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Utkarsh K, Srivastava N, Kumar S, Khan A, Dagar G, Kumar M, Singh M, Haque S. CAR-T cell therapy: a game-changer in cancer treatment and beyond. Clin Transl Oncol 2024:10.1007/s12094-023-03368-2. [PMID: 38244129 DOI: 10.1007/s12094-023-03368-2] [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: 09/09/2023] [Accepted: 12/04/2023] [Indexed: 01/22/2024]
Abstract
In recent years, cancer has become one of the primary causes of mortality, approximately 10 million deaths worldwide each year. The most advanced, chimeric antigen receptor (CAR) T cell immunotherapy has turned out as a promising treatment for cancer. CAR-T cell therapy involves the genetic modification of T cells obtained from the patient's blood, and infusion back to the patients. CAR-T cell immunotherapy has led to a significant improvement in the remission rates of hematological cancers. CAR-T cell therapy presently limited to hematological cancers, there are ongoing efforts to develop additional CAR constructs such as bispecific CAR, tandem CAR, inhibitory CAR, combined antigens, CRISPR gene-editing, and nanoparticle delivery. With these advancements, CAR-T cell therapy holds promise concerning potential to improve upon traditional cancer treatments such as chemotherapy and radiation while reducing associated toxicities. This review covers recent advances and advantages of CAR-T cell immunotherapy.
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Affiliation(s)
- Kumar Utkarsh
- Department of Microbiology and Biotechnology, Shoolini University, Solan, Himachal Pradesh, 173229, India
| | - Namita Srivastava
- Department of Microbiology and Biotechnology, Shoolini University, Solan, Himachal Pradesh, 173229, India
| | - Sachin Kumar
- Department of Microbiology and Biotechnology, Shoolini University, Solan, Himachal Pradesh, 173229, India
| | - Azhar Khan
- Faculty of Applied Science and Biotechnology, Shoolini University, Solan, Himachal Pradesh, 173229, India
| | - Gunjan Dagar
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Mukesh Kumar
- Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Mayank Singh
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - Shabirul Haque
- Department of Autoimmune Diseases, Feinstein Institute for Medical Research, Northwell Health, 350, Community Drive, Manhasset, NY, 11030, USA.
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Vuong C, Utkarsh K, Stojancic R, Subramaniam A, Fernandez O, Banerjee T, Abrams DM, Fijnvandraat K, Shah N. Use of consumer wearables to monitor and predict pain in patients with sickle cell disease. Front Digit Health 2023; 5:1285207. [PMID: 37954032 PMCID: PMC10634543 DOI: 10.3389/fdgth.2023.1285207] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023] Open
Abstract
Background In sickle cell disease (SCD), unpredictable episodes of acute severe pain, known as vaso-occlusive crises (VOC), disrupt school, work activities and family life and ultimately lead to multiple hospitalizations. The ability to predict VOCs would allow a timely and adequate intervention. The first step towards this ultimate goal is to use patient-friendly and accessible technology to collect relevant data that helps infer a patient's pain experience during VOC. This study aims to: (1) determine the feasibility of remotely monitoring with a consumer wearable during hospitalization for VOC and up to 30 days after discharge, and (2) evaluate the accuracy of pain prediction using machine learning models based on physiological parameters measured by a consumer wearable. Methods Patients with SCD (≥18 years) who were admitted for a vaso-occlusive crisis were enrolled at a single academic center. Participants were instructed to report daily pain scores (0-10) in a mobile app (Nanbar) and to continuously wear an Apple Watch up to 30 days after discharge. Data included heart rate (in rest, average and variability) and step count. Demographics, SCD genotype, and details of hospitalization including pain scores reported to nurses, were extracted from electronic medical records. Physiological data from the wearable were associated with pain scores to fit 3 different machine learning classification models. The performance of the machine learning models was evaluated using: accuracy, F1, root-mean-square error and area under the receiver-operating curve. Results Between April and June 2022, 19 patients (74% HbSS genotype) were included in this study and followed for a median time of 28 days [IQR 22-34], yielding a dataset of 2,395 pain data points. Ten participants were enrolled while hospitalized for VOC. The metrics of the best performing model, the random forest model, were micro-averaged accuracy of 92%, micro-averaged F1-score of 0.63, root-mean-square error of 1.1, and area under the receiving operating characteristic curve of 0.9. Conclusion Our random forest model accurately predicts high pain scores during admission for VOC and after discharge. The Apple Watch was a feasible method to collect physiologic data and provided accuracy in prediction of pain scores.
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Affiliation(s)
- Caroline Vuong
- Department of Pediatric Hematology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Kumar Utkarsh
- Department of Engineering Sciences and Applied Mathematics, Northwestern University, Evanston, IL, United States
| | - Rebecca Stojancic
- Division of Hematology—Duke Sickle Cell Comprehensive Care Unit, Department of Medicine, Duke University Hospital, Durham, NC, United States
| | - Arvind Subramaniam
- Division of Hematology—Duke Sickle Cell Comprehensive Care Unit, Department of Medicine, Duke University Hospital, Durham, NC, United States
| | - Olivia Fernandez
- Division of Hematology—Duke Sickle Cell Comprehensive Care Unit, Department of Medicine, Duke University Hospital, Durham, NC, United States
| | - Tanvi Banerjee
- Department of Computer Science & Engineering, Wright State University, Dayton, OH, United States
| | - Daniel M. Abrams
- Department of Engineering Sciences and Applied Mathematics, Northwestern University, Evanston, IL, United States
| | - Karin Fijnvandraat
- Department of Pediatric Hematology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Nirmish Shah
- Division of Hematology—Duke Sickle Cell Comprehensive Care Unit, Department of Medicine, Duke University Hospital, Durham, NC, United States
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Altabbaa S, Mann NA, Chauhan N, Utkarsh K, Thakur N, Mahmoud GAE. Era connecting nanotechnology with agricultural sustainability: issues and challenges. Nanotechnol Environ Eng 2023; 8:481-498. [DOI: 10.1007/s41204-022-00289-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/27/2022] [Indexed: 09/02/2023]
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Stojancic RS, Subramaniam A, Vuong C, Utkarsh K, Golbasi N, Fernandez O, Shah N. Predicting Pain in People With Sickle Cell Disease in the Day Hospital Using the Commercial Wearable Apple Watch: Feasibility Study. JMIR Form Res 2023; 7:e45355. [PMID: 36917171 PMCID: PMC10131899 DOI: 10.2196/45355] [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: 12/26/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is a genetic red blood cell disorder associated with severe complications including chronic anemia, stroke, and vaso-occlusive crises (VOCs). VOCs are unpredictable, difficult to treat, and the leading cause of hospitalization. Recent efforts have focused on the use of mobile health technology to develop algorithms to predict pain in people with sickle cell disease. Combining the data collection abilities of a consumer wearable, such as the Apple Watch, and machine learning techniques may help us better understand the pain experience and find trends to predict pain from VOCs. OBJECTIVE The aim of this study is to (1) determine the feasibility of using the Apple Watch to predict the pain scores in people with sickle cell disease admitted to the Duke University SCD Day Hospital, referred to as the Day Hospital, and (2) build and evaluate machine learning algorithms to predict the pain scores of VOCs with the Apple Watch. METHODS Following approval of the institutional review board, patients with sickle cell disease, older than 18 years, and admitted to Day Hospital for a VOC between July 2021 and September 2021 were approached to participate in the study. Participants were provided with an Apple Watch Series 3, which is to be worn for the duration of their visit. Data collected from the Apple Watch included heart rate, heart rate variability (calculated), and calories. Pain scores and vital signs were collected from the electronic medical record. Data were analyzed using 3 different machine learning models: multinomial logistic regression, gradient boosting, and random forest, and 2 null models, to assess the accuracy of pain scores. The evaluation metrics considered were accuracy (F1-score), area under the receiving operating characteristic curve, and root-mean-square error (RMSE). RESULTS We enrolled 20 patients with sickle cell disease, all of whom identified as Black or African American and consisted of 12 (60%) females and 8 (40%) males. There were 14 individuals diagnosed with hemoglobin type SS (70%). The median age of the population was 35.5 (IQR 30-41) years. The median time each individual spent wearing the Apple Watch was 2 hours and 17 minutes and a total of 15,683 data points were collected across the population. All models outperformed the null models, and the best-performing model was the random forest model, which was able to predict the pain scores with an accuracy of 84.5%, and a RMSE of 0.84. CONCLUSIONS The strong performance of the model in all metrics validates feasibility and the ability to use data collected from a noninvasive device, the Apple Watch, to predict the pain scores during VOCs. It is a novel and feasible approach and presents a low-cost method that could benefit clinicians and individuals with sickle cell disease in the treatment of VOCs.
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Affiliation(s)
- Rebecca Sofia Stojancic
- Duke Sickle Cell Comprehensive Care Unit, Department of Medicine, Division of Hematology, Duke University Hospital, Durham, NC, United States
| | - Arvind Subramaniam
- Duke Sickle Cell Comprehensive Care Unit, Department of Medicine, Division of Hematology, Duke University Hospital, Durham, NC, United States.,Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Caroline Vuong
- Department of Pediatric Hematology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Kumar Utkarsh
- Department of Engineering Sciences and Applied Mathematics, Northwestern University, Evanston, IL, United States
| | - Nuran Golbasi
- Joan & Sanford I Weill Medical College, Cornell University, New York, NY, United States.,University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Olivia Fernandez
- Duke Sickle Cell Comprehensive Care Unit, Department of Medicine, Division of Hematology, Duke University Hospital, Durham, NC, United States
| | - Nirmish Shah
- Duke Sickle Cell Comprehensive Care Unit, Department of Medicine, Division of Hematology, Duke University Hospital, Durham, NC, United States
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Johri AM, Singh KV, Mantella LE, Saba L, Sharma A, Laird JR, Utkarsh K, Singh IM, Gupta S, Kalra MS, Suri JS. Deep learning artificial intelligence framework for multiclass coronary artery disease prediction using combination of conventional risk factors, carotid ultrasound, and intraplaque neovascularization. Comput Biol Med 2022; 150:106018. [PMID: 36174330 DOI: 10.1016/j.compbiomed.2022.106018] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 12/13/2021] [Revised: 08/06/2022] [Accepted: 08/20/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Cardiovascular disease (CVD) is a major healthcare challenge and therefore early risk assessment is vital. Previous assessment techniques use either "conventional CVD risk calculators (CCVRC)" or machine learning (ML) paradigms. These techniques are ad-hoc, unreliable, not fully automated, and have variabilities. We, therefore, introduce AtheroEdge-MCDLAI (AE3.0DL) windows-based platform using multiclass Deep Learning (DL) system. METHODS Data was collected on 500 patients having both carotid ultrasound and corresponding coronary angiography scores (CAS), measured as stenosis in coronary arteries and considered as the gold standard. A total of 39 covariates were used, clubbed into three clusters, namely (i) Office-based: age, gender, body mass index, smoker, hypertension, systolic blood pressure, and diastolic blood pressure; (ii) Laboratory-based: Hyperlipidemia, hemoglobin A1c, and estimated glomerular filtration rate; and (iii) Carotid ultrasound image phenotypes: maximum plaque height, total plaque area, and intra-plaque neovascularization. Baseline characteristics for four classes (target labels) having significant (p < 0.0001) values were calculated using Chi-square and ANOVA. For handling the cohort's imbalance in the risk classes, AE3.0DL used the synthetic minority over-sampling technique (SMOTE). AE3.0DL used Recurrent Neural Network (RNN) and Long Short-Term Memory (LSTM) DL models and the performance (accuracy and area-under-the-curve) was computed using 10-fold cross-validation (90% training, 10% testing) frameworks. AE3.0DL was validated and benchmarked. RESULTS The AE3.0DL using RNN and LSTM showed an accuracy and AUC (p < 0.0001) pairs as (95.00% and 0.98), and (95.34% and 0.99), respectively, and showed an improvement of 32.93% and 9.94% against CCVRC and ML, respectively. AE3.0DL runs in <1 s. CONCLUSION DL algorithms are a powerful paradigm for coronary artery disease (CAD) risk prediction and CVD risk stratification.
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Affiliation(s)
- Amer M Johri
- Department of Medicine, Division of Cardiology, Queen's University, Kingston, ON, Canada
| | | | - Laura E Mantella
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada
| | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), Cagliari, Italy
| | - Aditya Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, USA
| | - John R Laird
- Heart and Vascular Institute, Adventist Health St. Helena, St Helena, CA, USA
| | | | | | - Suneet Gupta
- Department of Computer Science, Bennett University, Gr. Noida, India
| | - Manudeep S Kalra
- Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Jasjit S Suri
- Stroke Diagnostic and Monitoring Division, AtheroPoint™, Roseville, CA, USA; Knowledge Engineering Center, Global Biomedical Technologies, Inc., Roseville, CA, USA.
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Skandha SS, Agarwal M, Utkarsh K, Gupta SK, Koppula VK, Suri JS. A novel genetic algorithm-based approach for compression and acceleration of deep learning convolution neural network: an application in computer tomography lung cancer data. Neural Comput Appl 2022. [DOI: 10.1007/s00521-022-07567-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jaiswal A, Sharma E, Sharma C, Sharma S, Utkarsh K, Ali R. A comparative study of psychiatric comorbidity and quality of life between tension-type headache patients and healthy controls. Asian J Med Sci 2022. [DOI: 10.3126/ajms.v13i2.40853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Headache is a health disorder that affects a large proportion of the world population, resulting in a huge economic burden. Nearly half the world’s population has a history of current headache disorder. Its prevalence is reported to vary over a wide range from 1.3% to 65% in men and 2.7% to 86% in women. It is responsible for 7.2 million years of life lived with disability. The present study was planned to study the prevalence and clinical impact of psychiatric comorbidity and quality of life among patients with tension-type headache (TTH) in a North Indian population.
Aims and Objectives: To assess the psychiatric comorbidity and quality of life among the patients of Tension type Headache and compare them with healthy controls.
Materials and Methods: Patients presenting with complaints of headache and healthy individuals without complaints of headache were included in the study. A total of 100 patients were studied that were presenting in tertiary care hospital. Patients were subjected to a semi-structured interview, diagnosis made by ICHD-3 for TTH, and psychiatric comorbidity was detected by Mini-International Neuropsychiatric Interview applied to both patients and controls.
Results: Psychiatric morbidity was diagnosed in 90% of cases and only 9% of controls. Among cases with psychiatric morbidity, generalized anxiety disorder (28%) was the most common, followed by major depressive disorder (MDD) (27%), panic disorder (12%), social phobia (11%), agoraphobia (6%), alcohol dependence (4%), and substance dependence (2%), respectively. On the other hand, among controls, 7% had MDD and 2% had alcohol dependence. Statistically, a significant difference was found between the two groups (P<0.001). The quality of life of TTH patients with psychiatric comorbidity was significantly lower as compared to that of TTH patients without psychiatric morbidity.
Conclusion: The findings of the study showed a much higher prevalence of psychiatric comorbidity among TTH patients as compared to matched healthy controls. The quality of life of TTH patients was highly impaired, presence of psychiatric comorbidity made the quality of life of affected patients even worse.
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Singh V, Chandna H, Kumar A, Kumar S, Upadhyay N, Utkarsh K. IoT-Q-Band: A low cost internet of things based wearable band to detect and track absconding COVID-19 quarantine subjects. EAI Endorsed Transactions on Internet of Things 2020. [DOI: 10.4108/eai.13-7-2018.163997] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Jaiswal B, Utkarsh K, Bhattacharyya DK. PNME - A gene-gene parallel network module extraction method. J Genet Eng Biotechnol 2018; 16:447-457. [PMID: 30733759 PMCID: PMC6353772 DOI: 10.1016/j.jgeb.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/06/2018] [Accepted: 08/29/2018] [Indexed: 12/14/2022]
Abstract
In the domain of gene-gene network analysis, construction of co-expression networks and extraction of network modules have opened up enormous possibilities for exploring the role of genes in biological processes. Through such analysis, one can extract interesting behaviour of genes and would help in the discovery of genes participating in a common biological process. However, such network analysis methods in sequential processing mode often have been found time-consuming even for a moderately sized dataset. It is observed that most existing network construction techniques are capable of handling only positive correlations in gene-expression data whereas biologically-significant genes exhibit both positive and negative correlations. To address these problems, we propose a faster method for construction and analysis of gene-gene network and extraction of modules using a similarity measure which can identify both negatively and positively correlated co-expressed patterns. Our method utilizes General-purpose computing on graphics processing units (GPGPU) to provide fast, efficient and parallel extraction of biologically relevant network modules to support biomarker identification for breast cancer. The modules extracted are validated using p-value and q-value for both metastasis and non-metastasis stages of breast cancer. PNME has been found capable of identifying interesting biomarkers for this critical disease. We identified six genes with the interesting behaviours which have been found to cause breast cancer in homo-sapiens.
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Affiliation(s)
- Bikash Jaiswal
- Dept. of Computer Science and Engineering, Tezpur University, Napaam, Tezpur 784028, Assam, India
| | - Kumar Utkarsh
- Dept. of Computer Science and Engineering, Tezpur University, Napaam, Tezpur 784028, Assam, India
| | - D K Bhattacharyya
- Dept. of Computer Science and Engineering, Tezpur University, Napaam, Tezpur 784028, Assam, India
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Utkarsh K, Trivedi A, Srinivasan D, Reindl T. A Consensus-Based Distributed Computational Intelligence Technique for Real-Time Optimal Control in Smart Distribution Grids. IEEE Trans Emerg Top Comput Intell 2017. [DOI: 10.1109/tetci.2016.2635130] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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