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Liu HYH, Lee YYD, Sridharan S, Wang W, Khor R, Chu J, Oar A, Choong ES, Le H, Shanker M, Wigg A, Stuart K, Pryor D. Definitive Stereotactic Body Radiation Therapy in Early-Stage Solitary Hepatocellular Carcinoma: An Australian Multi-Institutional Review of Outcomes. Clin Oncol (R Coll Radiol) 2023; 35:787-793. [PMID: 37709623 DOI: 10.1016/j.clon.2023.08.012] [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: 06/13/2023] [Revised: 07/08/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
AIMS Standard curative options for early-stage, solitary hepatocellular carcinoma (HCC) are often unsuitable due to liver dysfunction, comorbidities and/or tumour location. Stereotactic body radiation therapy (SBRT) has shown high rates of local control in HCC; however, limited data exist in the treatment-naïve, curative-intent setting. We report the outcomes of patients with solitary early-stage HCC treated with SBRT as first-line curative-intent therapy. MATERIALS AND METHODS A multi-institutional retrospective study of treatment-naïve patients with Barcelona Clinic Liver Cancer stage 0/A, solitary ≤5 cm HCC, Child-Pugh score (CPS) A liver function who underwent SBRT between 2010 and 2019 as definitive therapy. The primary end point was freedom from local progression. Secondary end points were progression-free survival, overall survival, rate of treatment-related clinical toxicities and change in CPS >1. RESULTS In total, 68 patients were evaluated, with a median follow-up of 20 months (range 3-58). The median age was 68 years (range 50-86); 54 (79%) were men, 62 (91%) had cirrhosis and 50 (74%) were Eastern Cooperative Oncology Group 0. The median HCC diameter was 2.5 cm (range 1.3-5) and the median prescription biologically effective dose with a tumour a/b ratio of 10 Gy (BED10) was 93 Gy (interquartile range 72-100 Gy). Two-year freedom from local progression, progression-free survival and overall survival were 94.3% (95% confidence interval 86.6-100%), 59.5% (95% confidence interval 46.3-76.4%) and 88% (95% confidence interval 79.2-97.6%), respectively. Nine patients (13.2%) experienced grade ≥2 treatment-related clinical toxicities. A rise >1 in CPS was observed in six cirrhotic patients (9.6%). CONCLUSION SBRT is an effective and well-tolerated option to consider in patients with solitary, early-stage HCC. Prospective, randomised comparative studies are warranted to further refine its role as a first-line curative-intent therapy.
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Affiliation(s)
- H Y-H Liu
- Department of Cancer Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Faculty of Medicine, University of Queensland, St. Lucia, Queensland, Australia.
| | - Y-Y D Lee
- Department of Cancer Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Faculty of Medicine, University of Queensland, St. Lucia, Queensland, Australia
| | - S Sridharan
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - W Wang
- Department of Radiation Oncology, The Crown Princess Mary Cancer Centre, Westmead, New South Wales, Australia; Department of Radiation Oncology, Nepean Cancer Care Centre, Kingswood, New South Wales, Australia
| | - R Khor
- Department of Radiation Oncology, Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
| | - J Chu
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - A Oar
- Icon Cancer Centre, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - E S Choong
- Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - H Le
- Department of Radiation Oncology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia; South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - M Shanker
- Department of Cancer Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Faculty of Medicine, University of Queensland, St. Lucia, Queensland, Australia
| | - A Wigg
- Hepatology and Liver Transplantation Medicine Unit, Flinders Medical Centre, Adelaide, South Australia, Australia
| | - K Stuart
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - D Pryor
- Department of Cancer Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Faculty of Medicine, University of Queensland, St. Lucia, Queensland, Australia
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2
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Dolgalev I, Zhou H, Murrell N, Le H, Sakellaropoulos T, Coudray N, Zhu K, Vasudevaraja V, Yeaton A, Goparaju C, Li Y, Sulaiman I, Tsay JCJ, Meyn P, Mohamed H, Sydney I, Shiomi T, Ramaswami S, Narula N, Kulicke R, Davis FP, Stransky N, Smolen GA, Cheng WY, Cai J, Punekar S, Velcheti V, Sterman DH, Poirier JT, Neel B, Wong KK, Chiriboga L, Heguy A, Papagiannakopoulos T, Nadorp B, Snuderl M, Segal LN, Moreira AL, Pass HI, Tsirigos A. Inflammation in the tumor-adjacent lung as a predictor of clinical outcome in lung adenocarcinoma. Nat Commun 2023; 14:6764. [PMID: 37938580 PMCID: PMC10632519 DOI: 10.1038/s41467-023-42327-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
Approximately 30% of early-stage lung adenocarcinoma patients present with disease progression after successful surgical resection. Despite efforts of mapping the genetic landscape, there has been limited success in discovering predictive biomarkers of disease outcomes. Here we performed a systematic multi-omic assessment of 143 tumors and matched tumor-adjacent, histologically-normal lung tissue with long-term patient follow-up. Through histologic, mutational, and transcriptomic profiling of tumor and adjacent-normal tissue, we identified an inflammatory gene signature in tumor-adjacent tissue as the strongest clinical predictor of disease progression. Single-cell transcriptomic analysis demonstrated the progression-associated inflammatory signature was expressed in both immune and non-immune cells, and cell type-specific profiling in monocytes further improved outcome predictions. Additional analyses of tumor-adjacent transcriptomic data from The Cancer Genome Atlas validated the association of the inflammatory signature with worse outcomes across cancers. Collectively, our study suggests that molecular profiling of tumor-adjacent tissue can identify patients at high risk for disease progression.
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Affiliation(s)
- Igor Dolgalev
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
- Applied Bioinformatics Laboratories, NYU Grossman School of Medicine, New York, USA
- Division of Precision Medicine, Department of Medicine, NYU Grossman School of Medicine, New York, USA
| | - Hua Zhou
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
- Applied Bioinformatics Laboratories, NYU Grossman School of Medicine, New York, USA
| | - Nina Murrell
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
- Applied Bioinformatics Laboratories, NYU Grossman School of Medicine, New York, USA
- Division of Precision Medicine, Department of Medicine, NYU Grossman School of Medicine, New York, USA
| | - Hortense Le
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
- Division of Precision Medicine, Department of Medicine, NYU Grossman School of Medicine, New York, USA
| | | | - Nicolas Coudray
- Applied Bioinformatics Laboratories, NYU Grossman School of Medicine, New York, USA
- Division of Precision Medicine, Department of Medicine, NYU Grossman School of Medicine, New York, USA
- Department of Cell Biology, NYU Grossman School of Medicine, New York, USA
| | - Kelsey Zhu
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
| | | | - Anna Yeaton
- The Optical Profiling Platform at The Broad Institute of MIT And Harvard, Cambridge, USA
| | - Chandra Goparaju
- Department of Cardiothoracic Surgery, NYU Grossman School of Medicine, New York, USA
| | - Yonghua Li
- Division of Pulmonary, Critical Care and Sleep Medicine, NYU Grossman School of Medicine, New York, USA
| | - Imran Sulaiman
- Division of Pulmonary, Critical Care and Sleep Medicine, NYU Grossman School of Medicine, New York, USA
| | - Jun-Chieh J Tsay
- Division of Pulmonary, Critical Care and Sleep Medicine, NYU Grossman School of Medicine, New York, USA
| | - Peter Meyn
- Genome Technology Center, Office of Science and Research, NYU Grossman School of Medicine, New York, USA
| | - Hussein Mohamed
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
| | - Iris Sydney
- Center for Biospecimen Research and Development, NYU Grossman School of Medicine, New York, USA
| | - Tomoe Shiomi
- Center for Biospecimen Research and Development, NYU Grossman School of Medicine, New York, USA
| | - Sitharam Ramaswami
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
- Genome Technology Center, Office of Science and Research, NYU Grossman School of Medicine, New York, USA
| | - Navneet Narula
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
| | - Ruth Kulicke
- Celsius Therapeutics, Cambridge, Massachusetts, USA
| | - Fred P Davis
- Celsius Therapeutics, Cambridge, Massachusetts, USA
| | | | | | - Wei-Yi Cheng
- Pharma Research & Early Development Informatics, Roche Innovation Center New York, New Jersey, USA
| | - James Cai
- Pharma Research & Early Development Informatics, Roche Innovation Center New York, New Jersey, USA
| | - Salman Punekar
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Vamsidhar Velcheti
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Daniel H Sterman
- Division of Pulmonary, Critical Care and Sleep Medicine, NYU Grossman School of Medicine, New York, USA
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - J T Poirier
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Ben Neel
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Kwok-Kin Wong
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Luis Chiriboga
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
| | - Adriana Heguy
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
- Genome Technology Center, Office of Science and Research, NYU Grossman School of Medicine, New York, USA
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Thales Papagiannakopoulos
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Bettina Nadorp
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
- Applied Bioinformatics Laboratories, NYU Grossman School of Medicine, New York, USA
- Division of Precision Medicine, Department of Medicine, NYU Grossman School of Medicine, New York, USA
| | - Matija Snuderl
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Leopoldo N Segal
- Division of Pulmonary, Critical Care and Sleep Medicine, NYU Grossman School of Medicine, New York, USA
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Andre L Moreira
- Department of Pathology, NYU Grossman School of Medicine, New York, USA
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA
| | - Harvey I Pass
- Department of Cardiothoracic Surgery, NYU Grossman School of Medicine, New York, USA.
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA.
| | - Aristotelis Tsirigos
- Department of Pathology, NYU Grossman School of Medicine, New York, USA.
- Applied Bioinformatics Laboratories, NYU Grossman School of Medicine, New York, USA.
- Division of Precision Medicine, Department of Medicine, NYU Grossman School of Medicine, New York, USA.
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA.
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Ho T, Pham T, Le K, Ly T, Le H, Nguyen D, Ho V, Dang V, Phung T, Norman R, Mol B, Vuong L. O-233 Micronized progesterone plus dydrogesterone versus micronized progesterone alone for luteal phase support in frozen-thawed cycles: a prospective cohort study. Hum Reprod 2021. [DOI: 10.1093/humrep/deab128.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Does the addition of oral dydrogesterone to vaginal progesterone as luteal phase support improve pregnancy outcomes during frozen embryo transfer (FET) cycles compared with vaginal progesterone alone?
Summary answer
Luteal phase support with oral dydrogesterone added to vaginal progesterone improves live birth rates and reduces miscarriage rates compared with vaginal progesterone alone.
What is known already
Progesterone is an important hormone that triggers secretory transformation of the endometrium to allow implantation of the embryo. During in vitro fertilization (IVF), exogenous progesterone is administered for luteal phase support. However, there is wide inter-individual variation in absorption of progesterone via the vaginal wall. Oral dydrogesterone is effective and well tolerated when used to provide luteal phase support after fresh embryo transfer. However, there are currently no data on the effectiveness of luteal phase support with the combination of dydrogesterone with vaginal micronized progesterone compared with vaginal micronized progesterone after FET.
Study design, size, duration
Prospective cohort study conducted at an academic infertility center in Vietnam from 26 June 2019 to 30 March 2020.
Participants/materials, setting, methods
We studied 1364 women undergoing IVF with FET. The luteal support regimen was either vaginal micronized progesterone 400 mg twice daily plus oral dydrogesterone 10 mg twice daily (second part of the study) or vaginal micronized progesterone 400 mg twice daily (first 4 months of the study). The primary endpoint was live birth after the first FET of the started cycle, with miscarriage <12 weeks as one of the secondary endpoints.
Main results and the role of chance
The vaginal progesterone + dydrogesterone group and vaginal progesterone groups included 732 and 632 participants, respectively. Live birth rates were 46.3% versus 41.3%, respectively (rate ratio [RR] 1.12, 95% confidence interval [CI] 0.99–1.27, p = 0.06; multivariate analysis RR 1.30 (95% CI 1.01–1.68), p = 0.042), with a statistically significant lower rate of miscarriage at < 12 weeks (3.4% vs 6.6%; RR 0.51, 95% CI 0.32–0.83; p = 0.009). Birth weight of both singletons (2971.0 ± 628.4 vs. 3118.8 ± 559.2 g; p = 0.004) and twins (2175.5 ± 494.8 vs. 2494.2 ± 584.7; p = 0.002) was significantly lower in the progesterone plus dydrogesterone versus progesterone group.
Limitations, reasons for caution
The study were the open-label design and the non-randomized nature of the sequential administration of study treatments. However, our systematic comparison of the two strategies was able to be performed much more rapidly than a conventional randomized controlled trial. In addition, the single ethnicity population limits external generalizability.
Wider implications of the findings
Oral dydrogesterone in addition to vaginal progesterone as luteal phase support in FET cycles can reduce the miscarriage rate and improve the live birth rate. Carefully planned prospective cohort studies with limited bias could be used as an alternative to randomized controlled clinical trials to inform clinical practice.
Trial registration number
NCT03998761
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Affiliation(s)
- T Ho
- My Duc Hospital, IVFMD and HOPE Research Center, Ho Chi Minh, Vietnam
| | - T Pham
- My Duc Hospital, HOPE Research Center, Ho Chi Minh, Vietnam
| | - K Le
- My Duc Hospital, IVFMD Centre, Ho Chi Minh, Vietnam
| | - T Ly
- My Duc Hospital, IVFMD Centre, Ho Chi Minh, Vietnam
| | - H Le
- My Duc Hospital, IVFMD Centre, Ho Chi Minh, Vietnam
| | - D Nguyen
- My Duc Hospital, HOPE Research Center, Ho Chi Minh, Vietnam
| | - V Ho
- My Duc Hospital, IVFMD and HOPE Research Center, Ho Chi Minh, Vietnam
| | - V Dang
- My Duc Hospital, IVFMD and HOPE Research Center, Ho Chi Minh, Vietnam
| | - T Phung
- My Duc Hospital, IVFMD Centre, Ho Chi Minh, Vietnam
| | - R Norman
- The University of Adelaide, Robinson Research Institute and Adelaide Medical School, Adelaide, Australia
| | - B Mol
- Monash University, Department of Obstetrics & Gynaecology, Clayton, Australia
| | - L Vuong
- University of Medicine and Pharmacy at Ho Chi Minh City, Department of Obstetrics and Gynecology, Ho Chi Minh City, Vietnam
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4
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Siva S, Bressel M, Mai T, Le H, Vinod S, de Silva H, Macdonald S, Skala M, Hardcastle N, Rezo A, Pryor D, Gill S, Higgs B, Wagenfuehr K, Montgomery R, Awad R, Chesson B, Eade T, Wong W, Sasso G, De Abreu Lourenco R, Kron T, Ball D, Neeson P. OC-0335 Final results of TROG 13.01 SAFRON II: Single vs multi-fraction SABR for pulmonary oligometastases. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06868-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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5
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Balasubramani PP, Ojeda A, Grennan G, Maric V, Le H, Alim F, Zafar-Khan M, Diaz-Delgado J, Silveira S, Ramanathan D, Mishra J. Mapping cognitive brain functions at scale. Neuroimage 2021; 231:117641. [PMID: 33338609 PMCID: PMC8221518 DOI: 10.1016/j.neuroimage.2020.117641] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 10/31/2020] [Accepted: 12/08/2020] [Indexed: 12/30/2022] Open
Abstract
A fundamental set of cognitive abilities enable humans to efficiently process goal-relevant information, suppress irrelevant distractions, maintain information in working memory, and act flexibly in different behavioral contexts. Yet, studies of human cognition and their underlying neural mechanisms usually evaluate these cognitive constructs in silos, instead of comprehensively in-tandem within the same individual. Here, we developed a scalable, mobile platform, "BrainE" (short for Brain Engagement), to rapidly assay several essential aspects of cognition simultaneous with wireless electroencephalography (EEG) recordings. Using BrainE, we rapidly assessed five aspects of cognition including (1) selective attention, (2) response inhibition, (3) working memory, (4) flanker interference and (5) emotion interference processing, in 102 healthy young adults. We evaluated stimulus encoding in all tasks using the EEG neural recordings, and isolated the cortical sources of the spectrotemporal EEG dynamics. Additionally, we used BrainE in a two-visit study in 24 young adults to investigate the reliability of the neuro-cognitive data as well as its plasticity to transcranial magnetic stimulation (TMS). We found that stimulus encoding on multiple cognitive tasks could be rapidly assessed, identifying common as well as distinct task processes in both sensory and cognitive control brain regions. Event related synchronization (ERS) in the theta (3-7 Hz) and alpha (8-12 Hz) frequencies as well as event related desynchronization (ERD) in the beta frequencies (13-30 Hz) were distinctly observed in each task. The observed ERS/ERD effects were overall anticorrelated. The two-visit study confirmed high test-retest reliability for both cognitive and neural data, and neural responses showed specific TMS protocol driven modulation. We also show that the global cognitive neural responses are sensitive to mental health symptom self-reports. This first study with the BrainE platform showcases its utility in studying neuro-cognitive dynamics in a rapid and scalable fashion.
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Affiliation(s)
| | - Alejandro Ojeda
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Gillian Grennan
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Vojislav Maric
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Hortense Le
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Fahad Alim
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Mariam Zafar-Khan
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Juan Diaz-Delgado
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Sarita Silveira
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Dhakshin Ramanathan
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Department of Mental Health, VA San Diego Medical Center, San Diego, CA
| | - Jyoti Mishra
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
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Palma D, Theurer J, Prisman E, Read N, Berthelet E, Fung K, de Almeida J, Bayley A, Richardson K, Mlynarek A, Krishnan S, Le H, Mitchell S, Chen J, Corsten M, Johnson-Obaseki S, Odell M, Parker C, Kwan K, Nichols A. Radiotherapy vs. Trans-Oral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma (OPSCC): Results of a Randomized Trial. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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7
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Nguyen P, Vo N, Goonewardene M, Huang T, Ricciardo P, Vujcich N, Le H. An adult with severe hyperdontia: surgical challenges in a developing country. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Le H, Nguyen N, Tran P, Hoa N, Hung N, Moran A, Mossawi HJA, Kak N, Ahmedov S, Brooks MB, Nardell EA, Tierney DB. Process measure of FAST tuberculosis infection control demonstrates delay in likely effective treatment. Int J Tuberc Lung Dis 2019; 23:140-146. [PMID: 30621813 DOI: 10.5588/ijtld.18.0268] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING The tuberculous infection control strategy, FAST (Find cases Actively, Separate safely and Treat effectively), recommends prompt initiation of likely effective anti-tuberculosis treatment informed by Xpert® MTB/RIF results.OBJECTIVE: To describe FAST implementation at Quang Nam Provincial TB and Lung Disease Hospital (QNH), Tam Ky, Viet Nam, using time to initiation of effective TB treatment as a process measure. DESIGN Hospital logs were used to calculate the time to likely effective treatment in patients with pulmonary TB (PTB) hospitalised during the study period. RESULTS Between 1 January and 31 December 2016, of 858 patients treated for PTB, 493 (57.5%) received likely effective treatment. The median time to likely effective treatment was 3 days (interquartile range 2.0-6.0), with 213 (43.2%) patients receiving likely effective treatment within 2 days. Of 81 patients receiving likely effective treatment for drug-susceptible TB with a positive Xpert result as their initial in-patient diagnostic test, 64 (79.0%) received likely effective treatment within 2 days compared with 10 (5.7%) who were initially smear-negative then found to be Xpert-positive (P < 0.0001). CONCLUSIONS A 'time to' process measure of the FAST tuberculous infection control strategy indicates delays in the initiation of likely effective anti-tuberculosis treatment in a resource-limited hospital. Expanding access to Xpert may speed time to likely effective treatment.
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Affiliation(s)
- H Le
- University Research Co, LLC, Hanoi
| | - N Nguyen
- National Lung Hospital/National TB Program, Hanoi
| | - P Tran
- Pham Ngoc Thach Hospital, Quang Nam, Viet Nam
| | - N Hoa
- National Lung Hospital/National TB Program, Hanoi, Center for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France
| | - N Hung
- National Lung Hospital/National TB Program, Hanoi
| | - A Moran
- University Research Co, LLC, Chevy Chase, Maryland
| | | | - N Kak
- University Research Co, LLC, Chevy Chase, Maryland
| | - S Ahmedov
- United States Agency for International Development, Washington, DC
| | - M B Brooks
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - E A Nardell
- Division of Global Health Equity, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - D B Tierney
- Division of Global Health Equity, Brigham & Women's Hospital, Boston, Massachusetts, USA
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9
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Le H, LiHua D, JianJun F, Peng L, SongLin G. Immunogenicity study of an expressed outer membrane protein U of Vibrio vulnificus in Japanese eel (Anguilla japonica). J Appl Microbiol 2018; 125:1642-1654. [PMID: 30106200 DOI: 10.1111/jam.14068] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 04/27/2018] [Revised: 07/27/2018] [Accepted: 08/07/2018] [Indexed: 12/23/2022]
Abstract
AIMS Vibrio vulnificus is a common bacterial pathogen causing haemorrhagic septicaemia in eel farming. This study investigates the immunogenicity of an outer membrane protein U (OmpU) of V. vulnificus and the feasibility of the protein as a new subunit vaccine against V. vulnificus. METHODS AND RESULTS Partial gene sequence of the OmpU of V. vulnificus was cloned, and then the OmpU was expressed and purified. Three groups of Japanese eels (Anguilla japonica) were intraperitoneally (i.p) injected with bovine serum albumin (BSA group), formalin-killed whole cell of V. vulnificus (FKC group) or the expressed OmpU of V. vulnificus (OMP group). On 14, 21, 28 and 42 days postimmunization (dpi), the whole blood cells were collected to evaluate the stimulation index (SI) and bactericidal activity. The serum was obtained to assess the titres of specific antibody, lysozyme activity, complement activity and bactericidal activity. The lysozyme activities in the suspension of kidney, skin mucus and liver in eels were also ascertained. The results showed that the SI and the titres of anti-V. vulnificus antibody in the OMP group was significantly increased on 28 dpi; lysozyme activity in the kidney and skin mucus of OMP group on 42 and 14 dpi were both significantly higher than BSA group; eels in OMP group showed strong bactericidal capacity on 21 and 28 days; and the relative percent survival of OMP vs BSA group after challenged by V. vulnificus on 28 dpi was 80%. CONCLUSIONS These results showed that the expressed OmpU of V. vulnificus could significantly improve the immune function of Japanese eel and the resistance of eels to the infection of V. vulnificus. SIGNIFICANCE AND IMPACT OF THE STUDY This study offered an alternative preliminary strategy of making aquaculture vaccines against V. vulnificus for eel farming.
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Affiliation(s)
- H Le
- Fishery College of Jimei University/Engineering Research Center of the Modern Industry Technology for Eel. Ministry of Education, Xiamen, China
| | - D LiHua
- Fishery College of Jimei University/Engineering Research Center of the Modern Industry Technology for Eel. Ministry of Education, Xiamen, China
| | - F JianJun
- Fishery College of Jimei University/Engineering Research Center of the Modern Industry Technology for Eel. Ministry of Education, Xiamen, China
| | - L Peng
- Fishery College of Jimei University/Engineering Research Center of the Modern Industry Technology for Eel. Ministry of Education, Xiamen, China
| | - G SongLin
- Fishery College of Jimei University/Engineering Research Center of the Modern Industry Technology for Eel. Ministry of Education, Xiamen, China
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Hinchcliff E, Hong D, Le H, Chisholm G, Iyer R, Naing A, Jazaeri A. Adverse events and responses in patients with recurrent ovarian cancer undergoing early-phase immune checkpoint inhibitor clinical trials. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Amin A, Keshishian A, Trocio J, Dina O, Le H, Rosenblatt L, Mardekian J, Zhang Q, Baser O, Liu X, Vo L. P4566Risk of major bleeding among non-valvular atrial fibrillation patients prescribed apixaban, dabigatran, rivaroxaban, or warfarin in the US Medicare population. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Le H, Ottomani H, Sitruck G, Subtil F, Gueyffier F. P5824HYCHeF: a risk score to predict congestive heart failure incidence in hypertension. (based on 18795 individual patient data). Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Dembla V, Ray D, Lockett P, Fullmer C, Subramanian H, Subbiah V, Fu S, Janku F, Tsimberidou A, Naing A, Piha-Paul S, Hong D, Pant S, Miller V, Lim J, Le H, Karp D. Drug development in the MD Anderson Cancer Center (MDACC) Clinical Translational Research Center (CTRC) – 2011–2015: The challenge of precision medicine in a very broad playing field. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)33011-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Estevez J, Kim Y, Le A, Israelski D, Baatarkhuu O, Sarantuya T, Narantsetseg S, Nymadawa P, Le H, Yuen M, Dusheiko G, Rizzetto M, Nguyen M. Low rates of screening and treatment of chronic hepatitis B, C, D (HBV,
HCV, HDV), and hepatocellular carcinoma (HCC), associated barriers, and
proposed solutions: results of a survey of physicians from all major
provinces of Mongolia. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kim Y, Le A, Estevez J, Israelski D, Baatarkhuu O, Sarantuya T, Narantsetseg S, Nymadawa P, Le H, Yuen M, Dusheiko G, Rizzetto M, Nguyen M. Need for continuing medical education for liver disease management in
Mongolia. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.196] [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: 11/24/2022] Open
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Abstract
In this paper we present an explicit solution to the infinite-horizon optimal stopping problem for processes with stationary independent increments, where reward functions admit a certain representation in terms of the process at a random time. It is shown that it is optimal to stop at the first time the process crosses a level defined as the root of an equation obtained from the representation of the reward function. We obtain an explicit formula for the value function in terms of the infimum and supremum of the process, by making use of the Wiener–Hopf factorization. The main results are applied to several problems considered in the literature, to give a unified approach, and to new optimization problems from the finance industry.
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Abstract
Using the geometry of the Kendall shape space, in this paper we study the shape, as well as the size-and-shape, of the projection of a configuration after it has been rotated and, when the given configuration lies in a Euclidean space of an arbitrary dimension, we obtain expressions for the induced distributions of such shapes when the rotation is uniformly distributed.
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White CW, Lillico R, Sandha J, Hasanally D, Wang F, Ambrose E, Müller A, Rachid O, Li Y, Xiang B, Le H, Messer S, Ali A, Large SR, Lee TW, Dixon IMC, Lakowski TM, Simons K, Arora RC, Tian G, Nagendran J, Hryshko LV, Freed DH. Physiologic Changes in the Heart Following Cessation of Mechanical Ventilation in a Porcine Model of Donation After Circulatory Death: Implications for Cardiac Transplantation. Am J Transplant 2016; 16:783-93. [PMID: 26663659 DOI: 10.1111/ajt.13543] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 08/31/2015] [Accepted: 09/18/2015] [Indexed: 01/25/2023]
Abstract
Hearts donated following circulatory death (DCD) may represent an additional source of organs for transplantation; however, the impact of donor extubation on the DCD heart has not been well characterized. We sought to describe the physiologic changes that occur following withdrawal of life-sustaining therapy (WLST) in a porcine model of DCD. Physiologic changes were monitored continuously for 20 min following WLST. Ventricular pressure, volume, and function were recorded using a conductance catheter placed into the right (N = 8) and left (N = 8) ventricles, and using magnetic resonance imaging (MRI, N = 3). Hypoxic pulmonary vasoconstriction occurred following WLST, and was associated with distension of the right ventricle (RV) and reduced cardiac output. A 120-fold increase in epinephrine was subsequently observed that produced a transient hyperdynamic phase; however, progressive RV distension developed during this time. Circulatory arrest occurred 7.6±0.3 min following WLST, at which time MRI demonstrated an 18±7% increase in RV volume and a 12±9% decrease in left ventricular volume compared to baseline. We conclude that hypoxic pulmonary vasoconstriction and a profound catecholamine surge occur following WLST that result in distension of the RV. These changes have important implications on the resuscitation, preservation, and evaluation of DCD hearts prior to transplantation.
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Affiliation(s)
- C W White
- Cardiac Surgery, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - R Lillico
- College of Pharmacy, University of Manitoba, Winnipeg, Canada
| | - J Sandha
- Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - D Hasanally
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - F Wang
- National Research Council Institute for Biodiagnostics, Winnipeg, Canada
| | - E Ambrose
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - A Müller
- Department of Physiology, University of Alberta, Edmonton, Canada
| | - O Rachid
- College of Pharmacy, University of Manitoba, Winnipeg, Canada
| | - Y Li
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - B Xiang
- National Research Council Institute for Biodiagnostics, Winnipeg, Canada
| | - H Le
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - S Messer
- Papworth Hospital, Cambridge, United Kingdom
| | - A Ali
- Papworth Hospital, Cambridge, United Kingdom
| | - S R Large
- Papworth Hospital, Cambridge, United Kingdom
| | - T W Lee
- Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, Canada
| | - I M C Dixon
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - T M Lakowski
- College of Pharmacy, University of Manitoba, Winnipeg, Canada
| | - K Simons
- College of Pharmacy, University of Manitoba, Winnipeg, Canada
| | - R C Arora
- Cardiac Surgery, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - G Tian
- National Research Council Institute for Biodiagnostics, Winnipeg, Canada
| | - J Nagendran
- Cardiac Surgery, University of Alberta, Edmonton, Canada
| | - L V Hryshko
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - D H Freed
- Cardiac Surgery, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada.,Department of Physiology, University of Alberta, Edmonton, Canada.,Cardiac Surgery, University of Alberta, Edmonton, Canada.,Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
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White CW, Ambrose E, Müller A, Li Y, Le H, Thliveris J, Arora RC, Lee TW, Dixon IMC, Tian G, Nagendran J, Hryshko LV, Freed DH. Avoidance of Profound Hypothermia During Initial Reperfusion Improves the Functional Recovery of Hearts Donated After Circulatory Death. Am J Transplant 2016; 16:773-82. [PMID: 26780159 DOI: 10.1111/ajt.13574] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 08/17/2015] [Accepted: 08/31/2015] [Indexed: 01/25/2023]
Abstract
The resuscitation of hearts donated after circulatory death (DCD) is gaining widespread interest; however, the method of initial reperfusion (IR) that optimizes functional recovery has not been elucidated. We sought to determine the impact of IR temperature on the recovery of myocardial function during ex vivo heart perfusion (EVHP). Eighteen pigs were anesthetized, mechanical ventilation was discontinued, and cardiac arrest ensued. A 15-min standoff period was observed and then hearts were reperfused for 3 min at three different temperatures (5°C; N = 6, 25°C; N = 5, and 35°C; N = 7) with a normokalemic adenosine-lidocaine crystalloid cardioplegia. Hearts then underwent normothermic EVHP for 6 h during which time myocardial function was assessed in a working mode. We found that IR coronary blood flow differed among treatment groups (5°C = 483 ± 53, 25°C = 722 ± 60, 35°C = 906 ± 36 mL/min, p < 0.01). During subsequent EVHP, less myocardial injury (troponin I: 5°C = 91 ± 6, 25°C = 64 ± 16, 35°C = 57 ± 7 pg/mL/g, p = 0.04) and greater preservation of endothelial cell integrity (electron microscopy injury score: 5°C = 3.2 ± 0.5, 25°C = 1.8 ± 0.2, 35°C = 1.7 ± 0.3, p = 0.01) were evident in hearts initially reperfused at warmer temperatures. IR under profoundly hypothermic conditions impaired the recovery of myocardial function (cardiac index: 5°C = 3.9 ± 0.8, 25°C = 6.2 ± 0.4, 35°C = 6.5 ± 0.6 mL/minute/g, p = 0.03) during EVHP. We conclude that the avoidance of profound hypothermia during IR minimizes injury and improves the functional recovery of DCD hearts.
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Affiliation(s)
- C W White
- Cardiac Surgery, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada.,Departments of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Canada
| | - E Ambrose
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada.,Departments of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Canada
| | - A Müller
- Department of Physiology, University of Alberta, Edmonton, Canada
| | - Y Li
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - H Le
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - J Thliveris
- Human Anatomy and Cell Science, University of Manitoba, Winnipeg, Canada
| | - R C Arora
- Cardiac Surgery, University of Manitoba, Winnipeg, Canada.,Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada
| | - T W Lee
- Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, Canada
| | - I M C Dixon
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada.,Departments of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Canada
| | - G Tian
- Departments of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Canada.,National Research Council Institute for Biodiagnostics, Winnipeg, Canada
| | - J Nagendran
- Cardiac Surgery, University of Alberta, Edmonton, Canada
| | - L V Hryshko
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada.,Departments of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Canada
| | - D H Freed
- Institute of Cardiovascular Sciences, St. Boniface Research Center, Winnipeg, Canada.,Departments of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Canada.,Department of Physiology, University of Alberta, Edmonton, Canada.,Cardiac Surgery, University of Alberta, Edmonton, Canada.,Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
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Punekar Y, Landis SH, Bonar K, Le H. P132 Health care utilisation and costs among COPD patients newly prescribed maintenance therapy in the United Kingdom (UK): Abstract P132 Table 1. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.269] [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: 11/04/2022]
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Pairam E, Le H, Fernández-Nieves A. Stability of toroidal droplets inside yield stress materials. Phys Rev E Stat Nonlin Soft Matter Phys 2014; 90:021002. [PMID: 25215681 DOI: 10.1103/physreve.90.021002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Indexed: 06/03/2023]
Abstract
We study the stability of toroidal droplets inside a yield stress material. Similar to toroidal droplets in a viscous liquid, the slenderness of the torus controls whether it breaks into spherical droplets or grows thicker towards its center to coalesce onto itself and form a single spherical droplet. However, unlike tori generated in a viscous liquid, the elasticity of the outer medium can prevent either or both of these instabilities; this depends on the slenderness of the torus. Interestingly, we find that the value of the tube radius needed to prevent breakup is always larger than the value of the radius of the handle to prevent growth. This reflects the different deformations experienced by the yield stress material in either process. A simple model balancing the surface tension stress, which drives the evolution of the torus, and the yield stress, which favors its stability, accounts for all of our observations.
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Affiliation(s)
- E Pairam
- School of Physics, Georgia Institute of Technology, Atlanta, Georgia 30339-0430, USA
| | - H Le
- School of Physics, Georgia Institute of Technology, Atlanta, Georgia 30339-0430, USA
| | - A Fernández-Nieves
- School of Physics, Georgia Institute of Technology, Atlanta, Georgia 30339-0430, USA
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Meynaar IA, Knook AHM, Coolen S, Le H, Bos MMEM, van der Dijs F, von Lindern M, Steyerberg EW. Red cell distribution width as predictor for mortality in critically ill patients. Neth J Med 2013; 71:488-493. [PMID: 24218427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The objective of this study was to evaluate whether the red cell distribution width (RDW) is a significant risk factor for hospital mortality in critically ill patients and to investigate whether RDW is a parameter indicating inflammation, or a risk factor independent of inflammation. METHODS We studied all patients admitted to a ten-bed mixed intensive care unit in the Netherlands between May 2005 and December 2011 for whom RDW was available, and who had not received a blood transfusion in the preceding three months. Inflammation was measured by C-reactive protein and leucocyte count. Analyses included correlation, logistic regression analysis, and receiveroperating characteristic (ROC) curves. RESULTS We included 2915 patients, of whom 387 (13.3%) did not survive to hospital discharge. In univariate analysis higher RDW values were associated with increased hospital mortality. In multivariate analysis RDW remained an independent risk factor for mortality after correction for APACHE II score, age, admission type and mechanical ventilation (odds ratio 1.04, 95% confidence interval 1.02-1.06, for each femtolitre of RDW). Adding RDW to APACHE II, however, increased the area under the ROC curve marginally (from 0.845 to 0.849, p<0.001). RDW was not correlated with C-reactive protein and leucocyte count, refuting the hypothesis that the association between RDW and outcome is mediated through inflammation. CONCLUSION In critically ill patients, the RDW on ICU admission was an independent predictor of mortality. Since RDW was not correlated with inflammation, the underlying mechanism of this association warrants further investigation.
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Affiliation(s)
- I A Meynaar
- Intensive Care Unit, Reinier de Graaf Hospital, Delft, the Netherlands
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Rud AK, Borgen E, Mælandsmo GM, Flatmark K, Le H, Josefsen D, Solvoll I, Schirmer CB, Helland Å, Jørgensen L, Brustugun OT, Fodstad Ø, Boye K. Clinical significance of disseminated tumour cells in non-small cell lung cancer. Br J Cancer 2013; 109:1264-70. [PMID: 23942067 PMCID: PMC3778301 DOI: 10.1038/bjc.2013.450] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 07/08/2013] [Accepted: 07/10/2013] [Indexed: 12/18/2022] Open
Abstract
Background: Early-stage non-small cell lung cancer (NSCLC) patients have a high risk of disease relapse despite curatively intended surgical resection, and the detection of tumour cells in the bone marrow could be one method of determining the presence of the disseminated disease in its early stages. Methods: Bone marrow aspirates were collected from 296 patients at the time of surgery, and the presence of disseminated tumour cells was determined with the help of immunomagnetic selection (IMS) using the MOC31-antibody recognising EpCAM and with the help of standard immunocytochemistry (ICC) using the anti-cytokeratin (CK) antibodies AE1/AE3. Results: Disseminated tumour cells were found in 152 of 252 (59%) bone marrow samples using IMS and in 25 of 234 (11%) samples using ICC. No association between the two detection methods was observed. The presence of EpCAM+ cells was not associated with any clinicopathological parameters, whereas a higher frequency of CK+ cells was found in patients with an advanced pT status. Disseminated tumour cells, as detected using IMS, had no prognostic impact. Patients with CK+ cells in the bone marrow had a reduced relapse-free survival, but the difference was not statistically significant. Conclusion: Our findings do not support the further development of DTC detection for clinical use in early-stage NSCLC. Future studies should include the molecular characterisation of DTCs, along with an attempt to identify subpopulations of cells with biological and clinical significance.
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Affiliation(s)
- A K Rud
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, The Norwegian Radium Hospital, PO Box 4953 Nydalen NO-0424, Oslo, Norway.
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Markova SM, De Marco T, Bendjilali N, Kobashigawa EA, Mefford J, Sodhi J, Le H, Zhang C, Halladay J, Rettie AE, Khojasteh C, McGlothlin D, Wu AHB, Hsueh WC, Witte JS, Schwartz JB, Kroetz DL. Association of CYP2C9*2 with bosentan-induced liver injury. Clin Pharmacol Ther 2013; 94:678-86. [PMID: 23863877 DOI: 10.1038/clpt.2013.143] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 07/01/2013] [Indexed: 12/13/2022]
Abstract
Bosentan (Tracleer) is an endothelin receptor antagonist prescribed for the treatment of pulmonary arterial hypertension (PAH). Its use is limited by drug-induced liver injury (DILI). To identify genetic markers of DILI, association analyses were performed on 56 Caucasian PAH patients receiving bosentan. Twelve functional polymorphisms in five genes (ABCB11, ABCC2, CYP2C9, SLCO1B1, and SLCO1B3) implicated in bosentan pharmacokinetics were tested for associations with alanine aminotransferase (ALT), aspartate aminotransferase (AST), and DILI. After adjusting for body mass index, CYP2C9*2 was the only polymorphism associated with ALT, AST, and DILI (β = 2.16, P = 0.024; β = 1.92, P = 0.016; odds ratio 95% CI = 2.29-∞, P = 0.003, respectively). Bosentan metabolism by CYP2C9*2 in vitro was significantly reduced compared with CYP2C9*1 and was comparable to that by CYP2C9*3. These results suggest that CYP2C9*2 is a potential genetic marker for prediction of bosentan-induced liver injury and warrants investigation for the optimization of bosentan treatment.
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Affiliation(s)
- S M Markova
- Department of Bioengineering and Therapeutic Sciences, Institute for Human Genetics, University of California, San Francisco, San Francisco, California, USA
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Le H, Tfelt-Hansen P, Skytthe A, Kyvik KO, Olesen J. The importance of co-morbidity and environmental risk factors for the development of migraine. J Headache Pain 2013. [PMCID: PMC3620294 DOI: 10.1186/1129-2377-14-s1-p28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Esserlind AL, Christensen AF, Le H, Kirchmann M, Hauge AW, Toyserkani NM, Hansen T, Grarup N, Werge T, Steinberg S, Bettella F, Stefansson H, Olesen J. Replication and meta-analysis of common variants identifies a genome-wide significant locus in migraine. Eur J Neurol 2013; 20:765-72. [DOI: 10.1111/ene.12055] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Accepted: 11/01/2012] [Indexed: 01/31/2023]
Affiliation(s)
- A.-L. Esserlind
- Department of Neurology; The Danish Headache Center; Glostrup Hospital; University of Copenhagen; Glostrup; Denmark
| | - A. F. Christensen
- Department of Neurology; The Danish Headache Center; Glostrup Hospital; University of Copenhagen; Glostrup; Denmark
| | - H. Le
- Department of Neurology; The Danish Headache Center; Glostrup Hospital; University of Copenhagen; Glostrup; Denmark
| | - M. Kirchmann
- Department of Neurology; The Danish Headache Center; Glostrup Hospital; University of Copenhagen; Glostrup; Denmark
| | - A. W. Hauge
- Department of Neurology; The Danish Headache Center; Glostrup Hospital; University of Copenhagen; Glostrup; Denmark
| | - N. M. Toyserkani
- Department of Neurology; The Danish Headache Center; Glostrup Hospital; University of Copenhagen; Glostrup; Denmark
| | | | - N. Grarup
- The Novo Nordisk Foundation Center for Basic Metabolic Research; Faculty of Health and Medical Sciences; University of Copenhagen; Denmark
| | - T. Werge
- Institute of Biological Psychiatry; Mental Health Center Sct. Hans; University of Copenhagen; Roskilde; Denmark
| | - S. Steinberg
- deCODE Genetics; Sturlugata 8 IS-101; Reykjavik; Iceland
| | - F. Bettella
- deCODE Genetics; Sturlugata 8 IS-101; Reykjavik; Iceland
| | - H. Stefansson
- deCODE Genetics; Sturlugata 8 IS-101; Reykjavik; Iceland
| | - J. Olesen
- Department of Neurology; The Danish Headache Center; Glostrup Hospital; University of Copenhagen; Glostrup; Denmark
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Le H, Sivret EC, Parcsi G, Stuetz RM. Stability of volatile sulfur compounds (VSCs) in sampling bags - impact of temperature. Water Sci Technol 2013; 68:1880-1887. [PMID: 24185074 DOI: 10.2166/wst.2013.445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Volatile sulfur compounds (VSCs) are a major component of odorous emissions that can cause annoyance to local populations surrounding wastewater, waste management and agricultural practices. Odour collection and storage using sample bags can result in VSC losses due to sorption and leakage. Stability within 72 hour storage of VSC samples in three sampling bag materials (Tedlar, Mylar, Nalophan) was studied at three temperatures: 5, 20, and 30 °C. The VSC samples consisted of hydrogen sulfide (H2S), methanethiol (MeSH), ethanethiol (EtSH), dimethyl sulfide (DMS), tert-butanethiol (t-BuSH), ethylmethyl sulfide (EMS), 1-butanethiol (1-BuSH), dimethyl disulfide (DMDS), diethyl disulfide (DEDS), and dimethyl trisulfide (DMTS). The results for H2S showed that higher loss trend was clearly observed (46-50% at 24 hours) at 30 °C compared to the loss at 5 °C or 20 °C (of up to 27% at 24 hours) in all three bag materials. The same phenomenon was obtained for other thiols with the relative recoveries after a 24 hour period of 76-78% at 30 °C and 80-93% at 5 and 20 °C for MeSH; 77-80% at 30 °C and 79-95% at 5 and 20 °C for EtSH; 87-89% at 30 °C and 82-98% at 5 and 20 °C for t-BuSH; 61-73% at 30 °C and 76-98% at 5 and 20 °C for 1-BuSH. Results for other sulfides and disulfides (DMS, EMS, DMDS, DEDS) indicated stable relative recoveries with little dependency on temperature (83-103% after 24 hours). DMTS had clear loss trends (with relative recoveries of 74-87% in the three bag types after 24 hours) but showed minor differences in relative recoveries at 5, 20, and 30 °C.
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Affiliation(s)
- H Le
- UNSW Water Research Centre, School of Civil and Environmental Engineering, The University of New South Wales, Sydney, NSW 2052, Australia E-mail:
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Bakst R, Lee N, He S, Chernichenko N, Chen C, Linkov G, Le H, Koutcher J, Vakiani E, Wong R. Low-dose Radiation to the Nerve Alone Impairs Perineural Invasion Independent of Cancer Cell Death. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Le H, Yuping N, Xinni L, Xiaomei Z, Haishan S. 3.052 META ANALYSIS BETWEEN VAL166MET LOCUS POLYMORPHISM IN BDNF GENE AND DEMENTIA WITH LEWY BODIES. Parkinsonism Relat Disord 2012. [DOI: 10.1016/s1353-8020(11)70788-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Xie J, Sternovsky Z, Grün E, Auer S, Duncan N, Drake K, Le H, Horanyi M, Srama R. Dust trajectory sensor: accuracy and data analysis. Rev Sci Instrum 2011; 82:105104. [PMID: 22047326 DOI: 10.1063/1.3646528] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The Dust Trajectory Sensor (DTS) instrument is developed for the measurement of the velocity vector of cosmic dust particles. The trajectory information is imperative in determining the particles' origin and distinguishing dust particles from different sources. The velocity vector also reveals information on the history of interaction between the charged dust particle and the magnetospheric or interplanetary space environment. The DTS operational principle is based on measuring the induced charge from the dust on an array of wire electrodes. In recent work, the DTS geometry has been optimized [S. Auer, E. Grün, S. Kempf, R. Srama, A. Srowig, Z. Sternovsky, and V Tschernjawski, Rev. Sci. Instrum. 79, 084501 (2008)] and a method of triggering was developed [S. Auer, G. Lawrence, E. Grün, H. Henkel, S. Kempf, R. Srama, and Z. Sternovsky, Nucl. Instrum. Methods Phys. Res. A 622, 74 (2010)]. This article presents the method of analyzing the DTS data and results from a parametric study on the accuracy of the measurements. A laboratory version of the DTS has been constructed and tested with particles in the velocity range of 2-5 km/s using the Heidelberg dust accelerator facility. Both the numerical study and the analyzed experimental data show that the accuracy of the DTS instrument is better than about 1% in velocity and 1° in direction.
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Affiliation(s)
- J Xie
- NASA Lunar Science Institute: Colorado Center for Lunar Dust and Atmospheric Studies, and Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, Colorado 80303, USA
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Le H, Poljak Z, Deardon R, Dewey CE. Clustering of and Risk Factors for the Porcine High Fever Disease in a Region of Vietnam. Transbound Emerg Dis 2011; 59:49-61. [DOI: 10.1111/j.1865-1682.2011.01239.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lee HM, Le H, Lee BT, Lopez VA, Wong ND. Forced vital capacity paired with Framingham Risk Score for prediction of all-cause mortality. Eur Respir J 2010; 36:1002-6. [PMID: 20562119 DOI: 10.1183/09031936.00042410] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Forced vital capacity (FVC) measures lung function and predicts coronary heart disease (CHD); whether it provides additive prediction over CHD risk factors has not been established. We examined whether FVC adds to the prediction of all-cause mortality provided by Framingham Risk Score (FRS) alone. We examined 5,485 (61.1 million projected) nonsmoking adults from the USA who were aged 20-79 yrs. Subjects were from the Third National Health and Nutrition Examination Survey, were without obstructive lung disease, had FVC measurements and had ≤ 12 yrs (mean 8.8 yrs) mortality follow-up. We performed Cox regression analysis to examine whether FVC and forced expiratory volume in 1 s (FEV(1)) (categorised as low ≤ 85% predicted, borderline 86-94% predicted and normal ≥ 95% predicted) within FRS groups (10-yr risk of cardiovascular disease low <10%, intermediate 10-20%, high 20%) predict mortality. Receiver operator characteristic analysis examined whether FVC and FEV(1) added to the prediction provided by FRS. Low-, intermediate- and high-risk FRS groups had 79.5% (n = 4,361), 10.1% (n = 555) and 10.4% (n = 569) persons, respectively. Only the intermediate FRS group showed a graded increase in mortality (10.7, 18.2 and 42.8% per 1,000 person-yrs from highest to lowest FVC categories, respectively); those with low FVC had an almost three-fold greater risk of mortality (hazard ratio 2.64; p<0.01) than those with normal FVC. FVC provided incremental additive value for predicting mortality in addition to FRS for only this group (area under curve 0.65 versus 0.58; p<0.05). Similar results were obtained for FEV(1). Evaluation of lung function may be useful to improve risk stratification in persons with intermediate CHD risk where it adds to prediction of mortality over global risk assessment.
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Affiliation(s)
- H M Lee
- Division of Cardiology, Dept of Medicine, 115 Sprague Hall, University of California, Irvine, CA 92697, USA.
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Le H, Ducote J, Klopfer M, Molloi S. SU-GG-I-34: Image-Based Material Decomposition with Energy Resolving Computed Tomography. Med Phys 2010. [DOI: 10.1118/1.3468067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Le H, Ducote J, Klopfer M, Molloi S. TH-C-201C-01: Quantification of Breast Density Using MRI and CT in Postmortem Breasts. Med Phys 2010. [DOI: 10.1118/1.3469506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Alivov Y, Le H, Molloi S. TU-E-201B-08: K-Edge Imaging Using a Gold Nanoparticle Contrast Agent and a CT System with Photon Counting Detectors. Med Phys 2010. [DOI: 10.1118/1.3469318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Panda S, Hatori M, Keding SR, Le H. Cellular circuitry of melanopsin function. J Vis 2009. [DOI: 10.1167/9.14.24] [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: 11/24/2022] Open
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Chalyan DA, Le H, Klopfer MJ, Suh WM, Wong J, Molloi S. WE-C-304A-04: In Vivo Analysis of Coronary Blood Flow and Arterial Tree Volume Relationship in Swine. Med Phys 2009. [DOI: 10.1118/1.3182491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Le H, Ducote J, Klopfer M, Molloi S. SU-FF-I-139: Low Dose Breast CT with Photon Counting Detectors: A Phantom Study. Med Phys 2009. [DOI: 10.1118/1.3181260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lane M, Le H, Lee S, Young C, Heran M, Munk P. Abstract No. 334 EE: Imaging of Radiofrequency Ablation Followed by Cementoplasty in Treatment of Painful Neoplastic Lesions: Spectrum of Findings from 24 Patients with 33 Lesions. J Vasc Interv Radiol 2009. [DOI: 10.1016/j.jvir.2008.12.329] [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: 11/26/2022] Open
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Le H, Ducote JL, Molloi S. TH-C-332-07: Dual Energy Contrast-Enhanced Breast Computed Tomography: A Phantom Study. Med Phys 2008. [DOI: 10.1118/1.2962873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Le H, Molloi S. MO-D-332-08: Design Rules for the Coronary Arterial Tree System Based On CT Images of a Swine Heart. Med Phys 2008. [DOI: 10.1118/1.2962367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Le H, Ziogas A, Zell JA. Survival in colorectal cancer with Asian ethnicity. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4042] [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: 11/20/2022] Open
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