389/fphar.2022.897597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives: We aimed to identify whether ensemble learning can improve the performance of the epidermal growth factor receptor (EGFR) mutation status predicting model. Methods: We retrospectively collected 168 patients with non–small cell lung cancer (NSCLC), who underwent both computed tomography (CT) examination and EGFR test. Using the radiomics features extracted from the CT images, an ensemble model was established with four individual classifiers: logistic regression (LR), support vector machine (SVM), random forest (RF), and extreme gradient boosting (XGBoost). The synthetic minority oversampling technique (SMOTE) was also used to decrease the influence of data imbalance. The performances of the predicting model were evaluated using the area under the curve (AUC). Results: Based on the 26 radiomics features after feature selection, the SVM performed best (AUCs of 0.8634 and 0.7885 on the training and test sets, respectively) among four individual classifiers. The ensemble model of RF, XGBoost, and LR achieved the best performance (AUCs of 0.8465 and 0.8654 on the training and test sets, respectively). Conclusion: Ensemble learning can improve the model performance in predicting the EGFR mutation status of patients with NSCLC, showing potential value in clinical practice.
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Affiliation(s)
- Youdan Feng
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Fan Song
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Peng Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Guangda Fan
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Tianyi Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xiangyu Zhao
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Chenbin Ma
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Yangyang Sun
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xiao Song
- School of Medical Imaging, Shanxi Medical University, Taiyuan, China
| | - Huangsheng Pu
- College of Advanced Interdisciplinary Studies, National University of Defense Technology, Changsha, China
| | - Fei Liu
- Beijing Advanced Information and Industrial Technology Research Institute, Beijing Information Science and Technology University, Beijing, China
| | - Guanglei Zhang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- *Correspondence: Guanglei Zhang,
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Ma C, Zhang P, Song F, Sun Y, Fan G, Zhang T, Feng Y, Zhang G. KD-Informer: Cuff-Less Continuous Blood Pressure Waveform Estimation Approach Based on Single Photoplethysmography. IEEE J Biomed Health Inform 2022; 27:2219-2230. [PMID: 35700247 DOI: 10.1109/jbhi.2022.3181328] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Ambulatory blood pressure (BP) monitoring plays a critical role in the early prevention and diagnosis of cardiovascular diseases. However, cuff-based inflatable devices cannot be used for continuous BP monitoring, while pulse transit time or multi-parameter-based methods require more bioelectrodes to acquire electrocardiogram signals. Thus, estimating the BP waveforms only based on photoplethysmography (PPG) signals for continuous BP monitoring has essential clinical values. Nevertheless, extracting useful features from raw PPG signals for fine-grained BP waveform estimation is challenging due to the physiological variation and noise interference. For single PPG analysis utilizing deep learning methods, the previous works depend mainly on stacked convolution operation, which ignores the underlying complementary time-dependent information. Thus, this work presents a novel Transformer-based method with knowledge distillation (KD-Informer) for BP waveform estimation. Meanwhile, we integrate the prior information of PPG patterns, selected by a novel backward elimination algorithm, into the knowledge transfer branch of the KD-Informer. With these strategies, the model can effectively capture the discriminative features through a lightweight architecture during the learning process. Then, we further adopt an effective transfer learning technique to demonstrate the excellent generalization capability of the proposed model using two independent multicenter datasets. Specifically, we first fine-tuned the KD-Informer with a large and high-quality dataset (Mindray dataset) and then transferred the pre-trained model to the target domain (MIMIC dataset). The experimental test results on the MIMIC dataset showed that the KD-Informer exhibited an estimation error of 0.02 ± 5.93 mmHg for systolic BP (SBP) and 0.01 ± 3.87 mmHg for diastolic BP (DBP), which complied with the association for the advancement of medical instrumentation (AAMI) standard. These results demonstrate that the KD-Informer has high reliability and elegant robustness to measure continuous BP waveforms.
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