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Do VV, Spears CA, Ling PM, Eriksen MP, Weaver SR, Pechacek TF, Nyman AL, Emery SL, Berg CJ, Huang J. Racial/ethnic disparities in exposure to e-cigarette advertising among U.S. youth. Public Health 2024; 230:89-95. [PMID: 38521029 DOI: 10.1016/j.puhe.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/07/2024] [Accepted: 02/14/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVES This study aims to assess exposure to e-cigarette advertising across multiple marketing channels among U.S. youth and to examine whether racial/ethnic disparities exist in exposure to e-cigarette advertisements. STUDY DESIGN This is a cross-sectional study. METHODS Cross-sectional data were drawn from a longitudinal survey of participants recruited from two nationally representative panels (NORC's AmeriSpeak® and GfK's KnowledgePanel). A total of 2043 youth aged 13-17 completed the initial 2018 survey, and 2013 youth completed the follow-up survey in 2019 (including a replenishment sample of 690 youth). Outcome variables were self-reported e-cigarette advertisement exposure in the past three months through various sources, such as television, point of sale, and online/social media. Generalized estimating equation models were used to estimate the adjusted odds ratios (AOR) of the association between racial/ethnic identity and e-cigarette advertisement exposure. RESULTS The prevalence of reported exposure to e-cigarette advertisements through any channel was 79.8% (95% CI: 77.1-82.2) in 2018 and 74.9% (95% CI: 72.5-77.1) in 2019, respectively. Point of sale was the most common source of e-cigarette advertisement exposure in both years. Non-Hispanic Black and non-Hispanic Asian youth were more likely to report exposure to e-cigarette advertisements through television (AOR = 2.07, 95% CI: 1.44-2.99 and AOR = 2.11, 95% CI: 1.17-3.82, respectively) and online/social media (AOR = 1.61; 95% CI: 1.11-2.33 and AOR = 1.99, 95% CI: 1.10-3.59, respectively) channels compared with non-Hispanic White youth. CONCLUSIONS A substantial proportion of U.S. youth reported exposure to e-cigarette advertising through a variety of marketing channels. Significant racial/ethnic disparities existed, with non-Hispanic Black and Asian youth reporting more marketing exposure than their non-Hispanic White counterparts.
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Affiliation(s)
- V V Do
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - C A Spears
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - P M Ling
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA; Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - M P Eriksen
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - S R Weaver
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - T F Pechacek
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - A L Nyman
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - S L Emery
- NORC at University of Chicago, Chicago, IL, USA
| | - C J Berg
- Department of Prevention & Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - J Huang
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA.
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Kang L, Tang B, Huang J, Li J. 3D-MRI super-resolution reconstruction using multi-modality based on multi-resolution CNN. Comput Methods Programs Biomed 2024; 248:108110. [PMID: 38452685 DOI: 10.1016/j.cmpb.2024.108110] [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: 10/07/2023] [Revised: 01/28/2024] [Accepted: 03/01/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND AND OBJECTIVE High-resolution (HR) MR images provide rich structural detail to assist physicians in clinical diagnosis and treatment plan. However, it is arduous to acquire HR MRI due to equipment limitations, scanning time or patient comfort. Instead, HR MRI could be obtained through a number of computer assisted post-processing methods that have proven to be effective and reliable. This paper aims to develop a convolutional neural network (CNN) based super-resolution reconstruction framework for low-resolution (LR) T2w images. METHOD In this paper, we propose a novel multi-modal HR MRI generation framework based on deep learning techniques. Specifically, we construct a CNN based on multi-resolution analysis to learn an end-to-end mapping between LR T2w and HR T2w, where HR T1w is fed into the network to offer detailed a priori information to help generate HR T2w. Furthermore, a low-frequency filtering module is introduced to filter out the interference from HR-T1w during high-frequency information extraction. Based on the idea of multi-resolution analysis, detailed features extracted from HR T1w and LR T2w are fused at two scales in the network and then HR T2w is reconstructed by upsampling and dense connectivity module. RESULTS Extensive quantitative and qualitative evaluations demonstrate that the proposed method enhances the recovered HR T2w details and outperforms other state-of-the-art methods. In addition, the experimental results also suggest that our network has a lightweight structure and favorable generalization performance. CONCLUSION The results show that the proposed method is capable of reconstructing HR T2w with higher accuracy. Meanwhile, the super-resolution reconstruction results on other dataset illustrate the excellent generalization ability of the method.
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Affiliation(s)
- Li Kang
- College of Electronics and Information Engineering, Shenzhen University, the Guangdong Key Laboratory of Intelligent Information Processing, Shenzhen, 518060, China
| | - Bin Tang
- College of Electronics and Information Engineering, Shenzhen University, the Guangdong Key Laboratory of Intelligent Information Processing, Shenzhen, 518060, China
| | - Jianjun Huang
- College of Electronics and Information Engineering, Shenzhen University, the Guangdong Key Laboratory of Intelligent Information Processing, Shenzhen, 518060, China.
| | - Jianping Li
- College of Electronics and Information Engineering, Shenzhen University, the Guangdong Key Laboratory of Intelligent Information Processing, Shenzhen, 518060, China
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Walsh ME, Retzler R, Huang J, Daglish A, Tweedie D, Pepper C. A prospective cohort study exploring the impact of tonsillectomy on feeding difficulties in children. Clin Otolaryngol 2024; 49:314-319. [PMID: 38415339 DOI: 10.1111/coa.14148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/06/2023] [Accepted: 02/11/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES Paediatric feeding difficulties are common, affecting up to 25% of otherwise healthy children, symptoms include food refusal, gagging, choking, and excessive mealtime duration. These symptoms are commonly described in pre-operative discussions about tonsillectomy. This prospective study explores the impact of tonsillectomy on paediatric feeding difficulties. DESIGN This prospective cohort study invited caregivers of children undergoing tonsillectomy to complete a PediEAT questionnaire about their children's feeding behaviours, pre and post-operatively. The study was completed in two phases with 9 questions administered in phase 1 and three additional questions added for phase 2. A free text comments box was also provided. Responses were graded from 0 to 5, where 0 is 'never a problem' and 5 is 'always a problem' with eating behaviours. SETTING The study was conducted at our institution, a tertiary paediatric ENT unit. PARTICIPANTS Children aged between 6 months - 7 years undergoing tonsillectomy for any indication were invited to participate. MAIN OUTCOME MEASURES Changes to the Pedi-EAT scores pre and post operatively were the main outcome measure. RESULTS 102 participants were recruited between January 2020 and January 2022. The mean age of participants was 4.1 years, 87% had a concurrent adenoidectomy. The mean time to completion of post-operative questionnaire was 23 weeks after surgery. 9 of the 12 questions showed a statistically significant improvement in post-operative scores using a paired student t-test (p < 0.05). The most significant improvements related to 'gets tired from eating and is not able to finish' (1.49 pre-op, 0.91 post op, p < 0.01) and 'eats food that needs to be chewed' (1.4 pre-op, 0.72 post-op, p < 0.01). 13% of participants only underwent tonsillectomy and this group also showed a statistically significant improvement in fatigue during eating (p < 0.05). CONCLUSION Symptoms of fatigue during eating and avoidance of food requiring mastication are most likely to improve following tonsillectomy in children.
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Affiliation(s)
- M E Walsh
- Evelina London Childrens' Hospital, London, UK
| | - R Retzler
- Evelina London Childrens' Hospital, London, UK
| | - J Huang
- Evelina London Childrens' Hospital, London, UK
| | - A Daglish
- Evelina London Childrens' Hospital, London, UK
| | - D Tweedie
- Evelina London Childrens' Hospital, London, UK
| | - C Pepper
- Evelina London Childrens' Hospital, London, UK
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Ding S, Garofalo AM, Wang HQ, Weisberg DB, Li ZY, Jian X, Eldon D, Victor BS, Marinoni A, Hu QM, Carvalho IS, Odstrčil T, Wang L, Hyatt AW, Osborne TH, Gong XZ, Qian JP, Huang J, McClenaghan J, Holcomb CT, Hanson JM. A high-density and high-confinement tokamak plasma regime for fusion energy. Nature 2024:10.1038/s41586-024-07313-3. [PMID: 38658758 DOI: 10.1038/s41586-024-07313-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 03/14/2024] [Indexed: 04/26/2024]
Abstract
The tokamak approach, utilizing a toroidal magnetic field configuration to confine a hot plasma, is one of the most promising designs for developing reactors that can exploit nuclear fusion to generate electrical energy1,2. To reach the goal of an economical reactor, most tokamak reactor designs3-10 simultaneously require reaching a plasma line-averaged density above an empirical limit-the so-called Greenwald density11-and attaining an energy confinement quality better than the standard high-confinement mode12,13. However, such an operating regime has never been verified in experiments. In addition, a long-standing challenge in the high-confinement mode has been the compatibility between a high-performance core and avoiding large, transient edge perturbations that can cause very high heat loads on the plasma-facing-components in tokamaks. Here we report the demonstration of stable tokamak plasmas with a line-averaged density approximately 20% above the Greenwald density and an energy confinement quality of approximately 50% better than the standard high-confinement mode, which was realized by taking advantage of the enhanced suppression of turbulent transport granted by high density-gradients in the high-poloidal-beta scenario14,15. Furthermore, our experimental results show an integration of very low edge transient perturbations with the high normalized density and confinement core. The operating regime we report supports some critical requirements in many fusion reactor designs all over the world and opens a potential avenue to an operating point for producing economically attractive fusion energy.
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Affiliation(s)
- S Ding
- General Atomics, San Diego, CA, USA.
| | | | - H Q Wang
- General Atomics, San Diego, CA, USA
| | | | - Z Y Li
- General Atomics, San Diego, CA, USA
| | - X Jian
- General Atomics, San Diego, CA, USA
| | - D Eldon
- General Atomics, San Diego, CA, USA
| | - B S Victor
- Lawrence Livermore National Laboratory, Livermore, CA, USA
| | - A Marinoni
- Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Q M Hu
- Princeton Plasma Physics Laboratory, Princeton University, Princeton, NJ, USA
| | | | | | - L Wang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | | | | | - X Z Gong
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | - J P Qian
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | - J Huang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, China
| | | | - C T Holcomb
- Lawrence Livermore National Laboratory, Livermore, CA, USA
| | - J M Hanson
- Department of Applied Mathematics and Applied Physics, Columbia University, New York, NY, USA
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Li L, Xu Z, Jiang L, Zhuang L, Huang J, Liu D, Wu Q. Triglyceride-Glucose Index and Its Correlates: Associations with Serum Creatinine and Estimated Glomerular Filtration Rate in a Cross-Sectional Study from CHARLS 2011-2015. Metab Syndr Relat Disord 2024; 22:179-189. [PMID: 38133543 DOI: 10.1089/met.2023.0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Background: Chronic kidney disease (CKD) has emerged as a significant global public health challenge, and the estimated glomerular filtration rate (eGFR) is widely used due to its convenience, low cost, and broad clinical applicability. Concurrently, insulin resistance (IR) serves as a crucial marker of metabolic disturbance, and alternative indicators have garnered increasing attention in CKD research in recent years. Objective: This study aims to investigate the relationship between IR-related indices (TyG index, TyG-BMI index, and TyG-WC index) and serum creatinine levels, as well as the eGFR, with the intention of uncovering their potential roles in the assessment of renal function. Methods: We analyzed nationally representative cross-sectional data from a cohort of individuals aged 45 and above in China, comprising 11,608 participants. Participants were categorized into different groups based on quartiles of the TyG index, and multiple factors, including gender, age, lifestyle, and co-morbidities, were adjusted for using linear regression models. Results: By linear regression, TyG, TyG-BMI, and TyG-WC indices were significantly positively correlated with serum creatinine and significantly negatively correlated with eGFR. Results showed similar trends when TyG, TyG-BMI, and TyG-WC indices were used as categorical variables. In the fully adjusted model, the highest quartile of serum creatinine was higher than the first quartile for TyG, TyG-BMI, and TyG-WC indices, with β values of 2.673, 3.67, and 1.937 mg/dL, respectively; the highest quartile of eGFR was lower than the first quartile, with β values of -2.4, -2.955, and -1.823 mL/min/1.73 m2. P values were statistically significant. Conclusions: This study indicates a consistent correlation between the TyG index and its related indices with serum creatinine levels and eGFR among the middle aged and elderly population in China. These findings suggest the potential utility of these indices in early screening and management of the risk of chronic kidney disease.
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Affiliation(s)
- Lei Li
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Zichen Xu
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Luqing Jiang
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Lingdan Zhuang
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Jianjun Huang
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Daoqin Liu
- Department of Kidney Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Qiwen Wu
- Department of Laboratory Medicine, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
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Liu L, Li C, Yu L, Wang Y, Pan X, Huang J. Deciphering the role of SMARCA4 in cardiac disorders: Insights from single-cell studies on dilated cardiomyopathy and coronary heart disease. Cell Signal 2024; 119:111150. [PMID: 38552892 DOI: 10.1016/j.cellsig.2024.111150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 03/14/2024] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Dilated cardiomyopathy (DCM) and coronary heart disease (CHD) stand as two of the foremost causes of mortality. However, the comprehensive comprehension of the regulatory mechanisms governing DCM and CHD remains limited, particularly from the vantage point of single-cell transcriptional analysis. METHOD We used the GSE121893 dataset from the GEO database, analyzing single-cell expressions with tools like DropletUtils, Seurat, and Monocle. We also utilized the GSVA package for comparing gene roles in DCM and CHD, Finally, we conducted qRT-PCR and Western blot analyses to measure the expression levels of SMARCA4, Col1A1, Col3A1 and α-SMA, and the role of SMARCA4 on fibroblasts were explored by EdU and Transwell assay. RESULTS Our analysis identified six cell types in heart tissue, with fibroblasts showing the most interaction with other cells. DEGs in fibroblasts were linked to muscle development and morphogenesis. Pseudotime analysis revealed the dynamics of fibroblast changes in both the normal and disease groups and many transcription factors (TFs) potentially involved in this process. Among these TFs, SMARCA4 which was translated into protein BRG1, showed the most significantly difference. In vivo experiments have demonstrated that SMARCA4 indeed promoted fibroblasts proliferation and migration. CONCLUSION This study provides a clearer understanding of cell-type dynamics in heart diseases, emphasizing the role of fibroblasts and the significance of SMARCA4 in their function. Our results offer insights into the cellular mechanisms underlying DCM and CHD, potentially guiding future therapeutic strategies.
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Affiliation(s)
- Li Liu
- Department of Cardiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Youjiang Medical University for Nationalities, Baise 533000, China
| | - Chengban Li
- Graduate School of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Linxing Yu
- Graduate School of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Yubo Wang
- Graduate School of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Xingshou Pan
- Department of Cardiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Jianjun Huang
- Youjiang Medical University for Nationalities, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China.
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Wang B, Zhang C, Li K, Huang J, Sun J. Induced domestication of humic reduction-denitrification coupled bacteria improved treatment of sediment: Performance, remediation effect, and metabolic mechanisms. Environ Res 2024; 251:118761. [PMID: 38518914 DOI: 10.1016/j.envres.2024.118761] [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] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 03/24/2024]
Abstract
The high organic matter in river sediment primarily induces black and odorous rebound. Traditional humic-reducing bacteria demonstrate relatively single metabolic functions and restrain the remediation within complex sediment environments. In addition, Ca(NO3)2 is commonly utilized in synergistic with bioremediation to improve the reducing environment of sediments. In this study, a multifunctional bacterial community with humic reduction-denitrification coupled bacteria was domesticated by the step-feeding strategy in an anaerobic baffle reactor (ABR). The performance, remediation effect, and metabolic mechanisms were analyzed. The results indicated that humic-reducing bacteria (HRB) and denitrifying-humic-reducing bacteria (DF/HRB) have quinone-reduction and denitrification capabilities. The synergistic effect of DF/HRBs and Ca(NO3)2 was superior to HRBs and Ca(NO3)2 on the removal of total organic matter(TOM). Microbial community structure analysis revealed an enhanced relative abundance of denitrification and humic-reducing bacteria (e.g., Thauera, Pseudomonas, Sulfurospirillum, Desulfovibrio, Geobacter) in the DF/HRB, resulting in a superior synergistic effect of DF/HRBs with Ca(NO3)2. This work helps to present an innovative approach to domesticate humic-reducing bacteria suited for the remediation environment effectively. It also expands the application of humic-reducing bacteria for in-situ anaerobic remediation of river sediments.
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Affiliation(s)
- Bin Wang
- School of Environmental Science and Engineering, Tianjin University, Tianjin, 300350, PR China
| | - Chao Zhang
- Tianjin Academy of Eco-Environmental Sciences, Nankai, Tianjin, 300191, PR China
| | - Ketong Li
- School of Environmental Science and Engineering, Tianjin University, Tianjin, 300350, PR China
| | - Jianjun Huang
- School of Environmental Science and Engineering, Tianjin University, Tianjin, 300350, PR China
| | - Jingmei Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, 300350, PR China.
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Zelicha H, Yang J, Henning SM, Huang J, Lee RP, Thames G, Livingston EH, Heber D, Li Z. Effect of cinnamon spice on continuously monitored glycemic response in adults with prediabetes: a 4-week randomized controlled crossover trial. Am J Clin Nutr 2024; 119:649-657. [PMID: 38290699 DOI: 10.1016/j.ajcnut.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Previous clinical studies showing that cinnamon spice lowers blood glucose concentrations had inconsistent results. OBJECTIVES To determine the effect of daily cinnamon spice supplementation in an amount commonly used for seasoning on glucose concentrations in adults with obesity and prediabetes. METHODS Following a 2-wk run-in period of maintaining a low polyphenol/fiber diet, 18 participants with obesity and prediabetes underwent a 10-wk randomized, controlled, double-blind, crossover trial (mean age 51.1 y; mean fasting plasma glucose 102.9 mg/dL). The participants were randomly assigned to take cinnamon (4 g/d) or placebo for 4-wk, followed by a 2-wk washout period, and then crossed over to the other intervention for an additional 4-wk. Glucose changes were measured with continuous glucose monitoring. Oral glucose tolerance testing immediately following ingestion of cinnamon or placebo was performed at 4-time points to assess their acute effects both at the baseline and end of each intervention phase. Digestive symptom logs were obtained daily. RESULTS There were 694 follow-up days with 66,624 glucose observations. When compared with placebo, 24-h glucose concentrations were significantly lower when cinnamon was administered [mixed-models; effect size (ES) = 0.96; 95 % confidence interval (CI): -2.9, -1.5; P < 0.001]. Similarly, the mean net-area-under-the-curve (netAUC) for glucose was significantly lower than for placebo when cinnamon was given (over 24 h; ES = -0.66; 95 % CI: 2501.7, 5412.1, P = 0.01). Cinnamon supplementation resulted in lower glucose peaks compared with placebo (Δpeak 9.56 ± 9.1 mg/dL compared with 11.73 ± 8.0 mg/dL; ES = -0.57; 95 % CI: 0.8, 3.7, P = 0.027). Glucose-dependent-insulinotropic-polypeptide concentrations increased during oral glucose tolerance testing + cinnamon testing (mixed-models; ES = 0.51; 95 % CI: 1.56, 100.1, P = 0.04), whereas triglyceride concentrations decreased (mixed-models; ES = 0.55; 95 % CI: -16.0, -1.6, P = 0.02). Treatment adherence was excellent in both groups (cinnamon: 97.6 ± 3.4 % compared with placebo: 97.9 ± 3.7 %; ES = -0.15; 95 % CI: -1.8, 0.2, P = 0.5). No differences were found in digestive symptoms (abdominal pain, borborygmi, bloating, excess flatus, and stools/day) between cinnamon and placebo groups. CONCLUSIONS Cinnamon, a widely available and low-cost supplement, may contribute to better glucose control when added to the diet in people who have obesity-related prediabetes. This trial was registered at clinicaltrials.gov as NCT04342624.
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Affiliation(s)
- Hila Zelicha
- Department of Surgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jieping Yang
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Susanne M Henning
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Jianjun Huang
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Ru-Po Lee
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Gail Thames
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Edward H Livingston
- Department of Surgery, University of California, Los Angeles, Los Angeles, CA, United States
| | - David Heber
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States
| | - Zhaoping Li
- Department of Medicine, Center for Human Nutrition, David Geffen School of Medicine, Los Angeles, United States.
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Huang J, Li QY, Ji W, Guo XF, Hu XH. [Clinical and genetic analysis of a patient with HUPRA syndrome due to missense variants of SARS2 gene and literature review]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:172-179. [PMID: 38326069 DOI: 10.3760/cma.j.cn112148-20231009-00268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Objective: To explore the clinical manifestations and genotype of an infant with hyperuricemia, pulmonary hypertension, renal failure in infancy, and alkalosis syndrome (HUPRAS). Methods: Clinical data of the patient were collected. Peripheral blood samples from the patient and his parents were acquainted for whole exome sequencing. The filtrated variants were verified by Sanger sequencing. The pathogenicity of the variants was predicted by bioinformatic tools. Results: The patient is a male infant of 6 months old, carrying two missense variants in the SARS2 allele: a paternal inherited c.1205G>A (p. Arg402His) and a maternal inherited c.680G>A (p. Arg227Gln). The two variants were in extremely low population frequencies. The pathogenetic prediction tools categorized them as deleterious. Arg402 and Arg227 were highly conserved in evolution. The variants led to changes in the hydrogen bonds and hydrophobicity of seryl-tRNA synthetase encoded by SARS2. Conclusions: c.1205G>A (p. Arg402His) and c.680G>A (p. Arg227Gln) are the possible causative variants of the HUPRA syndrome.
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Affiliation(s)
- J Huang
- Department of Cardiology, Fujian Children's Hospital, Fuzhou 350011, China
| | - Q Y Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung, Blood Vessel Diseases, Beijing 100029, China
| | - W Ji
- Department of Cardiology, Shanghai Jiaotong University School of Medicine, Shanghai Children's Medical Center, Shanghai 200127, China
| | - X F Guo
- Department of Pediatrics, Fujian Provincial Maternity and Children's Hospital, Fuzhou 350001, China
| | - X H Hu
- Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
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Zhou DY, Liu C, Huang J, Xu N, Ji X, Yang KX, Peng JB, Pan H, Xu WJ, Zhu Z. [Characteristics and clinical analysis of MLH1 c.463dupC gene mutation in a Lynch syndrome family]. Zhonghua Yi Xue Za Zhi 2024; 104:547-551. [PMID: 38317368 DOI: 10.3760/cma.j.cn112137-20231122-01170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
In this study, a case of Lynch syndrome (LS) family line with a novel mutation site in the MLH1 c.463dupC gene was reported and the clinical and pathogenic genetic features of this family were analyzed. A 40-year-old female patient with colon cancer diagnosed at the First Affiliated Hospital of Kunming Medical University on October 2, 2020 was retrospectively included. The clinical data of the family were collected and the family lineage was drawn. The family tumor history met the Amsterdam Criteria Ⅱ and the diagnostic criteria of LS in Chinese, which was a typical LS family lineage. A germline code-shift missense mutation c.463dupC in the MLH1 gene located in exon 6, a possible pathogenic variant, was detected by second-generation sequencing (NGS) in the patient. Subsequently, Sanger sequencing was performed on a total of 20 direct lineage members of the family of the MLH1 gene, 7 cases were found to harbor the mutation and included in the LS high-risk control. Follow-up to October 2023 showed that the patient had endometrial and cervical polyps, one case had colorectal cancer, and two cases had intestinal polyps, all were treated with early intervention and therapy; two cases did not show any clinical symptoms. This study is the first to report a new mutation site for the potentially pathogenic MLH1 c.463dupC, providing a rationale for the pathogenicity of the mutation and standardized health management for familial carriers.
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Affiliation(s)
- D Y Zhou
- Day Surgery Center, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - C Liu
- Day Surgery Center, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - J Huang
- Department of Oncology, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - N Xu
- Department of Oncology, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - X Ji
- Day Surgery Center, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - K X Yang
- Department of Oncology, Yunnan Provincial Cancer Hospital, Kunming 650118, China
| | - J B Peng
- Department of Oncology, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - H Pan
- Day Surgery Center, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - W J Xu
- Day Surgery Center, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Z Zhu
- Day Surgery Center, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
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Wang Y, Hu D, Liu Y, Yang L, Huang J, Zhou J, Guo L, Fan X, Huang X, Peng M, Cheng C, Zhang W, Feng R, Tian X, Yu S, Xu KF. Sporadic lymphangioleiomyomatosis in a man with somatic mosaicism of TSC2 mutations, a case report. QJM 2024; 117:75-76. [PMID: 37843443 PMCID: PMC10849871 DOI: 10.1093/qjmed/hcad235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Indexed: 10/17/2023] Open
Affiliation(s)
- Y Wang
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - D Hu
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Y Liu
- McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China
| | - L Yang
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Huang
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Zhou
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - L Guo
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Center, Beijing, China
| | - X Fan
- Clinical Genome Center, Guangzhou KingMed Diagnostics Group Co., Ltd., Guangdong, China
| | - X Huang
- Clinical Genome Center, Guangzhou KingMed Diagnostics Group Co., Ltd., Guangdong, China
| | - M Peng
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - C Cheng
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - W Zhang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - R Feng
- Department of Pathology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - X Tian
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Yu
- Clinical Genome Center, Guangzhou KingMed Diagnostics Group Co., Ltd., Guangdong, China
| | - K -F Xu
- Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wang HHX, Li YT, Huang J, Zhang H, Huang W, Wong MCS. COVID-19: emerging trends, healthcare practice, artificial intelligence-assisted decision support, and implications for service innovation. Hong Kong Med J 2024; 30:7-9. [PMID: 38385214 DOI: 10.12809/hkmj245155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Affiliation(s)
- H H X Wang
- Editors, Hong Kong Medical Journal
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Young Cadre Branch, Guangdong Primary Healthcare Association, Guangzhou, China
| | - Y T Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - J Huang
- Editors, Hong Kong Medical Journal
- Centre for Health Education and Health Promotion, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - H Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - W Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - M C S Wong
- Centre for Health Education and Health Promotion, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Editor-in-Chief, Hong Kong Medical Journal
- School of Public Health, Fudan University, Shanghai, China
- The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Public Health, Peking University, Beijing, China
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13
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Lin WYY, Wong MCS, Huang J, Bai Y, Ng SC, Chan FKL. Dietary habits and physical activity during the third wave of the COVID-19 pandemic: associated factors, composite outcomes in a cross-sectional telephone survey of a Chinese population, and trend analysis. Hong Kong Med J 2024; 30:33-43. [PMID: 38369958 DOI: 10.12809/hkmj2210265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic created many challenges for Hong Kong residents attempting to maintain healthy lifestyle habits. This study aimed to measure the prevalences of unhealthy dietary habits and physical inactivity levels in Hong Kong Chinese, identify associated factors, and conduct a time trend analysis during the third wave of the COVID-19 pandemic. METHODS A cross-sectional telephone survey was conducted in Hong Kong by simple random sampling. The survey comprised socio-demographic characteristics, clinical information, the Hong Kong Diet Score (HKDS), smoking and alcohol consumption, and a Chinese version of the International Physical Activity Questionnaire Short Form. The composite outcome was low HKDS, physical inactivity, smoking, and alcohol consumption. We used 14 Health Behaviour Survey reports from 2003 to 2019 to establish a trend analysis regarding fruit and vegetable consumption, physical activity level, smoking, and alcohol consumption. RESULTS We performed 1500 complete telephone surveys with a response rate of 58.8%. Most participants were older adults (≥65 years, 66.7%), women (65.6%), and married (77.9%). The HKDS was significantly lower in men, single individuals, low-income participants, alcohol drinkers, and patients with diabetes mellitus or renal disease. Participants who were single, undergoing long-term management of medical diseases, or had diabetes or renal diseases exhibited greater likelihood of physical inactivity. CONCLUSION Prevalences of unhealthy lifestyle habits were high among men, single individuals, and chronic disease patients during the third wave of the COVID-19 pandemic in Hong Kong. The adoption of physical activity habits tended to decrease in the past two decades.
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Affiliation(s)
- W Y Y Lin
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota Innovation Center, Hong Kong SAR, China
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - J Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Y Bai
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - S C Ng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota Innovation Center, Hong Kong SAR, China
- State Key Laboratory of Digestive Disease and Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - F K L Chan
- Microbiota Innovation Center, Hong Kong SAR, China
- Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Hong Kong SAR, China
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Yan XQ, Ye MJ, Zou Q, Chen P, He ZS, Wu B, He DL, He CH, Xue XY, Ji ZG, Chen H, Zhang S, Liu YP, Zhang XD, Fu C, Xu DF, Qiu MX, Lv JJ, Huang J, Ren XB, Cheng Y, Qin WJ, Zhang X, Zhou FJ, Ma LL, Guo JM, Ding DG, Wei SZ, He Y, Guo HQ, Shi BK, Liu L, Liu F, Hu ZQ, Jin XM, Yang L, Zhu SX, Liu JH, Huang YH, Xu T, Liu B, Sun T, Wang ZJ, Jiang HW, Yu DX, Zhou AP, Jiang J, Luan GD, Jin CL, Xu J, Hu JX, Huang YR, Guo J, Zhai W, Sheng XN. Toripalimab plus axitinib versus sunitinib as first-line treatment for advanced renal cell carcinoma: RENOTORCH, a randomized, open-label, phase III study. Ann Oncol 2024; 35:190-199. [PMID: 37872020 DOI: 10.1016/j.annonc.2023.09.3108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors in combination with tyrosine kinase inhibitors are standard treatments for advanced clear cell renal cell carcinoma (RCC). This phase III RENOTORCH study compared the efficacy and safety of toripalimab plus axitinib versus sunitinib for the first-line treatment of patients with intermediate-/poor-risk advanced RCC. PATIENTS AND METHODS Patients with intermediate-/poor-risk unresectable or metastatic RCC were randomized in a ratio of 1 : 1 to receive toripalimab (240 mg intravenously once every 3 weeks) plus axitinib (5 mg orally twice daily) or sunitinib [50 mg orally once daily for 4 weeks (6-week cycle) or 2 weeks (3-week cycle)]. The primary endpoint was progression-free survival (PFS) assessed by an independent review committee (IRC). The secondary endpoints were investigator-assessed PFS, overall response rate (ORR), overall survival (OS), and safety. RESULTS A total of 421 patients were randomized to receive toripalimab plus axitinib (n = 210) or sunitinib (n = 211). With a median follow-up of 14.6 months, toripalimab plus axitinib significantly reduced the risk of disease progression or death by 35% compared with sunitinib as assessed by an IRC [hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.49-0.86; P = 0.0028]. The median PFS was 18.0 months in the toripalimab-axitinib group, whereas it was 9.8 months in the sunitinib group. The IRC-assessed ORR was significantly higher in the toripalimab-axitinib group compared with the sunitinib group (56.7% versus 30.8%; P < 0.0001). An OS trend favoring toripalimab plus axitinib was also observed (HR 0.61, 95% CI 0.40-0.92). Treatment-related grade ≥3 adverse events occurred in 61.5% of patients in the toripalimab-axitinib group and 58.6% of patients in the sunitinib group. CONCLUSION In patients with previously untreated intermediate-/poor-risk advanced RCC, toripalimab plus axitinib provided significantly longer PFS and higher ORR than sunitinib and had a manageable safety profile TRIAL REGISTRATION: ClinicalTrials.gov NCT04394975.
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Affiliation(s)
- X Q Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Genitourinary Oncology, Peking University Cancer Hospital & Institute, Beijing
| | - M J Ye
- Department of Urology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha
| | - Q Zou
- Department of Urology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing
| | - P Chen
- Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi
| | - Z S He
- Department of Urology, First Hospital of Peking University, Beijing
| | - B Wu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang
| | - D L He
- Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an
| | - C H He
- Department of Urology, Cancer Hospital of Henan Province, Zhengzhou
| | - X Y Xue
- Department of Urology, The First Affiliated Hospital, Fujian Medical University, Fuzhou
| | - Z G Ji
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - H Chen
- Department of Urology, Harbin Medical University Cancer Hospital, Harbin
| | - S Zhang
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu
| | - Y P Liu
- Department of Oncology, The First Hospital of China Medical University, Shenyang
| | - X D Zhang
- Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing
| | - C Fu
- Department of Urology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang
| | - D F Xu
- Department of Urology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai
| | - M X Qiu
- Department of Urology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu
| | - J J Lv
- Department of Urology, Provincial Hospital Affiliated to Shandong First Medical University, Jinan
| | - J Huang
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou
| | - X B Ren
- Department of Immunology and Biotherapy, Cancer Institute & Hospital, Tianjin Medical University, Tianjin
| | - Y Cheng
- Department of Medical Thoracic Oncology, Jilin Provincial Cancer Hospital, Changchun
| | - W J Qin
- Department of Urology, Xijing Hospital of Air Force Military Medical University, Xi'an
| | - X Zhang
- Department of Urology, The Third Medical Center, Chinese PLA General Hospital, Beijing
| | - F J Zhou
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou
| | - L L Ma
- Department of Urology, Peking University Third Hospital, Beijing
| | - J M Guo
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai
| | - D G Ding
- Department of Urology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou
| | - S Z Wei
- Department of Urology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan
| | - Y He
- Department of Urology, The Affiliated Hospital of Jiaxing University, Jiaxing
| | - H Q Guo
- Department of Urology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing
| | - B K Shi
- Department of Urology, Qilu Hospital of Shandong University, Jinan
| | - L Liu
- Department of Urology, Qilu Hospital of Shandong University, Jinan
| | - F Liu
- Department of Urology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou
| | - Z Q Hu
- Department of Urology, Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science & Technology, Wuhan
| | - X M Jin
- Department of Oncology, General Hospital of Ningxia Medical University, Yinchuan
| | - L Yang
- Department of Urology, The Second Hospital of Lanzhou University, Lanzhou
| | - S X Zhu
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou
| | - J H Liu
- Department of Urology, The Second Affiliated Hospital of Kunming Medical University, Kunming
| | - Y H Huang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou
| | - T Xu
- Department of Urology, Peking University People's Hospital, Beijing
| | - B Liu
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
| | - T Sun
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang
| | - Z J Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing
| | - H W Jiang
- Department of Urology, Huashan Hospital, Fudan University, Shanghai
| | - D X Yu
- Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei
| | - A P Zhou
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - J Jiang
- Department of Urology, The PLA General Hospital Army Characteristic Medical Center, Chongqing
| | - G D Luan
- Shanghai Junshi Biosciences Co., Ltd., Shanghai
| | - C L Jin
- Shanghai Junshi Biosciences Co., Ltd., Shanghai
| | - J Xu
- Shanghai Junshi Biosciences Co., Ltd., Shanghai
| | - J X Hu
- Shanghai Junshi Biosciences Co., Ltd., Shanghai
| | - Y R Huang
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - J Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Genitourinary Oncology, Peking University Cancer Hospital & Institute, Beijing
| | - W Zhai
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - X N Sheng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Genitourinary Oncology, Peking University Cancer Hospital & Institute, Beijing.
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Agostini M, Alexander A, Araujo GR, Bakalyarov AM, Balata M, Barabanov I, Baudis L, Bauer C, Belogurov S, Bettini A, Bezrukov L, Biancacci V, Bossio E, Bothe V, Brudanin V, Brugnera R, Caldwell A, Cattadori C, Chernogorov A, Comellato T, D’Andrea V, Demidova EV, Marco ND, Doroshkevich E, Fischer F, Fomina M, Gangapshev A, Garfagnini A, Gooch C, Grabmayr P, Gurentsov V, Gusev K, Hakenmüller J, Hemmer S, Hofmann W, Huang J, Hult M, Inzhechik LV, Csáthy JJ, Jochum J, Junker M, Kazalov V, Kermaïdic Y, Khushbakht H, Kihm T, Kilgus K, Kirpichnikov IV, Klimenko A, Kneißl R, Knöpfle KT, Kochetov O, Kornoukhov VN, Korošec M, Krause P, Kuzminov VV, Laubenstein M, Lindner M, Lippi I, Lubashevskiy A, Lubsandorzhiev B, Lutter G, Macolino C, Majorovits B, Maneschg W, Manzanillas L, Marshall G, Misiaszek M, Morella M, Müller Y, Nemchenok I, Pandola L, Pelczar K, Pertoldi L, Piseri P, Pullia A, Ransom C, Rauscher L, Redchuk M, Riboldi S, Rumyantseva N, Sada C, Salamida F, Schönert S, Schreiner J, Schütt M, Schütz AK, Schulz O, Schwarz M, Schwingenheuer B, Selivanenko O, Shevchik E, Shirchenko M, Shtembari L, Simgen H, Smolnikov A, Stukov D, Vasenko AA, Veresnikova A, Vignoli C, Sturm KV, Wester T, Wiesinger C, Wojcik M, Yanovich E, Zatschler B, Zhitnikov I, Zhukov SV, Zinatulina D, Zschocke A, Zsigmond AJ, Zuber K, Zuzel G. An improved limit on the neutrinoless double-electron capture of 36Ar with GERDA. Eur Phys J C Part Fields 2024; 84:34. [PMID: 38229675 PMCID: PMC10788323 DOI: 10.1140/epjc/s10052-023-12280-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/21/2023] [Indexed: 01/18/2024]
Abstract
The GERmanium Detector Array (Gerda) experiment operated enriched high-purity germanium detectors in a liquid argon cryostat, which contains 0.33% of 36 Ar, a candidate isotope for the two-neutrino double-electron capture (2ν ECEC) and therefore for the neutrinoless double-electron capture (0ν ECEC). If detected, this process would give evidence of lepton number violation and the Majorana nature of neutrinos. In the radiative 0ν ECEC of 36 Ar, a monochromatic photon is emitted with an energy of 429.88 keV, which may be detected by the Gerda germanium detectors. We searched for the 36 Ar 0ν ECEC with Gerda data, with a total live time of 4.34 year (3.08 year accumulated during Gerda Phase II and 1.26 year during Gerda Phase I). No signal was found and a 90% CL lower limit on the half-life of this process was established T 1 / 2 > 1.5 · 10 22 year. Supplementary Information The online version contains supplementary material available at 10.1140/epjc/s10052-023-12280-6.
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Huang J, Hu H, Kang L. Time Convolutional Network-Based Maneuvering Target Tracking with Azimuth-Doppler Measurement. Sensors (Basel) 2024; 24:263. [PMID: 38203124 PMCID: PMC10781359 DOI: 10.3390/s24010263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024]
Abstract
In the field of maneuvering target tracking, the combined observations of azimuth and Doppler may cause weak observation or non-observation in the application of traditional target-tracking algorithms. Additionally, traditional target tracking algorithms require pre-defined multiple mathematical models to accurately capture the complex motion states of targets, while model mismatch and unavoidable measurement noise lead to significant errors in target state prediction. To address those above challenges, in recent years, the target tracking algorithms based on neural networks, such as recurrent neural networks (RNNs), long short-term memory (LSTM) networks, and transformer architectures, have been widely used for their unique advantages to achieve accurate predictions. To better model the nonlinear relationship between the observation time series and the target state time series, as well as the contextual relationship among time series points, we present a deep learning algorithm called recursive downsample-convolve-interact neural network (RDCINN) based on convolutional neural network (CNN) that downsamples time series into subsequences and extracts multi-resolution features to enable the modeling of complex relationships between time series, which overcomes the shortcomings of traditional target tracking algorithms in using observation information inefficiently due to weak observation or non-observation. The experimental results show that our algorithm outperforms other existing algorithms in the scenario of strong maneuvering target tracking with the combined observations of azimuth and Doppler.
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Affiliation(s)
| | | | - Li Kang
- School of Intelligent Information Processing, Shenzhen University, Shenzhen 518060, China; (J.H.); (H.H.)
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Huang J, Liao LY, Jiang WJ, Li YH, Lu BM, Wen ZP, Li FJ, Fang DL, Lu GM. Identification of new subtypes and potential genetic signatures in triple-negative breast cancer using weighted gene co-expression network analysis. Eur Rev Med Pharmacol Sci 2024; 28:603-614. [PMID: 38305604 DOI: 10.26355/eurrev_202401_35057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
OBJECTIVE Triple-negative breast cancer (TNBC) is a heterogeneous disease with aggressive behavior and poor prognosis. Here, we used gene expression profiling to define new subtypes of TNBC, which may improve prevention and treatment through personalized medicine. MATERIALS AND METHODS Gene expression profiles from the public datasets GSE76250, GSE61724, GSE61723, and GES76275 were subjected to co-expression analysis to identify differentially expressed genes (DEGs) between TNBC and non-TNBC tissues. Consistency clustering was used to define TNBC subtypes, whose correlation with gene modules was analyzed. Enrichment analysis was used to identify module genes' biological functions and pathways. Single-sample gene set enrichment analysis was used to assess immune cell infiltration in the different TNBC subtypes, and the ChAMP package was used to examine methylation sites in TNBC. RESULTS A total of 4,958 DEGs in TNBC were identified, which showed the same expression differences across all datasets as in the dataset GSE76250 and clustered into 9 co-expression modules. TNBC samples clustered into two subtypes based on nine hub genes from the modules. Class I showed the most significant correlation with module 1, whose genes were related mainly to interleukin-1 response, while class II showed the most significant correlation with module 6, whose genes were related mainly to the transforming growth factor-β pathway. Class I was significantly enriched in cell cycle and DNA replication, and tumors of this subtype showed lower immune cell infiltration than class II tumors. Tumor infiltration by Th2 cells correlated positively with the expression of MCM10 and negatively with the expression of PREX2. A greater methylation of CIDEC, DLC1, EDNRB, EGR2 and SRPK1 correlated with better prognosis. CONCLUSIONS Class I TNBC, for which a useful biomarker is MCM10, may be associated with a worse prognosis than class II TNBC, for which PREX2 may serve as a biomarker.
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Affiliation(s)
- J Huang
- Department of Gland Surgery, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, Guangxi, China.
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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Huang J, Zhang XH, Cai Y, Yang D, Shi J, Xing P, Xu T, Wu L, Su W, Xu R, Wei T, Chen HJ, Yang JJ. Rationale and Design of a Phase II Trial of Combined Serplulimab and Chemotherapy in Patients with Histologically Transformed Small Cell Lung Cancer: a Prospective, Single-arm and Multicentre Study. Clin Oncol (R Coll Radiol) 2024; 36:39-45. [PMID: 37977903 DOI: 10.1016/j.clon.2023.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
AIMS Transformed small cell lung cancer (T-SCLC) is a highly aggressive clinical disease with a notably poor prognosis. It most often arises from epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) following treatment. To date, no standard treatment has been established for T-SCLC. Platinum-etoposide was the most commonly used regimen, but progression-free survival remains unsatisfactory. Therefore, there is an urgent unmet need to develop novel and effective strategies for this population. Our study, a multicentre, open-label, single-arm phase II clinical trial (NCT05957510), aims to evaluate the efficacy and safety of serplulimab plus chemotherapy in untreated T-SCLC patients after histological transformation. MATERIALS AND METHODS In total, 36 eligible participants experiencing SCLC transformation from EGFR-mutant NSCLC will be enrolled to receive combination therapy of serplulimab, etoposide and carboplatin for four to six cycles, followed by maintenance therapy with serplulimab for up to 2 years. The primary endpoint is progression-free survival; secondary endpoints include objective response rate, overall survival and safety. RESULTS Enrolment started in July 2023 and is ongoing, with an estimated completion date of December 2025. CONCLUSIONS This study aims to provide valuable insights into the efficacy and safety of combining serplulimab with chemotherapy for treating patients with T-SCLC originating from EGFR-mutant NSCLC.
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Affiliation(s)
- J Huang
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - X-H Zhang
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Y Cai
- Medical Oncology Department V, Guangdong Nongken Central Hospital, Zhanjiang, China
| | - D Yang
- The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - J Shi
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - P Xing
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - T Xu
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - L Wu
- The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - W Su
- Department of Pulmonary Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - R Xu
- Department of Oncology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - T Wei
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - H-J Chen
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - J-J Yang
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
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B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, 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P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Huang J, Mao T, Zhang J, Li Z, Wu Q. [Decreased DNase1L3 secretion and associated antibodies induce impaired degradation of NETs in patients with sporadic SLE]. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2024; 40:43-50. [PMID: 38246176] [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: 01/23/2024]
Abstract
Objective To evaluate the correlation between alterations in DNase1 and DNase1L3 enzyme activities and impairment of NET degradation in patients with sporadic SLE, and to investigate the underlying mechanism. Methods 46 sporadic SLE patients and 30 age- and sex-matched healthy individuals were recruited. Serum levels of DNase1, DNase1L3 and corresponding autoantibodies were detected by ELISA. DNase1 and DNase1L3 were isolated by immunoprecipitation; NETs and enzyme degradation activities were detected using a modified immunofluorescence. DNase1L3 secretion by PBMCs was analyzed by ELISPOT, Western blotting and reverse transcription PCR. Results Levels of H3-dsDNA and Ela-dsDNA complexes were significantly elevated in SLE patients. LDGs in SLE population was significantly higher than in the control group, and LDGs was positively correlated with H3-dsDNA and Ela-dsDNA NETs complexes. The ability of SLE patients to degrade NET in vitro was significantly lower than that of the control group. Degradation experiments of DNase1 and DNase1L3 in different proportions showed that the decrease in DNase1L3 activity was the primary contributor to the elevated NET residue level. The concentration of DNase1L3 autoantibodies in SLE patients was significantly elevated compared to the control group. In addition, the capacity of PBMCs to secrete DNase1L3 was significantly lower in the SLE patients compared to the control group. Conclusion Decreased secretion of DNase1L3 and the presence of relevant autoantibodies notably impede NET degradation in patients with SLE, offering new directions for the monitoring and treatment of SLE patients.
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Affiliation(s)
- Jianjun Huang
- Department of Laboratory Medicine, First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China
| | - Tongjun Mao
- Department of Rheumatology, First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China
| | - Jun Zhang
- Department of Laboratory Medicine, First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China
| | - Zhi Li
- Department of Rheumatology, First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China
| | - Qiwen Wu
- Department of Laboratory Medicine, First Affiliated Hospital of Wannan Medical College, Wuhu 241001, China. *Corresponding author, E-mail:
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McDaniel CC, Lo-Ciganic WH, Huang J, Chou C. A machine learning model to predict therapeutic inertia in type 2 diabetes using electronic health record data. J Endocrinol Invest 2023:10.1007/s40618-023-02259-1. [PMID: 38160431 DOI: 10.1007/s40618-023-02259-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To estimate the therapeutic inertia prevalence for patients with type 2 diabetes, develop and validate a machine learning model predicting therapeutic inertia, and determine the added predictive value of area-level social determinants of health (SDOH). METHODS This prognostic study with a retrospective cohort design used OneFlorida data (linked electronic health records (EHRs) from 1240 practices/clinics in Florida). The study cohort included adults (aged ≥ 18) with type 2 diabetes, HbA1C ≥ 7% (53 mmol/mol), ≥one ambulatory visit, and ≥one antihyperglycemic medication prescribed (excluded patients prescribed insulin before HbA1C). The outcome was therapeutic inertia, defined as absence of treatment intensification within six months after HbA1C ≥ 7% (53 mmol/mol). The predictors were patient, provider, and healthcare system factors. Machine learning methods included gradient boosting machines (GBM), random forests (RF), elastic net (EN), and least absolute shrinkage and selection operator (LASSO). The DeLong test compared the discriminative ability (represented by C-statistics) between models. RESULTS The cohort included 31,087 patients with type 2 diabetes (mean age = 58.89 (SD = 13.27) years, 50.50% male, 58.89% White). The therapeutic inertia prevalence was 39.80% among the 68,445 records. GBM outperformed (C-statistic from testing sample = 0.84, 95% CI = 0.83-0.84) RF (C-statistic = 0.80, 95% CI = 0.79-0.80), EN (C-statistic = 0.80, 95% CI = 0.80-0.81), and LASSO (C-statistic = 0.80, 95% CI = 0.80-0.81), p < 0.05. Area-level SDOH significantly increased the discriminative ability versus models without SDOH (C-statistic for GBM = 0.84, 95% CI = 0.84-0.85 vs. 0.84, 95% CI = 0.83-0.84), p < 0.05. CONCLUSIONS Using EHRs of patients with type 2 diabetes from a large state, machine learning predicted therapeutic inertia (prevalence = 40%). The model's ability to predict patients at high risk of therapeutic inertia is clinically applicable to diabetes care.
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Affiliation(s)
- C C McDaniel
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, 4306 Walker Building, Auburn, AL, 36849, USA.
| | - W-H Lo-Ciganic
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Center for Pharmaceutical Policy and Prescribing, University of Pittsburgh, Pittsburgh, PA, USA
- North Florida/South Georgia Veterans Health System, Geriatric Research Education and Clinical Center, Gainesville, FL, USA
| | - J Huang
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - C Chou
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, 4306 Walker Building, Auburn, AL, 36849, USA
- Department of Medical Research, China Medical University Hospital, Taichung City, Taiwan
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Yang DZ, Huang J. [The new era of the assessment and management of polycystic ovary syndrome: the interpretation of 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome]. Zhonghua Fu Chan Ke Za Zhi 2023; 58:881-887. [PMID: 38123193 DOI: 10.3760/cma.j.cn112141-20231015-00148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
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Li AA, Huang J. [Research progress of myocardial work in assessment of subclinical myocardial systolic dysfunction using pressure-strain loop technique]. Zhonghua Xin Xue Guan Bing Za Zhi 2023; 51:1295-1299. [PMID: 38123216 DOI: 10.3760/cma.j.cn112148-20230925-00187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- A A Li
- Department of Echocardiography, Affiliated Changzhou Second People's Hospital with Nanjing Medical University, Changzhou 213000, China
| | - J Huang
- Department of Echocardiography, Affiliated Changzhou Second People's Hospital with Nanjing Medical University, Changzhou 213000, China
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Huang J, Zheng D, Fang Y, Dehaen W. Design and synthesis of a BOAHY-derived tracker for fluorescent labeling of mitochondria. Spectrochim Acta A Mol Biomol Spectrosc 2023; 303:123201. [PMID: 37541090 DOI: 10.1016/j.saa.2023.123201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 07/07/2023] [Accepted: 07/21/2023] [Indexed: 08/06/2023]
Abstract
Fluorescence microscopy has proven to be a crucial powerful tool to specifically visualize cellular organelles. In-depth visualization of the structure of mitochondria in living cells is of great value to better understand their function. Herein, based on our experience in construction of fluorescent difluoroboronate anchored acylhydrazones (BOAHY) chromophores, we rationally designed a novel monoboron complex with a connected triphenylphosphonium moiety, and evaluated its spectroscopic properties, cytotoxicity and intracellular localization. Owing to the positive charge on our fluorescent dye, the molecule had an excellent mitochondria-targeting ability (Pearson's correlation is 0.86).To the best of our knowledge, this is the first example of a BOAHY dye which has been applied as an efficient tracker to target mitochondria in living cells.
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Affiliation(s)
- Jianjun Huang
- Sustainable Chemistry for Metals and Molecules, Department of Chemistry, KU Leuven, Celestijnenlaan 200F, 3001 Leuven, Belgium
| | - Dongbin Zheng
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yuyu Fang
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Wim Dehaen
- Sustainable Chemistry for Metals and Molecules, Department of Chemistry, KU Leuven, Celestijnenlaan 200F, 3001 Leuven, Belgium.
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Zhou M, Yao L, Wu Y, Lin S, Huang J. [Analysis and prediction of burden of viral hepatitis C-associated diseases in China from 1990 to 2044]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2023; 35:476-485. [PMID: 38148536 DOI: 10.16250/j.32.1374.2023059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE To measure the burden of hepatitis C-associated diseases in China from 1990 to 2019, and to predict its changes from 2020 to 2044, so as to provide insights into formulation of the targeted hepatitis C control strategy. METHODS The total burden due to hepatitis C-associated diseases in China from 1990 to 2019 were extracted from the Global Burden of Disease 2019 (GBD 2019) data resources, and the trends in age-standardized prevalence, incidence, mortality and disability-adjusted life years (DALYs) rate of hepatitis C-associated acute hepatitis C (AHC), chronic liver diseases (CLD) and liver cancer in China from 1990 to 2019 were evaluated in China from 1990 to 2019 using estimated annual percentage change (EAPC). In addition, the changes in the burden of hepatitis C-associated diseases were predicted in China from 2020 to 2044 using a Bayesian model. RESULTS The prevalence, incidence, mortality and DALY rate of hepatitis C-associated diseases all appeared an overall tendency towards a decline in China from 1990 to 2019 (EAPC = -2.64%, -2.24%, -3.81% and -3.90%, respectively); however, there was a minor rise in the incidence and prevalence of hepatitis C-associated diseases from 2015 to 2019. The overall prevalence of hepatitis C-associated diseases reduced from 2 152.7/105 in 1990 to 1 254.1/105 in 2019 in China, with a reduction of 41.7%. The overall incidence reduced from 87.9/105 in 1990 to 55.0/105 in 2019 in China, with a reduction of 37.4%, and the highest incidence was seen for AHC, followed by CLD and liver cancer. The overall mortality and DALY rate of hepatitis C-associated diseases was 4.0/105 and 100.8/105 in China from 1990 to 2019, with CLD showing the largest contributions to the gross mortality and DALY. The mortality and DALY rate of hepatitis C-associated diseases were 5.5/105 and 142.4/105 among men in China in 2019, which were both much higher than among women (2.8/105 and 60.3/105, respectively), and the overall prevalence (1 604.9/105), mortality (30.2/105) and DALYs (437.1/105) of hepatitis C-associated diseases were all highest among patients at ages of 70 years and older, and the highest incidence was seen among patients at ages of 0 to 9 years (167.3/105). The incidence of hepatitis C-associated diseases was predicted to rise in China from 2020 to 2044; however, the DALY rate was projected to appear a tendency towards a decline. CONCLUSIONS Although the burden of hepatitis C-associated diseases showed a tendency towards a decline in China from 1990 to 2019, the burden remained high, and was predicted to slightly rise from 2020 to 2044. High attention should be paid to screening of hepatitis C among infants and treatment among adults.
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Affiliation(s)
- M Zhou
- Medical Department, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian 350005, China
| | - L Yao
- Department of Hepatology, The First Affiliated Hospital, Fujian Medical University, Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases, Fuzhou, Fujian 350005, China
| | - Y Wu
- Department of Hepatology, The First Affiliated Hospital, Fujian Medical University, Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases, Fuzhou, Fujian 350005, China
| | - S Lin
- Department of Hepatology, The First Affiliated Hospital, Fujian Medical University, Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases, Fuzhou, Fujian 350005, China
| | - J Huang
- Department of Hepatology, The First Affiliated Hospital, Fujian Medical University, Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases, Fuzhou, Fujian 350005, China
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Yao L, Lin S, Huang J, Wu Y. [Burden of hepatitis B-associated diseases in China from 1990 to 2030]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2023; 35:464-475. [PMID: 38148535 DOI: 10.16250/j.32.1374.2023068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE To measure the burden of hepatitis B-associated diseases in China from 1990 to 2019, and to predict its changes from 2020 to 2030. METHODS The age-standardized prevalence, incidence, mortality and disability-adjusted life years (DALY) rate of hepatitis B-associated diseases in China from 1990 to 2019 were extracted from the Global Burden of Disease 2019 (GBD 2019) data resources, and the trends in burdens of hepatitis B-associated diseases were evaluated from 1990 to 2019 using estimated annual percentage change (EAPC) and annual percent change (APC). In addition, the changes in the burden of hepatitis B-associated diseases were predicted in China from 2020 to 2023 using the Bayesian model. RESULTS The overall incidence of hepatitis B-associated diseases reduced from 2 725.98/105 in 1990 to 1 397.31/105 in 2019 in China [estimated annual percentage change (EAPC) = -2.35%, 95% confidential interval (CI): (-2.58%, -2.13%)], with a reduction in the prevalence from 12 239.53/105 in 1990 to 6 566.12/105 in 2019 [EAPC = -2.34%, 95% CI: (-2.54%, -2.14%)], a reduction in the mortality from 24.67/105 in 1990 to 8.07/105 in 2019 [EAPC = -4.92%, 95% CI: (-5.37%, -4.47%)], and a reduction in the DALY rate from 793.38/105 in 1990 to 247.71/105 in 2019 [(EAPC = -5.15%, 95% CI: (-5.64%, -4.66%)]. The DALY rate of hepatitis B-associated diseases were mainly attributed to liver cancer, and the DALY rate of hepatitis B-associated diseases appeared a tendency towards a rise in China from 2012 to 2019 [APC = 1.30%, 95% CI: (0.16%, 2.45%)]. The overall burden of hepatitis Bassociated diseases was higher in males than in females, and the DALY rate of hepatitis B-associated diseases increased with age, with the greatest DALY rate seen among patients at ages of 50 to 69 years. The overall incidence of hepatitis B-associated diseases was projected to be 866.79/105 in China in 2030, with the greatest incidence seen in acute hepatitis B (854.87/105), and the burden of hepatitis B-associated diseases was predicted to decline in China from 2020 to 2030; however, the burden of liver disease was projected to appear a tendency towards a rise. CONCLUSIONS The burden of hepatitis B-associated diseases appears an overall tendency towards a decline in China from 1990 to 2030; however, the burden of liver cancer appears a tendency towards aggravation. Early diagnosis and treatment of liver cancer should be given a high priority.
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Affiliation(s)
- L Yao
- Department of Hepatology, the First Affiliated Hospital of Fujian Medical University; Hepatology Research Institute, Fujian Medical University; Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases, Fuzhou, Fujian 350005, China
| | - S Lin
- Department of Hepatology, the First Affiliated Hospital of Fujian Medical University; Hepatology Research Institute, Fujian Medical University; Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases, Fuzhou, Fujian 350005, China
| | - J Huang
- Department of Hepatology, the First Affiliated Hospital of Fujian Medical University; Hepatology Research Institute, Fujian Medical University; Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases, Fuzhou, Fujian 350005, China
| | - Y Wu
- Department of Hepatology, the First Affiliated Hospital of Fujian Medical University; Hepatology Research Institute, Fujian Medical University; Fujian Clinical Research Center for Hepatopathy and Intestinal Diseases, Fuzhou, Fujian 350005, China
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Zhou Y, Tang L, Tong Y, Huang J, Wang J, Zhang Y, Jiang H, Xu N, Gong Y, Yin J, Jiang Q, Zhou J, Zhou Y. [Spatial distribution characteristics of the prevalence of advanced schistosomiasis and seroprevalence of anti- Schistosoma antibody in Hunan Province in 2020]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2023; 35:444-450. [PMID: 38148532 DOI: 10.16250/j.32.1374.2023103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE To investigate the spatial distribution characteristics of the prevalence of advanced schistosomiasis and seroprevalence of anti-Schistosoma antibody, and to examine the correlation between the prevalence of advanced schistosomiasis and seroprevalence of anti-Schistosoma antibody in Hunan Province in 2020, so as to provide insights into advanced schistosomiais control in the province. METHODS The epidemiological data of schistosomiasis in Hunan Province in 2020 were collected, including number of permanent residents in survey villages, number of advanced schistosomiasis patients, number of residents receiving serological tests and number of residents seropositive for anti-Schistosoma antibody, and the prevalence advanced schistosomiasis and seroprevalence of anti-Schistosoma antibody were descriptively analyzed. Village-based spatial distribution characteristics of prevalence advanced schistosomiasis and seroprevalence of anti-Schistosoma antibody were identified in Hunan Province in 2020, and the correlation between the revalence advanced schistosomiasis and seroprevalence of anti-Schistosoma antibody was examined using Spearman correlation analysis. RESULTS The prevalence of advanced schistosomiasis was 0 to 2.72% and the seroprevalence of anti-Schistosoma antibody was 0 to 20.25% in 1 153 schistosomiasis-endemic villages in Hunan Province in 2020. Spatial clusters were identified in both the prevalence of advanced schistosomiasis (global Moran's I = 0.416, P < 0.01) and the seroprevalence of anti-Schistosoma antibody (global Moran's I = 0.711, P < 0.01) in Hunan Province. Local spatial autocorrelation analysis identified 98 schistosomiasis-endemic villages with high-high clusters of the prevalence of advanced schistosomiasis, 134 endemic villages with high-high clusters of the seroprevalence of anti-Schistosoma antibody and 36 endemic villages with high-high clusters of both the prevalence of advanced schistosomiasis and seroprevalence of anti-Schistosoma antibody in Hunan Province. In addition, spearman correlation analysis showed a positive correlation between the prevalence of advanced schistosomiasis and seroprevalence of anti-Schistosoma antibody (rs = 0.235, P < 0.05). CONCLUSIONS There were spatial clusters of the prevalence of advanced schistosomiasis and seroprevalence of anti-Schistosoma antibody in Hunan Province in 2020, which were predominantly located in areas neighboring the Dongting Lake. These clusters should be given a high priority in the schistosomiasis control programs.
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Affiliation(s)
- Y Zhou
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
| | - L Tang
- Hunan Institute of Schistosomiasis Control, Yueyang, Hunan 414000, China
| | - Y Tong
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
| | - J Huang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
| | - J Wang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
| | - Y Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
| | - H Jiang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
| | - N Xu
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
| | - Y Gong
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
| | - J Yin
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
| | - Q Jiang
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
| | - J Zhou
- Hunan Institute of Schistosomiasis Control, Yueyang, Hunan 414000, China
| | - Y Zhou
- Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Tropical Disease Research Center, Fudan University, Shanghai 200032, China
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Yuan H, Fang CL, Deng YP, Huang J, Niu RZ, Chen JL, Chen TB, Zhu ZQ, Chen L, Xiong LL, Wang TH. Corrigendum to "A2B5-positive oligodendrocyte precursor cell transplantation improves neurological deficits in rats following spinal cord contusion associated with changes in expression of factors involved in the Notch signaling pathway" [Neurochirurgie 68 (2) (2022) 188-95]. Neurochirurgie 2023; 70:101481. [PMID: 37925774 DOI: 10.1016/j.neuchi.2023.101481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- H Yuan
- Institute of Neuroscience, Kunming Medical University, Kunming 650031, Yunnan, China; Department of Spine Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China
| | - C-L Fang
- Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Department of Anesthesiology, National Traditional Chinese Medicine Clinical Research Base and Western Medicine Translational Medicine Research Center, Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou 646000, Sichuan, China
| | - Y-P Deng
- Department of Anesthesiology, National Traditional Chinese Medicine Clinical Research Base and Western Medicine Translational Medicine Research Center, Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou 646000, Sichuan, China
| | - J Huang
- Institute of Neuroscience, Kunming Medical University, Kunming 650031, Yunnan, China
| | - R-Z Niu
- Laboratory Animal Department, Kunming Medical University, Kunming 650031, Yunnan, China
| | - J-L Chen
- Laboratory Animal Department, Kunming Medical University, Kunming 650031, Yunnan, China
| | - T-B Chen
- Laboratory Animal Department, Kunming Medical University, Kunming 650031, Yunnan, China
| | - Z-Q Zhu
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China
| | - L Chen
- Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - L-L Xiong
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China
| | - T-H Wang
- Institute of Neuroscience, Kunming Medical University, Kunming 650031, Yunnan, China; Laboratory Animal Department, Kunming Medical University, Kunming 650031, Yunnan, China; Institute of Neurological Disease, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
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Chin-Hon J, Davenport L, Huang J, Akerman M, Hindenburg A. Safety and efficacy of oral anticoagulants in extreme weights. Thromb Res 2023; 231:1-6. [PMID: 37738772 DOI: 10.1016/j.thromres.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND The 2021 International Society on Thrombosis and Haemostasis' (ISTH) recommends standard doses of apixaban and rivaroxaban regardless of high body mass index (BMI) and weight, but had not compare DOACs head-to-head in obesity or address underweight patients. METHODS Our aim is to evaluate the safety and efficacy of DOACs in underweight and obese patients compared to warfarin. The primary endpoints include incidence of thromboembolic and bleeding events. Descriptive statistics was used for continuous variables. The Kruskal-Wallis test was used to compare the four-groups for continuous measures and the chi-square test or Fisher's exact test was used to analyze categorical data. The chi-square test or Fisher's exact test, was used for categorical variables, and the Mann-Whitney test (the non-parametric counterpart to the two-sample t-test) for continuous data. RESULTS Of 2940 patients receiving anticoagulation for venous thromboembolism (VTE) treatment or atrial fibrillation (AF), 492 met eligibility criteria. Within each group, 248 patients received warfarin, 101 received apixaban, 100 received rivaroxaban and 43 received dabigatran. Patients were characterized in 4 body mass index (BMI) categories, in which 80 were underweight and 412 were obese. CONCLUSIONS When each DOAC was compared to warfarin in rates of VTE, apixaban showed statistically significant lower rate of VTE (p = 0.0149). However, no statistical significance was identified in the rate of VTE between DOACs combined vs. warfarin (p = 0.1529). When each DOAC was compared to warfarin, apixaban showed the lowest rate of overall bleeding (p = 0.0194). However, no statistical difference in the rate of bleeding was observed between DOACs combined vs. warfarin (p = 0.3284). Patients with extreme body weights requiring anticoagulation for VTE and AF may safety benefit from DOAC therapy. This evaluation showed apixaban with the lowest rate of VTE and bleeding compared to warfarin, rivaroxaban, and dabigatran. These results provide experience for the clinician to use DOACs, particularly apixaban, in underweight and obese populations.
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Affiliation(s)
- J Chin-Hon
- NYU Langone Hospital - Long Island, Department of Pharmacy, United States of America; NYU Long Island School of Medicine, United States of America.
| | - L Davenport
- NYU Langone Hospital - Long Island, Department of Pharmacy, United States of America
| | - J Huang
- Perlmutter Cancer Center at NYU Langone Hematology Oncology Associates - Mineola, United States of America
| | - M Akerman
- NYU Long Island School of Medicine, United States of America
| | - A Hindenburg
- NYU Long Island School of Medicine, United States of America; Perlmutter Cancer Center at NYU Langone Hematology Oncology Associates - Mineola, United States of America
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31
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Lu S, Xie W, Zhang Y, Sun F, Huang J, Wang J, Zhu J, Zhen Z, Zhang Y. Off-target resistance to larotrectinib in two patients with NTRK fusion-positive pediatric solid tumors. Ann Oncol 2023; 34:1065-1067. [PMID: 37666486 DOI: 10.1016/j.annonc.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 08/13/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023] Open
Affiliation(s)
- S Lu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - W Xie
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Y Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - F Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - J Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - J Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - J Zhu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Z Zhen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Y Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
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Yang J, Lee R, Henning SM, Xing E, Huang J, Yang S, Garcia MC, Surampudi V, Heber D, Li Z. Concentrated Grape Powder Consumption Modulates Cholesterol Metabolism and Homeostasis in Healthy Subjects. Mol Nutr Food Res 2023; 67:e2300224. [PMID: 37672802 DOI: 10.1002/mnfr.202300224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
SCOPE Four weeks' of concentrated grape powder (GP) consumption reduces circulating cholesterol in healthy free-living subjects consuming a low-fiber/low-polyphenol diet. Here, the study aims to investigate the underlying mechanisms for cholesterol reduction by evaluating biomarkers of cholesterol de novo biosynthesis, intestinal absorption, miRNA involved in transcriptional regulation of cholesterol metabolism, as well as cholesterol oxidation. METHODS AND RESULTS Fasting plasma samples collected from 19 healthy free-living subjects at baseline and week 4 of GP consumption are used in this study. Gas chromatography-mass (GC-MS) analysis of plasma samples shows that lathosterol, a precursor of cholesterol synthesis, is significantly decreased after GP consumption indicating reduced cholesterol de novo biosynthesis. Markers of intestinal absorption, campesterol, and β-sitosterol are not changed. Realtime PCR shows that plasma exosomal miRNA-1 is increased after GP consumption. GC-MS also shows that GP consumption reduces the plasma cholesterol oxidation product 27-hydroxycholesterol (27-HC). CONCLUSIONS This study enhances the understanding of the mechanisms of the cholesterol lowering effects of GP, and provides new insights into the potential health benefits of grape consumption.
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Affiliation(s)
- Jieping Yang
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 1083390095, USA
| | - Rupo Lee
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 1083390095, USA
| | - Susanne M Henning
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 1083390095, USA
| | - Emily Xing
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 1083390095, USA
| | - Jianjun Huang
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 1083390095, USA
| | - Scarlet Yang
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 1083390095, USA
| | - Michael C Garcia
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 1083390095, USA
| | - Vijaya Surampudi
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 1083390095, USA
| | - David Heber
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 1083390095, USA
| | - Zhaoping Li
- Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, CA, 1083390095, USA
- Department of Medicine, VA Greater Los Angeles Health Care System, Los Angeles, CA, 90073, USA
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Zhu S, Gong C, Zheng Y, Huang J. A case of primary embryonal rhabdomyosarcoma of the right breast in a 17-year-old girl. Asian J Surg 2023; 46:4977-4978. [PMID: 37704478 DOI: 10.1016/j.asjsur.2023.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/07/2023] [Indexed: 09/15/2023] Open
Affiliation(s)
- Shuo Zhu
- Guizhou Medical University, Department of Clinical Medicine, University Town, Gui'an New District, Guizhou Province, China.
| | - Chulan Gong
- The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Guiyang City, Guizhou Province, China.
| | - Yu Zheng
- The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Guiyang City, Guizhou Province, China.
| | - Jianjun Huang
- The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Guiyang City, Guizhou Province, China.
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Zheng Y, Liu J, Li Y, Huang J. IL-2RG is a predictor of prognosis and response to immune checkpoint blockages and is correlated with immune infiltrates in breast cancer. Asian J Surg 2023; 46:5359-5361. [PMID: 37543457 DOI: 10.1016/j.asjsur.2023.07.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/16/2023] [Indexed: 08/07/2023] Open
Affiliation(s)
- Yu Zheng
- Department of Breast Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, China.
| | - Jinting Liu
- Department of Breast Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, China.
| | - Yanwen Li
- Department of Breast Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, China.
| | - Jianjun Huang
- Department of Breast Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, China.
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Agostini M, Alexander A, Araujo GR, Bakalyarov AM, Balata M, Barabanov I, Baudis L, Bauer C, Belogurov S, Bettini A, Bezrukov L, Biancacci V, Bossio E, Bothe V, Brugnera R, Caldwell A, Calgaro S, Cattadori C, Chernogorov A, Chiu PJ, Comellato T, D'Andrea V, Demidova EV, Di Giacinto A, Di Marco N, Doroshkevich E, Fischer F, Fomina M, Gangapshev A, Garfagnini A, Gooch C, Grabmayr P, Gurentsov V, Gusev K, Hackenmüller S, Hemmer S, Hofmann W, Huang J, Hult M, Inzhechik LV, Janicskó Csáthy J, Jochum J, Junker M, Kazalov V, Kermaïdic Y, Khushbakht H, Kihm T, Kilgus K, Kirpichnikov IV, Klimenko A, Knöpfle KT, Kochetov O, Kornoukhov VN, Krause P, Kuzminov VV, Laubenstein M, Lehnert B, Lindner M, Lippi I, Lubashevskiy A, Lubsandorzhiev B, Lutter G, Macolino C, Majorovits B, Maneschg W, Manzanillas L, Marshall G, Miloradovic M, Mingazheva R, Misiaszek M, Morella M, Müller Y, Nemchenok I, Neuberger M, Pandola L, Pelczar K, Pertoldi L, Piseri P, Pullia A, Ransom C, Rauscher L, Redchuk M, Riboldi S, Rumyantseva N, Sada C, Sailer S, Salamida F, Schönert S, Schreiner J, Schütt M, Schütz AK, Schulz O, Schwarz M, Schwingenheuer B, Selivanenko O, Shevchik E, Shirchenko M, Shtembari L, Simgen H, Smolnikov A, Stukov D, Sullivan S, Vasenko AA, Veresnikova A, Vignoli C, von Sturm K, Wester T, Wiesinger C, Wojcik M, Yanovich E, Zatschler B, Zhitnikov I, Zhukov SV, Zinatulina D, Zschocke A, Zsigmond AJ, Zuber K, Zuzel G. Final Results of GERDA on the Two-Neutrino Double-β Decay Half-Life of ^{76}Ge. Phys Rev Lett 2023; 131:142501. [PMID: 37862664 DOI: 10.1103/physrevlett.131.142501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 08/15/2023] [Indexed: 10/22/2023]
Abstract
We present the measurement of the two-neutrino double-β decay rate of ^{76}Ge performed with the GERDA Phase II experiment. With a subset of the entire GERDA exposure, 11.8 kg yr, the half-life of the process has been determined: T_{1/2}^{2ν}=(2.022±0.018_{stat}±0.038_{syst})×10^{21} yr. This is the most precise determination of the ^{76}Ge two-neutrino double-β decay half-life and one of the most precise measurements of a double-β decay process. The relevant nuclear matrix element can be extracted: M_{eff}^{2ν}=(0.101±0.001).
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Affiliation(s)
- M Agostini
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - A Alexander
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - G R Araujo
- Physik-Institut, Universität Zürich, Zurich, Switzerland
| | - A M Bakalyarov
- National Research Centre "Kurchatov Institute," Moscow, Russia
| | - M Balata
- INFN Laboratori Nazionali del Gran Sasso, Assergi, Italy
| | - I Barabanov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - L Baudis
- Physik-Institut, Universität Zürich, Zurich, Switzerland
| | - C Bauer
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - S Belogurov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
- Institute for Theoretical and Experimental Physics, NRC "Kurchatov Institute," Moscow, Russia
| | - A Bettini
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, Padua, Italy
- INFN Padova, Padua, Italy
| | - L Bezrukov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - V Biancacci
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, Padua, Italy
- INFN Padova, Padua, Italy
| | - E Bossio
- Physik Department, Technische Universität München, Germany
| | - V Bothe
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - R Brugnera
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, Padua, Italy
- INFN Padova, Padua, Italy
| | - A Caldwell
- Max-Planck-Institut für Physik, Munich, Germany
| | - S Calgaro
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, Padua, Italy
- INFN Padova, Padua, Italy
| | | | - A Chernogorov
- Institute for Theoretical and Experimental Physics, NRC "Kurchatov Institute," Moscow, Russia
- National Research Centre "Kurchatov Institute," Moscow, Russia
| | - P-J Chiu
- Physik-Institut, Universität Zürich, Zurich, Switzerland
| | - T Comellato
- Physik Department, Technische Universität München, Germany
| | - V D'Andrea
- INFN Laboratori Nazionali del Gran Sasso and Università degli Studi dell'Aquila, L'Aquila, Italy
| | - E V Demidova
- Institute for Theoretical and Experimental Physics, NRC "Kurchatov Institute," Moscow, Russia
| | - A Di Giacinto
- INFN Laboratori Nazionali del Gran Sasso, Assergi, Italy
| | - N Di Marco
- INFN Laboratori Nazionali del Gran Sasso and Gran Sasso Science Institute, Assergi, Italy
| | - E Doroshkevich
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - F Fischer
- Max-Planck-Institut für Physik, Munich, Germany
| | - M Fomina
- Joint Institute for Nuclear Research, Dubna, Russia
| | - A Gangapshev
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - A Garfagnini
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, Padua, Italy
- INFN Padova, Padua, Italy
| | - C Gooch
- Max-Planck-Institut für Physik, Munich, Germany
| | - P Grabmayr
- Physikalisches Institut, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - V Gurentsov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - K Gusev
- Joint Institute for Nuclear Research, Dubna, Russia
- National Research Centre "Kurchatov Institute," Moscow, Russia
- Physik Department, Technische Universität München, Germany
| | | | | | - W Hofmann
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - J Huang
- Physik-Institut, Universität Zürich, Zurich, Switzerland
| | - M Hult
- European Commission, JRC-Geel, Geel, Belgium
| | - L V Inzhechik
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | | | - J Jochum
- Physikalisches Institut, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - M Junker
- INFN Laboratori Nazionali del Gran Sasso, Assergi, Italy
| | - V Kazalov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - Y Kermaïdic
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - H Khushbakht
- Physikalisches Institut, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - T Kihm
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - K Kilgus
- Physikalisches Institut, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - I V Kirpichnikov
- Institute for Theoretical and Experimental Physics, NRC "Kurchatov Institute," Moscow, Russia
| | - A Klimenko
- Joint Institute for Nuclear Research, Dubna, Russia
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - K T Knöpfle
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - O Kochetov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - V N Kornoukhov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - P Krause
- Physik Department, Technische Universität München, Germany
| | - V V Kuzminov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M Laubenstein
- INFN Laboratori Nazionali del Gran Sasso, Assergi, Italy
| | - B Lehnert
- Institut für Kern- und Teilchenphysik, Technische Universität Dresden, Dresden, Germany
| | - M Lindner
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | | | | | - B Lubsandorzhiev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - G Lutter
- European Commission, JRC-Geel, Geel, Belgium
| | - C Macolino
- INFN Laboratori Nazionali del Gran Sasso and Università degli Studi dell'Aquila, L'Aquila, Italy
| | | | - W Maneschg
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | | | - G Marshall
- Department of Physics and Astronomy, University College London, London, United Kingdom
| | - M Miloradovic
- Physik-Institut, Universität Zürich, Zurich, Switzerland
| | - R Mingazheva
- Physik-Institut, Universität Zürich, Zurich, Switzerland
| | - M Misiaszek
- Institute of Physics, Jagiellonian University, Cracow, Poland
| | - M Morella
- INFN Laboratori Nazionali del Gran Sasso and Gran Sasso Science Institute, Assergi, Italy
| | - Y Müller
- Physik-Institut, Universität Zürich, Zurich, Switzerland
| | - I Nemchenok
- Joint Institute for Nuclear Research, Dubna, Russia
| | - M Neuberger
- Physik Department, Technische Universität München, Germany
| | - L Pandola
- INFN Laboratori Nazionali del Sud, Catania, Italy
| | - K Pelczar
- European Commission, JRC-Geel, Geel, Belgium
| | - L Pertoldi
- Physik Department, Technische Universität München, Germany
- INFN Padova, Padua, Italy
| | - P Piseri
- Dipartimento di Fisica, Università degli Studi di Milano and INFN Milano, Milan, Italy
| | - A Pullia
- Dipartimento di Fisica, Università degli Studi di Milano and INFN Milano, Milan, Italy
| | - C Ransom
- Physik-Institut, Universität Zürich, Zurich, Switzerland
| | - L Rauscher
- Physikalisches Institut, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | | | - S Riboldi
- Dipartimento di Fisica, Università degli Studi di Milano and INFN Milano, Milan, Italy
| | - N Rumyantseva
- Joint Institute for Nuclear Research, Dubna, Russia
- National Research Centre "Kurchatov Institute," Moscow, Russia
| | - C Sada
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, Padua, Italy
- INFN Padova, Padua, Italy
| | - S Sailer
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - F Salamida
- INFN Laboratori Nazionali del Gran Sasso and Università degli Studi dell'Aquila, L'Aquila, Italy
| | - S Schönert
- Physik Department, Technische Universität München, Germany
| | - J Schreiner
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - M Schütt
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - A-K Schütz
- Physikalisches Institut, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - O Schulz
- Max-Planck-Institut für Physik, Munich, Germany
| | - M Schwarz
- Physik Department, Technische Universität München, Germany
| | | | - O Selivanenko
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - E Shevchik
- Joint Institute for Nuclear Research, Dubna, Russia
| | - M Shirchenko
- Joint Institute for Nuclear Research, Dubna, Russia
| | - L Shtembari
- Max-Planck-Institut für Physik, Munich, Germany
| | - H Simgen
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - A Smolnikov
- Joint Institute for Nuclear Research, Dubna, Russia
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - D Stukov
- National Research Centre "Kurchatov Institute," Moscow, Russia
| | - S Sullivan
- Max-Planck-Institut für Kernphysik, Heidelberg, Germany
| | - A A Vasenko
- Institute for Theoretical and Experimental Physics, NRC "Kurchatov Institute," Moscow, Russia
| | - A Veresnikova
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - C Vignoli
- INFN Laboratori Nazionali del Gran Sasso, Assergi, Italy
| | - K von Sturm
- Dipartimento di Fisica e Astronomia, Università degli Studi di Padova, Padua, Italy
- INFN Padova, Padua, Italy
| | - T Wester
- Institut für Kern- und Teilchenphysik, Technische Universität Dresden, Dresden, Germany
| | - C Wiesinger
- Physik Department, Technische Universität München, Germany
| | - M Wojcik
- Institute of Physics, Jagiellonian University, Cracow, Poland
| | - E Yanovich
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - B Zatschler
- Institut für Kern- und Teilchenphysik, Technische Universität Dresden, Dresden, Germany
| | - I Zhitnikov
- Joint Institute for Nuclear Research, Dubna, Russia
| | - S V Zhukov
- National Research Centre "Kurchatov Institute," Moscow, Russia
| | - D Zinatulina
- Joint Institute for Nuclear Research, Dubna, Russia
| | - A Zschocke
- Physikalisches Institut, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | | | - K Zuber
- Institut für Kern- und Teilchenphysik, Technische Universität Dresden, Dresden, Germany
| | - G Zuzel
- Institute of Physics, Jagiellonian University, Cracow, Poland
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Jian X, Chen J, Ding S, Garofalo A, Gong X, Holland C, Huang J, Chan VS, Qin X, Yu G, Ma RR, Du X, Hong R, Staebler G, Wang H, Yan Z, Bass E, Brower D, Ding W, Orlov D. Experimental Validation of a Kinetic Ballooning Mode in High-Performance High-Bootstrap Current Fraction Fusion Plasmas. Phys Rev Lett 2023; 131:145101. [PMID: 37862644 DOI: 10.1103/physrevlett.131.145101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 07/09/2023] [Accepted: 08/21/2023] [Indexed: 10/22/2023]
Abstract
We report the observation of a set of coherent high frequency electromagnetic fluctuations that leads to a turbulence induced self-regulating phenomenon in the DIII-D high bootstrap current fraction plasma. The fluctuations have frequency of 130-220 kHz, the poloidal wavelength and phase velocity are 16-30 m^{-1} and ∼30 km/s, respectively, in the outboard midplane with the estimated toroidal mode number n∼5-9. The fluctuations are located in the internal transport barrier (ITB) region at large radius and are experimentally validated to be kinetic ballooning modes (KBM). Quasilinear estimation predicts the KBM to be able to drive experimental particle flux and non-negligible thermal flux, suggesting its significant role in regulating the ITB saturation.
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Affiliation(s)
- X Jian
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
- University of California, San Diego, La Jolla, California 92093-0417, USA
| | - J Chen
- University of California Los Angeles, Los Angeles, California 90095, USA
| | - S Ding
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - A Garofalo
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - X Gong
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - C Holland
- University of California, San Diego, La Jolla, California 92093-0417, USA
| | - J Huang
- Institute of Plasma Physics, Chinese Academy of Sciences, Hefei, Anhui 230031, China
| | - V S Chan
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - X Qin
- University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - G Yu
- University of California at Davis, Davis, California 95616, USA
| | - R R Ma
- Southwestern Institute of Physics, P.O. Box 432 Chengdu 610041, China
| | - X Du
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - R Hong
- University of California Los Angeles, Los Angeles, California 90095, USA
| | - G Staebler
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - H Wang
- General Atomics, P.O. Box 85608, San Diego, California 92186-5608, USA
| | - Z Yan
- University of Wisconsin-Madison, Madison, Wisconsin 53706, USA
| | - E Bass
- University of California, San Diego, La Jolla, California 92093-0417, USA
| | - D Brower
- University of California Los Angeles, Los Angeles, California 90095, USA
| | - W Ding
- University of California Los Angeles, Los Angeles, California 90095, USA
| | - D Orlov
- University of California, San Diego, La Jolla, California 92093-0417, USA
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Mi Y, Xue Z, Qu S, Yin Y, Huang J, Kou R, Wang X, Luo S, Li W, Tang Y. The economic burden of coronary heart disease in mainland China. Public Health 2023; 224:140-151. [PMID: 37797560 DOI: 10.1016/j.puhe.2023.08.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/06/2023] [Accepted: 08/25/2023] [Indexed: 10/07/2023]
Abstract
OBJECTIVES The aim of this study was to systematically evaluate the current economic burden of coronary heart disease (CHD) in mainland China and provide a reference for the formulation of policies to reduce the economic burden of CHD. STUDY DESIGN A systematic literature review was conducted of empirical studies on the economic burden of CHD over the past 20 years. METHODS PubMed, Web of Science, Embase, China Knowledge Resource Integrated Database and the WANFANG database were comprehensively searched for relevant articles published between 1 January 2000 and 22 December 2021. Content analysis was used to extract the data, and Stata 17.0 software was used for analysis. The median values were used to describe trends. RESULTS A total of 35 studies were included in this review. The annual median per-capita hospitalisation expense and the average expense per hospitalisation were $3544.40 ($891.64-$18,371.46) and $5407.34 ($1139.93-$8277.55), respectively. The median ratio on medical consumables expenses, drug expenses, medical examination expenses and treatment expenses were 41.59% (12.40%-63.73%), 26.90% (7.30%-60.00%), 9.45% (1.65%-33.40%) and 10.10% (2.36%-66.00%), respectively. The median per-capita hospitalisation expense in the eastern, central and western regions were $9374.45 ($2056.13-$18,371.46), $4751.5 ($2951.95-$8768.93) and $3251.25 ($891.64-$13,986.38), respectively. The median average expense per hospitalisation in the eastern and central regions were $6177.15 ($1679.15-$8277.55) and $1285.49 ($1239.93-$2197.36), respectively. The median average length of stay in the eastern, central and western regions were 9.3 days, 15.2 days and 16.1 days, respectively. CONCLUSIONS The economic burden of CHD is more severe in mainland China than in developed countries, especially in terms of the direct economic burden. In terms of the types of direct medical expenses, a proportion of medical examination expenses, treatment expenses and drug expenses were lowest in the eastern region, but medical consumables expenses were the highest in this region. This study provides guidance for the formulation of policies to reduce the economic burden of CHD in mainland China.
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Affiliation(s)
- Y Mi
- School of Public Health, Weifang Medical University, Weifang, PR China
| | - Z Xue
- School of Public Health, Weifang Medical University, Weifang, PR China
| | - S Qu
- School of Public Health, Weifang Medical University, Weifang, PR China
| | - Y Yin
- Qingdao Stomatological Hospital, Qingdao, PR China
| | - J Huang
- School of Public Health, Weifang Medical University, Weifang, PR China
| | - R Kou
- School of Public Health, Weifang Medical University, Weifang, PR China
| | - X Wang
- Personnel Department, Weifang Medical University, Weifang, PR China
| | - S Luo
- School of Management, Weifang Medical University, Weifang, PR China
| | - W Li
- School of Public Health, Weifang Medical University, Weifang, PR China.
| | - Y Tang
- School of Public Health, Weifang Medical University, Weifang, PR China.
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Kang KH, Price AT, Reynoso FJ, Laugeman E, Morris ED, Samson P, Huang J, Badiyan SN, Kim H, Brenneman RJ, Abraham CD, Knutson N, Henke LE. A Pilot Study of Simulation-Free Hippocampal-Avoidance Whole Brain Radiotherapy Using Diagnostic MR-Based and Online Adaptive Planning. Int J Radiat Oncol Biol Phys 2023; 117:e113. [PMID: 37784653 DOI: 10.1016/j.ijrobp.2023.06.894] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) We aimed to demonstrate the clinical feasibility and safety of a simulation-free hippocampal avoidance whole brain radiotherapy (HA-WBRT) workflow in a Phase I clinical trial (NCT05096286). Feasibility was defined as successful completion of the simulation-free HA-WBRT workflow through treatment delivery in at last 70% of treated patients. MATERIALS/METHODS Ten candidates for HA-WBRT were enrolled for treatment on a ring gantry CT-guided Linac with online adaptive capabilities. Structures were contoured on the diagnostic brain MRI, which was then registered to a separate head computed tomography (CT) of similar head shape, obtained from an atlas-based database. A HA-WBRT "pre-plan" was generated using the atlas-based CT (AB-CT) and the NRG-CC001 constraints. At first fraction, the AB-CT was used as the primary dataset and deformed to the patient's cone-beam CT (CBCT) for dose calculation. The brain, ventricles, and brainstem contours were matched through rigid translation and rotation to the corresponding anatomy on the CBCT to aid in alignment, given the differences in rotational head positioning from diagnostic MRI to CBCT setup. Lastly, the lens, optic nerves, and brain contours were manually edited based on CBCT visualization. Plans were then optimized, and the adaptive plan was chosen for treatment if the plan met all objectives. Workflow tasks were timed. In addition, conventional plans using patients' sim CTs were created for each patient for the purpose of prospective dosimetric comparison. The dosimetric parameters were compared for each patient between the delivered sim-free plan and the conventional sim CT plan using the sign test via statistical software, with p<.05 indicating significance. RESULTS Median time from approved sim order to first fraction was 4 days (range: 2-7); median time in room (door-to-door) was 49 minutes (range: 35-70). All patients successfully completed all ten fractions and 90% of the simulation-free radiation plans met all NRG-CC001 constraints. For one patient, the sim-free plan at fraction one failed the planning target volume (PTV) coverage objective (coverage of 89%); this was deemed acceptable for delivery by the treating radiation oncologist. An offline replan was then performed to meet NRG-CC001 constraints and used for the subsequent nine fractions. There was no clinically meaningful difference in dosimetric constraints between the sim-free plan (calculated on AB-CT) and conventional CT sim plan. Statistically, the sim-free plans provided improved PTV coverage to higher doses compared to the conventional plans (Table). At a median follow-up of 43 days (range: 9 -280), the intracranial progression-free survival rate was 90%. CONCLUSION Simulation-free HA-WBRT is feasible, results in plans that are dosimetrically comparable to conventional CT sim workflows and succeeds in decreasing time to initiation of HA-WBRT by at least 50%. Further studies with a larger cohort are warranted to optimize the workflow.
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Affiliation(s)
- K H Kang
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - A T Price
- University Hospitals, Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH
| | - F J Reynoso
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - E Laugeman
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - E D Morris
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - P Samson
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - J Huang
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - S N Badiyan
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - H Kim
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - R J Brenneman
- Banner MD Anderson Cancer Center at Banner North Colorado Medical Center, Greeley, CO
| | - C D Abraham
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - N Knutson
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - L E Henke
- University Hospitals, Department of Radiation Oncology, Case Western Reserve University, Cleveland, OH
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Lin TA, Ke S, Hu C, Assadi RK, Huang J, Kleinberg LR, Mukherjee D, Weingart J, Holdhoff M, Grossman S, Redmond KJ. Low Dose Fractionated Radiation Therapy as a Chemo-Potentiator of Salvage Temozolomide (TMZ) for Recurrent Anaplastic Astrocytoma (AA) and Glioblastoma Multiforme (GBM): A Single-Arm Phase I/II Trial. Int J Radiat Oncol Biol Phys 2023; 117:S85. [PMID: 37784589 DOI: 10.1016/j.ijrobp.2023.06.407] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Cell survival curves demonstrate low-dose radiation hypersensitivity, with steepest cell kill at 0.3-0.5 Gy/fx. This phase 1/2 study assessed the safety and efficacy of low-dose fractionated radiation therapy (LDFRT) as a chemopotentiator of concurrent TMZ for patients with recurrent GBM or AA. MATERIALS/METHODS Patients with recurrent GBM or AA s/p standard of care therapy and ≥12 months from prior RT and ≥2 months from prior TMZ were eligible to receive 0.5 Gy of RT twice daily for 10 fx with concurrent TMZ (150-200 mg/m2), both delivered in 5 consecutive days of a 28-day cycle for up to 6 cycles, followed by 6 more cycles of adjuvant TMZ. In phase 1, hematologic toxicity was assessed 1 month after starting therapy. Brain MRIs were obtained every 2 months, or every 1 month in cases of potential progression. Progression was defined by RANO criteria. Pseudoprogression consisted of MRI changes independent of clinical deterioration or steroid use that stabilize/reverse without oncologic intervention. The primary endpoint was 1-year overall survival (OS), with a lower bound of an 80% CI >28% deemed promising for further study based on historical data. Secondary endpoints were rates of pseudoprogression and hematologic toxicity. RESULTS Thirty-one patients were enrolled/analyzed. Grade 3-4 acute hematologic toxicity was seen in 8 (27%) patients. Median follow-up was 9.5 (range: 0.1-66.3) months (mos). Median and 1-yr OS were 9.6 (95% CI = 7.0-15.4) mos and 34.5% (95% CI = 20.9%-57.0%). The lower bound of the 80% CI for 1-yr OS was 24.8%. 77% of patients experienced pseudoprogression, with a median time to pseudoprogression from start of LDFRT of 1.9 (95% CI = 1.7-4.4) mos and median duration of 3.6 (95% CI = 1.6-Not estimable) mos. Patients with pseudoprogression had improved OS vs. those without (N = 6; median 10.6 vs 3.9 mos, HR = 0.12 [95% CI = 0.03-0.40]; P < 0.01). CONCLUSION LDFRT in the re-irradiation setting for GBM or AA was safe. High rates of pseudoprogression were observed at strikingly low RT doses, with improved OS amongst patients with vs. without pseudoprogression. While pseudoprogression is common at definitive doses of brain RT, it is rare at palliative doses (e.g., 30 Gy/10 fx). Thus, low-dose RT hypersensitivity may be elicited by LDFRT with TMZ for patients with GBM/AA. Further study is needed to optimally apply this radiobiological property to improve patient outcomes.
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Affiliation(s)
- T A Lin
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - S Ke
- Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - C Hu
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Division of Quantitative Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - R K Assadi
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - J Huang
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - L R Kleinberg
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - D Mukherjee
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - J Weingart
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - M Holdhoff
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - S Grossman
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - K J Redmond
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
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Rimner A, Huang J, Pagano A, Ginsberg M, Chang J, Riely G, Simone CB, Gomez DR, Shepherd AF. Phase II Study of Hemithoracic Intensity-Modulated Pleural Radiation Therapy (IMPRINT) for Patients with Pleural Metastases from Thymic Malignancies. Int J Radiat Oncol Biol Phys 2023; 117:e56-e57. [PMID: 37785717 DOI: 10.1016/j.ijrobp.2023.06.771] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Pleural metastases are common sites for recurrence and progression in patients with thymic malignancies. The management of pleural metastases typically involves surgical resection with or without neoadjuvant or adjuvant systemic therapy. After surgical resection of pleural metastases, the 5-year progression-free survival (PFS) rate is about 29-45%. While radiation therapy (RT) is standardly used in the management of locally-advanced thymic malignancies, the role of RT in patients with pleural metastases in unclear. Intensity-modulated pleural radiation therapy (IMPRINT) is a RT technique currently being used to treat malignant pleural mesothelioma (MPM) patients with 2 intact lungs at centers that specialize in MPM treatment. This IMPRINT technique can potentially be extrapolated to thymic patients with pleural metastases. Because the risk of toxicity is of greater concern for thymic patients given their overall relatively favorable prognosis, the rate of toxicity, particularly radiation pneumonitis, needs to be established in the thymic patient population. MATERIALS/METHODS This is a single-arm, single institution Phase II study of hemithoracic IMPRINT for patients with pleural metastases from thymic malignancies. The primary endpoint of this study is grade 3 or higher radiation pneumonitis within 4 months of completing RT. Secondary endpoints include any toxicity, progression-free survival, patterns of failure and overall survival. Patients must have a pathologically confirmed diagnosis of a thymic malignancy with radiologic or pathologic evidence of pleural metastases. Thymoma or thymic carcinoma are allowed. Patients may have de novo stage IVA disease or recurrent disease in the pleura. There must be no evidence of extrathoracic metastatic disease or contralateral pleural/pericardial disease. Surgical resection of the pleural nodules (ex: pleurectomy/decortication, debulking/metastasectomy) are allowed. Extrapleural pneumonectomy is not allowed. Patients are excluded if they have undergone prior thoracic radiation therapy preventing hemithoracic pleural IMRT, whereas prior thymic bed radiation and/or prior pleural SBRT are allowed. RT will be administered to the ipsilateral pleura to 50.4 Gy in 28 fractions. An optional dose-painting boost to gross disease up to 60 Gy while respecting normal tissue constraints is allowed. Patients can be treated with photon or proton therapy. Simulation, contouring and RT planning guidelines have been developed. Patients will be followed per protocol at regular intervals for at least 12 months following RT. The expected accrual is 36 patients over 4 years. Further information can be found on clinicaltrials.gov (NCT05354570). RESULTS To be determined. CONCLUSION To be determined.
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Affiliation(s)
- A Rimner
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Huang
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - A Pagano
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - M Ginsberg
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - J Chang
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - G Riely
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - D R Gomez
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - A F Shepherd
- Memorial Sloan Kettering Cancer Center, New York, NY
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Zhang J, Peng G, Ding Q, Qin Y, Wu B, Zhang Z, Zou Z, Shi L, Hong X, Han J, Liang Z, Yang K, Huang J. Standard Therapy vs. Individualized Therapy in Elderly Locally Advanced Nasopharyngeal Carcinoma: A Real-World Study. Int J Radiat Oncol Biol Phys 2023; 117:e589. [PMID: 37785782 DOI: 10.1016/j.ijrobp.2023.06.1937] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Concurrent chemoradiotherapy (CRT) with/without induction chemotherapy has been the standard therapy (ST) for locally advanced nasopharyngeal carcinoma (LA-NPC). However, most patients supporting these clinical trials were younger than 65 years of age. For the toxicity of CRT and the poor tolerance of elderly patients, it is still controversial whether ST could bring the most promising survival benefits for elderly NPC compared with individualized therapy (IT). Thus, in this real-world study we compared the survival and safety of ST with IT in elderly LA-NPC to explore an effective and tolerable treatment strategy for elderly LA-NPC. MATERIALS/METHODS A total of 109 newly diagnosed elderly LA-NPC (>65 years old) from Jan. 2013-Jul. 2020 were retrospectively enrolled and divided into the ST group and IT group according to the original treatment tendency. ST refers to CRT with/without induction chemotherapy. IT group included patients not suitable for CRT and were given individualized treatment fully discussed by at least two oncologists from our head and neck team. A 1:1 propensity score matching (PSM) generated a matched cohort of ST and IT. The survivals and treatment related toxicities were compared between the two groups. RESULTS There were 46 cases in the ST group and 63 cases in the IT group. The 5-year overall survival (OS) rate, cancer-specific survival (CSS) rate, progression- free survival (PFS) rate, local recurrence-free survival (LRFS) rate and distant metastasis-free survival (DMFS) rate were 68.64%, 76.42%, 73.69%, 85.67% and 86.82%, respectively. By 1:1PSM, 35 cases in each group were matched. No significant differences of OS, CSS, PFS, LRFS and DMFS were found between ST and IT groups in the PSM-matched cohorts (P = 0.87, P = 0.79, P = 0.51, P = 0.81 and P = 0.24, respectively). Compared with patients in the ST group, cases received IT were associated with less severe acute toxicities including anemia, leucopenia, neutropenia, and thrombocytopenia. CONCLUSION For elderly LA-NPC, IT had similar survivals while less severe toxicities compared with ST, which revolutionarily challenged the role of ST for elderly LA-NPC. In the future, more studies are need to explore a less toxic treatment modality with noninferior efficacy for elderly LA-NPC.
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Affiliation(s)
- J Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - G Peng
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Q Ding
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Y Qin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - B Wu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Z Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Z Zou
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - L Shi
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - X Hong
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J Han
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Z Liang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - K Yang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J Huang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Wang A, Zhu B, Huang J, Wong MCS, Xue H. Quality of primary healthcare in China: challenges and strategies. Hong Kong Med J 2023; 29:372-374. [PMID: 37794614 DOI: 10.12809/hkmj235149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Affiliation(s)
- A Wang
- School of Economics and Management, Xidian University, Xi'an, China
| | - B Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China
| | - J Huang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Editor-in-Chief, Hong Kong Medical Journal
| | - M C S Wong
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Editor-in-Chief, Hong Kong Medical Journal
- School of Public Health, Fudan University, Shanghai, China
- The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Public Health, Peking University, Beijing, China
| | - H Xue
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, United States
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Oliveira C, Huang J, Onar A, Robinson GW, Gajjar A, Merchant TE. Dose-Effect of Proton and Photon Craniospinal Irradiation on Vertebral Growth in Pediatric Patients with Medulloblastoma. Int J Radiat Oncol Biol Phys 2023; 117:S77-S78. [PMID: 37784571 DOI: 10.1016/j.ijrobp.2023.06.393] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Craniospinal irradiation (CSI) directly damages vertebral growth plates causing skeletal dysplasia leading to reduced height in pediatric long-term survivors. The objective of this study is to quantify the adjusted effect of CSI on standing and sitting height by radiation dose and modality in children. MATERIALS/METHODS Two hundred sixty-five patients (M/F 169/96) were treated at a single institution on a clinical and molecular risk-directed trial for medulloblastoma (NCT01878617) using proton or photon therapy. Three CSI dose regimens were evaluated: 15 Gy (n = 31), 23.4 Gy (n = 103), ≥36 Gy (n = 131). Vertebral body dose was limited to 18-20 CGE for 23.4 Gy or 36 Gy proton therapy. All patients received post-CSI protocol-specified chemotherapy. Non-parametric tests were applied for baseline patient comparison. Changes in growth over time were calculated using random coefficients models using patient-specific intercepts and slopes. Dose-effects were modeled for ages 5, 10, and 18 years. RESULTS Age at CSI and race were similar between the three dose levels. Females most often received 23.4 Gy and males ≥36 Gy (p = 0.001). Higher CSI doses were associated with photon therapy (p<0.001). Median follow-up was 3 years (range 0.1-7.1). Annual growth rate was significantly different between 15 Gy (3.66 cm/year) and the higher dose levels of 23.4 Gy (2.81 cm/year, p = 0.0389) and ≥36 Gy (2.46 cm/year, p = 0.0032). Lower annual growth rate in females (vs. males, p = 0.0331) was observed in models for those aged 5 (-0.17 cm/year), 10 (-0.35 cm/year), and 18 years (-0.62 cm/year). In multivariate analysis, modelled annual growth rate was dose-dependent at ages 5 and 10 years. The differences were, respectively, 1.68 cm/year between 15 and 23.4 Gy (p = 0.0005) and 0.98 cm/year between 23.4 and ≥36 Gy (p = 0.0002), and 1.13 cm/year between 15 and 23.4 Gy (p = 0.0002) and 0.68 cm/year between 23.4 and ≥36 Gy (p = 0.0003). Radiation modality did not impact standing height over time significantly. Annual sitting height growth was 2.34, 1.67 and 1.1 cm/year for the three dose levels (p<0.0001-0.001). In the multivariate model, a 5-year-old receiving 15 or 23.4 Gy had similar annual sitting height growth, but not when 23.4 Gy was compared to ≥36 Gy (0.83 cm/year, p<0.0001). In a separate model for a patient aged 10 years, there was a difference comparing all CSI regimens (0.81 cm/year, p<0.0001, 15 vs 23.4 Gy; 0.54 cm/year, p = 0.0002, 23.4 vs ≥36 Gy). Sitting height growth was affected by CSI dose at age 18 years, with a difference of 2.2 cm/year between 15 vs 23.4 Gy (p = 0.0013), and no difference between 23.4 and ≥36 Gy. CONCLUSION Annual growth rates show a dose-response relationship, independent of treatment modality. A dose-response in sitting height growth rate is seen at any age, while the annual standing height growth rate was only affected by CSI dose in 5- and 10-year-olds. While all CSI doses had a significant impact on the annual standing height, sitting height growth rates approximated normal values for those treated with a low CSI dose.
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Affiliation(s)
- C Oliveira
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN
| | - J Huang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | - A Onar
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | - G W Robinson
- St. Jude Children's Research Hospital, Memphis, TN
| | - A Gajjar
- St. Jude Children's Research Hospital, Memphis, TN
| | - T E Merchant
- Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN
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Abstract
PURPOSE Patients with Graves' orbitopathy (GO) have characteristic facial expressions that are different from those of healthy individuals due to the combination of somatic and psychiatric symptoms. However, the facial expressions of GO patients have not yet been described and analyzed systematically. Thus, the present study aimed to present the facial expressions of GO patients and explore their applications in clinical practice. METHODS Facial image and clinical data of 943 GO patients were included, and 126 patients answered quality of life (GO-QOL) questionnaires. Each patient was labeled for one facial expression. Then, a portrait was drawn for every facial expression. Logistic and linear regression was performed to analyze the correlation between facial expression and clinical indicators, including QOL, disease activity and severity. The VGG-19 network model was utilized to discriminate facial expressions automatically. RESULTS Two groups, i.e., the non-negative emotion (neutral, happy) and the negative emotion (disgust, angry, fear, sadness, surprise), and seven expressions of GO patients were systematically analyzed. Facial expression was statistically associated with GO activity (P = 0.002), severity (P < 0.001), QOL visual functioning subscale scores (P = 0.001), and QOL appearance subscale score (P = 0.012). The deep learning model achieved satisfactory results (accuracy 0.851, sensitivity 0.899, precision 0.899, specificity 0.720, F1 score 0.899, and AUC 0.847). CONCLUSIONS As a novel clinical sign, facial expression holds the potential to be incorporated into GO assessment system in the future. The discrimination model may assist clinicians in real-life patient care.
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Affiliation(s)
- C Lei
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - M Qu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - H Sun
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - J Huang
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - J Huang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - X Song
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
| | - G Zhai
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China.
| | - H Zhou
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
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Zarabi H, Helis CA, Russell G, Huang J, Liu W, Soltys SG, Mendoza M, Braunstein SE, Salans MA, Wang TJC, Gallitto M, Shi W, Cappelli L, Shen C, Young MD, Mignano JE, Halasz LM, Barbour AB, Masters AH, Chan MD. Multi-Institutional Report of Re-Irradiation for Recurrent High-Grade Glioma. Int J Radiat Oncol Biol Phys 2023; 117:S85-S86. [PMID: 37784590 DOI: 10.1016/j.ijrobp.2023.06.408] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Significant heterogeneity exists with regards to prior published reports of re-irradiation (re-RT) in patients with recurrent high grade glioma (HGG). A multi-institutional database of 10 academic centers across the United States was created to analyze prognostic outcomes for re-RT for recurrent HGG, which included WHO Grade III and Grade IV tumors. MATERIALS/METHODS Patients with HGG who had initially received standard radiotherapy (RT) and were subsequently treated with a course of re-RT at recurrence were included in the study. Factors assessed to delineate a significant association with overall survival (OS) and toxicity included age, KPS, number of relapses, dose, use of bevacizumab (BEV) or temozolomide (TMZ), time from prior RT, histology, RT target, re-RT target> 5cm and extent of resection, and MGMT methylation status. The Kaplan-Meier Method was used to estimate OS. Cox proportional hazards regression models were used to identify factors associated with OS. Toxicity outcomes were assessed using logistic regression. Significance was assumed if p<0.05. Data management and decision management software were used for all analyses. RESULTS Between 2001 and 2022, 280 patients from 10 academic institutions were treated with re-RT for diagnosis of recurrent HGG. 133 patients (71.1%) had a histologic glioblastoma (GBM) at the time of re-RT, with the remainder having Grade 3 gliomas. Median dose delivered at re-RT was 47 Gy BED10 (IQR 47 - 53 Gy BED10), with the most common regimen being 35 Gy in 10 fractions. 83 patients (56%) had GTV greater than 5 cm treated with re-RT. 183 patients (79%) received concurrent systemic therapy, including 95 (41%) who received concurrent TMZ and 86 (45%) who received concurrent BEV. Median OS for the entire cohort was 10 months. Increasing dose at re-RT was associated with improved OS (OR 0.80 95% CI 0.67-0.95, p = 0.10 per 10 Gy BED10), as was dose greater than 47 Gy BED10, which is equivalent to 35 Gy in 10 fractions (OR 0.70, 95% CI 0.54-0.91). Concurrent TMZ was also associated with improved OS (OR 0.68, 95% CI 0.46-0.83, p < 0.01). 32/143 (22%) patients evaluable for toxicity experienced Grade 2 or greater adverse radiation effect (ARE). Use of BEV was associated with decreased toxicity (OR 0.45, 95% CI 0.21-0.98, p = 0.05). Dose at re-RT (OR 1.07 per 10 Gy BED10, p = 0.78), a GTV > 5cm (OR 1.39, p = 0.44), and the use of concurrent TMZ (OR 1.90, p = 0.10) were not associated with Grade 2 or greater ARE. CONCLUSION Higher dose of re-RT and use of concurrent TMZ led to improved OS in recurrent HGG patients without an associated increased rate of ARE. Use of BEV decreased the likelihood of Grade 2 or greater ARE in the re-RT setting for these recurrent HGG patients.
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Affiliation(s)
- H Zarabi
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC
| | - C A Helis
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC
| | - G Russell
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC
| | - J Huang
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - W Liu
- University of Iowa, Iowa City, IA
| | - S G Soltys
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M Mendoza
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - S E Braunstein
- University of California San Francisco, Department of Radiation Oncology, San Francisco, CA
| | - M A Salans
- University of California San Francisco, San Francisco, CA
| | | | - M Gallitto
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - W Shi
- Thomas Jefferson University Hospital, Philadelphia, PA
| | - L Cappelli
- Department of Radiation Oncology, Thomas Jefferson University Hospital, Philadelphia, PA
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - M D Young
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - J E Mignano
- Tufts Medical Center, Department of Radiation Oncology, Boston, MA
| | - L M Halasz
- Department of Radiation Oncology, University of Washington/ Fred Hutchinson Cancer Center, Seattle, WA
| | | | | | - M D Chan
- Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC
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Lybbert C, Huang J, Jones KG, Mickey BJ, Tadler S, Odell D, Stanford J, Kuck K. Clinical validation of an adapted Eleveld Model for high-dose propofol treatments for depression. J Clin Monit Comput 2023; 37:1369-1377. [PMID: 36967391 DOI: 10.1007/s10877-023-00986-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/16/2023] [Indexed: 03/28/2023]
Abstract
Repeated administration of high doses of propofol to patients with treatment-resistant depression (TRD) has been shown to produce antidepressant effects in small clinical trials. These effects can be elicited when the patient's EEG burst-suppression ratio (BSR) is maintained at 70-90% for 15 min in repeated treatments. This deep anesthesia domain lies beyond the range of current propofol pharmacokinetic/pharmacodynamic (PK/PD) models. In this study, we adapt the Eleveld model for use at deep anesthesia levels with a BSR endpoint, with the goal of aiding the estimation of the dosage of propofol needed to achieve 70-90% BSR for 15 min. We test the ability of the adapted model to predict BSR for these treatments. Twenty participants underwent 6-9 treatments of high doses of propofol (5-9 of which were included in this analysis) for a total of 115 treatments. To adapt the Eleveld model for this endpoint, we optimized the model parameters Ke0, γ and Ce50. These parameters were then used in the adapted model to estimate second-by-second BSR for each treatment. Estimated BSR was compared with observed BSR for each treatment of each participant. Median absolute performance error (MdAPE) between the estimated and observed BSR (25th-75th percentile) was 6.63 (3.79-12.96) % points and 8.51 (4.32-16.74) % between the estimated and observed treatment duration. This predictive performance is statistically significantly better at predicting BSR compared with the standard Eleveld model at deep anesthesia levels. Our adapted Eleveld model provides a useful tool to aid dosing propofol for high-dose anesthetic treatments for depression.
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Affiliation(s)
- C Lybbert
- Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA.
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA.
| | - J Huang
- Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
| | - K G Jones
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA
| | - B J Mickey
- Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA
| | - S Tadler
- Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA
| | - D Odell
- Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA
| | - J Stanford
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - K Kuck
- Department of Anesthesiology, University of Utah, Salt Lake City, UT, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA
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Hui C, Wakelee HA, Neal JW, Ramchandran KJ, Das M, Nagpal S, Roy M, Huang J, Pollom E, Myall N. CNS Control after First-Line Osimertinib in Patients with Metastatic EGFR-Mutant NSCLC. Int J Radiat Oncol Biol Phys 2023; 117:e110. [PMID: 37784648 DOI: 10.1016/j.ijrobp.2023.06.888] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Although osimertinib (osi) has excellent intracranial activity in EGFR-mutant metastatic non-small cell lung cancer (NSCLC), there is no consensus regarding whether to continue osi for central nervous system (CNS) control with second-line chemotherapy (chemo) at the time of systemic progression. We aimed to compare CNS outcomes after first-line osi in patients receiving second-line chemo with or without continuation of osi. MATERIALS/METHODS We retrospectively reviewed patients with EGFR-mutant NSCLC with brain metastases (BrM) at the time of initiating first-line osi who experienced progression and started second-line chemo. Cumulative incidence of local and distant CNS progression, and extracranial (EC) progression was calculated from time of second-line chemo initiation with death as a competing risk. Overall survival (OS) was analyzed using Kaplan-Meier. RESULTS We included 52 patients with a median follow up of 9.6 months (range 0.4-36.4). Median OS and CNS progression-free survival (PFS) from the time of starting second-line chemo was 12.5 months (95% CI 8.1-16.9), and 5.3 months (95% CI 3.35-7.26), respectively. The 1-year cumulative incidence of local, distant CNS progression, any CNS progression, and EC progression was 14.4% (95% CI 4.5-24.2), 42.8% (95% CI 22.8-56.8), 42.8% (95% CI 22.8-56.8) and 66.8% (95% CI 53.5-80.2), respectively. After progression on first-line osi, 25 (48.1%) and 27 patients (51.9%) continued and discontinued osi, respectively. Patients who continued osi had significantly higher BrM burden than those who did not, with 17 (68%), 3 (12%), and 5 (20%) versus 26 (96%), 0, and 1 (3.7%) patient having <10 or >11 parenchymal brain lesions, or leptomeningeal disease (LMD) at the time of second line therapy, respectively (p<0.01). In those who continued osi vs those who did not, median OS (10.8 vs 12.5 months; p = 0.37), median intracranial PFS (5.3 vs 4.8 months; p = 0.99), 1-year cumulative incidence of local (8.4% versus 20 % p = 0.26), and 1-year distant CNS progression (24.8% vs 60%; p = 0.08) was not significantly different. CNS complications such as symptomatic, hospitalizations, and steroid initiation for CNS disease, and progression of LMD were not significantly different between the two groups. Eventually, 10 patients underwent salvage RT post first-line osi and median time to salvage RT was 7.8 months (range 2-9.4). Of patients who underwent salvage RT, 2 patients (20%) had continued osi with second-line chemo. Twelve patients (44.4%) who did not continue osi eventually re-started osi for progressive disease. CONCLUSION Patients who continued osi had significantly higher BrM tumor burden. Despite these patients being at higher risk for CNS progression, time to CNS progression and incidence of CNS complications were not significantly different in the two cohorts. Patients who discontinued osi were more likely to undergo salvage RT. Continuation of osi may allow patients to defer salvage RT.
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Affiliation(s)
- C Hui
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - H A Wakelee
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - J W Neal
- Stanford University School of Medicine, Stanford, CA
| | | | - M Das
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - S Nagpal
- Department of Neurology, Stanford Cancer Institute, Stanford, CA
| | - M Roy
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - J Huang
- Department of Medicine, Stanford University, Stanford, CA
| | - E Pollom
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - N Myall
- Department of Medicine, Stanford University School of Medicine, Stanford, CA
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Dai L, Huang J, Hu L, Wu J, Wang J, Meng Q, Sun F, Duan Q, Yu J. Efficacy of Nimotuzumab plus Concurrent Chemo-Radiotherapy for Unresectable Esophageal Cancer: A Real-World Study. Int J Radiat Oncol Biol Phys 2023; 117:e354. [PMID: 37785223 DOI: 10.1016/j.ijrobp.2023.06.2432] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The esophageal cancer ranked 7th in the morbidity of malignant cancer and the 6th contributed to carcinoma deaths. Most patients are diagnosed of advanced stage at first visiting. The 5-year survival rate of unresectable esophageal cancer is about 20% after the standard treatment of concurrent chemo-radiotherapy. Nimotuzumab, a humanized anti-EGFR antibody, has shown good efficacy and low toxicity in epithelial tumors. This two-center, real-world study evaluated the efficacy and safety of nimotuzumab combined with concurrent chemoradiotherapy in unresectable esophageal squamous cell carcinoma (ESCC). MATERIALS/METHODS Totally 503 eligible unresectable ESCC patients from Jan 2014 to Dec 2020 were included. 1:2 nearest neighbor propensity score matching (PSM) was performed to match the Nimo group (nimotuzumab plus concurrent chemo-radiotherapy) and CRT group (concurrent chemo-radiotherapy), and the covariates included age, gender, tumor location, lesion length, TNM stage, clinical stage, and radiotherapy dose. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). RESULTS A total of 61 patients were in Nimo group which received nimotuzumab (200 mg/w, 4-6 weeks) combined with concurrent chemo-radiotherapy (chemotherapy: S-1/FP/TP/DP for 2-4 cycles; radiotherapy: 2DRT,3D-CRT or IMRT, 50-70 Gy in 25-35 fractions) and 107 patients in CRT group only received concurrent chemo-radiotherapy. The baseline characteristics were well balanced between the two groups. The efficacy of Nimo group was better than that of CRT group. The ORR was 85.2% vs. 71.0%, (P=0.037), the DCR was 98.4% vs. 91.6%, (P>0.05). The median PFS was 28.07 months vs. 19.54 months, and the 1-, 3- and 5-year PFS rates were 78.2% vs. 72.9%, 37.5% vs. 28.3%, and 29.1% vs. 21.3%, respectively (HR: 0.6860, 95% CI: 0.4902-0.9600, P=0.034). The median OS was 34.93 months vs. 24.30 months and the 1-, 3- and 5-year OS rates were 88.5% vs. 81.3%, 46.8% vs. 35.2% and 37.4% vs. 28.0%, respectively (HR: 0.6701, 95% CI: 0.4792-0.9372, P=0.024). The adverse events including radiation esophagitis, radiation pneumonitis, bone marrow suppression, nausea, vomiting, and rash were no significantly different between the two groups (P>0.05). CONCLUSION Nimotuzumab combined with concurrent chemo-radiotherapy improved the ORR, and prolonged PFS and OS in unresectable ESCC patients with a good tolerance.
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Affiliation(s)
- L Dai
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - J Huang
- Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - L Hu
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - J Wu
- Department of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - J Wang
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - Q Meng
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - F Sun
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - Q Duan
- Department of Radiotherapy, Changzhou Second People's Hospital, Nanjing Medical University, Changzhou, China
| | - J Yu
- Department of Radiation Oncology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Wang HHX, Li YT, Huang J, Huang W, Wong MCS. Advances and opportunities in the new digital era of telemedicine, e-health, artificial intelligence, and beyond. Hong Kong Med J 2023; 29:380-382. [PMID: 37880812 DOI: 10.12809/hkmj235152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
Affiliation(s)
- H H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Department of General Practice, The Second Hospital of Hebei Medical University, Shijiazhuang, China
- Usher Institute, Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, Scotland, United Kingdom
| | - Y T Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - J Huang
- Centre for Health Education and Health Promotion, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - W Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - M C S Wong
- Centre for Health Education and Health Promotion, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Editor-in-Chief, Hong Kong Medical Journal
- School of Public Health, Fudan University, Shanghai, China
- The Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Public Health, Peking University, Beijing, China
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DeCesaris C, Wilson T, Kim J, Burt LM, Grant JD, Harkenrider MM, Huang J, Jhingran A, Kidd EA, Konski AA, Lin LL, Small W, Suneja G, Gaffney DK. Financial Improvements from Short Course Adjuvant Vaginal Cuff Brachytherapy (VCB) in Early Endometrial Cancer Compared to Standard of Care, "SAVE" Trial. Int J Radiat Oncol Biol Phys 2023; 117:S92. [PMID: 37784606 DOI: 10.1016/j.ijrobp.2023.06.421] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Early-stage endometrial cancer is often managed with hysterectomy followed by adjuvant VCB. Financial toxicity from cancer treatment is a strong driver of adherence. The SAVE trial is a multicenter, prospective randomized trial of standard of care (SoC) VCB doses delivered in 3-5 fractions per physician discretion compared to a 2-fraction course. We report on secondary cost endpoints, quantifying the financial impacts of shorter treatment courses on institutions and participating patients. MATERIALS/METHODS Technical (TechCs), professional (PCs), and total charges (TotCs) were collected prospectively and are reported as raw and Medicare-adjusted charges per patient. Geographic variations were standardized with CMS Geographic Practice Cost Indices (GPCI), and inflation was adjusted using the Consumer Price Index (CPI): Medical Care. Distance to treatment center was calculated from the patient's zip code to the corresponding treatment center. Cost of commutes was estimated through round-trip travel distance multiplied by average gas MPG for new vehicles by treatment year and state. Median income for each patient's zip code was estimated using 5-year Household income in 2021 inflation-adjusted dollars from the US Census. Mann-Whitney U, T- and Chi-square tests were used to compare characteristics between the two groups. RESULTS One hundred eight patients were analyzed. SoC VCB was delivered in 3, 4 and 5 fractions for 27/54 (50%), 11/54 (20%), and 16/54 (30%), respectively. Median total distance traveled per patient for SoC vs. experimental arms was 213 vs 137 miles (p = .12), and median cost of commute for patients was 36.3 vs 18.0 USD (p = .11). Compared to 2-fraction treatment, 5-fraction treatment resulted in longer travel distances (median 462 vs. 137 miles, p < 0.01) and increased travel costs (median 59.3 v. 18.0 USD, p = < 0.01). Median income by zip code for SoC v. experimental arms was 79,704 vs. 79,671 USD (p = 1.0). For SoC v. experimental arms, 11 (20%) vs 7 (13%) of patients had zip codes with median income in the lowest or second lowest quintiles (p = 0.5). Adjusted raw PCs per patient did not differ between SoC vs. experimental arms (9,159$ vs. 7,532$, p = 0.19). TechCs were significantly higher on the SoC arm (35,734$ vs. 24,696$ p = < 0.01), as were TotCs (44,892$ vs. 32,228$, p < 0.01;). Medicare-adjusted PCs, TechCs, and TotCs were higher for the SoC arm (Table 1). CONCLUSION Two-fraction VCB resulted in fewer treatments per patient, reduced cost of travel compared to longer courses, and an adjusted reduction in healthcare expenditures compared to standard of care. Ongoing work will include assessment of patient-reported financial toxicities.
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Affiliation(s)
- C DeCesaris
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - T Wilson
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT
| | - J Kim
- University of Utah, Economics Department, Salt Lake City, UT
| | - L M Burt
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - J D Grant
- Intermountain Healthcare, Salt Lake City, UT
| | | | - J Huang
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - A Jhingran
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E A Kidd
- Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, CA
| | - A A Konski
- University of Pennsylvania School of Medicine, Philadelphia, PA
| | - L L Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - W Small
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - G Suneja
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - D K Gaffney
- Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
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