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Han K, Zou J, Zhao Z, Baskurt Z, Zheng Y, Barnes T, Croke JM, Fyles A, Gladwish AP, Lecavalier-Barsoum M, Lukovic J, Marchand EL, Milosevic M, Taggar A, Bratman SV, Leung EW. Clinical Validation of HPV ctDNA for Early Detection of Residual Disease Following Chemoradiation in Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:S7-S8. [PMID: 37784556 DOI: 10.1016/j.ijrobp.2023.06.216] [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) Despite chemoradiation (CRT), 30-40% of patients with locally advanced cervical cancer relapse. Most cases are caused by human papilloma virus (HPV), and HPV circulating tumor DNA (ctDNA) may identify patients at highest risk of relapse. Our previous pilot study showed that detectable HPV ctDNA at the end of CRT is associated with inferior progression-free survival (PFS) using digital polymerase chain reaction (dPCR), and that a next generation sequencing approach (HPV-seq) may outperform dPCR. We hypothesized that HPV ctDNA may identify cervical cancer patients at increased risk of relapse following CRT and aimed to prospectively validate HPV ctDNA as a tool for early detection of residual disease. MATERIALS/METHODS This prospective, multicenter validation study accrued 70 patients with HPV+ stage IB-IVA cervical cancer treated with definitive CRT from 2017-2022. Patients underwent phlebotomy at baseline, end of, 4-6 weeks and 3 months post CRT for HPV ctDNA levels. HPV genotyping was performed on the baseline plasma sample using HPV-seq. HPV genotype-specific DNA levels in plasma were quantified using both dPCR and HPV-seq. PFS was estimated using the Kaplan-Meier method and compared using the log rank test. Multivariable Cox regression analyses incorporating stage and HPV ctDNA detectability assessed independent prognostic factors associated with PFS. RESULTS At the time of abstract, results for 67 patients were available. The majority had squamous histology (84%) and stage IIB (36%) or IIIC1 (25%) disease. HPV genotyping using HPV-seq revealed 54% (36/67) of cases harboring HPV-16, and 46% harboring other HPV types: 15 HPV-18; 5 HPV-59; 2 HPV-31; 2 HPV-33; 2 HPV-52; 1 each HPV-39, HPV-45, HPV-53, HPV-58, and HPV-82. With a median follow up of 2.2 (range 0.4 - 5.2) years, there were 21 PFS events. Most recurrences (14/21) were distant and/or paraaortic; 4 local and nodal/distant; 2 pelvic nodal; and 1 local. Patients with detectable HPV ctDNA on dPCR at the end of, 4-6 weeks and 3 months post CRT had significantly worse 2-year PFS compared to those with undetectable HPV ctDNA (78 vs 52%, p = 0.04; 82 vs 26%, p < 0.001; and 80 vs 23%, p = < 0.001, respectively). HPV-seq showed similar results (87 vs 55%, p = 0.02; 81 vs 45%, p = 0.003; and 84 vs 31%, p = < 0.001, respectively). On multivariable analyses, detectable HPV ctDNA on dPCR and HPV-seq remained independently associated with inferior PFS (see table). CONCLUSION HPV-seq enables HPV genotyping directly from plasma in locally advanced cervical cancer. Persistent HPV ctDNA following CRT is independently associated with inferior PFS in this prospective validation study. HPV ctDNA testing can be used to identify, as early as at the end of CRT, patients at high risk of recurrence in future treatment intensification trials.
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Affiliation(s)
- K Han
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - J Zou
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Z Zhao
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Z Baskurt
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Y Zheng
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - T Barnes
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - J M Croke
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - A Fyles
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - A P Gladwish
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Royal Victoria Hospital, Barrie, ON, Canada
| | | | - J Lukovic
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - E L Marchand
- Hopital Maisonneuve-Rosemont, Montreal, QC, Canada
| | - M Milosevic
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - A Taggar
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - S V Bratman
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - E W Leung
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Scott A, Weersink M, Liu Z, Milosevic M, Croke J, Fyles A, Lukovic J, Rink A, Beiki-Ardakani A, Borg J, Xie J, Chan K, Ballantyne H, Skliarenko J, Conway J, Gladwish A, Weersink R, Han K. Comparing Dosimetry of Locally Advanced Cervix Cancer Patients Treated with 3 vs. 4 Fractions of MRI-Guided Brachytherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.601] [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: 11/16/2022]
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Mitera G, Tsang D, Wright P, Sussman J, Craig T, Thompson R, Tyldesley S, Foxcroft S, Goddard K, Greenland J, Koul R, McCurdy B, Milosevic M, Morneau M, Morrison A, Pan L, Pantarotto J, Rutledge R, Warde P, Patel S. First Pan-Canadian Consensus Recommendations for Proton Beam Therapy Access in Canada. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Stevanovic N, Markovic V, Milosevic M, Djurdjevic A, Stajic J, Milenkovic B, Nikezic D. Correlations between track parameters in a solid-state nuclear track detector and its diffraction pattern. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.109986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Scott A, Polo A, Zubizarreta E, Aidoo C, Milosevic M, Rodin D. Access to Radiotherapy in Ghana: A Geospatial Analysis. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Madariaga Urrutia A, Bonilla L, King I, Garg S, Bowering V, Dhani N, Milosevic M, Han K, Lajkosz K, Karakasis K, Ghiassi P, Siman S, Rouzbahman M, Downs G, Park N, Sheen C, Udagani S, Stockley T, Oza A, Lheureux S. 805P Clinically actionable alterations in adolescents and young adults (AYA) with gynaecological cancers. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Milosevic M, Rodin D. SP-0049 Using health economics to make the case for brachytherapy – HALYS, QALYS and DALYS. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abdovic S, Cuk M, Hizar I, Milosevic M, Jerkovic A, Saraga M. Pretreatment morning urine osmolality and oral desmopressin lyophilisate treatment outcome in patients with primary monosymptomatic enuresis. Int Urol Nephrol 2021; 53:1529-1534. [PMID: 33774753 DOI: 10.1007/s11255-021-02843-5] [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: 01/13/2021] [Accepted: 03/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the association between urine osmolality (Uosm) in patients with primary monosymptomatic enuresis (PMNE) and response to desmopressin (dDAVP) lyophilisate. METHODS This was a prospective cohort study that included 419 children with enuresis seen in outpatient clinic between October 2017 and October 2019. Patient workup included symptom checklist, 48 h frequency/volume chart, kidney and bladder ultrasound, uroflow, urinalysis and culture, spot urine Ca/creatinine, and first-morning Uosm. Patients < 5 years, with secondary enuresis, or loss of follow-up were excluded. Oral dDAVP lyophilisate was recommended to all with PMNE and normal bladder capacity. After 1 month of therapy, initial success was assessed according to ICCS. Significant predictor variables for complete response were identified and analyzed using correlation coefficients and binary logistic regression. RESULTS There were 48 patients with PMNE who received dDAVP and were followed for treatment success. Partial and complete responses were achieved for 14 (29.2%) and 20 cases (41.7%), respectively. Older age and lower Uosm were found to be significantly in favor of complete response to dDAVP lyophilisate, P = 0.007 and 0.033, respectively. ROC analysis determined the Uosm of ≤ 814 mOsm/kg as a cut-off value for complete success (sensitivity 65% and specificity 75%, AUC = 68.2%). The odds ratio for complete success for selected cut-off value was 5.57 (95% CI 1.588-19.551, P = 0.007). CONCLUSION High pretreatment morning Uosm (> 814 mOsm/kg) might be suggestive of an alternative treatment to dDAVP lyophilisate in PMNE because of the higher risk of treatment failure.
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Affiliation(s)
- S Abdovic
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia.
| | - M Cuk
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia
| | - I Hizar
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia
| | - M Milosevic
- Andrija Stampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
| | - A Jerkovic
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia
| | - M Saraga
- Department of Pediatric Nephrology, University Hospital Center Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
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Khoja L, Hurst N, Weiss J, Liu Z, Laframboise S, Clarke B, Han K, Milosevic M, Fyles A, Dhani N, Croke J. Vulvar Carcinoma: Patterns Of Practice And Clinical Outcomes From A Large Academic Cancer Centre. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Milosevic M, Edwards J, Tsang D, Dunning J, Shackcloth M, Batchelor T, Coonar A, Hasan J, Davidson B, Marchbank A, Grumett S, Williams N, Macbeth F, Farewell V, Treasure T. Pulmonary Metastasectomy in Colorectal Cancer: updated analysis of 93 randomized patients - control survival is much better than previously assumed. Colorectal Dis 2020; 22:1314-1324. [PMID: 32388895 PMCID: PMC7611567 DOI: 10.1111/codi.15113] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/24/2020] [Indexed: 12/23/2022]
Abstract
AIM Lung metastases from colorectal cancer are resected in selected patients in the belief that this confers a significant survival advantage. It is generally assumed that the 5-year survival of these patients would be near zero without metastasectomy. We tested the clinical effectiveness of this practice in Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC), a randomized, controlled noninferiority trial. METHOD Multidisciplinary teams in 14 hospitals recruited patients with resectable lung metastases into a two-arm trial. Randomization was remote and stratified according to site, with minimization for age, sex, primary cancer stage, interval since primary resection, prior liver involvement, number of metastases and carcinoembryonic antigen level. The trial management group was blind to patient allocation until after intention-to-treat analysis. RESULTS From 2010 to 2016, 93 participants were randomized. These patients were 35-86 years of age and had between one and six lung metastases at a median of 2.7 years after colorectal cancer resection; 29% had prior liver metastasectomy. The patient groups were well matched and the characteristics of these groups were similar to those of observational studies. The median survival after metastasectomy was 3.5 (95% CI: 3.1-6.6) years compared with 3.8 (95% CI: 3.1-4.6) years for controls. The estimated unadjusted hazard ratio for death within 5 years, comparing the metastasectomy group with the control group, was 0.93 (95% CI: 0.56-1.56). Use of chemotherapy or local ablation was infrequent and similar in each group. CONCLUSION Patients in the control group (who did not undergo lung metastasectomy) have better survival than is assumed. Survival in the metastasectomy group is comparable with the many single-arm follow-up studies. The groups were well matched with features similar to those reported in case series.
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Affiliation(s)
- M. Milosevic
- Institute for Lung Diseases of VojvodinaThoracic Surgery ClinicSremska KamenicaSerbia
| | - J. Edwards
- Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
| | - D. Tsang
- Basildon and Thurrock University Hospitals NHS Foundation TrustBasildonUK
| | - J. Dunning
- South Tees Hospitals NHS Foundation TrustThe James Cook University HospitalMiddlesbroughUK
| | - M. Shackcloth
- Liverpool Heart And Chest Hospital NHS Foundation TrustLiverpoolUK
| | - T. Batchelor
- Bristol Royal InfirmaryUniversity Hospitals Bristol NHS Foundation TrustBristolUK
| | - A. Coonar
- Royal Papworth Hospital NHS Foundation TrustCambridgeUK
| | - J. Hasan
- The Christie NHS Foundation TrustManchesterUK
| | - B. Davidson
- Division of SurgeryRoyal Free London NHS Foundation TrustUCLLondonUK
| | - A. Marchbank
- Derriford HospitalUniversity Hospitals Plymouth NHS TrustPlymouthUK
| | - S. Grumett
- The Royal Wolverhampton NHS TrustNew Cross HospitalWolverhamptonUK
| | - N.R. Williams
- Surgical & Interventional Trials Unit (SITU)University College LondonLondonUK
| | - F. Macbeth
- Centre for Trials ResearchCardiff UniversityCardiffUK
| | | | - T. Treasure
- Clinical Operational Research UnitUniversity College LondonLondonUK
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Kang J, Tsai CC, Hasegawa H, Morris-Paterson T, Higgins S, Crum W, Gnoni V, Green D, Gunasinghe C, Nesbitt A, Williams S, Milosevic M, Ashkan K, Goadsby P, Leschziner G, Harridge S, Rosenzweig I. The effect of hyper-buoyancy floatation (HBF), a model of simulated microgravity, on sleep and cognitive function in humans. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Velec M, Tadic T, Xie J, Moseley J, Patel T, Milosevic M, Fyles A, Han K, Croke J. Deformable Dose Accumulation for Hybrid CBCT-MRI Guided Adaptive Radiotherapy for Cervix Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tadic T, Croke J, Xie J, Stanescu T, Letourneau D, Bissonnette J, Breen S, Simeonov A, Dickie C, Hill C, Li W, Ellis C, Winter J, Velec M, Fyles A, Han K, Jaffray D, Milosevic M. In-Room MRI for Adaptive Radiotherapy for Cervical Cancer Using an Integrated MR-Guided Radiation Therapy System. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.834] [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: 11/15/2022]
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Milosevic M. SP-0150 Using functional imaging as a guidance and decision tool in radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30570-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Kojic M, Milosevic M, Simic V, Geroski V, Ziemys A, Filipovic N, Ferrari M. Smeared multiscale finite element model for electrophysiology and ionic transport in biological tissue. Comput Biol Med 2019; 108:288-304. [PMID: 31015049 DOI: 10.1016/j.compbiomed.2019.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 03/22/2019] [Accepted: 03/23/2019] [Indexed: 10/27/2022]
Abstract
Basic functions of living organisms are governed by the nervous system through bidirectional signals transmitted from the brain to neural networks. These signals are similar to electrical waves. In electrophysiology the goal is to study the electrical properties of biological cells and tissues, and the transmission of signals. From a physics perspective, there exists a field of electrical potential within the living body, the nervous system, extracellular space and cells. Electrophysiological problems can be investigated experimentally and also theoretically by developing appropriate mathematical or computational models. Due to the enormous complexity of biological systems, it would be almost impossible to establish a detailed computational model of the electrical field, even for only a single organ (e.g. heart), including the entirety of cells comprising the neural network. In order to make computational models feasible for practical applications, we here introduce the concept of smeared fields, which represents a generalization of the previously formulated multiscale smeared methodology for mass transport in blood vessels, lymph, and tissue. We demonstrate the accuracy of the smeared finite element computational models for the electric field in numerical examples. The electrical field is further coupled with ionic mass transport within tissue composed of interstitial spaces extracellularly and by cytoplasm and organelles intracellularly. The proposed methodology, which couples electrophysiology and molecular ionic transport, is applicable to a variety of biological systems.
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Affiliation(s)
- M Kojic
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA; Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400, Kragujevac, Serbia; Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000, Belgrade, Serbia.
| | - M Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400, Kragujevac, Serbia; Belgrade Metropolitan University, Tadeuša Košćuška 63, 11000, Belgrade, Serbia
| | - V Simic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400, Kragujevac, Serbia
| | - V Geroski
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400, Kragujevac, Serbia
| | - A Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA
| | - N Filipovic
- University of Kragujevac, Faculty for Engineering Sciences, Sestre Janic 6, 34000, Kragujevac, Serbia
| | - M Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA
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Abdovic S, Cuk M, Cekada N, Milosevic M, Geljic A, Fusic S, Bastic M, Bahtijarevic Z. Predicting posterior urethral obstruction in boys with lower urinary tract symptoms using deep artificial neural network. World J Urol 2018; 37:1973-1979. [DOI: 10.1007/s00345-018-2588-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 11/28/2018] [Indexed: 10/27/2022] Open
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Grabovac I, Milosevic M, Mustajbegovic J. Perceived and Experienced Discrimination and Sexual Identity Disclosure of Lesbian, Gay and Bisexual Patients in Croatia. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.148] [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: 11/15/2022] Open
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Han K, Welch M, Weiss J, Pintilie M, Fyles T, Milosevic M. An MRI-Based Radiomic Signature for Disease-Free Survival in Locally Advanced Cervical Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Schulman D, Milosevic M, Singh P. TECHNOLOGY-ENABLED SUBJECTIVE WELLNESS OBSERVATIONS BY INFORMAL CAREGIVERS: A QUALITATIVE ANALYSIS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.471] [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: 11/12/2022] Open
Affiliation(s)
| | | | - P Singh
- Philips Research North America
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Ziemys A, Yokoi K, Kai M, Liu YT, Kojic M, Simic V, Milosevic M, Holder A, Ferrari M. Progression-dependent transport heterogeneity of breast cancer liver metastases as a factor in therapeutic resistance. J Control Release 2018; 291:99-105. [PMID: 30332610 DOI: 10.1016/j.jconrel.2018.10.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 12/13/2022]
Abstract
Metastatic disease is a major cause of mortality in cancer patients. While many drug delivery strategies for anticancer therapeutics have been developed in preclinical studies of primary tumors, the drug delivery properties of metastatic tumors have not been sufficiently investigated. Therapeutic efficacy hinges on efficient drug permeation into the tumor microenvironment, which is known to be heterogeneous thus potentially making drug permeation heterogeneous, also. In this study, we have identified that 4 T1 liver metastases, treated with pegylated liposomal doxorubicin, have unfavorable and heterogeneous transport of doxorubicin. Our drug extravasation results differ greatly from analogous studies with 4 T1 tumors growing in the primary site. A probabilistic tumor population model was developed to estimate drug permeation efficiency and drug kinetics of liver metastases by integrating the transport and structural properties of tumors and delivered drugs. The results demonstrate significant heterogeneity in metastases with regard to transport properties of doxorubicin within the same animal model, and even within the same organ. These results also suggest that the degree of heterogeneity depends on the stage of tumor progression and that differences in transport properties can define transport-based tumor phenotypes. These findings may have valuable clinical implications by illustrating that therapeutic agents can permeate and eliminate metastases of "less resistant" transport phenotypes, while sparing tumors with more "resistant" transport properties. We anticipate that these results could challenge the current paradigm of drug delivery into metastases, highlight potential caveats for therapies that may alter tumor perfusion, and deepen our understanding of the emergence of drug transport-based therapeutic resistance.
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Affiliation(s)
- A Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA.
| | - K Yokoi
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA
| | - M Kai
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA
| | - Y T Liu
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA
| | - M Kojic
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA; Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia; Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000 Belgrade, Serbia
| | - V Simic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - M Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - A Holder
- Department of Surgery, Houston Methodist, Houston, TX, USA
| | - M Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA
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Milosevic M, Simic V, Milicevic B, Koay E, Ferrari M, Ziemys A, Kojic M. Correction function for accuracy improvement of the Composite Smeared Finite Element for diffusive transport in biological tissue systems. Comput Methods Appl Mech Eng 2018; 338:97-116. [PMID: 30555187 PMCID: PMC6292687 DOI: 10.1016/j.cma.2018.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Modeling of drug transport within capillaries and tissue remains a challenge, especially in tumors and cancers where the capillary network exhibits extremely irregular geometry. Recently introduced Composite Smeared Finite Element (CSFE) provides a new methodology of modeling complex convective and diffusive transport in the capillary-tissue system. The basic idea in the formulation of CSFE is in dividing the FE into capillary and tissue domain, coupled by 1D connectivity elements at each node. Mass transport in capillaries is smeared into continuous fields of pressure and concentration by introducing the corresponding Darcy and diffusion tensors. Despite theoretically correct foundation, there are still differences in the overall mass transport to (and from) tissue when comparing smeared model and a true 3D model. The differences arise from the fact that the smeared model cannot take into account the detailed non-uniform pressure and concentration distribution in the vicinity of capillaries. We introduced a field of correction function for diffusivity through the capillary walls of smeared models, in order to have the same mass accumulation in tissue as in case of true 3D models. The parameters of the numerically determined correction function are: ratio of thickness and diameter of capillary wall, ratio of diffusion coefficient in capillary wall and surrounding tissue; and volume fraction of capillaries within tissue domain. Partitioning at the capillary wall - blood interface can also be included. It was shown that the correction function is applicable to complex configurations of capillary networks, providing improved accuracy of our robust smeared models in computer simulations of real transport problems, such as in tumors or human organs.
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Affiliation(s)
- M. Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia
- Belgrade Metropolitan University, Tadeusa Koscuska 63, 11000 Belgrade, Serbia
| | - V. Simic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia
| | - B. Milicevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia
| | - E.J. Koay
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - M. Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
| | - A. Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
| | - M. Kojic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
- Serbian Academy of Sciences and Arts, Knez Mihailova 35,11000 Belgrade
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Kojic M, Milosevic M, Simic V, Koay EJ, Kojic N, Ziemys A, Ferrari M. Multiscale smeared finite element model for mass transport in biological tissue: From blood vessels to cells and cellular organelles. Comput Biol Med 2018; 99:7-23. [PMID: 29807251 DOI: 10.1016/j.compbiomed.2018.05.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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: 04/26/2018] [Revised: 05/19/2018] [Accepted: 05/19/2018] [Indexed: 11/16/2022]
Abstract
One of the basic and vital processes in living organisms is mass exchange, which occurs on several levels: it goes from blood vessels to cells and organelles within cells. On that path, molecules, as oxygen, metabolic products, drugs, etc. Traverse different macro and micro environments - blood, extracellular/intracellular space, and interior of organelles; and also biological barriers such as walls of blood vessels and membranes of cells and organelles. Many aspects of this mass transport remain unknown, particularly the biophysical mechanisms governing drug delivery. The main research approach relies on laboratory and clinical investigations. In parallel, considerable efforts have been directed to develop computational tools for additional insight into the intricate process of mass exchange and transport. Along these lines, we have recently formulated a composite smeared finite element (CSFE) which is composed of the smeared continuum pressure and concentration fields of the capillary and lymphatic system, and of these fields within tissue. The element offers an elegant and simple procedure which opens up new lines of inquiry and can be applied to large systems such as organs and tumors models. Here, we extend this concept to a multiscale scheme which concurrently couples domains that span from large blood vessels, capillaries and lymph, to cell cytosol and further to organelles of nanometer size. These spatial physical domains are coupled by the appropriate connectivity elements representing biological barriers. The composite finite element has "degrees of freedom" which include pressures and concentrations of all compartments of the vessels-tissue assemblage. The overall model uses the standard, measurable material properties of the continuum biological environments and biological barriers. It can be considered as a framework into which we can incorporate various additional effects (such as electrical or biochemical) for transport through membranes or within cells. This concept and the developed FE software within our package PAK offers a computational tool that can be applied to whole-organ systems, while also including specific domains such as tumors. The solved examples demonstrate the accuracy of this model and its applicability to large biological systems.
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Affiliation(s)
- M Kojic
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA; Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia; Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000, Belgrade, Serbia.
| | - M Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - V Simic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - E J Koay
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - N Kojic
- Center for Engineering in Medicine and Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - A Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA
| | - M Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA
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Yap M, Allo G, Cuartero J, Pintilie M, Kamel-Reid S, Murphy J, Mackay H, Clarke B, Fyles A, Milosevic M. Prognostic Significance of Human Papilloma Virus and p16 Expression in Patients with Vulvar Squamous Cell Carcinoma who Received Radiotherapy. Clin Oncol (R Coll Radiol) 2018; 30:254-261. [DOI: 10.1016/j.clon.2018.01.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 11/17/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
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Lukovic J, Han K, Pintilie M, Chaudary N, Hill R, Fyles A, Milosevic M. OC-0149: Intratumoral heterogeneity and hypoxia gene expression signatures in cervix cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30459-6] [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: 11/16/2022]
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25
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Conway J, Felder S, Tang J, Fyles A, Milosevic M, Lukovic J, Han K, Croke J. PO-0811: Patient-reported quality of life in cervical cancer patients treated with definitive chemoradiation. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31121-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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26
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Lecavalier-Barsoum M, Chaudary N, Thapa P, Larsen M, Pintilie M, Han K, Hill R, Milosevic M. EP-1527: Targeting CXCL12/CXCR4 to enhance the therapeutic ratio during radiochemotherapy for cervix cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31836-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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27
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Skliarenko J, D'Souza D, Perdrizet J, Ang M, Barbera L, Gutierrez E, Ravi A, Tanderup K, Warde P, Chan K, Isaranuwatchai W, Milosevic M. OC-0076: MR-guided vs CT-guided brachytherapy more effective and less costly in locally advanced cervical cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30386-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Hamilton JL, Foxcroft S, Moyo E, Cooke-Lauder J, Spence T, Zahedi P, Bezjak A, Jaffray D, Lam C, Létourneau D, Milosevic M, Tsang R, Wong R, Liu FF. Strategic planning in an academic radiation medicine program. Curr Oncol 2017; 24:e518-e523. [PMID: 29270061 DOI: 10.3747/co.24.3725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background In this paper, we report on the process of strategic planning in the Radiation Medicine Program (rmp) at the Princess Margaret Cancer Centre. The rmp conducted a strategic planning exercise to ensure that program priorities reflect the current health care environment, enable nimble responses to the increasing burden of cancer, and guide program operations until 2020. Methods Data collection was guided by a project charter that outlined the project goal and the roles and responsibilities of all participants. The process was managed by a multidisciplinary steering committee under the guidance of an external consultant and consisted of reviewing strategic planning documents from close collaborators and institutional partners, conducting interviews with key stakeholders, deploying a program-wide survey, facilitating an anonymous and confidential e-mail feedback box, and collecting information from group deliberations. Results The process of strategic planning took place from December 2014 to December 2015. Mission and vision statements were developed, and core values were defined. A final document, Strategic Roadmap to 2020, was established to guide programmatic pursuits during the ensuing 5 years, and an implementation plan was developed to guide the first year of operations. Conclusions The strategic planning process provided an opportunity to mobilize staff talents and identify environmental opportunities, and helped to enable more effective use of resources in a rapidly changing health care environment. The process was valuable in allowing staff to consider and discuss the future, and in identifying strategic issues of the greatest importance to the program. Academic programs with similar mandates might find our report useful in guiding similar processes in their own organizations.
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Affiliation(s)
- J L Hamilton
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - S Foxcroft
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - E Moyo
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - J Cooke-Lauder
- Health Industry Management Practice, Schulich School of Business, York University, and
| | - T Spence
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - P Zahedi
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - A Bezjak
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - D Jaffray
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - C Lam
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - D Létourneau
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - M Milosevic
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - R Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - R Wong
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - F F Liu
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
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Chan K, Simeonov A, Di Tomasso A, O'Leary G, Filici AL, Rink A, Beiki-Ardakani A, Borg J, Croke J, Fyles T, Han K, Milosevic M. Implementation of Real-Time MR-Guided Interstitial Brachytherapy for Gynecological Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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30
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D'Souza D, Perdrizet J, Skliarenko J, Ang M, Barbera L, Ravi A, Gutierrez E, Tanderup K, Warde P, Chan K, Isaranuwatchai W, Milosevic M. A Cost-Utility Analysis Comparing MR-Guided Brachytherapy to Standard 2D Brachytherapy for Patients With Locally Advanced Cervical Cancer in Ontario, Canada. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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Gerber R, Han K, Xie J, Jiang H, Beiki-Ardakani A, Fyles T, Milosevic M, Croke J. Patient-Reported Sexual Health After Definitive Chemoradiation Therapy and MR-Guided Brachytherapy for Cervical Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chaudary N, Cheung M, Foltz W, Abdalaty AH, Stewart J, Lindsay P, Siddiqui I, Larsen M, Hill R, Milosevic M, Kim J, Hedley D. Preclinical Development of Targeted Stereotactic Body Radiation Therapy for Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pawlicki T, Coffey M, Milosevic M. Incident Learning Systems for Radiation Oncology: Development and Value at the Local, National and International Level. Clin Oncol (R Coll Radiol) 2017; 29:562-567. [DOI: 10.1016/j.clon.2017.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/06/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022]
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Kojic M, Milosevic M, Simic V, Koay E, Fleming J, Nizzero S, Kojic N, Ziemys A, Ferrari M. A composite smeared finite element for mass transport in capillary systems and biological tissue. Comput Methods Appl Mech Eng 2017; 324:413-437. [PMID: 29200531 PMCID: PMC5703437 DOI: 10.1016/j.cma.2017.06.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
One of the key processes in living organisms is mass transport occurring from blood vessels to tissues for supplying tissues with oxygen, nutrients, drugs, immune cells, and - in the reverse direction - transport of waste products of cell metabolism to blood vessels. The mass exchange from blood vessels to tissue and vice versa occurs through blood vessel walls. This vital process has been investigated experimentally over centuries, and also in the last decades by the use of computational methods. Due to geometrical and functional complexity and heterogeneity of capillary systems, it is however not feasible to model in silico individual capillaries (including transport through the walls and coupling to tissue) within whole organ models. Hence, there is a need for simplified and robust computational models that address mass transport in capillary-tissue systems. We here introduce a smeared modeling concept for gradient-driven mass transport and formulate a new composite smeared finite element (CSFE). The transport from capillary system is first smeared to continuous mass sources within tissue, under the assumption of uniform concentration within capillaries. Here, the fundamental relation between capillary surface area and volumetric fraction is derived as the basis for modeling transport through capillary walls. Further, we formulate the CSFE which relies on the transformation of the one-dimensional (1D) constitutive relations (for transport within capillaries) into the continuum form expressed by Darcy's and diffusion tensors. The introduced CSFE is composed of two volumetric parts - capillary and tissue domains, and has four nodal degrees of freedom (DOF): pressure and concentration for each of the two domains. The domains are coupled by connectivity elements at each node. The fictitious connectivity elements take into account the surface area of capillary walls which belongs to each node, as well as the wall material properties (permeability and partitioning). The overall FE model contains geometrical and material characteristics of the entire capillary-tissue system, with physiologically measurable parameters assigned to each FE node within the model. The smeared concept is implemented into our implicit-iterative FE scheme and into FE package PAK. The first three examples illustrate accuracy of the CSFE element, while the liver and pancreas models demonstrate robustness of the introduced methodology and its applicability to real physiological conditions.
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Affiliation(s)
- M. Kojic
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
- Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000 Belgrade, Serbia
- Corresponding author: Milos Kojic, Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030, , phone: 713 441 7355; fax: 713 441 7438
| | - M. Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - V. Simic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - E.J. Koay
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77030
| | - J.B. Fleming
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX 77030
| | - S. Nizzero
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
- Applied Physics Graduate Program, Rice University, Houston, TX 77005
| | - N. Kojic
- Center for Engineering in Medicine and Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | - A. Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
| | - M. Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
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Grabovac I, Mustajbegovic J, Milosevic M. Are patients ready for lesbian, gay and bisexual family physicians - A Croatian study. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw173.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tran K, Rahal R, Brundage M, Fung S, Louzado C, Milosevic M, Xu J, Bryant H. Use of low-value radiotherapy practices in Canada: an analysis of provincial cancer registry data. ACTA ACUST UNITED AC 2016; 23:351-355. [PMID: 27803600 DOI: 10.3747/co.23.3359] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND As part of Choosing Wisely Canada (a national campaign to encourage patient-provider conversations about unnecessary medical tests, treatments, and procedures), a list of ten oncology practices that could be low-value in some instances was developed. Of those practices, two were specific to radiation therapy (rt): conventional fractionation as part of breast-conserving therapy (bct) for women with early-stage breast cancer, and multifraction radiation for palliation of uncomplicated painful bone metastases. Here, we report baseline findings for the current utilization rates of those two rt practices in Canada. RESULTS The use of conventional fractionation as part of bct varied substantially from province to province. Of women 50 years of age and older, between 8.8% (Alberta) and 36.5% (Saskatchewan) received radiation in 25 fractions (excluding boost irradiation) as part of bct. The use of hypofractionated rt (that is, 16 fractions excluding boost irradiation)-a preferred approach for many patients-was more common in all 6 reporting provinces, ranging from 43.2% in Saskatchewan to 94.7% in Prince Edward Island. The use of multifraction rt for palliation of bone metastases also varied from province to province, ranging from 40.3% in British Columbia to 69.0% in Saskatchewan. The most common number of fractions delivered to bone metastases was 1, at 50.2%; the second most common numbers were 2-5 fractions, at 41.7%. CONCLUSIONS Understanding variation in the use of potentially low-value rt practices can help to inform future strategies to promote higher-value care, which balances high-quality care with the efficient use of limited system resources. Further work is needed to understand the factors contributing to the interprovincial variation observed and to develop benchmarks for the appropriate rate of use of these rt practices.
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Affiliation(s)
- K Tran
- Canadian Partnership Against Cancer, Toronto, ON
| | - R Rahal
- Canadian Partnership Against Cancer, Toronto, ON
| | - M Brundage
- Departments of Oncology and of Public Health Sciences, Queen's University, Kingston, ON
| | - S Fung
- Canadian Partnership Against Cancer, Toronto, ON
| | - C Louzado
- Canadian Partnership Against Cancer, Toronto, ON
| | - M Milosevic
- Department of Radiation Oncology, University of Toronto, and Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, ON
| | - J Xu
- Canadian Partnership Against Cancer, Toronto, ON
| | - H Bryant
- Canadian Partnership Against Cancer, Toronto, ON;; Departments of Community Health Sciences and of Oncology, University of Calgary, Calgary, AB
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Chan K, Benwell Q, Schneider K, Ang M, D'Souza D, Milosevic M, Barbera L. A Canadian Experience: Current State and Challenges of Magnetic Resonance--Guided Cervical Cancer Brachytherapy in Ontario. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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38
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Prati S, Milosevic M, Sciutto G, Bonacini I, Kazarian S, Mazzeo R. Analyses of trace amounts of dyes with a new enhanced sensitivity FTIR spectroscopic technique: MU-ATR (metal underlayer ATR spectroscopy). Anal Chim Acta 2016; 941:67-79. [DOI: 10.1016/j.aca.2016.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 11/27/2022]
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39
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Rodin D, Hanna T, Burger E, Zubizarreta E, Yap M, Barton M, Atun R, Knaul F, Van Dyk J, Lievens Y, Gospodarowicz M, Jaffray D, Milosevic M. Global Access to Radiation Therapy for Cervical Cancer: The Cost of Inaction. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kojic M, Milosevic M, Kojic N, Koay EJ, Fleming JB, Ferrari M, Ziemys A. Mass release curves as the constitutive curves for modeling diffusive transport within biological tissue. Comput Biol Med 2016; 92:156-167. [PMID: 29182964 DOI: 10.1016/j.compbiomed.2016.06.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/15/2016] [Accepted: 06/24/2016] [Indexed: 11/17/2022]
Abstract
In diffusion governed by Fick's law, the diffusion coefficient represents the phenomenological material parameter and is, in general, a constant. In certain cases of diffusion through porous media, the diffusion coefficient can be variable (i.e. non-constant) due to the complex process of solute displacements within microstructure, since these displacements depend on porosity, internal microstructural geometry, size of the transported particles, chemical nature, and physical interactions between the diffusing substance and the microstructural surroundings. In order to provide a simple and general approach of determining the diffusion coefficient for diffusion through porous media, we have introduced mass release curves as the constitutive curves of diffusion. The mass release curve for a selected direction represents cumulative mass (per surface area) passed in that direction through a small reference volume, in terms of time. We have developed a methodology, based on numerical Finite Element (FE) and Molecular Dynamics (MD) methods, to determine simple mass release curves of solutes through complex media from which we calculate the diffusion coefficient. The diffusion models take into account interactions between solute particles and microstructural surfaces, as well as hydrophobicity (partitioning). We illustrate the effectiveness of our approach on several examples of complex composite media, including an imaging-based analysis of diffusion through pancreatic cancer tissue. The presented work offers an insight into the role of mass release curves in describing diffusion through porous media in general, and further in case of complex composite media such as biological tissue.
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Affiliation(s)
- M Kojic
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030, United States; Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia; Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000 Belgrade, Serbia.
| | - M Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - N Kojic
- Center for Engineering in Medicine and Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - E J Koay
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - J B Fleming
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - M Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030, United States
| | - A Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030, United States
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Keller H, Kueng R, Shek T, Driscoll B, Yeung I, Milosevic M, Jaffray D. WE-H-207A-06: Hypoxia Quantification in Static PET Images: The Signal in the Noise. Med Phys 2016. [DOI: 10.1118/1.4958011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Skliarenko J, Carlone M, Han K, Beiki–Ardakani A, Borg J, Croke J, Ujaimi R, Levin W, Rink A, Xie J, Fyles A, Milosevic M. PO-0960: Making MR-guided cervix cancer brachytherapy efficient: Are plan adaptation & daily planning needed? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32210-1] [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: 11/29/2022]
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43
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Rosewall T, Wheat J, Currie G, Catton C, Chung P, Milosevic M. The Association between Reconstructed Bladder Wall Dose and Chronic Urinary Toxicity Following Prostate Radiotherapy. J Med Imaging Radiat Sci 2016. [DOI: 10.1016/j.jmir.2015.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chaudary N, Pintilie M, Hill R, Milosevic M. Plerixafor Improves Local Control and Reduces Metastases in Cervical Cancer Treated with Radiotherapy and Chemotherapy. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30151-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Boström PJ, Thoms J, Sykes J, Ahmed O, Evans A, van Rhijn BWG, Mirtti T, Stakhovskyi O, Laato M, Margel D, Pintilie M, Kuk C, Milosevic M, Zlotta AR, Bristow RG. Hypoxia Marker GLUT-1 (Glucose Transporter 1) is an Independent Prognostic Factor for Survival in Bladder Cancer Patients Treated with Radical Cystectomy. Bladder Cancer 2016; 2:101-109. [PMID: 27376131 PMCID: PMC4927886 DOI: 10.3233/blc-150033] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Tumour hypoxia, which is frequent in many cancer types, is associated with treatment resistance and poor prognosis. The role of hypoxia in surgically treated bladder cancer (BC) is not well described. We studied the role of hypoxia in two independent series of urothelial bladder cancers treated with radical cystectomy. METHODS 279 patients from the University Hospital Network (UHN), Toronto, Canada, and Turku University, Finland were studied. Hypoxia biomarkers (HIF1-α, CAIX, GLUT-1) and proliferation marker Ki-67 were analyzed with immunohistochemistry using defined tissue microarrays. Kaplan-Meier methods and Cox proportional hazards regression models were used to investigate prognostic role of the factors. RESULTS In univariate analyses, strong GLUT-1 positivity and a high Ki-67 index were associated with poor survival. In multivariate model containing clinical prognostic variables, GLUT-1 was an independent prognostic factor associated with worse disease-specific survival (HR 2.9, 95% CI 0.7-12.6, Wald p = 0.15 in the Toronto cohort and HR 3.2, 95% CI 1.3-7.5, Wald p = 0.0085 in the Turku cohort). CONCLUSION GLUT-1 is frequently upregulated and is an independent prognostic factor in surgically treated bladder cancer. Further studies are needed to evaluate the potential role of hypoxia-based and targeted therapies in hypoxic bladder tumours.
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Affiliation(s)
- P J Boström
- Department of Surgical Oncology, University of Toronto and Princess Margaret Hospital (University Health Network), Toronto, ON, Canada; Department of Urology, Turku University Hospital, Turku, Finland
| | - J Thoms
- Department of Radiation Oncology, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - J Sykes
- Department of Biostatistics, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - O Ahmed
- Department of Radiation Oncology, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - A Evans
- Department of Pathology, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - B W G van Rhijn
- Department of Surgical Oncology, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - T Mirtti
- Department of Pathology, Helsinki University Hospital, Helsinki, Finland; Institute for Molecular Medicine (FIMM), Helsinki, Finland
| | - O Stakhovskyi
- Department of Surgical Oncology, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - M Laato
- Department of Urology, Turku University Hospital , Turku, Finland
| | - D Margel
- Department of Surgical Oncology, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - M Pintilie
- Department of Biostatistics, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - C Kuk
- Department of Surgical Oncology, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - M Milosevic
- Department of Radiation Oncology, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - A R Zlotta
- Department of Surgical Oncology, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
| | - R G Bristow
- Department of Radiation Oncology, University of Toronto and Princess Margaret Hospital (University Health Network) , Toronto, ON, Canada
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Skliarenko J, Carlone M, Han K, Beiki-Ardakani A, Borg J, Levin W, Manchul L, Xie J, Fyles T, Milosevic M. Process Optimization of MRI Guided Brachytherapy for Cervical Cancer: Is Daily Replanning Required? Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Han K, Pintilie M, Lipscombe L, Lega I, Milosevic M, Fyles T. Metformin Use Is Associated With Lower Cervical Cancer–Specific Mortality. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.029] [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: 11/29/2022]
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French J, Purificacion S, Brown E, MacDonald R, Wilson L, Kumar E, Bird L, Brady J, Milosevic M, Mitera G. Each Cancer Journey Begins With One Shared Step: Patient Engagement and Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Swinnen T, Milosevic M, Scheers T, Lefevre J, Van Huffel S, Dankaerts W, Westhovens R, de Vlam K. THU0605-HPR Patterns of Physical Activity Matter: Bout Analysis Reveals Differences Between Patients with Axial Spondyloarthritis and Healthy Controls. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Hill R, Chaudary N, Jelveh S, Lindsay P, Mackay H, Milosevic M. SP-0596: New models to study therapeutic targets in tumours and normal tissues. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40590-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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