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Arockiaraj M, Paul D, Clement J, Tigga S, Jacob K, Balasubramanian K. Novel molecular hybrid geometric-harmonic-Zagreb degree based descriptors and their efficacy in QSPR studies of polycyclic aromatic hydrocarbons. SAR QSAR Environ Res 2023; 34:569-589. [PMID: 37538006 DOI: 10.1080/1062936x.2023.2239149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/16/2023] [Indexed: 08/05/2023]
Abstract
The physicochemical characteristics of polycyclic aromatic compounds critical to environmental modelling such as octanol partition coefficients, solubility, lipophilicity, polarity and several equilibrium constants are functions of their underlying molecular structures, prompting the development of mathematical models to predict such characteristics for which experimental results are difficult to obtain. We propose twelve novel descriptors derived from geometric, harmonic and Zagreb degree-based descriptors and then test the effectiveness of these descriptors on a data set consisting of 55 benzenoid hydrocarbons of environmental importance. Our computations show that the proposed descriptors have a good linear correlation and predictive power when compared to the degree and distance type descriptors. We have also derived the QSPR expressions for four properties of a large series of polycyclic aromatics arising from circumscribing coronenes and show that a scaling factor can be deduced to derive physicochemical properties of such series up to 2D graphene sheets.
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Affiliation(s)
- M Arockiaraj
- Department of Mathematics, Loyola College, Chennai, India
| | - D Paul
- Department of Mathematics, Sri Sairam Institute of Technology, Chennai, India
| | - J Clement
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore, India
| | - S Tigga
- Department of Mathematics, Loyola College, Chennai, India
| | - K Jacob
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore, India
| | - K Balasubramanian
- School of Molecular Sciences, Arizona State University, Tempe, AZ, USA
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Tang WHW, Yimer H, Tummala M, Shao S, Chung G, Clement J, Chu BC, Hubbell E, Kurtzman KN, Swanton C, Roberts LR. Performance of a targeted methylation-based multi-cancer early detection test by race and ethnicity. Prev Med 2023; 167:107384. [PMID: 36495927 DOI: 10.1016/j.ypmed.2022.107384] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022]
Abstract
Disparities in cancer screening and outcomes based on factors such as sex, socioeconomic status, and race and ethnicity in the United States are well documented. A blood-based multi-cancer early detection (MCED) test that detects a shared cancer signal across multiple cancer types and also predicts the cancer signal origin was developed and validated in the Circulating Cell-free Genome Atlas study (CCGA; NCT02889978). CCGA is a prospective, multicenter, case-control, observational study with longitudinal follow-up (overall N = 15,254). In this pre-specified, exploratory, descriptive analysis, test performance was evaluated among racial and ethnic groups. Overall, 4077 participants comprised the independent validation set with confirmed cancer status (cancer: n = 2823; non-cancer: n = 1254). Participants were stratified into the following racial/ethnic groups: Black (non-Hispanic), Hispanic (all races), Other (non-Hispanic), Other/unknown and White (non-Hispanic). Cancer and non-cancer participants were predominantly White (n = 2316, 82.0% and n = 996, 79.4%, respectively). Across groups, specificity for cancer signal detection ranged from 98.1% [n = 103; 95% CI: 93.2-99.5%] to 100% [n = 85; 95% CI: 95.7-100.0%]. The sensitivity for cancer signal detection across groups ranged from 43.9% [n = 57; 95% CI: 31.8-56.7%] to 63.0% [n = 192; 95% CI: 56.0-69.5%] and generally increased with clinical stage. The MCED test had consistently high specificity and similar sensitivity across racial and ethnic groups, though results are limited by sample size for some groups. Results support the broad applicability of this MCED test and clinical implementation on a population scale as a complement to standard screening.
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Affiliation(s)
| | | | | | | | - Gina Chung
- The Christ Hospital Health Network, Cincinnati, OH, USA
| | | | - Bong Chul Chu
- GRAIL, LLC, a subsidiary of Illumina, Inc, Menlo Park, CA, USA
| | - Earl Hubbell
- GRAIL, LLC, a subsidiary of Illumina, Inc, Menlo Park, CA, USA
| | | | - Charles Swanton
- The Francis Crick Institute, London, UK and University College London Cancer Institute, London, UK
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Clement J, Esposito G, Crutzen N. Municipal Pathways in Response to COVID-19: A Strategic Management Perspective on Local Public Administration Resilience. Adm Soc 2023; 55:3-29. [PMID: 36606211 PMCID: PMC9716190 DOI: 10.1177/00953997221100382] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
This paper aims to understand the different resilience pathways local governments may take during moments of crisis, specifically focusing on the COVID-19 pandemic. Through survey responses from local administrations in Wallonia, Belgium, we consider how varied contexts led to different strategic resilience pathways. These pathways range from static (i.e., no strategy) to innovative change. Our findings highlight that digital technology solutions may play a role in supporting resilience across the different pathways. Therefore, we adapt strategic public management literature to suggest propositions for future research to test the specific role that digital technologies play in supporting resilience within local administrations.
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Affiliation(s)
- Jessica Clement
- HEC Liège Management School at the University of Liège, Belgium
| | - Giovanni Esposito
- HEC Liège Management School at the University of Liège, Belgium
- University of Antwerp, Belgium
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Shao SH, Allen B, Clement J, Chung G, Gao J, Hubbell E, Liu MC, Swanton C, Tang WHW, Yimer H, Tummala M. Multi-cancer early detection test sensitivity for cancers with and without current population-level screening options. Tumori 2022:3008916221133136. [PMID: 36316952 DOI: 10.1177/03008916221133136] [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: 11/18/2022]
Abstract
There are four solid tumors with common screening options in the average-risk population aged 21 to 75 years (breast, cervical, colorectal, and, based on personalized risk assessment, prostate), but many cancers lack recommended population screening and are often detected at advanced stages when mortality is high. Blood-based multi-cancer early detection tests have the potential to improve cancer mortality through additional population screening. Reported here is a post-hoc analysis from the third Circulating Cell-free Genome Atlas substudy to examine multi-cancer early detection test performance in solid tumors with and without population screening recommendations and in hematologic malignancies. Participants with cancer in the third Circulating Cell-free Genome Atlas substudy analysis were split into three subgroups: solid screened tumors (breast, cervical, colorectal, prostate), solid unscreened tumors, and hematologic malignancies. In this post hoc analysis, sensitivity is reported for each subgroup across all ages and those aged ⩾50 years overall, by cancer, and by clinical cancer stage. Aggregate sensitivity in the solid screened, solid unscreened, and hematologic malignancy subgroups was 34%, 66%, and 55% across all cancer stages, respectively; restricting to participants aged ⩾50 years showed similar aggregate sensitivity. Aggregate sensitivity was 27%, 53%, and 60% across stages I to III, respectively. Within the solid unscreened subgroup, aggregate sensitivity was >75% in 8/18 cancers (44%) and >50% in 13/18 (72%). This multi-cancer early detection test detected cancer signals at high (>75%) sensitivity for multiple cancers without existing population screening recommendations, suggesting its potential to complement recommended screening programs. Clinical trial identifier: NCT02889978.
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Affiliation(s)
| | - Brian Allen
- GRAIL, LLC, a subsidiary of Illumina Inc., Menlo Park, CA, USA
| | | | - Gina Chung
- The Christ Hospital Health Network, Cincinnati, OH, USA
| | - Jingjing Gao
- GRAIL, LLC, a subsidiary of Illumina Inc., Menlo Park, CA, USA
| | - Earl Hubbell
- GRAIL, LLC, a subsidiary of Illumina Inc., Menlo Park, CA, USA
| | | | - Charles Swanton
- The Francis Crick Institute, London, UK
- University College London Cancer Institute, London, UK
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Elkrief A, Hennessy C, Kuderer NM, Rubinstein SM, Wulff-Burchfield E, Rosovsky RP, Vega-Luna K, Thompson MA, Panagiotou OA, Desai A, Rivera DR, Khaki AR, Tachiki L, Lynch RC, Stratton C, Elias R, Batist G, Kasi A, Shah DP, Bakouny Z, Cabal A, Clement J, Crowell J, Dixon B, Friese CR, Fry SL, Grover P, Gulati S, Gupta S, Hwang C, Khan H, Kim SJ, Klein EJ, Labaki C, McKay RR, Nizam A, Pennell NA, Puc M, Schmidt AL, Shahrokni A, Shaya JA, Su CT, Wall S, Williams N, Wise-Draper TM, Mishra S, Grivas P, French B, Warner JL, Wildes TM. Geriatric risk factors for serious COVID-19 outcomes among older adults with cancer: a cohort study from the COVID-19 and Cancer Consortium. Lancet Healthy Longev 2022; 3:e143-e152. [PMID: 35187516 PMCID: PMC8843069 DOI: 10.1016/s2666-7568(22)00009-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Older age is associated with poorer outcomes of SARS-CoV-2 infection, although the heterogeneity of ageing results in some older adults being at greater risk than others. The objective of this study was to quantify the association of a novel geriatric risk index, comprising age, modified Charlson comorbidity index, and Eastern Cooperative Oncology Group performance status, with COVID-19 severity and 30-day mortality among older adults with cancer. METHODS In this cohort study, we enrolled patients aged 60 years and older with a current or previous cancer diagnosis (excluding those with non-invasive cancers and premalignant or non-malignant conditions) and a current or previous laboratory-confirmed COVID-19 diagnosis who reported to the COVID-19 and Cancer Consortium (CCC19) multinational, multicentre, registry between March 17, 2020, and June 6, 2021. Patients were also excluded for unknown age, missing data resulting in unknown geriatric risk measure, inadequate data quality, or incomplete follow-up resulting in unknown COVID-19 severity. The exposure of interest was the CCC19 geriatric risk index. The primary outcome was COVID-19 severity and the secondary outcome was 30-day all-cause mortality; both were assessed in the full dataset. Adjusted odds ratios (ORs) and 95% CIs were estimated from ordinal and binary logistic regression models. FINDINGS 5671 patients with cancer and COVID-19 were included in the analysis. Median follow-up time was 56 days (IQR 22-120), and median age was 72 years (IQR 66-79). The CCC19 geriatric risk index identified 2365 (41·7%) patients as standard risk, 2217 (39·1%) patients as intermediate risk, and 1089 (19·2%) as high risk. 36 (0·6%) patients were excluded due to non-calculable geriatric risk index. Compared with standard-risk patients, high-risk patients had significantly higher COVID-19 severity (adjusted OR 7·24; 95% CI 6·20-8·45). 920 (16·2%) of 5671 patients died within 30 days of a COVID-19 diagnosis, including 161 (6·8%) of 2365 standard-risk patients, 409 (18·5%) of 2217 intermediate-risk patients, and 350 (32·1%) of 1089 high-risk patients. High-risk patients had higher adjusted odds of 30-day mortality (adjusted OR 10·7; 95% CI 8·54-13·5) than standard-risk patients. INTERPRETATION The CCC19 geriatric risk index was strongly associated with COVID-19 severity and 30-day mortality. Our CCC19 geriatric risk index, based on readily available clinical factors, might provide clinicians with an easy-to-use risk stratification method to identify older adults most at risk for severe COVID-19 as well as mortality. FUNDING US National Institutes of Health National Cancer Institute Cancer Center.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Orestis A Panagiotou
- Department of Health Services Policy and Practice, Brown University School of Public Health, Providence, RI, USA
| | | | | | | | - Lisa Tachiki
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Ryan C Lynch
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Catherine Stratton
- Yale Cancer Center at Yale University School of Medicine, New Haven, CT, USA
| | - Rawad Elias
- Hartford Healthcare Cancer Institute, Hartford, CT, USA
| | - Gerald Batist
- Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Anup Kasi
- The University of Kansas Medical Center, Kansas City, KS, USA
| | - Dimpy P Shah
- Mays Cancer Center at UT Health San Antonio MD Anderson Cancer Center, San Antonio, TX, USA
| | | | - Angelo Cabal
- Moores Comprehensive Cancer Center at the University of California, San Diego (UCSD), San Diego, CA, USA
| | | | | | | | | | - Stacy L Fry
- University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA
| | - Punita Grover
- University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Shuchi Gulati
- University of Cincinnati Cancer Center, Cincinnati, OH, USA
| | - Shilpa Gupta
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Clara Hwang
- Henry Ford Cancer Institute, Henry Ford Hospital, Detroit, MI, USA
| | - Hina Khan
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Soo Jung Kim
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Elizabeth J Klein
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Rana R McKay
- Moores Comprehensive Cancer Center at the University of California, San Diego (UCSD), San Diego, CA, USA
| | - Amanda Nizam
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | | | | | | | | | - Justin A Shaya
- Moores Comprehensive Cancer Center at the University of California, San Diego (UCSD), San Diego, CA, USA
| | | | - Sarah Wall
- The Ohio State University, Columbus, OH, USA
| | | | | | - Sanjay Mishra
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Petros Grivas
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
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Klein EA, Richards D, Cohn A, Tummala M, Lapham R, Cosgrove D, Chung G, Clement J, Gao J, Hunkapiller N, Jamshidi A, Kurtzman K, Seiden MV, Swanton C, Liu MC. Abstract LB013: Clinical validation of a targeted methylation-based multi-cancer early detection test. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-lb013] [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: 11/16/2022]
Abstract
Abstract
Introduction: A multi-cancer early detection (MCED) test as a complement to existing screening tests could increase the number of cancer cases detected in a population, potentially improving patient outcomes and survival as well as decreasing harmful and aggressive treatments. The Circulating Cell-free Genome Atlas study (CCGA; NCT02889978) was designed to develop and validate a blood-based MCED test analyzing plasma cell-free DNA (cfDNA) to detect cancer signals across multiple cancer types and simultaneously predict their signal origin. Here, the results of the third and final pre-specified CCGA validation sub-study for a refined MCED test in a large cohort in preparation for clinical use are reported. Methods: CCGA is a prospective, multicenter, case-control, observational study with longitudinal follow-up (overall population N=15,254). In this sub-study (n=5309), key primary objectives were to evaluate test performance for cancer signal detection (specificity, overall sensitivity, sensitivity by clinical stage) and signal origin prediction (accuracy). cfDNA from evaluable samples was analyzed using a targeted methylation bisulfite sequencing assay and a machine learning algorithm. The classifier was trained to target a specificity of 99.4% and locked before analysis of the independent validation set. Overall, 4077 participants comprised the independent validation set with confirmed status (cancer: n=2823; non-cancer: n=1254 with non-cancer status confirmed at year-one follow-up). MCED test results are reported for this confirmed status set. Results: Mean (SD) age in the cancer and non-cancer groups was 62.6 (11.76) and 56.2 (12.63) years, respectively. Specificity for cancer signal detection was 99.5% (1248/1254; 95% confidence interval: 99.0-99.8%). Overall sensitivity for cancer signal detection was 51.5% (1453/2823; 49.6-53.3%); sensitivity increased with stage (Stage I: 16.8% [14.5-19.5%], Stage II: 40.4% [36.8-44.1%], Stage III: 77.0% [73.4-80.3%], Stage IV: 90.1% [87.5-92.2%]). Stage I-III sensitivity was 67.6% (593/877; 64.4-70.6%) in a pre-specified set of 12 high-signal cancers accounting for ~63% of annual US cancer deaths [1] and was 40.7% (863/2118; 38.7-42.9%) in all cancers. Cancer signals were detected across >50 cancer types [2]. Overall accuracy of signal origin prediction in true positives was 88.7% (87.0-90.2%). Conclusions: In this pre-specified, large-scale, clinical validation sub-study of CCGA, the MCED test detected cancer signals across >50 cancer types, which is critical to maximize the number of cancer cases detected in a population. This MCED test performed with high specificity and high accuracy of signal origin prediction. These data lay the foundation for population-scale clinical implementation of this test. 1.US Mortality Data 1969-2016 (www.seer.cancer.gov); based on 2015-2016. 2.Amin et al. CA Cancer J Clin. 2017;67:93e99.
Citation Format: Eric A. Klein, Donald Richards, Allen Cohn, Mohan Tummala, Rosanna Lapham, David Cosgrove, Gina Chung, Jessica Clement, Jingjing Gao, Nathan Hunkapiller, Arash Jamshidi, Kathryn Kurtzman, Michael V. Seiden, Charles Swanton, Minetta C. Liu. Clinical validation of a targeted methylation-based multi-cancer early detection test [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB013.
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Affiliation(s)
| | | | | | | | | | | | - Gina Chung
- 7The Christ Hospital Health Network, Cincinnati, OH
| | | | | | | | | | | | | | - Charles Swanton
- 11The Francis Crick Institute & University College London Cancer Institute, London, United Kingdom
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Klein EA, Richards D, Cohn A, Tummala M, Lapham R, Cosgrove D, Chung G, Clement J, Gao J, Hunkapiller N, Jamshidi A, Kurtzman KN, Seiden MV, Swanton C, Liu MC. Clinical validation of a targeted methylation-based multi-cancer early detection test using an independent validation set. Ann Oncol 2021; 32:1167-1177. [PMID: 34176681 DOI: 10.1016/j.annonc.2021.05.806] [Citation(s) in RCA: 301] [Impact Index Per Article: 100.3] [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: 05/19/2021] [Revised: 05/27/2021] [Accepted: 05/30/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND A multi-cancer early detection (MCED) test used to complement existing screening could increase the number of cancers detected through population screening, potentially improving clinical outcomes. The Circulating Cell-free Genome Atlas study (CCGA; NCT02889978) was a prospective, case-controlled, observational study and demonstrated that a blood-based MCED test utilizing cell-free DNA (cfDNA) sequencing in combination with machine learning could detect cancer signals across multiple cancer types and predict cancer signal origin (CSO) with high accuracy. The objective of this third and final CCGA substudy was to validate an MCED test version further refined for use as a screening tool. PATIENTS AND METHODS This pre-specified substudy included 4077 participants in an independent validation set (cancer: n = 2823; non-cancer: n = 1254, non-cancer status confirmed at year-one follow-up). Specificity, sensitivity, and CSO prediction accuracy were measured. RESULTS Specificity for cancer signal detection was 99.5% [95% confidence interval (CI): 99.0% to 99.8%]. Overall sensitivity for cancer signal detection was 51.5% (49.6% to 53.3%); sensitivity increased with stage [stage I: 16.8% (14.5% to 19.5%), stage II: 40.4% (36.8% to 44.1%), stage III: 77.0% (73.4% to 80.3%), stage IV: 90.1% (87.5% to 92.2%)]. Stage I-III sensitivity was 67.6% (64.4% to 70.6%) in 12 pre-specified cancers that account for approximately two-thirds of annual USA cancer deaths and was 40.7% (38.7% to 42.9%) in all cancers. Cancer signals were detected across >50 cancer types. Overall accuracy of CSO prediction in true positives was 88.7% (87.0% to 90.2%). CONCLUSION In this pre-specified, large-scale, clinical validation substudy, the MCED test demonstrated high specificity and accuracy of CSO prediction and detected cancer signals across a wide diversity of cancers. These results support the feasibility of this blood-based MCED test as a complement to existing single-cancer screening tests. CLINICAL TRIAL NUMBER NCT02889978.
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Affiliation(s)
- E A Klein
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, USA.
| | | | - A Cohn
- The US Oncology Network, Denver, USA
| | - M Tummala
- Mercy Clinic Cancer Center, Springfield, USA
| | - R Lapham
- Spartanburg Regional Healthcare System, Spartanburg, USA
| | | | - G Chung
- The Christ Hospital Health Network, Cincinnati, USA
| | - J Clement
- Hartford HealthCare Cancer Institute, Hartford, USA
| | - J Gao
- GRAIL, Inc., Menlo Park, USA
| | | | | | | | - M V Seiden
- US Oncology Research, The Woodlands, USA
| | - C Swanton
- The Francis Crick Institute, London, UK; University College London Cancer Institute, London, UK
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Atanasova V, Tiefenbacher A, Clement J, Wöran K, Bergmann M, Dolznig H, Egger G. 482P Identification of proteome and secretome signatures in primary colorectal cancer associated fibroblasts. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.593] [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: 10/23/2022] Open
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Arockiaraj M, Clement J, Tratnik N, Mushtaq S, Balasubramanian K. Weighted Mostar indices as measures of molecular peripheral shapes with applications to graphene, graphyne and graphdiyne nanoribbons. SAR QSAR Environ Res 2020; 31:187-208. [PMID: 31960721 DOI: 10.1080/1062936x.2019.1708459] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 12/19/2019] [Indexed: 06/10/2023]
Abstract
In this study we consider relatively new bond-additive Mostar indices that appear to provide quantitative measures of peripheral shapes of molecules. We have computed weighted Mostar, edge-Mostar and total-Mostar indices of graphene, [Formula: see text]-types of graphyne and graphdiyne, which are of considerable interest owing to their novel properties and thus find applications in a number of areas such as sensors, catalysis, chemisorption and nanomedicine. We have implemented the results to analyse the weighted Mostar indices and have obtained exact analytical expressions for the title molecules. We propose that Mostar indices together with frontier molecular orbitals, and HOMO-LUMO gaps can provide measures of chemical reactivity and analysis of peripheral molecular shapes.
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Affiliation(s)
- M Arockiaraj
- Department of Mathematics, Loyola College, Chennai, India
| | - J Clement
- Department of Mathematics, St. Joseph's College of Engineering, Chennai, India
| | - N Tratnik
- Faculty of Education, University of Maribor, Maribor, Slovenia
- Faculty of Natural Sciences and Mathematics, University of Maribor, Maribor, Slovenia
| | - S Mushtaq
- Department of Mathematics, Loyola College, University of Madras, Chennai, India
| | - K Balasubramanian
- School of Molecular Sciences, Arizona State University, Tempe, AZ, USA
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Hennessey A, Buller D, Sama S, Girard E, Clement J, Ristau BT. Case report: Adenosquamous carcinoma of the prostate with greater than 20 month response to multimodal therapy. Urol Case Rep 2019; 29:101084. [PMID: 31867218 PMCID: PMC6906645 DOI: 10.1016/j.eucr.2019.101084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 12/02/2019] [Indexed: 11/16/2022] Open
Abstract
Adenosquamous carcinoma is an extremely rare and lethal subtype of prostate cancer affecting an estimated 0.03 per million men annually. It has been associated with prior hormone therapy for prostate adenocarcinoma. We present a case of de novo adenosquamous carcinoma of the prostate treated with a multimodal approach including surgery, androgen-deprivation therapy, chemotherapy, and radiation.
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Affiliation(s)
- Alex Hennessey
- Division of Urology, UConn Health, 263 Farmington Avenue, Farmington, CT, USA
| | - Dylan Buller
- University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT, USA
| | - Shashank Sama
- Department of Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT, USA
| | - Eric Girard
- Department of Surgery, UConn Health, 263 Farmington Avenue, Farmington, CT, USA
| | - Jessica Clement
- Department of Hematology and Oncology, UConn Health, 263 Farmington Avenue, Farmington, CT, USA
| | - Benjamin T Ristau
- Division of Urology, UConn Health, 263 Farmington Avenue, Farmington, CT, USA
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Abstract
Purpose Medical marijuana is often used as adjuvant therapy in cancer patients for symptom management, although limited evidence-based studies evaluating its efficacy or safety exist. Similar to over-the-counter medications, supplements, or herbal products, documentation of medical marijuana is important to monitor efficacy, potential adverse effects, or interactions. The objective of this quality improvement study was to improve the consistency of medical marijuana documentation in cancer patients by assessing current practices; educating healthcare team members about the importance of documentation and newly established documentation process; and evaluating the new documentation process. Methods This three-part quality improvement study was approved by the Institutional Review Board. In part I, a voluntary survey was sent via email to Cancer Center healthcare personnel to assess the current documentation process of medical marijuana. In part II, a best practice process for documenting medical marijuana in the electronic medical record was established. Medical marijuana was to be listed as a historical medication in the medication list. In-person and electronic education sessions were offered to Cancer Center clinical staff. The education emphasized the importance of documenting medical marijuana use and provided a detailed process for electronic medical record documentation. A pre- and post-test to assess understanding was also included. Part III was a retrospective chart review to evaluate documentation practices of certified medical marijuana users in the Cancer Center. Patients included in the study were greater than 18 years old and certified for medical marijuana use on or after 1 January 2018. Department of Corrections patients were excluded. Descriptive statistics were used for data analysis. Results The survey results in part I demonstrated a lack of consistency in the documentation of medical marijuana in the Cancer Center. The pre- and post-test scores measured in part II showed a significant improvement in understanding after education was provided. The average pre-test score was a 61 and post-test score was 88, indicating an average increase of 27 points. A larger increase in test scores was observed in those attending the in-person education than the online sessions ( p < 0.002). The results of the retrospective chart review in part III revealed 56 patients who met inclusion criteria, but only 39 patients were alive and evaluated at the time of the retrospective chart review. Of the 39 patients, 22 never completed the patient registration process and therefore, would never have been able to obtain medical marijuana. Seven patients had medical marijuana properly documented in their medication list and 10 patients were missing documentation in the medication list, showing room for improvement in documentation practices. Conclusions This quality improvement study led to the implementation of medical marijuana documentation in the medication list. Education increased healthcare team members understanding of medical marijuana utilization and the importance of documentation.
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Affiliation(s)
| | | | | | - Lisa M Holle
- John Dempsey Hospital at UConn Health, Farmington, CT, USA
- UConn School of Pharmacy, Storrs, CT, USA
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Kethireddy N, Boyle E, Haley M, Reddy A, Forouhar F, Clement J. CLL associated giant cell hepatitis. Leuk Res 2019; 82:43-45. [PMID: 31170661 DOI: 10.1016/j.leukres.2019.05.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 10/26/2022]
Affiliation(s)
| | - Evan Boyle
- University of Connecticut, United States
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14
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Beaulieu M, Gabana C, Rose C, Macdonald P, Clement J, Kiaii M. Stenosis at the area of Transposition – An Under-Recognized Complication of Transposed Brachiobasilic Fistulas. J Vasc Access 2018. [DOI: 10.1177/112972980700800409] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background With an increased focus on native AV fistula creation in hemodialysis patients, a transposed brachiobasilic fistula (tBBF) is becoming an increasingly utilized option. This study describes the outcomes of tBBFs in a chronic hemodialysis population. In particular, we focus on the incidence and location of stenosis, and review the impact of angioplasty on these lesions. Methods A retrospective cohort study using all patients with a tBBF created between January 2001 and December 2004. Results Of the 543 fistulas created during the study period, 93 were tBBFs. The mean age of patients was 65 years, 56% were male and 55% were diabetic. Stenosis occurred in 54% (46/85) of fistulas; the location of stenosis in the majority (74%) was at or near the area of basilic vein transposition and 50% of fistulas with stenosis in this location required three or more angioplasties. Primary (unassisted) patency was 42% at one year in this cohort. Secondary patency was 68% at 1 year and 58% and 53% at 2 and 3 years respectively. Conclusion In a cohort of hemodialysis patients who received a tBBF, we describe a reasonable primary and secondary patency rate and a high rate of stenosis at the point of transposition of the basilic vein. Such stenosis usually requires multiple percutaneous or surgical interventions to ensure or reestablish conduit patency. Further study is required regarding the optimal surgical technique, monitoring, and treatment of stenosis of this fistula type including the utility of repeat angioplasty.
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Affiliation(s)
- M.C. Beaulieu
- Division of Nephrology, St. Paul's
Hospital, Vancouver, British Columbia - Canada
| | - C. Gabana
- Division of Nephrology, St. Paul's
Hospital, Vancouver, British Columbia - Canada
| | - C. Rose
- Division of Nephrology, St. Paul's
Hospital, Vancouver, British Columbia - Canada
| | - P.S. Macdonald
- Division of Vascular Surgery, St.
Paul's Hospital, Vancouver, British Columbia - Canada
| | - J. Clement
- Department of Radiology, St. Paul's
Hospital, Vancouver, British Columbia - Canada
| | - M. Kiaii
- Division of Nephrology, St. Paul's
Hospital, Vancouver, British Columbia - Canada
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15
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Fan Y, Matthews H, Kilpatrick N, Claes P, Clement J, Penington A. Facial morphology and growth following surgery for congenital midline cervical cleft patients. Int J Oral Maxillofac Surg 2018; 47:437-441. [PMID: 29373199 DOI: 10.1016/j.ijom.2017.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 11/01/2017] [Accepted: 12/14/2017] [Indexed: 11/16/2022]
Abstract
Congenital midline cervical cleft (CMCC) is a rare condition that consists of a cutaneous midline neck lesion with a sinus extending inferiorly towards the sternum. A fibrous band that extends superiorly to the mandible is a consistent feature of the condition. Restriction of growth of the mandible, possibly due to incomplete removal of the band, is the most significant long-term problem. It remains unclear whether early removal of the fibrous band might allow catch-up growth of the mandible. This study utilized non-invasive three-dimensional photographs to objectively evaluate the facial growth of six CMCC patients. The growth of these CMCC patients was compared to the average growth of age- and sex-matched controls from a database of three-dimensional facial photographs of clinically normal subjects. After surgical removal of the fibrous cord, CMCC patients experience growth in the chin at the same rate as in the normal population; no evidence was found for catch-up growth. As a result, individuals with CMCC are likely to require further surgical intervention to correct the residual retrognathia on completion of facial growth. Early excision of the lesion including aggressive resection of the fibrous band is still recommended, as this should optimize the early growth of the mandible in infancy.
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Affiliation(s)
- Y Fan
- Department of Dentistry, The University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia
| | - H Matthews
- Murdoch Children's Research Institute, Melbourne, Australia; The University of Melbourne Department of Paediatrics at the Royal Children's Hospital, Melbourne, Australia
| | - N Kilpatrick
- Murdoch Children's Research Institute, Melbourne, Australia; The University of Melbourne Department of Paediatrics at the Royal Children's Hospital, Melbourne, Australia
| | - P Claes
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Electrical Engineering, KU Leuven, Leuven, Belgium; ESAT/PSI, Medical Image Computing, UZ Leuven, Leuven, Belgium; Medical Imaging Research Centre, Leuven, Belgium
| | - J Clement
- Department of Dentistry, The University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Cranfield University, Cranfield, Bedfordshire, UK
| | - A Penington
- Murdoch Children's Research Institute, Melbourne, Australia; The University of Melbourne Department of Paediatrics at the Royal Children's Hospital, Melbourne, Australia.
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16
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Clement J, Lee APK, Verpooten GA, Laenen L, Vergote V, De Samblanx H, Berneman ZN, Van Ranst M, Maes P. Acute hantavirus infection presenting as haemolytic-uraemic syndrome (HUS): the importance of early clinical diagnosis. Eur J Clin Microbiol Infect Dis 2017; 37:135-140. [PMID: 28986730 DOI: 10.1007/s10096-017-3113-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 09/11/2017] [Accepted: 09/11/2017] [Indexed: 01/30/2023]
Abstract
The European prototype of hantavirus, Puumala virus (PUUV), isolated from a common wild rodent, the bank vole (Myodes glareolus), causes nephropathia epidemica (NE). NE can perfectly mimic haemolytic-uraemic syndrome (HUS), progressing from an aspecific flu-like syndrome to acute kidney injury with thrombocytopaenia, and presenting with some signs of haemolytic anaemia and/or coagulopathy. Moreover, both NE and HUS can occur in local outbreaks. We report an isolated case of NE, initially referred for plasmapheresis for suspected HUS, although signs of overt haemolysis were lacking. Early suspicion of hantavirus infection, later confirmed by serology and reverse transcription polymerase chain reaction (RT-PCR), prevented subsequent excessive treatment modalities.
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Affiliation(s)
- J Clement
- National Reference Laboratory for Hantavirus Infections, University Hospitals Leuven, Leuven, Belgium.
- Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
| | - A P K Lee
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - G A Verpooten
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - L Laenen
- National Reference Laboratory for Hantavirus Infections, University Hospitals Leuven, Leuven, Belgium
- Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - V Vergote
- National Reference Laboratory for Hantavirus Infections, University Hospitals Leuven, Leuven, Belgium
- Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - H De Samblanx
- Department of Haematology, Antwerp University Hospital, Edegem, Belgium
| | - Z N Berneman
- Department of Haematology, Antwerp University Hospital, Edegem, Belgium
| | - M Van Ranst
- National Reference Laboratory for Hantavirus Infections, University Hospitals Leuven, Leuven, Belgium
- Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - P Maes
- National Reference Laboratory for Hantavirus Infections, University Hospitals Leuven, Leuven, Belgium
- Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
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17
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Greenwood C, Clement J, Dicken A, Evans JPO, Lyburn I, Martin RM, Rogers K, Stone N, Zioupos P. Towards new material biomarkers for fracture risk. Bone 2016; 93:55-63. [PMID: 27622884 DOI: 10.1016/j.bone.2016.09.006] [Citation(s) in RCA: 12] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/05/2016] [Accepted: 09/08/2016] [Indexed: 12/28/2022]
Abstract
Osteoporosis is a prevalent bone condition, characterised by low bone mass and increased fracture risk. Currently, the gold standard for identifying osteoporosis and increased fracture risk is through quantification of bone mineral density (BMD) using dual energy X-ray absorption (DEXA). However, the risk of osteoporotic fracture is determined collectively by bone mass, architecture and physicochemistry of the mineral composite building blocks. Thus DEXA scans alone inevitably fail to fully discriminate individuals who will suffer a fragility fracture. This study examines trabecular bone at both ultrastructure and microarchitectural levels to provide a detailed material view of bone, and therefore provides a more comprehensive explanation of osteoporotic fracture risk. Physicochemical characterisation obtained through X-ray diffraction and infrared analysis indicated significant differences in apatite crystal chemistry and nanostructure between fracture and non-fracture groups. Further, this study, through considering the potential correlations between the chemical biomarkers and microarchitectural properties of trabecular bone, has investigated the relationship between bone mechanical properties (e.g. fragility) and physicochemical material features.
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Affiliation(s)
- C Greenwood
- Cranfield Forensic Institute, Cranfield University, Defence Academy of the UK, Shrivenham, UK.
| | - J Clement
- Forensic Odontology, Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - A Dicken
- The Imaging Science Group, Nottingham Trent University, Nottingham, UK
| | - J P O Evans
- The Imaging Science Group, Nottingham Trent University, Nottingham, UK
| | | | - R M Martin
- Social and Community Medicine, Bristol University, Bristol, UK
| | - K Rogers
- Cranfield Forensic Institute, Cranfield University, Defence Academy of the UK, Shrivenham, UK
| | - N Stone
- Physics and Astronomy, Exeter University, Exeter, UK
| | - P Zioupos
- Cranfield Forensic Institute, Cranfield University, Defence Academy of the UK, Shrivenham, UK
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Morris JL, Cottrell S, Fettig CJ, Hansen WD, Sherriff RL, Carter VA, Clear JL, Clement J, DeRose RJ, Hicke JA, Higuera PE, Mattor KM, Seddon AWR, Seppä HT, Stednick JD, Seybold SJ. Managing bark beetle impacts on ecosystems and society: priority questions to motivate future research. J Appl Ecol 2016. [DOI: 10.1111/1365-2664.12782] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jesse L. Morris
- Department of Geography; University of Utah; Salt Lake City UT USA
| | - Stuart Cottrell
- Department of Human Dimensions of Natural Resources; Colorado State University; Fort Collins CO USA
| | - Christopher J. Fettig
- Pacific Southwest Research Station; Invasives and Threats; Ecosystem Function and Health; USDA Forest Service; Davis CA USA
| | | | | | | | - Jennifer L. Clear
- Department of Forest Ecology; Czech University of Life Sciences; Prague Czech Republic
- Department of Marine and Coastal Sciences; Rutgers University; New Brunswick NJ USA
| | - Jessica Clement
- Ruckelshaus Institute of Environment and Natural Resources; University of Wyoming; Laramie WY USA
| | - R. Justin DeRose
- Rocky Mountain Research Station; Forest Inventory and Analysis; USDA Forest Service; Ogden UT USA
| | | | - Philip E. Higuera
- Department of Ecosystem and Conservation Sciences; University of Montana; Missoula MT USA
| | - Katherine M. Mattor
- Department of Human Dimensions of Natural Resources; Colorado State University; Fort Collins CO USA
| | | | - Heikki T. Seppä
- Department of Geosciences and Geography; University of Helsinki; Helsinki Finland
| | - John D. Stednick
- Department of Forest and Rangeland Stewardship; Colorado State University; Fort Collins CO USA
| | - Steven J. Seybold
- Pacific Southwest Research Station; Invasives and Threats; Ecosystem Function and Health; USDA Forest Service; Davis CA USA
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19
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Clement J, Colson P, Saegeman V, Lagrou K, Van Ranst M. Are hantavirus infections also part of the rapidly growing spectrum of an infection-triggered reactive haemophagocytic syndrome? Clin Microbiol Infect 2016; 22:745-6. [PMID: 27263030 DOI: 10.1016/j.cmi.2016.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 05/16/2016] [Indexed: 10/21/2022]
Affiliation(s)
- J Clement
- National Hantavirus Reference Centre, Laboratory of Clinical and Epidemiological Virology and Rega Institute for Medical Research, University of Leuven, Leuven, Belgium.
| | - P Colson
- Clinique et Maternite Sainte-Elisabeth, Emergency Department, Namur, Belgium
| | - V Saegeman
- Microbiology and Immunology & Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - K Lagrou
- Microbiology and Immunology & Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - M Van Ranst
- Microbiology and Immunology & Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
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20
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Clement J, Hee RV, Ysebaert D, Verpoote G, Broe MD. Abstacts of the meeting of the Belgian Society of Internal Medicine (10 February 1990). Acta Clin Belg 2016. [DOI: 10.1080/17843286.1990.11718080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Clement J, Mckenna P, Ghoos S, Thomas I, Loock FV, Colson P. Abstracts of the meeting of the Belgian Society of Internal Medicine (20 January 1996). Acta Clin Belg 2016. [DOI: 10.1080/17843286.1996.11718498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Clement J, Mckenna P, Leirs H, Kunz C. Abstracts of the meeting of the Belgian Society oflnternal Medicine (29 January 1994). Acta Clin Belg 2016. [DOI: 10.1080/17843286.1994.11718376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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23
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Cormont A, Siepel H, Clement J, Melman T, WallisDeVries M, van Turnhout C, Sparrius L, Reemer M, Biesmeijer J, Berendse F, de Snoo G. Landscape complexity and farmland biodiversity: Evaluating the CAP target on natural elements. J Nat Conserv 2016. [DOI: 10.1016/j.jnc.2015.12.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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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24
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Clement J, Colson P, Saegeman V, Lagrou K, Van Ranst M. 'Bedside assessment' of acute hantavirus infections and their possible classification into the spectrum of haemophagocytic syndromes. Eur J Clin Microbiol Infect Dis 2016; 35:1101-6. [PMID: 27101352 DOI: 10.1007/s10096-016-2638-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 03/20/2016] [Indexed: 11/29/2022]
Abstract
Hantavirus infections, recently renamed 'hantavirus fever' (HTVF), belong to the most common but also most underestimated zoonoses in the world. A small number of reports described the so-called 'lipid paradox' in HTVF, i.e. the striking contrast between a very low serum total cholesterol and/or high-density lipoprotein cholesterol (HDLc), and a paradoxical concomitant hypertriglyceridaemia. In a prospective study, with patients being their own control after illness, we wanted to verify if this quick and easy 'bedside test' was robust enough to warrant a preliminary diagnosis of acute kidney injury (AKI) caused by HTVF. The study cohort consisted of 58 Belgian cases (mean age 44 years), admitted with varying degrees of AKI and of thrombocytopaenia, both characteristic for presumptive HTVF. All cases were sero-confirmed as having acute HTVF. At or shortly after hospital admission, a significant (p < 0.001) decrease of total cholesterol and HDLc was found in comparison with normalised levels in the same cohort, quantified a few days after spontaneous AKI recovery. Conversely, fasting triglyceride levels during HTVF infection were significantly (p < 0.001) higher during illness than after recovery. This 'lipid paradox' was most outspoken in severe HTVF cases, often accompanying, or even predicting, major kidney or lung complications. Thus, this 'bedside assessment' seems to hold even promise for presumptive diagnosis of more severe so-called 'hantavirus cardio-pulmonary syndrome' (HCPS) cases, mostly described hitherto in the New World. In more severe AKI cases, the mean total cholesterol was significantly lower (p = 0.02) than in milder cases, i.e. cases with peak serum creatinine levels of < 1.5 mg/dL. Thrombocytopaenia, generally accepted as the severity index in HTVF, appeared, moreover, significantly correlated with serum levels of total cholesterol (R = 0.52, p < 0.001) and with serum levels of HDLc (R = 0.45, p < 0.01). A link with the novel clinical entity of haemophagocytic syndromes, also characterised by manifest hypertriglyceridaemia, is discussed.
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Affiliation(s)
- J Clement
- National Reference Centre for Hantavirus Infections, Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.
| | - P Colson
- Emergency Unit, Clinique Sainte Elisabeth, Namur, Belgium
| | - V Saegeman
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - K Lagrou
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - M Van Ranst
- National Reference Centre for Hantavirus Infections, Laboratory of Clinical and Epidemiological Virology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.,Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
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25
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Damas S, Wilkinson C, Kahana T, Veselovskaya E, Abramov A, Jankauskas R, Jayaprakash PT, Ruiz E, Navarro F, Huete MI, Cunha E, Cavalli F, Clement J, Lestón P, Molinero F, Briers T, Viegas F, Imaizumi K, Humpire D, Ibáñez O. Study on the performance of different craniofacial superimposition approaches (II): Best practices proposal. Forensic Sci Int 2015; 257:504-508. [PMID: 26482539 DOI: 10.1016/j.forsciint.2015.07.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 07/25/2014] [Revised: 05/21/2015] [Accepted: 07/27/2015] [Indexed: 11/18/2022]
Abstract
Craniofacial superimposition, although existing for one century, is still a controversial technique within the scientific community. Objective and unbiased validation studies over a significant number of cases are required to establish a more solid picture on the reliability. However, there is lack of protocols and standards in the application of the technique leading to contradictory information concerning reliability. Instead of following a uniform methodology, every expert tends to apply his own approach to the problem, based on the available technology and deep knowledge on human craniofacial anatomy, soft tissues, and their relationships. The aim of this study was to assess the reliability of different craniofacial superimposition methodologies and the corresponding technical approaches to this type of identification. With all the data generated, some of the most representative experts in craniofacial identification joined in a discussion intended to identify and agree on the most important issues that have to be considered to properly employ the craniofacial superimposition technique. As a consequence, the consortium has produced the current manuscript, which can be considered the first standard in the field; including good and bad practices, sources of error and uncertainties, technological requirements and desirable features, and finally a common scale for the craniofacial matching evaluation. Such a document is intended to be part of a more complete framework for craniofacial superimposition, to be developed during the FP7-founded project MEPROCS, which will favour and standardize its proper application.
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Affiliation(s)
- S Damas
- European Centre for Soft Computing, Mieres, Spain.
| | - C Wilkinson
- Centre for Anatomy & Human Identification, University of Dundee, UK
| | - T Kahana
- Division of Identification and Forensic Sciences, Israel National Police, Jerusalem, Israel
| | - E Veselovskaya
- Institute of Ethnology and Anthropology Russian Academy of Science, Moscow, Russia
| | - A Abramov
- Main Department of Criminalistics Investigation Committee of Russia, Moscow, Russia
| | - R Jankauskas
- Department of Anatomy, Histology and Anthropology, Vilnius University, Vilnius, Lithuania
| | - P T Jayaprakash
- Science Program, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - E Ruiz
- Legal Medicine School, Complutense University of Madrid, Spain
| | - F Navarro
- Physical Anthropology Laboratory, University of Granada, Granada, Spain
| | - M I Huete
- Physical Anthropology Laboratory, University of Granada, Granada, Spain
| | - E Cunha
- Forensic Sciences Centre (CENCIFOR), Coimbra, Portugal; Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - F Cavalli
- Research Unit of Paleoradiology and Allied Sciences, Ospedali Riuniti di Trieste, Trieste, Italy
| | - J Clement
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - P Lestón
- Department of Identification - Criminalist Services, Civil Guard, Madrid, Spain
| | - F Molinero
- Department of Identification - Criminalist Services, Civil Guard, Madrid, Spain
| | - T Briers
- South Africa Police Service, Pretoria, South Africa
| | - F Viegas
- Crime Scene Investigation Section, Forensic Laboratory, Portuguese Criminal Police, Lisbon, Portugal
| | - K Imaizumi
- National Research Institute of Police Science, Japan
| | | | - O Ibáñez
- European Centre for Soft Computing, Mieres, Spain; Department of Computer Science and Artificial Intelligence, University of Granada, Granada, Spain
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Singh T, Wiesenfeld D, Clement J, Chandu A, Nastri A. Ameloblastoma: demographic data and treatment outcomes from Melbourne, Australia. Aust Dent J 2015; 60:24-9. [PMID: 25329538 DOI: 10.1111/adj.12244] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is a lack of published data on the demographics and treatment outcomes of ameloblastomas treated in Australia. Our objective was to collect this data and compare the findings to other international studies. METHODS A retrospective study of 42 patients with ameloblastoma was conducted at The Royal Melbourne Hospital, Australia. Data on the demographic features, management techniques (ablative and reconstructive), and outcomes were collected and analysed. RESULTS The majority of tumours were solid/multicystic (81%) and occurred most commonly in the mandible (80.5%). Unicystic ameloblastomas affected a younger age group, with Type 3 being the most common subtype. Overall, the recurrence rate for solid/multicystic ameloblastomas was 14.7%; however, radical surgery was found to have a significantly lower recurrence rate when compared to conservative management (p=0.015), with a mean of 51 months follow-up. Results indicated that vascularized free-flaps had fewer postoperative complications than non-vascularized bone grafts; however, the differences did not reach statistical significance. CONCLUSIONS This is the largest clinicopathological study regarding ameloblastoma management from Australia, and our results support the current literature in recommending radical surgery for the treatment of solid/multicystic and Type 3 unicystic tumours.
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Affiliation(s)
- T Singh
- Oral and Maxillofacial Surgery, The Royal Melbourne Hospital, Parkville, Victoria; Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria
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28
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Clement J, Van Esbroeck M, Lagrou K, Verschueren J, Sunil-Chandra NP, Van Ranst M. Leptospirosis versus hantavirus infections in the Netherlands and in Belgium, 2000 to 2014. ACTA ACUST UNITED AC 2014; 19. [PMID: 25306880 DOI: 10.2807/1560-7917.es2014.19.38.20912] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J Clement
- National Reference Centre for Hantaviruses, Clinical and Epidemiological Virology, University Hospitals of Leuven, Leuven, Belgium
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Affiliation(s)
- C. Greenwood
- Department of Engineering and Applied Science; Cranfield University; Shrivenham Wiltshire SN6 8LA UK
| | - K. Rogers
- Department of Engineering and Applied Science; Cranfield University; Shrivenham Wiltshire SN6 8LA UK
| | - S. Beckett
- Department of Engineering and Applied Science; Cranfield University; Shrivenham Wiltshire SN6 8LA UK
| | - J. Clement
- Faculty of Medicine; Dentistry and Health Science; Melbourne Dental School; The University of Melbourne; 720 Swanston Street Melbourne 3010 Vic. Australia
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30
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Clement J, Vergote V, Laenen L, Van Ranst M. Letter to the editor: Distinguishing between hantavirus-induced haemorrhagic fever with renal syndrome and pregnancy-induced liver pathologies (AFLP and HELLP syndromes). Euro Surveill 2013. [DOI: 10.2807/ese.18.22.20493-en] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J Clement
- National Reference Laboratory for Hantavirus Infections, Laboratory of Clinical Virology, University Hospital Gasthuisberg, Leuven, Belgium
| | - V Vergote
- National Reference Laboratory for Hantavirus Infections, Laboratory of Clinical Virology, University Hospital Gasthuisberg, Leuven, Belgium
| | - L Laenen
- National Reference Laboratory for Hantavirus Infections, Laboratory of Clinical Virology, University Hospital Gasthuisberg, Leuven, Belgium
| | - M Van Ranst
- National Reference Laboratory for Hantavirus Infections, Laboratory of Clinical Virology, University Hospital Gasthuisberg, Leuven, Belgium
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Clement J, Vergote V, Laenen L, Van Ranst M. Distinguishing between hantavirus-induced haemorrhagic fever with renal syndrome and pregnancy-induced liver pathologies (AFLP and HELLP syndromes. Euro Surveill 2013; 18:20493. [PMID: 23787079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
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Gizzi M, Delaere B, Weynand B, Clement J, Maes P, Vergote V, Laenen L, Hjelle B, Verroken A, Dive A, Michaux I, Evrard P, Creytens D, Bulpa P. Another case of "European hantavirus pulmonary syndrome" with severe lung, prior to kidney, involvement, and diagnosed by viral inclusions in lung macrophages. Eur J Clin Microbiol Infect Dis 2013; 32:1341-5. [PMID: 23670277 PMCID: PMC7102061 DOI: 10.1007/s10096-013-1885-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 04/17/2013] [Indexed: 12/24/2022]
Abstract
Puumala virus (PUUV) is considered a classic Old World etiologic agent of nephropathia epidemica (NE), or hemorrhagic fever with renal syndrome (HFRS). HFRS is considered to be distinct from hantavirus (cardio-)pulmonary syndrome (HPS or HCPS), described in the New World. Here, we report a severe case, which fulfilled most, if not all, Centers for Disease Control and Prevention (CDC) criteria for HPS, needing non-invasive ventilation and subsequent acute hemodialysis. However, the etiological agent was PUUV, as proved by serological testing, real-time polymerase chain reaction (PCR), and sequencing. Viral antigen was detected by specific anti-PUUV immunostaining, showing, for the first time, greenish intracytoplasmic inclusions in bronchoalveolar lavage (BAL) macrophages. This case definitely confirms that HPS can be encountered during PUUV infections. Interestingly, special findings could render the diagnosis easier, such as greenish homogeneous cytoplasmic inclusions, surrounded by a fine clear halo in BAL macrophages. Therefore, although the diagnosis remains difficult before the onset of renal involvement, the occurrence of severe respiratory failure mimicking community-acquired pneumonia must alert the clinician for possible HPS, especially in endemic areas.
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Affiliation(s)
- M. Gizzi
- Intensive Care Unit, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, 5530 Yvoir, Belgium
| | - B. Delaere
- Infectious Diseases Unit, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - B. Weynand
- Pathology Unit, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - J. Clement
- National Reference Centre for Hantaviruses, University Hospitals Leuven, Gasthuisberg, University of Leuven, Leuven, KU Belgium
- Zoonotic Infectious Diseases unit, Clinical Virology, Rega Institute for Medical Research, Leuven, KU Belgium
| | - P. Maes
- National Reference Centre for Hantaviruses, University Hospitals Leuven, Gasthuisberg, University of Leuven, Leuven, KU Belgium
- Zoonotic Infectious Diseases unit, Clinical Virology, Rega Institute for Medical Research, Leuven, KU Belgium
| | - V. Vergote
- National Reference Centre for Hantaviruses, University Hospitals Leuven, Gasthuisberg, University of Leuven, Leuven, KU Belgium
- Zoonotic Infectious Diseases unit, Clinical Virology, Rega Institute for Medical Research, Leuven, KU Belgium
| | - L. Laenen
- National Reference Centre for Hantaviruses, University Hospitals Leuven, Gasthuisberg, University of Leuven, Leuven, KU Belgium
- Zoonotic Infectious Diseases unit, Clinical Virology, Rega Institute for Medical Research, Leuven, KU Belgium
| | - B. Hjelle
- Departments of Pathology, Biology, Molecular Genetics and Microbiology, Center for Infectious Diseases and Immunity, University of New Mexico, Albuquerque, NM USA
| | - A. Verroken
- Microbiology Unit, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - A. Dive
- Intensive Care Unit, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, 5530 Yvoir, Belgium
| | - I. Michaux
- Intensive Care Unit, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, 5530 Yvoir, Belgium
| | - P. Evrard
- Intensive Care Unit, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, 5530 Yvoir, Belgium
| | - D. Creytens
- Pathology Department, University Hospital Ghent, Ghent, Belgium
| | - P. Bulpa
- Intensive Care Unit, Centre Hospitalier Universitaire de Mont-Godinne, Université Catholique de Louvain, 5530 Yvoir, Belgium
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Galsky MD, Hendricks R, Svatek R, Bangs R, Hoffman-Censits J, Clement J, Dreicer R, Guancial E, Hahn N, Lerner SP, O'Donnell PH, Quale DZ, Siefker-Radtke A, Shipley W, Sonpavde G, Vaena D, Vinson J, Rosenberg J. Critical analysis of contemporary clinical research in muscle-invasive and metastatic urothelial cancer: a report from the Bladder Cancer Advocacy Network Clinical Trials Working Group. Cancer 2013; 119:1994-8. [PMID: 23456777 DOI: 10.1002/cncr.27973] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 11/06/2012] [Accepted: 11/19/2012] [Indexed: 11/08/2022]
Abstract
BACKGROUND There have been no improvements in the treatment of metastatic urothelial cancer in the past several decades. A census of contemporary clinical research in this disease was performed to identify potential barriers and opportunities. METHODS These authors performed a search for clinical trials exploring interventions in muscle-invasive and metastatic urothelial cancer, using the ClinicalTrials.gov registry. Data extracted from the registry included title, recruitment status, interventions, sponsor, phase, enrollment, study design, and study sites. RESULTS Among 120 eligible trials exploring interventions in muscle-invasive and metastatic urothelial cancer, 73% were phase 2 and 73% were nonrandomized. The majority (63%) involved treatment in the metastatic disease state. The median planned enrollment size per trial was 45 patients (interquartile range, 47 patients). The majority of trials (55%) involved ≤ 3 study sites. Trials most commonly explored interventions in the first-line metastatic (30%) or second-line metastatic (37%) settings. Targeted therapeutics were studied in 58% of the trials. Among 56 trials that completed enrollment, the median time to complete accrual was 50 months (range, 10-109 months), and these trials enrolled a median of 40 patients per trial (interquartile range, 44 patients). CONCLUSIONS The majority of contemporary clinical trials in muscle-invasive and metastatic urothelial cancer are small, nonrandomized, phase 2 trials involving 1 to 3 study sites. Enhanced communication and collaboration among the urothelial cancer community, and other stakeholders, is needed to facilitate the design and conduct of trials capable of expediting progress in this disease.
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Affiliation(s)
- Matthew D Galsky
- Mount Sinai School of Medicine, Tisch Cancer Institute, New York, NY 10029, USA.
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Haredasht SA, Taylor CJ, Maes P, Verstraeten WW, Clement J, Barrios M, Lagrou K, Van Ranst M, Coppin P, Berckmans D, Aerts JM. Model-Based Prediction of Nephropathia Epidemica Outbreaks Based on Climatological and Vegetation Data and Bank Vole Population Dynamics. Zoonoses Public Health 2012; 60:461-77. [DOI: 10.1111/zph.12021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [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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Greenwood C, Rogers K, Beckett S, Clement J. Bone mineral crystallisation kinetics. J Mater Sci Mater Med 2012; 23:2055-2060. [PMID: 22743865 DOI: 10.1007/s10856-012-4679-2] [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] [Received: 10/07/2011] [Accepted: 05/11/2012] [Indexed: 06/01/2023]
Abstract
The kinetics of bone apatite crystallisation are examined using a novel approach to obtain quantitative, direction dependence features such as growth rate and activation energy. X-ray diffraction was employed for analysis of bovine, porcine and 'anorganic' bone specimens. Apatite coherence length was utilised as the independent variable within a Johnson-Mehl-Avrami (JMA) model. A direction averaged crystallisation activation energy of 183 ± 8 kJ mol(-1) was observed for the three bone groups. The Johnson-Mehl-Avrami 'n' exponent decreased with increasing temperature for all bone groups, indicating that apatite crystallisation changes to a diffusion limited process at higher temperatures. The results revealed little evidence to support any organic component 'protective' effect, and, on the contrary indicated that the organic matrix promotes apatite crystallisation.
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Affiliation(s)
- C Greenwood
- Department of Engineering and Applied Science, Cranfield University, Shrivenham, Wiltshire, SN6 8LA, UK.
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Clement J, Maes P, Lagrou K, Van Ranst M, Lameire N. A unifying hypothesis and a single name for a complex globally emerging infection: hantavirus disease. Eur J Clin Microbiol Infect Dis 2012; 31:1-5. [PMID: 22068273 PMCID: PMC7101631 DOI: 10.1007/s10096-011-1456-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 10/11/2011] [Indexed: 12/11/2022]
Affiliation(s)
- J. Clement
- National Reference Laboratory for Hantavirus Infections, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - P. Maes
- National Reference Laboratory for Hantavirus Infections, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - K. Lagrou
- National Reference Laboratory for Hantavirus Infections, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - M. Van Ranst
- National Reference Laboratory for Hantavirus Infections, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium
| | - N. Lameire
- Nephrology, University Hospital Gent, De Pintelaan 85, 9000 Gent, Belgium
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Claes P, Walters M, Clement J. Improved facial outcome assessment using a 3D anthropometric mask. Int J Oral Maxillofac Surg 2011; 41:324-30. [PMID: 22103995 DOI: 10.1016/j.ijom.2011.10.019] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 08/16/2011] [Accepted: 10/20/2011] [Indexed: 11/29/2022]
Abstract
The capacity to process three-dimensional facial surfaces to objectively assess outcomes of craniomaxillofacial care is urgently required. Available surface registration techniques depart from conventional facial anthropometrics by not including anatomical relationship in their analysis. Current registrations rely on the manual selection of areas or points that have not moved during surgery, introducing subjectivity. An improved technique is proposed based on the concept of an anthropometric mask (AM) combined with robust superimposition. The AM is the equivalent to landmark definitions, as used in traditional anthropometrics, but described in a spatially dense way using (∼10.000) quasi-landmarks. A robust superimposition is performed to align surface images facilitating accurate measurement of spatial differences between corresponding quasi-landmarks. The assessment describes magnitude and direction of change objectively and can be displayed graphically. The technique was applied to three patients, without any modification and prior knowledge: a 4-year-old boy with Treacher-Collins syndrome in a resting and smiling pose; surgical correction for hemimandibular hypoplasia; and mandibular hypoplasia with staged orthognathic procedures. Comparisons were made with a reported closest-point (CP) strategy. Contrasting outcomes were found where the CP strategy resulted in anatomical implausibility whilst the AM technique was parsimonious to expected differences.
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Affiliation(s)
- P Claes
- K.U. Leuven, Medical Imaging Research Center, Faculty of Engineering, Department of Electrical Engineering - ESAT, Center for Processing Speech and Images, Herestraat 49, Leuven, Belgium.
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Haredasgt SA, Barrios M, Maes P, Clement J, Lagrou K, Ranst MV, Coppin P, Berckmans D, Aerts JM. P1-387 Time series analysis performed on nephropathia epidemica in Belgium. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976f.78] [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: 11/03/2022]
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Clement J, van der Groen G, Maes P, Van Ranst M. Puumala virus reference strain for hantavirus serodiagnosis in France. Eur J Clin Microbiol Infect Dis 2010; 29:1-2; author reply 3. [PMID: 19885688 DOI: 10.1007/s10096-009-0829-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Choueiri TK, Regan MM, Rosenberg JE, Oh WK, Clement J, Amato AM, McDermott D, Cho DC, Atkins MB, Signoretti S. Carbonic anhydrase IX and pathological features as predictors of outcome in patients with metastatic clear-cell renal cell carcinoma receiving vascular endothelial growth factor-targeted therapy. BJU Int 2010; 106:772-8. [PMID: 20230385 DOI: 10.1111/j.1464-410x.2010.09218.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To investigate the utility of tumour carbonic anhydrase IX (CAIX) expression and histological features for predicting the outcome in patients with metastatic clear-cell renal cell carcinoma (mRCC) treated with vascular endothelial growth factor (VEGF)-targeted therapy. PATIENTS AND METHODS We identified 118 patients with mRCC initiating first-line VEGF-targeted therapy, including 94 with clinical and histological data, and available tissue. The primary endpoint was to detect an interaction between sorafenib vs sunitinib treatment and CAIX status on tumour shrinkage. Other treatment outcomes were also assessed. RESULTS There was heterogeneity in tumour responsiveness to sunitinib or sorafenib according to CAIX status; the mean shrinkage was -17% vs -25% for sunitinib-treated patients with high vs low tumour CAIX expression, compared to -13% vs +9% for sorafenib-treated patients (P interaction, 0.05). A higher tumour clear-cell component was independently associated with greater tumour shrinkage (P= 0.02), response (P= 0.02) and treatment duration (P= 0.02). CONCLUSIONS Although CAIX expression had no prognostic value in patients with clear-cell mRCC treated with VEGF-targeted therapy, it might be a predictive biomarker for response to sorafenib treatment. Patients with a higher clear-cell component in their tumours are likely to have a superior clinical benefit from VEGF-targeted therapy.
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Steinert S, Sänger J, Schmidt A, Hartmann A, Höffken K, Clement J. Link between BMP expression and clinical outcome in breast carcinomas. Cell Commun Signal 2009. [PMCID: PMC4291722 DOI: 10.1186/1478-811x-7-s1-a38] [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: 11/30/2022] Open
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Steinert S, Kroll T, Taubert I, Pusch L, Hortschansky P, Höffken K, Wölfl S, Clement J. Unfolded protein response is activated by single application of BMP-2. Cell Commun Signal 2009. [PMCID: PMC4291720 DOI: 10.1186/1478-811x-7-s1-a37] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Choueiri TK, Regan M, Oh W, Clement J, Amato A, McDermott D, Cho D, Atkins M, Signoretti S. Prognostic and predictive values of carbonic anhydrase IX (CAIX) and pathologic features in patients with metastatic clear cell renal cell carcinoma receiving targeted therapy. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16067 Background: Tumor Carbonic Anhydrase IX (CAIX) expression and histologic features can predict outcome in patients with metastatic renal cell carcinoma (mRCC) treated with immunotherapy. We sought to investigate the prognostic and predictive utility of such features in patients receiving VEGF-targeted therapy. Methods: We identified 118 patients with mRCC initiating first- line VEGF-targeted therapy including 94 with clinical data, clear cell histology and available tissue. Tumors were evaluated for specific histologic features and for CAIX expression by immunohistochemistry using the MN75 antibody. The relationship between these pathology findings and tumor shrinkage and other treatment outcomes was assessed. Results: Higher tumor clear cell component was independently associated with greater tumor shrinkage (p=0.02), response (p=0.02) and treatment duration (p=0.02). Patients with high vs. low tumor CAIX expression had mean tumor shrinkages of -12% vs. -5%, respectively (p=.38). There was heterogeneity in tumor responsiveness to sunitinib or sorafenib according to CAIX status (p=0.055 for interaction): mean shrinkage was -17% vs. -25% (mean difference +8%, 95% CI -14% to +31%) for sunitinib-treated patients with high vs. low tumor CAIX expression compared to -13% vs. +9% (mean difference -22%, 95% CI -42% to -1%) for sorafenib-treated patients. Conclusions: Patients with higher clear cell component in their tumors are likely to experience superior clinical benefit from VEGF-targeted therapy. Although CAIX expression was not found to be of prognostic value in patients with clear cell mRCC treated with VEGF-targeted therapy, it may be a predictive biomarker for response to sorafenib treatment. [Table: see text]
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Affiliation(s)
- T. K. Choueiri
- Dana- Faber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - M. Regan
- Dana- Faber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - W. Oh
- Dana- Faber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - J. Clement
- Dana- Faber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - A. Amato
- Dana- Faber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - D. McDermott
- Dana- Faber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - D. Cho
- Dana- Faber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - M. Atkins
- Dana- Faber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Brigham and Women's Hospital, Boston, MA
| | - S. Signoretti
- Dana- Faber Cancer Institute, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Brigham and Women's Hospital, Boston, MA
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Abstract
OBJECTIVES To create physician awareness of complementary and alternative medicine therapy use in patients with prostate cancer so that physicians can monitor for adverse events. Approximately one fourth to one third of patients diagnosed with prostate cancer reported complementary and alternative medicine use, and many of these patients are taking a supplement called "Dr. Donsbach's Prostasol." METHODS We discuss the cases of 2 patients with prostate cancer who were taking Dr. Donsbach's Prostasol and developed venous thromboembolic events while taking this supplement, in the absence of other obvious risk factors. We review these 2 cases and the time-line for the development of the venous thromboembolic events and use of Dr. Donsbach's Prostasol. We compared Prostasol with PC-SPES, a similar supplement that was associated with thrombosis and was ultimately taken off the market because of patient safety concerns. RESULTS Prostasol contains phytoestrogens that could result in both the suppression of testosterone and the predisposition to thrombosis. Both patients had suppression of their testosterone to castrate levels with an associated decrease in prostate-specific antigen at the time of their thrombotic event. CONCLUSIONS These cases are suggestive of an association between Prostasol use and venous thromboembolic events. Physicians should be aware of the use of this agent in their patients, although it is not known whether it would be appropriate to prescribe prophylactic low-dose warfarin therapy. If possible, additional study of complementary and alternative medicine therapies for safety and efficacy are indicated.
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Affiliation(s)
- Jessica Clement
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.
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Bhalla S, van Wyngaarden C, Clement J. Abstract No. 263 EE: Pulmonary AVM’s in HHT; a Pictorial Review of Diagnosis and Embotherapy. J Vasc Interv Radiol 2008. [DOI: 10.1016/j.jvir.2007.12.297] [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] Open
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Affiliation(s)
- J Clement
- Hantavirus Reference Centre K.U. Leuven, Laboratory of Clinical and Epidemiological Virology & Rega Institute for Medical Research, University of Leuven, Belgium.
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Lamb GC, Dahlen CR, Vonnahme KA, Hansen GR, Arseneau JD, Perry GA, Walker RS, Clement J, Arthington JD. Influence of a CIDR prior to bull breeding on pregnancy rates and subsequent calving distribution. Anim Reprod Sci 2007; 108:269-78. [PMID: 17905546 DOI: 10.1016/j.anireprosci.2007.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2007] [Accepted: 08/28/2007] [Indexed: 11/18/2022]
Abstract
We determined whether insertion of a CIDR for 7 days prior to the breeding season enhanced pregnancy rates and altered the date of conception in suckled beef cows mated naturally. Suckled beef cows (n=2033) from 15 locations were randomly assigned to one of two treatments: (1) cows received a CIDR 7 days prior to the breeding season for 7 days (CIDR; n=999); (2) cows received no treatment (Control; n=1034). On the first day of the breeding season bulls were introduced to herds at a rate of 15-25 cows per yearling bull or 20-30 cows per mature bull. Pregnancy status and the date of conception were determined via transrectal ultrasonography at 56 and 120 days after initiation of the breeding season. Overall pregnancy rates ranged from 59.3 to 98.9% among the 15 locations. The percentage of cows becoming pregnant during the first 30 days of the breeding season was similar between CIDR (68.2%) and Control (66.7%) cows, and overall pregnancy rates were similar between CIDR (88.9%) and Control (88.6%) cows. The average day of conception after initiation of the breeding season was shorter (P<0.01) for CIDR (20.1+/-0.8 days) compared to Control cows (23.2+/-0.8 days). Of cows conceiving during the breeding season, more (P<0.05) CIDR cows (35.9%) conceived during the first 10 days of the breeding season than Control cows (30.8%). Neither body condition score and nor parity affected pregnancy rates or days to conception, whereas pregnancy rates and days to conception were affected (P<0.01) by location and days postpartum. Days to conception were greater for cows that calved within 40 days (31.6+/-1.2 days) of initiation of the breeding season compared to cows calving between 40 and 50 days (25.3+/-1.2 days) prior to initiation of the breeding season, which were greater than those cows calving between 50-60 days (20.0+/-0.8 days) and 60-70 days (21.3+/-1.0 days) prior to initiation of the breeding season. Cows calving greater than 70 days (17.3+/-1.5 days) from initiation of the breeding season had the shortest interval to conception. We concluded that insertion of a CIDR prior to the breeding season failed to increase overall pregnancy rates, but did influence the average day of conception.
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Affiliation(s)
- G C Lamb
- North Central Research and Outreach Center, University of Minnesota, 1861 Highway 169E, Grand Rapids, MN 55744, USA.
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Beaulieu MC, Gabana C, Rose C, MacDonald PS, Clement J, Kiaii M. Stenosis at the area of transposition - an under-recognized complication of transposed brachiobasilic fistulas. J Vasc Access 2007; 8:268-274. [PMID: 18161673] [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: 05/25/2023] Open
Abstract
BACKGROUND With an increased focus on native AV fistula creation in hemodialysis patients, a transposed brachiobasilic fistula (tBBF) is becoming an increasingly utilized option. This study describes the outcomes of tBBFs in a chronic hemodialysis population. In particular, we focus on the incidence and location of stenosis, and review the impact of angioplasty on these lesions. METHODS A retrospective cohort study using all patients with a tBBF created between January 2001 and December 2004. RESULTS Of the 543 fistulas created during the study period, 93 were tBBFs. The mean age of patients was 65 years, 56% were male and 55% were diabetic. Stenosis occurred in 54% (46/85) of fistulas; the location of stenosis in the majority (74%) was at or near the area of basilic vein transposition and 50% of fistulas with stenosis in this location required three or more angioplasties. Primary (unassisted) patency was 42% at one year in this cohort. Secondary patency was 68% at 1 year and 58% and 53% at 2 and 3 years respectively. CONCLUSION In a cohort of hemodialysis patients who received a tBBF, we describe a reasonable primary and secondary patency rate and a high rate of stenosis at the point of transposition of the basilic vein. Such stenosis usually requires multiple percutaneous or surgical interventions to ensure or reestablish conduit patency. Further study is required regarding the optimal surgical technique, monitoring, and treatment of stenosis of this fistula type including the utility of repeat angioplasty.
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Affiliation(s)
- M C Beaulieu
- Division of Nephrology, St. Paul's Hospital, Vancouver, British Columbia, Canada.
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Pachmann K, Camara O, Lobodasch K, Clement J, Dengler R, Hoeffken K. Monitoring of circulating tumor cells during systemic therapy allows distinguishing breast cancer patients at risk for relapse. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11006 Background: Recent refinement of methods, allowing detection of minimal numbers of residual cells from malignant tumors have reactivated the debate, to what extent single tumor cells in lymph nodes, bone marrow and peripheral blood can be considered as “micrometastases”. The presence of such cells, indeed, reflects only the first step in the metastatic process, dissemination, and the formation of metastases from such cells seems to be quite ineffective. If, however these cells react to therapy in an identical way as the tumor itself, these cells can be used to monitor therapy response very early during primary systemic (neoadjuvant) therapy, during adjuvant therapy, where no other target is available to control therapy success and already during therapy initiation in metastatic disease. Methods: Circulating epithelial cells were enumerated from 1 ml of anticoagulated blood after red blood cell lysis, staining of live cells with a fluorochrome labeled anti-epithelial antibody and automated microscopy before and after each chemotherapy cycle for monitoring of therapy success. Results: The response of the peripherally circulating cells of 35 patients with breast cancer treated with neoadjuvant chemotherapy varied from marginal (less than tenfold) to highly responsive (more than thousand fold) already during the first three to four courses and showed identical response to therapy as the whole tumor with a correlation of p > 0.9. The method was subsequently applied to monitor the response of such cells in the adjuvant treatment. In the first 25 patients with a follow up of more than 4 years, an increase in cell numbers already from the begin of therapy or following an initial response was observed in 20% of patients and all of these patients have subsequently relapsed (p<0,0001). These results have now been corroborated in a total of 148 patients, confirming a hazard ratio of 25 for relapse in the following 5 years for patients with increasing cell numbers during therapy independent of therapy regimen and a significance of p<0.0001. Conclusions: Quantitative monitoring of circulating tumor cells can be used as a tool for therapy survey in breast cancer in the absence of manifest tumor. No significant financial relationships to disclose.
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Affiliation(s)
- K. Pachmann
- Clinic for Internal Medicine II, Jena, Germany; Friedrich Schiller University, Jena, Germany; DRK Krankenhaus Chemnitz Rabenstein, Chemnitz, Germany; Practice for Hematology and Oncology, Regensburg, Germany
| | - O. Camara
- Clinic for Internal Medicine II, Jena, Germany; Friedrich Schiller University, Jena, Germany; DRK Krankenhaus Chemnitz Rabenstein, Chemnitz, Germany; Practice for Hematology and Oncology, Regensburg, Germany
| | - K. Lobodasch
- Clinic for Internal Medicine II, Jena, Germany; Friedrich Schiller University, Jena, Germany; DRK Krankenhaus Chemnitz Rabenstein, Chemnitz, Germany; Practice for Hematology and Oncology, Regensburg, Germany
| | - J. Clement
- Clinic for Internal Medicine II, Jena, Germany; Friedrich Schiller University, Jena, Germany; DRK Krankenhaus Chemnitz Rabenstein, Chemnitz, Germany; Practice for Hematology and Oncology, Regensburg, Germany
| | - R. Dengler
- Clinic for Internal Medicine II, Jena, Germany; Friedrich Schiller University, Jena, Germany; DRK Krankenhaus Chemnitz Rabenstein, Chemnitz, Germany; Practice for Hematology and Oncology, Regensburg, Germany
| | - K. Hoeffken
- Clinic for Internal Medicine II, Jena, Germany; Friedrich Schiller University, Jena, Germany; DRK Krankenhaus Chemnitz Rabenstein, Chemnitz, Germany; Practice for Hematology and Oncology, Regensburg, Germany
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