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Sengupta S, Tubio CR, Pinto RS, Barbosa J, Silva MM, Gonçalves R, Kundu M, Lanceros-Mendez S, Costa CM. Ternary composites of poly(vinylidene fluoride-co-hexafluoropropylene) with silver nanowires and titanium dioxide nanoparticles as separator membranes for lithium-ion batteries. J Colloid Interface Sci 2024; 668:25-36. [PMID: 38669993 DOI: 10.1016/j.jcis.2024.04.149] [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: 03/14/2024] [Revised: 04/12/2024] [Accepted: 04/21/2024] [Indexed: 04/28/2024]
Abstract
In the realm of polymer composites, there is growing interest in the use of more than one filler for achieving multifunctional properties. In this work, a composite separator membrane has been developed for lithium-ion battery application, by incorporating conductive silver nanowires (AgNWs) and titanium dioxide (TiO2) nanoparticles into a poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) polymer matrix. The composite membranes were manufactured by solvent casting and thermally induced phase separation, with total filler content varying up to 10 wt%. The ternary composites composites present improved mechanical characteristics, ionic conductivity and lithium transfer number compared to the neat polymer matrix. On the other hand, the filler type and content within the composite has little bearing on the morphology, polymer phase, or thermal stability. Once applied as a separator in lithium-ion batteries, the highest discharge capacity value was obtained for the 5 wt% AgNWs/5 wt% TiO2/PVDF-HFP membrane at different C-rates, benefiting from the synergetic effect from both fillers. This work demonstrates that higher battery performance can be achieved for next-generation lithium-ion batteries by using separator membranes based on ternary composites.
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Affiliation(s)
- S Sengupta
- Electrochemial Energy Storage Laboratory, Department of Chemistry, SRM Institute of Science and Technology, Chennai, India
| | - C R Tubio
- BCMaterials, Basque Center for Materials, Applications and Nanostructures, UPV/EHU Science Park, 48940 Leioa, Spain
| | - R S Pinto
- Centre of Chemistry, University of Minho, 4710-057 Braga, Portugal; Centre of Physics Universities of Minho and Porto, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - J Barbosa
- Centre of Chemistry, University of Minho, 4710-057 Braga, Portugal
| | - M M Silva
- Centre of Chemistry, University of Minho, 4710-057 Braga, Portugal
| | - R Gonçalves
- Centre of Chemistry, University of Minho, 4710-057 Braga, Portugal
| | - M Kundu
- Electrochemial Energy Storage Laboratory, Department of Chemistry, SRM Institute of Science and Technology, Chennai, India; International Iberian Nanotechnology Laboratory (INL), Av. Mestre Jose Veiga, 4715-330 Braga, Portugal.
| | - S Lanceros-Mendez
- BCMaterials, Basque Center for Materials, Applications and Nanostructures, UPV/EHU Science Park, 48940 Leioa, Spain; Centre of Physics Universities of Minho and Porto, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal; Laboratory of Physics for Materials and Emergent Technologies, LapMET, University of Minho, Braga 4710-057, Portugal; Ikerbasque, Basque Foundation for Science, 48009 Bilbao, Spain
| | - C M Costa
- Centre of Physics Universities of Minho and Porto, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal; Laboratory of Physics for Materials and Emergent Technologies, LapMET, University of Minho, Braga 4710-057, Portugal; Institute of Science and Innovation for Bio-Sustainability (IB-S), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
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Kamboj N, Dey A, Birara S, Majumder M, Sengupta S, Metre RK. Designing one-compartment H 2O 2 fuel cell using electroactive phenalenyl-based [Fe 2(hnmh-PLY) 3] complex as the cathode material. Dalton Trans 2024; 53:7152-7162. [PMID: 38572846 DOI: 10.1039/d4dt00134f] [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: 04/05/2024]
Abstract
The sustainable chemical energy of H2O2 as a fuel and an oxidant in an advantageous single-compartment fuel cell design can be converted into electric energy, which requires molecular engineering to design suitable cathodes for lowering the high overpotential associated with H2O2 reduction. The present work covers the synthesis and structural characterization of a novel cathode material, [FeIII2(hnmh-PLY)3] complex, 1, designed from a PLY-derived Schiff base ligand (E)-9-(2-((2-hydroxynaphthalen-1-yl)methylene)hydrazineyl)-1H-phenalen-1-one, hnmh-PLYH2. Complex 1, when coated on the surface of a glassy carbon electrode (GC-1) significantly catalyzed the reduction of H2O2 in an acidic medium. Therefore, a complex 1 modified glassy carbon electrode was employed in a one-compartment H2O2 fuel cell operated in 0.1 M HCl with Ni foam as the corresponding anode to produce a high open circuit potential (OCP) of 0.65 V and a peak power density (PPD) of 2.84 mW cm-2. CV studies of complex 1 revealed the crucial participation of two Fe(III) centers for initiating H2O2 reduction, and the role of coordinated redox-active PLY units is also highlighted. In the solid state, the π-conjugated network of coordinating (hnmh-PLY) ligands in complex 1 has manifested interesting face-to-face π-π stacking interactions, which have helped the reduction of the complex and facilitated the overall catalytic performance.
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Affiliation(s)
- Nisha Kamboj
- Department of Chemistry, Indian Institute of Technology Jodhpur, Rajasthan-342030, India.
| | - Ayan Dey
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology Jodhpur, Rajasthan-342030, India.
| | - Sunita Birara
- Department of Chemistry, Indian Institute of Technology Jodhpur, Rajasthan-342030, India.
| | - Moumita Majumder
- Department of Chemistry, School of Science and Environmental Studies, Dr Vishwanath Karad MIT World Peace University, Pune, Maharashtra-411038, India.
| | - Srijan Sengupta
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology Jodhpur, Rajasthan-342030, India.
| | - Ramesh K Metre
- Department of Chemistry, Indian Institute of Technology Jodhpur, Rajasthan-342030, India.
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Samanta S, Sengupta S, Biswas S, Ghosh S, Barman S, Dey A. Iron Dioxygen Adduct Formed during Electrochemical Oxygen Reduction by Iron Porphyrins Shows Catalytic Heme Dioxygenase Reactivity. J Am Chem Soc 2023; 145:26477-26486. [PMID: 37993986 DOI: 10.1021/jacs.3c10980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Heme dioxygenases oxidize the indole ring of tryptophan to kynurenine which is the first step in the biosynthesis of several important biomolecules like NAD, xanthurenic acid, and picolinic acid. A ferrous heme dioxygen adduct (or FeIII-O2•-) is the oxidant, and both the atoms of O2 are inserted in the product and its catalytic function has been difficult to emulate as it is complicated by competing rapid reactions like auto-oxidation and/or formation of the μ-oxo dimer. In situ resonance Raman spectroscopy technique, SERRS-RDE, is used to probe the species accumulated during electrochemical ORR catalyzed by site-isolated imidazole-bound iron porphyrin installed on a self-assembled monolayer covered electrode. These in situ SERRS-RDE data using labeled O2 show that indeed a FeIII-O2•- species accumulate on the electrode during ORR between -0.05 and -0.30 V versus Ag/AgCl (satd. KCl) and is reduced by proton coupled electron transfer to a FeIII-OOH species which, on the other hand, builds up on the electrode between -0.20 and -0.40 V versus Ag/AgCl (satd. KCl). This FeIII-OOH species then gives way to a FeIV═O species, which accumulates at -0.50 V versus Ag/AgCl (satd. KCl). When 2,3-dimethylindole is present in the solution and the applied potential is held in the range where FeIII-O2•- species accumulate, it gets oxidized to N-(2-acetylphenyl)acetamide retaining both the oxygens from O2 mimicking the reaction of heme dioxygenases. Turnover numbers more than 104 are recorded, establishing this imidazole-bound ferrous porphyrin as a functional model of heme dioxygenases.
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Affiliation(s)
- Soumya Samanta
- School of Chemical Sciences, Indian Association for the Cultivation of Science, Kolkata 700032, India
| | - Srijan Sengupta
- School of Chemical Sciences, Indian Association for the Cultivation of Science, Kolkata 700032, India
| | - Saptarshi Biswas
- School of Chemical Sciences, Indian Association for the Cultivation of Science, Kolkata 700032, India
| | - Sucheta Ghosh
- School of Chemical Sciences, Indian Association for the Cultivation of Science, Kolkata 700032, India
| | - Sudip Barman
- School of Chemical Sciences, Indian Association for the Cultivation of Science, Kolkata 700032, India
| | - Abhishek Dey
- School of Chemical Sciences, Indian Association for the Cultivation of Science, Kolkata 700032, India
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Kamboj N, Dey A, Lama P, Majumder M, Sengupta S, Metre RK. A closed-shell phenalenyl-based dinuclear iron(III) complex as a robust cathode for a one-compartment H 2O 2 fuel cell. Dalton Trans 2023; 52:17163-17175. [PMID: 37877475 DOI: 10.1039/d3dt02975a] [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: 10/26/2023]
Abstract
Closed-shell phenalenyl (PLY) systems are increasingly becoming more attractive as building blocks for developing promising catalysts and electroactive cathode materials, as they have tremendous potential to accept electrons and participate in redox reactions. Herein, we report a PLY-based dinuclear [FeIII2(hmbh-PLY)3] complex, 1, and its utility as a cathode material in a H2O2 fuel cell. Complex 1 was synthesized from a new Schiff base ligand, (E)-9-(2-(2-hydroxy-3-methoxybenzylidene)hydrazineyl)-1H-phenalen-1-one, hmbh-PLYH2, designed using a PLY precursor, Hz-PLY. The newly derived ligand and complex 1 were characterized by various analytical techniques, including single-crystal X-ray diffraction (SCXRD). The cyclic voltammetry (CV) study revealed that complex 1 undergoes five electron reductions under an applied electric potential. When the electroactive complex 1 was employed as a cathode in a membrane-less one-compartment H2O2 fuel cell, with Ni foam as the corresponding anode, the designed fuel cell exhibited an exceptionally high peak power density (PPD) of 2.41 mW cm-2, in comparison with those of all the previously reported Fe-based molecular complexes. DFT studies were performed to gain reasonable insights into the two-electron catalytic reduction (pathway I) of H2O2 by the Fe-center of complex 1 and to explore the geometries, energetics of the electrocatalyst, reactive intermediates and transition states.
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Affiliation(s)
- Nisha Kamboj
- Department of Chemistry, Indian Institute of Technology Jodhpur, Rajasthan 342030, India.
| | - Ayan Dey
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology Jodhpur, Rajasthan 342030, India.
| | - Prem Lama
- CSIR-Indian Institute of Petroleum, Haridwar Road, Mokhampur, Dehradun 248005, India
| | - Moumita Majumder
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology Jodhpur, Rajasthan 342030, India.
| | - Srijan Sengupta
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology Jodhpur, Rajasthan 342030, India.
| | - Ramesh K Metre
- Department of Chemistry, Indian Institute of Technology Jodhpur, Rajasthan 342030, India.
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Upadhyay R, Elguindy AN, Sengupta S, Wang K, Beyer S, Thomas EM, Raval R, Palmer JD. Initial Report of Boswellia Serrata for Management of Cerebral Radiation Necrosis after Stereotactic Radiosurgery for Brain Metastases. Int J Radiat Oncol Biol Phys 2023; 117:S172-S173. [PMID: 37784429 DOI: 10.1016/j.ijrobp.2023.06.639] [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) Radiation necrosis (RN) is a concerning late toxicity after radiation therapy (RT) for brain metastases. Oral corticosteroids are the mainstay of management; however, they are not optimal for long-term use given multiple side effects and drug interactions, particularly with the emergence of immunotherapy for several cancers. Boswellia serrata (BS) is an over-the-counter supplement used for its anti-inflammatory properties and has been recently shown to reduce cerebral edema after brain RT. We evaluated the response rates with BS in a series of patients with brain metastases treated with stereotactic radiosurgery (SRS) who developed RN. MATERIALS/METHODS We included patients who developed RN after SRS for brain metastases at our institution from 2020-2022 and were treated with BS. Patients were prescribed over the counter BS 4.2-4.5g daily in divided doses. Follow-up MRI imaging was obtained every 2-3 months after starting BS. Response was assessed using Response Assessment in Neuro-Oncology (RANO) criteria. Primary endpoint was ≥25% decrease in edema volume on T2-FLAIR MRI from baseline. Patients were censored if they had tumor progression or repeat RT to necrotic area, or death. Kaplan-Meier curves were used for survival estimates. RESULTS A total of 50 patients received BS for Grade 1-3 CTCAE v5.0 RN (G1 = 11, G2 = 36, and G3 = 3). Median age was 62.8 years (range 36.9 - 50) and median RT dose was 24 Gy in 3 fractions. Median time to RN after SRS was 10 months(m). Median follow-up after starting BS was 6m and 40 patients had at least 1 follow up MRI available to evaluate response. The best response was complete response (CR) in 15% patients and partial response (PR) in 40% while 35% had stable disease (SD) and 10% had progressive disease. Median time to CR was 9m (6-12m) and PR was 6m (3-12m). Percentage of patients who had any response (CR or PR) at 3, 6, 9 and 12 months was 25%, 60%, 43% and 50%, respectively. 56% patients had symptomatic RN, of which 35.7% had improvement in symptoms with BS alone, while 64% required steroid use. Overall, median duration of response in patients with CR, PR or SD was 7.5m(range 2-31m). Salvage treatment for RN was steroids (33), surgery (4), Bevacizumab (5) or hyperbaric oxygen therapy (1). No patients had any CTCAE grade 3 or higher toxicities. 3 patients (6%) had any side-effects all of whom had Grade 1-2 gastrointestinal intolerance or diarrhea. 2 patients stopped treatment due to enrolment on an immunotherapy clinical trial. Overall, 39 patients remained on BS at last follow-up or death. CONCLUSION We observed >50% response rates with use of BS in our cohort of patients with Grade 1-3 RN after SRS. More than 1/3rd patients with symptomatic RN were able to avoid long-term steroid use. BS is an easily available over-the-counter drug that appears to be a safe and promising treatment option for RN, and can potentially decrease steroid dependence in these patients, reducing the risk of several side-effects. Further prospective studies to compare Boswellia with placebo is warranted.
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Affiliation(s)
| | - A N Elguindy
- The James Cancer Center, Ohio State University Wexner Medical Center, Columbus, OH
| | - S Sengupta
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - K Wang
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - S Beyer
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - E M Thomas
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - R Raval
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - J D Palmer
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
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Hall J, Wang K, Lui KP, Darawsheh R, Shumway JW, Carey LA, Hayes KR, Lee CB, Moschos S, Sengupta S, Chaudhary R, Yogendran L, Struve TD, Vatner RE, Pater LE, Breneman JC, Weiner AA, Shen C. Safety and Efficacy of Stereotactic Radiosurgery with Concurrent Targeted Systemic Therapy for Brain Metastases. Int J Radiat Oncol Biol Phys 2023; 117:e107. [PMID: 37784639 DOI: 10.1016/j.ijrobp.2023.06.882] [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) Data describing the safety and efficacy of central nervous system (CNS)-active targeted systemic therapies in combination with stereotactic radiosurgery (SRS, 1 fraction) and/or radiotherapy (SRT, 3-5 fractions) for brain metastases are emerging but limited. We report rates of local and intracranial failure and radiation necrosis in patients receiving CNS-active targeted systemic therapy and SRS/SRT. MATERIALS/METHODS We retrospectively identified patients with intact brain metastases at two institutions from 2009-2022 who were treated with SRS/SRT and CNS-active targeted systemic therapy in any sequence. Patients were followed for a minimum of 3 months after SRS/SRT with brain MRI. Patients typically stopped the targeted agent 2-4 days prior to radiation and resumed 2-4 days after. Targeted therapies included inhibitors of ALK/ROS1 (Alectinib, Ceritinib, Crizotinib, Lorlatinib), EGFR (Afatinib, Erlotinib, Gefitinib, Osimertinib), BRAF (Dabrafenib, Encorafenib, Vemurafenib), MEK (Binimetinib, Trametinib), CDK 4/6 (Abemaciclib, Palbociclib, Ribociclib), HER2 (Afatinib, Lapatinib, Neratinib, Pertuzumab, Trastuzumab, T-DM1, T-DXd, Tucatinib), KRAS (Adagrasib and Sotorasib), PARP (Niraparib, Olaparib), VEGF(R) (Axitinib, Bevacizumab, Ramucirumab), and less-selective tyrosine (receptor) kinase inhibitors (Bosutinib, Brigatinib, Entrectinib, Lenvatinib, Pazopanib, Sorafenib, Sunitinib). Local failure (LF) and radiation necrosis were determined radiographically with clinical impression (grade 2 (symptomatic) or higher (G2+)) and compared between different systemic agents. RESULTS The study included 95 patients with 310 metastases (SRS 246, SRT 64 metastases). Most common primary histologies were non-small cell lung cancer (36% 34/95), breast cancer (28% 27/95), and melanoma (16% 15/95). Overall survival at 1 and 2 years was 80% (76/95) and 55% (52/95), respectively. Median follow-up was 16.6 (range 3-91) months. Median tumor size was 7mm (range 1-75mm). Median number of brain metastases per patient was 2.5 (range 1-12). The G2+ radiation necrosis rate was 5.8% (18/310) while the LF rate was 9.7% (30/310) per metastasis. There was no significant difference in G2+ radiation necrosis by class of targeted therapy. Sixty-two percent (59/95) of patients experienced distant intracranial failure. Median intracranial progression free survival (PFS) was 8.0 (range 0.4-61.4) months. CONCLUSION Although heterogeneous, patients treated with SRS/SRT and ongoing CNS-active targeted systemic therapies have on average >6 month intracranial PFS and little evidence of significant toxicity. We observed <6% G2+ radiation necrosis for this cohort, and no particular class of agent was associated with a significantly higher rate of G2+ radiation necrosis.
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Affiliation(s)
- J Hall
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - K Wang
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - K P Lui
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - R Darawsheh
- University of North Carolina, Chapel Hill, NC
| | - J W Shumway
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - L A Carey
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - K Reeder Hayes
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - C B Lee
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - S Moschos
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - S Sengupta
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - R Chaudhary
- Division of Oncology, University of Cincinnati, Cincinnati, OH
| | - L Yogendran
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - T D Struve
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - R E Vatner
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - L E Pater
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - J C Breneman
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - A A Weiner
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
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MacDonald T, Sackett JJ, Gaskill-Shipley M, Rao R, Chaudhary R, Curry R, Forbes J, Andaluz N, Zuccarello M, Yogendran L, Sengupta S, Struve Iii TD, Vatner RE, Pater LE, Mascia AE, Breneman JC, Wang K. Neurologic Events and Outcomes in Patients Receiving Proton and Photon Reirradiation for High Grade Non-Codeleted Gliomas. Int J Radiat Oncol Biol Phys 2023; 117:e133-e134. [PMID: 37784697 DOI: 10.1016/j.ijrobp.2023.06.936] [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) Patients undergoing reirradiation (ReRT) for high grade glioma are at risk for tumor progression, pseudoprogression, and radiation necrosis. We investigated factors associated with neurologic events and disease control after re-irradiation with protons and photons at a single academic center. MATERIALS/METHODS We reviewed records and MRIs of patients receiving scanning beam proton (since center opening in 2016) and photon (since 2015) reirradiation in ≥10 fractions for grade 3 anaplastic astrocytoma (AA) and grade 4 glioblastoma (GBM), excluding 1p19q co-deleted oligodendrogliomas and extensive multifocal/leptomeningeal disease. The primary endpoint was time from ReRT to ≥ grade 2 pseudoprogression or radiation necrosis (PsP/RN, grade 2: moderate symptoms requiring outpatient steroids/bevacizumab, grade 3: severe symptoms leading to admission or surgical intervention). Dose was converted to EQD2 using a/b = 3. Cox proportional hazards model was used to calculate survival and time to PsP/RN. RESULTS A total of 53 patients were included (26 protons, 27 photons, median KPS 80). Patients receiving protons had more favorable features. Compared to the photons, the proton group was younger (48 vs. 58) and more likely to have AA (46% vs. 22%) and resection within 3 months (42% vs 26%). The proton group also had a longer interval from prior RT (57 vs. 39 months) and were less likely to receive bevacizumab at reRT (15% vs. 59%). CTV was 130 cc for protons vs 99 cc for photons, and most had active disease at time of ReRT identified on planning MRI (76% protons, 85% photons). Median OS was 10.5 months (14.1 months protons, 8.1 months photons), with time from initial RT the only significant factor on multivariate analysis. Median PFS was 9.4 months (9.8 months protons, 6.2 months photons). 9 patients (18%) had ≥ grade 3 PsP/RN (8 proton, 1 photon) and 21 patients (41%) had ≥ grade 2 PsP/RN (16 proton, 5 photon). Grade 3 events included 1 seizure (photon group), 1 hemorrhage, 1 thalamic stroke, 1 shunt placement, 1 re-resection, and PSP4 4 PsP/RN requiring admission. Protons were associated shorter time to ≥ grade 2 PsP/RN (4 months vs. not reached, p = 0.027). When accounting for bevacizumab use at time of reRT, the association between protons and PsP/RN lost significance but there remained a trend (grade 2, p = 0.095, HR 2.4; grade 3, p = 0.105, HR 5.8). CTV, MGMT status, EQD2, and interval from prior RT were not associated with PsP/RN. CONCLUSION High grade neurologic events were common in patients with predominantly active, unresected high grade gliomas receiving ReRT. Though ascertainment and survival bias are significant limitations, pseudoprogression and necrosis appeared to be more prominent in patients receiving protons. These results contribute to ongoing efforts to both optimize ReRT for high grade glioma and investigate biologic effects of proton therapy.
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Affiliation(s)
- T MacDonald
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - J J Sackett
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | | | - R Rao
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - R Chaudhary
- Division of Oncology, University of Cincinnati, Cincinnati, OH
| | - R Curry
- CTI Clinical Trial and Consulting Services, Covington, KY
| | - J Forbes
- Department of Neurosurgery, University of Cincinnati, Cincinnati, OH
| | - N Andaluz
- Department of Neurosurgery, University of Cincinnati, Cincinnati, OH
| | - M Zuccarello
- Department of Neurosurgery, University of Cincinnati, Cincinnati, OH
| | - L Yogendran
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - S Sengupta
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - T D Struve Iii
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - R E Vatner
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - L E Pater
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - A E Mascia
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - J C Breneman
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - K Wang
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
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Ray M, Guha S, Dhungana RR, Karak A, Choudhury B, Ray B, Zubair H, Ray M, Sengupta S, Bhatt DL, Goldberg RJ, Selker HP. Development and validation of a predictive model for the diagnosis of rheumatic heart disease in low-income countries based on two cross-sectional studies. Int J Cardiol Cardiovasc Risk Prev 2023; 18:200195. [PMID: 37455788 PMCID: PMC10344801 DOI: 10.1016/j.ijcrp.2023.200195] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
Objectives We developed a questionnaire-based risk-scoring system to identify children at risk for rheumatic heart disease (RHD) in rural India. The resulting predictive model was validated in Nepal, in a population with a similar demographic profile to rural India. Methods The study involved 8646 students (mean age 13.0 years, 46% boys) from 20 middle and high schools in the West Midnapore district of India. The survey asked questions about the presence of different signs and symptoms of RHD. Students with possible RHD who experienced sore throat and joint pain were offered an echocardiogram to screen for RHD. Their findings were compared with randomly selected students without these symptoms. The data were analyzed to develop a predictive model for identifying RHD. Results Based on our univariate analyses, seven variables were used for building a predictive model. A four-variable model (joint pain plus sore throat, female sex, shortness of breath, and palpitations) best predicted the risk of RHD with a C-statistic of 0.854. A six-point scoring system developed from the model was validated among similarly aged children in Nepal. Conclusions A simple questionnaire-based predictive instrument could identify children at higher risk for this disease in low-income countries where RHD remains prevalent. Echocardiography could then be used in these high-risk children to detect RHD in its early stages. This may support a strategy for more effective secondary prophylaxis of RHD.
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Affiliation(s)
- Madhab Ray
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA
| | - Santanu Guha
- Department of Cardiology, Kolkata Medical College, Kolkata, India
| | | | - Avik Karak
- Department of Cardiology, Kolkata Medical College, Kolkata, India
| | | | | | | | | | | | - Deepak L. Bhatt
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, New York, NY, USA
| | - Robert J. Goldberg
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Harry P. Selker
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA
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9
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Tabaie A, Sengupta S, Pruitt ZM, Fong A. A natural language processing approach to categorise contributing factors from patient safety event reports. BMJ Health Care Inform 2023; 30:bmjhci-2022-100731. [PMID: 37257922 DOI: 10.1136/bmjhci-2022-100731] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/12/2023] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVES The objective of this study was to explore the use of natural language processing (NLP) algorithm to categorise contributing factors from patient safety event (PSE). Contributing factors are elements in the healthcare process (eg, communication failures) that instigate an event or allow an event to occur. Contributing factors can be used to further investigate why safety events occurred. METHODS We used 10 years of self-reported PSE reports from a multihospital healthcare system in the USA. Reports were first selected by event date. We calculated χ2 values for each ngram in the bag-of-words then selected N ngrams with the highest χ2 values. Then, PSE reports were filtered to only include the sentences containing the selected ngrams. Such sentences were called information-rich sentences. We compared two feature extraction techniques from free-text data: (1) baseline bag-of-words features and (2) features from information-rich sentences. Three machine learning algorithms were used to categorise five contributing factors representing sociotechnical errors: communication/hand-off failure, technology issue, policy/procedure issue, distractions/interruptions and lapse/slip. We trained 15 binary classifiers (five contributing factors * three machine learning models). The models' performances were evaluated according to the area under the precision-recall curve (AUPRC), precision, recall, and F1-score. RESULTS Applying the information-rich sentence selection algorithm boosted the contributing factor categorisation performance. Comparing the AUPRCs, the proposed NLP approach improved the categorisation performance of two and achieved comparable results with baseline in categorising three contributing factors. CONCLUSIONS Information-rich sentence selection can be incorporated to extract the sentences in free-text event narratives in which the contributing factor information is embedded.
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Affiliation(s)
- Azade Tabaie
- Center for Biostatistics, Informatics, and Data Science, MedStar Health Research Institute, Washington, District of Columbia, USA
| | - Srijan Sengupta
- Department of Statistics, North Carolina State University, Raleigh, North Carolina, USA
| | - Zoe M Pruitt
- National Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, District of Columbia, USA
| | - Allan Fong
- Center for Biostatistics, Informatics, and Data Science, MedStar Health Research Institute, Washington, District of Columbia, USA
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10
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Ganguly I, Buhrman G, Kline E, Mun SK, Sengupta S. Automated Error Labeling in Radiation Oncology via Statistical Natural Language Processing. Diagnostics (Basel) 2023; 13:1215. [PMID: 37046433 PMCID: PMC10093130 DOI: 10.3390/diagnostics13071215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/12/2023] [Accepted: 03/16/2023] [Indexed: 04/14/2023] Open
Abstract
A report published in 2000 from the Institute of Medicine revealed that medical errors were a leading cause of patient deaths, and urged the development of error detection and reporting systems. The field of radiation oncology is particularly vulnerable to these errors due to its highly complex process workflow, the large number of interactions among various systems, devices, and medical personnel, as well as the extensive preparation and treatment delivery steps. Natural language processing (NLP)-aided statistical algorithms have the potential to significantly improve the discovery and reporting of these medical errors by relieving human reporters of the burden of event type categorization and creating an automated, streamlined system for error incidents. In this paper, we demonstrate text-classification models developed with clinical data from a full service radiation oncology center (test center) that can predict the broad level and first level category of an error given a free-text description of the error. All but one of the resulting models had an excellent performance as quantified by several metrics. The results also suggest that more development and more extensive training data would further improve future results.
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Affiliation(s)
- Indrila Ganguly
- Department of Statistics, North Carolina State University, Raleigh, NC 27607, USA
| | - Graham Buhrman
- Department of Educational Psychology, University of Wisconsin–Madison, Madison, WI 53706, USA
| | - Ed Kline
- RadPhysics Services LLC, Albuquerque, NM 87111, USA
| | - Seong K. Mun
- Arlington Innovation Center, Health Research, Virginia Tech, Arlington, VA 22203, USA
| | - Srijan Sengupta
- Department of Statistics, North Carolina State University, Raleigh, NC 27607, USA
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11
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Hayne D, Stockler M, Martin A, Mccombie S, Zebic D, Krieger L, Anderson P, Bastick P, Beardsley E, Blatt A, Frydenberg M, Green W, Grummet J, Hawks C, Ischia J, Mitterdorfer A, Patel M, Roberts M, Sengupta S, Srivastav R, Winter M, Redfern A, Davis I. Adding Mitomycin to BCG as adjuvant intravesical therapy for high-risk, non-muscle-invasive -bladder cancer: A randomised phase 3 trial: The BCG+MM Study (ANZUP1301). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00567-5] [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: 02/12/2023]
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12
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Yanchenko E, Sengupta S. Core-periphery structure in networks: A statistical exposition. Statist Surv 2023. [DOI: 10.1214/23-ss141] [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: 03/03/2023]
Affiliation(s)
- Eric Yanchenko
- Department of Statistics, North Carolina State University, SAS Hall, 2311 Stinson Dr, Raleigh, NC 27607
| | - Srijan Sengupta
- Department of Statistics, North Carolina State University, SAS Hall, 2311 Stinson Dr, Raleigh, NC 27607
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13
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Boxley C, Krevat S, Sengupta S, Ratwani R, Fong A. Using Community Detection Techniques to Identify Themes in COVID-19-Related Patient Safety Event Reports. J Patient Saf 2022; 18:e1196-e1202. [PMID: 36112536 PMCID: PMC9696685 DOI: 10.1097/pts.0000000000001051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has transformed how healthcare is delivered to patients. As the pandemic progresses and healthcare systems continue to adapt, it is important to understand how these changes in care have changed patient care. This study aims to use community detection techniques to identify and facilitate analysis of themes in patient safety event (PSE) reports to better understand COVID-19 pandemic's impact on patient safety. With this approach, we also seek to understand how community detection techniques can be used to better identify themes and extract information from PSE reports. METHODS We used community detection techniques to group 2082 PSE reports from January 1, 2020, to January 31, 2021, that mentioned COVID-19 into 65 communities. We then grouped these communities into 8 clinically relevant themes for analysis. RESULTS We found the COVID-19 pandemic is associated with the following clinically relevant themes: (1) errors due to new and unknown COVID-19 protocols/workflows; (2) COVID-19 patients developing pressure ulcers; (3) unsuccessful/incomplete COVID-19 testing; (4) inadequate isolation of COVID-19 patients; (5) inappropriate/inadequate care for COVID-19 patients; (6) COVID-19 patient falls; (7) delays or errors communicating COVID-19 test results; and (8) COVID-19 patients developing venous thromboembolism. CONCLUSIONS Our study begins the long process of understanding new challenges created by the pandemic and highlights how machine learning methods can be used to understand these and similar challenges. Using community detection techniques to analyze PSE reports and identify themes within them can help give healthcare systems the necessary information to improve patient safety and the quality of care they deliver.
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Affiliation(s)
- Christian Boxley
- From the National Center for Human Factors in Healthcare, Medstar Health, Washington, District of Columbia
| | - Seth Krevat
- From the National Center for Human Factors in Healthcare, Medstar Health, Washington, District of Columbia
| | | | - Raj Ratwani
- From the National Center for Human Factors in Healthcare, Medstar Health, Washington, District of Columbia
| | - Allan Fong
- From the National Center for Human Factors in Healthcare, Medstar Health, Washington, District of Columbia
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14
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Sengupta S, Bose S. 396 A Rare Encounter of “Forgotten Disease”. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
With the advent and prompt use of antibiotics after throat infections, the rare entity of Necrobacillosis has almost disappeared in clinical practice. Here we present a case of a fit and well 27-year-old lady who was brought into A&E with septic shock, DIC and MODS after initial diagnosis of a sore throat 4 days ago which was treated by oral antibiotics. She was found to have bilateral patchy consolidations which later became necrotic cavities, empyema thoracis, peritonitis and abscess cavities in abdomen with evolving splenic abscess, prolonged QT and ectopics and type 2 respiratory failure. She was resuscitated, intubated, and transferred to the ICU. With an isolate of Fusobacterium necrophorum from blood culture Meropenem, clindamycin and metronidazole were started. However, over the next few days of treatment, lack of clinical response prompted antibiotics changing, and surgical drainage of abscesses in chest and abdomen. Eventually after a considerable period of abdominal abscess drainage and about 3 weeks of metronidazole and other antibiotics followed by Piperacillin and tazobactam for another 3 weeks the patient recovered from sepsis and was stepped down to ward. This case though rare is a good example of the benefits of surgical drainage and prolonged antibiotics for septic patients with collections. A rapid weaning only results in re-collection and clinical deterioration, or recurrent collection as happened to this patient. This is a rare case of Lemierre's syndrome which depicts the surgical difficulties faced due to recurrent abscess cavities formed in this condition.
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Affiliation(s)
- S Sengupta
- Frimley Park Hospital , Camberley , United Kingdom
| | - S Bose
- Salford Royal NHS Foundation Trust , Manchester , United Kingdom
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15
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Shukla V, Gera B, Ganju S, Varma S, Maheshwari N, Guchhait P, Sengupta S. Application of CFD model for Passive Autocatalytic Recombiners to formulate an empirical correlation for integratral containment analysis. Nuclear Engineering and Technology 2022. [DOI: 10.1016/j.net.2022.06.002] [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] [Indexed: 10/18/2022]
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16
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Sengupta S, Handoo A, Mehta S, Kaushik M. T105 POCT in critical care: An accuracy check! Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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Sørli JB, Sengupta S, Jensen ACØ, Nikiforov V, Clausen PA, Hougaard KS, Højriis S, Frederiksen M, Hadrup N. Risk assessment of consumer spray products using in vitro lung surfactant function inhibition, exposure modelling and chemical analysis. Food Chem Toxicol 2022; 164:112999. [PMID: 35427705 DOI: 10.1016/j.fct.2022.112999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/14/2022] [Accepted: 04/05/2022] [Indexed: 11/26/2022]
Abstract
Consumer spray products release aerosols that can potentially be inhaled and reach the deep parts of the lungs. A thin layer of liquid, containing a mixture of proteins and lipids known as lung surfactant, coats the alveoli. Inhibition of lung surfactant function can lead to acute loss of lung function. We focused on two groups of spray products; 8 cleaning and 13 impregnation products, and in the context of risk assessment, used an in vitro method for assessing inhibition of lung surfactant function. Original spray-cans were used to generate aerosols to measure aerodynamic particle size distribution. We recreated a real-life exposure scenario to estimate the alveolar deposited dose. Most impregnation products inhibited lung surfactant function at the lowest aerosolization rate, whereas only two cleaning products inhibited function at the highest rates. We used inhibitory dose and estimated alveolar deposition to calculate the margin of safety (MoS). The MoS for the inhibitory products was ≤1 for the impregnation products, while much larger for the cleaning products (>880). This risk assessment focused on the risk of lung surfactant function disruption and provides knowledge on an endpoint of lung toxicity that is not investigated by the currently available OECD test guidelines.
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Affiliation(s)
- J B Sørli
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
| | - S Sengupta
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
| | - A C Ø Jensen
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
| | - V Nikiforov
- Norwegian Institute for Air Research (NILU), Tromsø, Norway.
| | - P A Clausen
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
| | - K S Hougaard
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Sara Højriis
- COWI, Parallelvej 2, Kgs, Lyngby, Denmark; DHI A/S, Agern Allé 5, Hørsholm, Denmark.
| | - M Frederiksen
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
| | - N Hadrup
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
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18
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O'Brien J, Manning T, Kelly B, Chen K, Merrilees D, Joseph J, Sengupta S, Goad J, Bolton D, Lawrenstchuk N. Sealing the leak: A 10-year multicentre experience managing refractory post retroperitoneal lymph node dissection chylous ascites. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00647-9] [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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19
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Sarkar B, Munshi A, Shahid T, Sengupta S, Bhaskar R, Ganesh T, Paul A, Bhattacharjee B, Pun R, Imbulgoda N, Biswal S, Rastogi K, Bansal K, Baba A, Yasmin T, Bhattacharya J, Ghosh T, De A, Chatterjee P, Pradhan A. Growth Characteristics of Woman Radiation Oncologists in South Asia: Assessment of Gender Neutrality and Leadership Position. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1027] [Citation(s) in RCA: 1] [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: 11/28/2022]
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20
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Sengupta S, Prendergast B, Furnaz S, Ronderos R, Almaghraby A, Asch FM, Blechova K, Zaky H, Dworakowski R, Izumi C, Lancellotti P, Habib G. Socio-economic variations in the clinical presentation, etiology and outcome of infective endocarditis in the ESC-EORP EURO-ENDO (European Infective Endocarditis) registry: a prospective cohort study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1710] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Infective endocarditis (IE) is a life threatening disease associated with high mortality and morbidity worldwide. We sought to determine how socio-economic factors may influence variations in epidemiology, clinical presentation, investigation and management (and their consequence upon clinical outcomes) in a large international multi-centre registry.
Methods
The ESC-EORPEURO-ENDO registry comprises a prospective cohort of 3116 adult patients admitted to 156 hospitals in 40 countries with IE between January 2016 and March 2018. We analysed the complete dataset to assess potentially important determinants of variation according to World Bank economic stratification (high income (Group 1) [73.8%]; upper-middle income (Group 2) [17.1%]; lower-middle income (Group 3)[9.1%]).
Results
Patients in Group 3 were younger (median age [IQR]: Group 1 - 66 [54–75] years; Group 2 - 57 [40–68] years; Group 3 - 33 [26–43] years; p<0.001) with a higher prevalence of smoking, intravenous drug use and human immunodeficiency virus (HIV) infection (all p<0.001). Group 3 patients with IE presented later (median [IQR) days since symptom onset: Group 1 - 12 [3–35]; Group 2 - 20 [6–51]; Group 3 - 31 [12–62]; p<0.001) and were more likely to develop congestive heart failure (13.6%; 11.3%; and 22.6%, respectively; p<0.001), septic shock (8.3%; 11.1%; 13.4%; p=0.007), and persistent fever for greater than 7 days (9.6%; 14.4%; 27.9%; p<0.001) following hospital admission. Surgery was performed less frequently in Group 3 (75.4%, 76.8% and 51.3% in Groups 1, 2 and 3, respectively; p<0.001) and mortality was highest in the poorest countries (14.6%; 23.6% and 23.7%, respectively; p<0.001).
Conclusion
Socio-economic factors influence the clinical profile of patients presenting with IE across the world. Despite being younger, patients from the poorest countries presented with more frequent complications and higher mortality associated with delayed diagnosis and less frequent use of surgery.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Sengupta
- Sengupta Hospital and Research Institute, Nagpur, India
| | | | - S Furnaz
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - R Ronderos
- Institute of Cardiological Research UBA-CONICET, Buenos Aires, Argentina
| | - A Almaghraby
- Alexandria University hospital, Alexandria, Egypt
| | - F M Asch
- Medstar Research Institute, Washington, DC, United States of America
| | | | - H Zaky
- Dubai Hospital and Rashid Hospital, Dubai, United Arab Emirates
| | | | - C Izumi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | | | - G Habib
- Hospital La Timone of Marseille, Marseille, France
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21
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Sengupta S, Mohan J, MacGowan G, Jakovljevic D. Peak atrial longitudinal strain predicts exercise tolerance in heart failure with preserved ejection fraction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0742] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose
The present study i) determined left atrial (LA) and left ventricular (LV) strains at rest and in response to exercise in patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF), and ii) assessed the relationship between LA and LV strains and exercise tolerance.
Methods
Forty HFpEF patients (age 59±7 yrs; 25 females), 40 stable HFrEF patients (age 57+6 yrs, 15 females) and 20 controls (age 56+6 yrs, 13 females) underwent baseline clinical and biochemical assessment, resting and exercise stress transthoracic echocardiography using modified Bruce protocol. Speckle-tracking echocardiography was performed to define peak atrial longitudinal strain (PALS) and left ventricular global longitudinal strain (LVGLS). LA stiffness index and LV stiffness index were also derived.
Results
Compared to healthy controls, HFpEF and HFrEF showed significantly lower PALS at rest (34.03±1.85 vs. 23.06±4.69 vs. 11.51±1.44%, p<0.01) and after exercise (34.41±1.24 vs. 18.48±3.51 vs 10.47±1.49, p<0.01 for both). In response to exercise, the PALS significantly reduced in HFpEF by 26%, but only 8% in HFrEF and remained unchanged in controls. LA stiffness index was higher in HFpEF and HFrEF compared to healthy controls at rest (0.57±0.22 vs. 1.19±0.63 vs. 0.27±0.06, p<0.01) and in response to exercise (0.83±0.46 vs. 1.37±0.63 vs. 0.33±0.04, p<0.01). Compared to healthy controls, HFpEF and HFrEF demonstrated significantly lower LVGLS at rest (−20.27±0.98 vs. −15.89±2.72 vs.-11.14±3.40%, p<0.01) and after exercise (−19.9±0.8 vs.-15.5±3.18 vs.-11.01±2.6%, p<0.01). LV stiffness index was significantly higher in HFpEF and HFrEF compared to healthy controls at rest (0.16±0.05 vs. 0.14±0.07 vs. 0.11±0.02, p<0.01) and in response to exercise (0.18±0.07 vs. 0.15±0.06 vs. 0.13±0.02, p<0.01). Exercise tolerance i.e. exercise duration was significantly lower by 28% and 30% in HFpEF and HFrEF compared with controls (363±152 vs. 352±91 vs. 505±42, p<0.01). There was a significant relationship between peak atrial longitudinal strain and exercise tolerance in HFpEF (r=0.32, p=0.04).There was no significant relationship between exercise tolerance and LVGLS (r=0.058, p=0.72), LA stiffness (r=−0.17, p=0.3), LV stiffness (r=0.88, p=.59). There was no significant relationship between exercise tolerance and PALS (r=0.021, p=0.89) or LVGLS (r=0.12, p=0.48) in HFrEF.
Conclusion
HFpEF and HFrEF are associated with reduced left atrial and left ventricular strains and increased arial and ventricular stiffness.Peak atrial longitudinal strain is a significant determinant of exercise tolerance in HFpEF but not in HFrEF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Sengupta
- Sengupta Hospital and Research Institute, Nagpur, India
| | - J.C Mohan
- Jaipur Golden Hospital, New Delhi, India
| | - G.A MacGowan
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Translational, Clinical & Biosciences Research Institutes, Faculty of Medical Sciences, Newcastle Upon Tyne, United Kingdom
| | - D.J Jakovljevic
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Translational, Clinical & Biosciences Research Institutes, Faculty of Medical Sciences, Newcastle Upon Tyne, United Kingdom
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22
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Phadnis S, Sengupta S, Chakraborty A. Work From Home, Mental Health and Employee Needs: A pilot study in selected information technology organizations in India. APJHM 2021. [DOI: 10.24083/apjhm.v16i3.977] [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: 11/23/2022] Open
Abstract
Introduction: The Coronavirus (COVID-19) pandemic has impacted the economy and has resulted in changes to the working arrangements of employees who are based at home and may continue to work from home (WFH). Organizations are expected to develop an inclusive policy for their employees to promote mental health whilst working from home. The aim of this study was to document the impact of WFH on mental health and determine the expectations of employees from their organizations regarding occupational health policy.
Methodology: A cross-sectional study was conducted on the impact of work from home on mental health and to document the mental health support needs of employees. Google form was floated through social media platform to receive the responses. A total of 74 responses were received. Descriptive analysis was conducted using Microsoft Excel, while qualitative answers were manually analysed.
Results: About 67% employees (n=45) mentioned that their workload has increased significantly during work from home. Thirty five percent (n=26) felt lonely and lost and 47% (n= 34) felt disconnected from the real world, indicating the mental health impact of work from home. Fifty three percent employees (n=40) mentioned that there were no efforts made by their organization to reduce the mental health impact of work from home.
Conclusion: The results of this study indicate that there is an urgent need to create a comprehensive occupational health and safety policy inclusive of strategies to improve mental health by the organizations in light of “work from home” as a “new-normal”.
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23
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Pruitt Z, Boxley C, Krevat S, Sengupta S, Ratwani R, Fong A. The Impact of COVID-19 on Medical Device Reporting and Investigation. PatientSaf 2021. [DOI: 10.33940/data/2021.9.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction
The Manufacturer and User Facility Device Experience (MAUDE) database houses medical device reports submitted to the U.S. Food and Drug Administration (FDA). In May 2020, the FDA released guidance about medical device reporting during a pandemic, anticipating delays in reporting and investigating events involving medical devices.
Methods
We aimed to understand how the COVID-19 pandemic impacted medical device reporting by analyzing reports in the MAUDE database that mention COVID-19.
Results
From the 816,470 reports submitted between January 1 and July 31, 2020, 3,500 (0.43%) included phrases related to COVID-19. Of these reports, 4.8% (167/3,500) described adverse events during COVID-19 patients’ treatment, and 90.3% (3,161 /3,500) described barriers manufacturers faced investigating malfunctioning devices during the pandemic. 4.9% (172/3,500) of reports were not related to COVID-19. Malfunctions were clinically significant in 85.8% (3,004/3,500) of reports.
Discussion
Reports indicate challenges some manufacturers had when investigating medical devices during the pandemic. The pandemic made investigating implants uniquely difficult, as restrictions to person-to-person contact limited the type of care patients could receive. Because full-scale investigations into malfunctioning devices may be difficult to perform during the pandemic, safety issues may go unaddressed and result in future harm to patients.
Conclusion
The COVID-19 pandemic and the myriad of healthcare, travel, and shipping challenges it created impacted how manufacturers reported and investigated medical devices. At the current time, it is unclear how manufacturers will address delayed clinical management of implant devices and other uninvestigated malfunctions after the pandemic and how this will impact patient safety.
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Affiliation(s)
- Zoe Pruitt
- MedStar Health National Center for Human Factors in Healthcare
| | | | - Seth Krevat
- MedStar Health National Center for Human Factors in Healthcare
| | | | - Raj Ratwani
- MedStar Health National Center for Human Factors in Healthcare
| | - Allan Fong
- MedStar Health National Center for Human Factors in Healthcare
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24
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Sarkar B, Shahid T, Indira G, Biswal S, Sengupta S, Biswas L, Goswami S, Pusarla C, de A, Ghosh T, Mukherjee M, Samanta A, Raj R, Bhattacharya J. PO-1123 Post mastectomy RT planning on institutional, RTOG & ESTRO contouring guidelines comparison. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07574-5] [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: 11/16/2022]
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25
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Dasgupta A, Sengupta S. Scalable Estimation of Epidemic Thresholds via Node Sampling. Sankhya Ser A 2021; 84:321-344. [PMID: 34248309 PMCID: PMC8260572 DOI: 10.1007/s13171-021-00249-0] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/11/2021] [Indexed: 02/06/2023]
Abstract
Infectious or contagious diseases can be transmitted from one person to another through social contact networks. In today's interconnected global society, such contagion processes can cause global public health hazards, as exemplified by the ongoing Covid-19 pandemic. It is therefore of great practical relevance to investigate the network transmission of contagious diseases from the perspective of statistical inference. An important and widely studied boundary condition for contagion processes over networks is the so-called epidemic threshold. The epidemic threshold plays a key role in determining whether a pathogen introduced into a social contact network will cause an epidemic or die out. In this paper, we investigate epidemic thresholds from the perspective of statistical network inference. We identify two major challenges that are caused by high computational and sampling complexity of the epidemic threshold. We develop two statistically accurate and computationally efficient approximation techniques to address these issues under the Chung-Lu modeling framework. The second approximation, which is based on random walk sampling, further enjoys the advantage of requiring data on a vanishingly small fraction of nodes. We establish theoretical guarantees for both methods and demonstrate their empirical superiority.
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Affiliation(s)
- Anirban Dasgupta
- Computer Science and Engineering, Indian Institute of Technology, Gandhinagar, Gandhinagar, India
| | - Srijan Sengupta
- Statistics, North Carolina State University, Raleigh, NC USA
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Moitra S, Moitra S, Ghosh AK, Sengupta S, Das PK, Das A, Mitra R, Murgia N, Usmani OS. Reference values of impulse oscillometry (IOS) for healthy Indian adults. Int J Tuberc Lung Dis 2021; 24:536-539. [PMID: 32398207 DOI: 10.5588/ijtld.19.0796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Subhabrata Moitra
- ISGlobal, Barcelona, Spain, CIBER Epidemiologia y Salud Publica (CIBERSP), Barcelona, Spain, Universitat Pompeu Fabra, Barcelona, Spain
| | - Saibal Moitra
- Division of Pulmonary Medicine, Charnock Hospital, Kolkata, India, Department of Pneumology, Allergy & Asthma Research Centre, Kolkata, India
| | - A K Ghosh
- Department of Statistics, Presidency University, Kolkata, India
| | - S Sengupta
- Division of Pulmonary Medicine, Charnock Hospital, Kolkata, India
| | - P K Das
- Division of Pulmonary Medicine, Charnock Hospital, Kolkata, India, Department of Pneumology, Allergy & Asthma Research Centre, Kolkata, India
| | - A Das
- Department of Respiratory Medicine, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | - R Mitra
- Department of Pulmonary Medicine, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, India
| | - N Murgia
- Department of Medicine, University of Perugia, Perugia, Italy
| | - O S Usmani
- National Heart and Lung Institute, Imperial College London, London, UK, ,
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Mahammedi A, Ramos A, Bargalló N, Gaskill M, Kapur S, Saba L, Carrete H, Sengupta S, Salvador E, Hilario A, Revilla Y, Sanchez M, Perez-Nuñez M, Bachir S, Zhang B, Oleaga L, Sergio J, Koren L, Martin-Medina P, Wang L, Benegas M, Ostos F, Gonzalez-Ortega G, Calleja P, Udstuen G, Williamson B, Khandwala V, Chadalavada S, Woo D, Vagal A. Brain and Lung Imaging Correlation in Patients with COVID-19: Could the Severity of Lung Disease Reflect the Prevalence of Acute Abnormalities on Neuroimaging? A Global Multicenter Observational Study. AJNR Am J Neuroradiol 2021; 42:1008-1016. [PMID: 33707278 DOI: 10.3174/ajnr.a7072] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/04/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Our aim was to study the association between abnormal findings on chest and brain imaging in patients with coronavirus disease 2019 (COVID-19) and neurologic symptoms. MATERIALS AND METHODS In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patients with COVID-19 from March 3, 2020, to June 25, 2020. Our inclusion criteria were patients diagnosed with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and available chest CT and brain imaging. The 5 lobes of the lungs were individually scored on a scale of 0-5 (0 corresponded to no involvement and 5 corresponded to >75% involvement). A CT lung severity score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement). RESULTS A total of 135 patients met the inclusion criteria with 132 brain CT, 36 brain MR imaging, 7 MRA of the head and neck, and 135 chest CT studies. Compared with 86 (64%) patients without acute abnormal findings on neuroimaging, 49 (36%) patients with these findings had a significantly higher mean CT lung severity score (9.9 versus 5.8, P < .001). These patients were more likely to present with ischemic stroke (40 [82%] versus 11 [13%], P < .0001) and were more likely to have either ground-glass opacities or consolidation (46 [94%] versus 73 [84%], P = .01) in the lungs. A threshold of the CT lung severity score of >8 was found to be 74% sensitive and 65% specific for acute abnormal findings on neuroimaging. The neuroimaging hallmarks of these patients were acute ischemic infarct (28%), intracranial hemorrhage (10%) including microhemorrhages (19%), and leukoencephalopathy with and/or without restricted diffusion (11%). The predominant CT chest findings were peripheral ground-glass opacities with or without consolidation. CONCLUSIONS The CT lung disease severity score may be predictive of acute abnormalities on neuroimaging in patients with COVID-19 with neurologic manifestations. This can be used as a predictive tool in patient management to improve clinical outcome.
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Affiliation(s)
- A Mahammedi
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - A Ramos
- Departments of Neuroradiology (A.R., E.S., A.H., L.K., P.M.-M.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - N Bargalló
- Neurology (S.S., D.W.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - M Gaskill
- Departments of Neuroradiology (L.O., N.B.), Hospital Clínic de Barcelona, Sunyer Biomedical Research Institute, Barcelona, Spain
| | - S Kapur
- Cardiopulmonary Imaging, (S.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - L Saba
- Department of Neuroradiology (L.S.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - H Carrete
- Department of Neuroradiology (H.C.), Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - S Sengupta
- Neurology (S.S., D.W.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - E Salvador
- Departments of Neuroradiology (A.R., E.S., A.H., L.K., P.M.-M.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Hilario
- Departments of Neuroradiology (A.R., E.S., A.H., L.K., P.M.-M.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Y Revilla
- Cardiopulmonary Imaging (Y.R., M.P.-N.) Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Sanchez
- Department of Neuroradiology (L.S.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - M Perez-Nuñez
- Cardiopulmonary Imaging (Y.R., M.P.-N.) Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - L Oleaga
- Departments of Neuroradiology (L.O., N.B.), Hospital Clínic de Barcelona, Sunyer Biomedical Research Institute, Barcelona, Spain
| | - J Sergio
- Department of Neuroradiology (L.S.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - L Koren
- Departments of Neuroradiology (A.R., E.S., A.H., L.K., P.M.-M.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Martin-Medina
- Departments of Neuroradiology (A.R., E.S., A.H., L.K., P.M.-M.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - L Wang
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - M Benegas
- Department of Neuroradiology (L.S.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - F Ostos
- Neurology (F.O., G.G.-O., P.C.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - G Gonzalez-Ortega
- Neurology (F.O., G.G.-O., P.C.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Calleja
- Neurology (F.O., G.G.-O., P.C.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - G Udstuen
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - B Williamson
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - V Khandwala
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | | | - D Woo
- Neurology (S.S., D.W.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - A Vagal
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
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Nandurkar R, Sluka P, Li M, Wardan H, Davis I, Sengupta S. Lytic Effects of Water on Bladder Cancer Cell Lines – Implications for Clinical Use of Water Irrigation to Reduce Recurrence. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.037] [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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Li M, Toniolo J, Nandurkar R, Papa N, Lawrentschuk N, Davis ID, Sengupta S. Continuous Bladder Irrigation after Transurethral Resection of Non-Muscle Invasive Bladder Cancer for Prevention of Tumour Recurrence – A Systematic Review. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.036] [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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Ho H, Ng M, Guerrieri M, Tan A, Bolton D, Chan Y, Lawrentschuk N, Cham C, McMillan K, Sengupta S, Koufogiannis G, Cokelek M, Spencer S, Liu M, Pham T, Lim Joon D, Foroudi F, Tacey M, Khor R, Ding W, Subramanian B, Chao M. Low Dose Rate Brachytherapy and Long-Term Treatment Outcomes In Patients Less Than 60 Years of Age. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.528] [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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Niazi T, Williams S, Davis I, Stockler M, Martin A, Bracken K, Roncolato F, McJannett M, Horvath L, Sengupta S, Hughes S, McDermott R, Catto J, Kelly P, Vapiwala N, Parulekar W, Morgan S, Rendon R, Sweeney C. 694TiP DASL-HiCaP: Darolutamide augments standard therapy for localised very high-risk cancer of the prostate (ANZUP1801). A randomised phase III double-blind, placebo-controlled trial of adding darolutamide to androgen deprivation therapy and definitive or salvage radiation. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2088] [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] Open
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Li M, Cheung K, Sengupta S. A systematic review and meta-analysis of negative predictive value of multi-parametric MRI as a pre-biopsy triage tool. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33743-5] [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: 10/23/2022] Open
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Rosenthal VD, Bat-Erdene I, Gupta D, Belkebir S, Rajhans P, Zand F, Myatra SN, Afeef M, Tanzi VL, Muralidharan S, Gurskis V, Al-Abdely HM, El-Kholy A, AlKhawaja SAA, Sen S, Mehta Y, Rai V, Hung NV, Sayed AF, Guerrero-Toapanta FM, Elahi N, Morfin-Otero MDR, Somabutr S, De-Carvalho BM, Magdarao MS, Velinova VA, Quesada-Mora AM, Anguseva T, Ikram A, Aguilar-de-Moros D, Duszynska W, Mejia N, Horhat FG, Belskiy V, Mioljevic V, Di-Silvestre G, Furova K, Gamar-Elanbya MO, Gupta U, Abidi K, Raka L, Guo X, Luque-Torres MT, Jayatilleke K, Ben-Jaballah N, Gikas A, Sandoval-Castillo HR, Trotter A, Valderrama-Beltrán SL, Leblebicioglu H, Riera F, López M, Maurizi D, Desse J, Pérez I, Silva G, Chaparro G, Golschmid D, Cabrera R, Montanini A, Bianchi A, Vimercati J, Rodríguez-del-Valle M, Domínguez C, Saul P, Chediack V, Piastrelini M, Cardena L, Ramasco L, Olivieri M, Gallardo P, Juarez P, Brito M, Botta P, Alvarez G, Benchetrit G, Caridi M, Stagnaro J, Bourlot I, García M, Arregui N, Saeed N, Abdul-Aziz S, ALSayegh S, Humood M, Mohamed-Ali K, Swar S, Magray T, Aguiar-Portela T, Sugette-de-Aguiar T, Serpa-Maia F, Fernandes-Alves-de-Lima L, Teixeira-Josino L, Sampaio-Bezerra M, Furtado-Maia R, Romário-Mendes A, Alves-De-Oliveira A, Vasconcelos-Carneiro A, Anjos-Lima JD, Pinto-Coelho K, Maciel-Canuto M, Rocha-Batista M, Moreira T, Rodrigues-Amarilo N, Lima-de-Barros T, Guimarães KA, Batista C, Santos C, de-Lima-Silva F, Santos-Mota E, Karla L, Ferreira-de-Souza M, Luzia N, de-Oliveira S, Takeda C, Azevedo-Ferreira-Lima D, Faheina J, Coelho-Oliveira L, do-Nascimento S, Machado-Silva V, Bento-Ferreira, Olszewski J, Tenorio M, Silva-Lemos A, Ramos-Feijó C, Cardoso D, Correa-Barbosa M, Assunção-Ponte G, Faheina J, da-Silva-Escudero D, Servolo-Medeiros E, Andrade-Oliveira-Reis M, Kostadinov E, Dicheva V, Petrov M, Guo C, Yu H, Liu T, Song G, Wang C, Cañas-Giraldo L, Marin-Tobar D, Trujillo-Ramirez E, Andrea-Rios P, Álvarez-Moreno C, Linares C, González-Rubio P, Ariza-Ayala B, Gamba-Moreno L, Gualtero-Trujill S, Segura-Sarmiento S, Rodriguez-Pena J, Ortega R, Olarte N, Pardo-Lopez Y, Luis Marino Otela-Baicue A, Vargas-Garcia A, Roncancio E, Gomez-Nieto K, Espinosa-Valencia M, Barahona-Guzman N, Avila-Acosta C, Raigoza-Martinez W, Villamil-Gomez W, Chapeta-Parada E, Mindiola-Rochel A, Corchuelo-Martinez A, Martinez A, Lagares-Guzman A, Rodriguez-Ferrer M, Yepes-Gomez D, Muñoz-Gutierrez G, Arguello-Ruiz A, Zuniga-Chavarria M, Maroto-Vargas L, Valverde-Hernández M, Solano-Chinchilla A, Calvo-Hernandez I, Chavarria-Ugalde O, Tolari G, Rojas-Fermin R, Diaz-Rodriguez C, Huascar S, Ortiz M, Bovera M, Alquinga N, Santacruz G, Jara E, Delgado V, Salgado-Yepez E, Valencia F, Pelaez C, Gonzalez-Flores H, Coello-Gordon E, Picoita F, Arboleda M, Garcia M, Velez J, Valle M, Unigarro L, Figueroa V, Marin K, Caballero-Narvaez H, Bayani V, Ahmed S, Alansary A, Hassan A, Abdel-Halim M, El-Fattah M, Abdelaziz-Yousef R, Hala A, Abdelhady K, Ahmed-Fouad H, Mounir-Agha H, Hamza H, Salah Z, Abdel-Aziz D, Ibrahim S, Helal A, AbdelMassih A, Mahmoud AR, Elawady B, El-sherif R, Fattah-Radwan Y, Abdel-Mawla T, Kamal-Elden N, Kartsonaki M, Rivera D, Mandal S, Mukherjee S, Navaneet P, Padmini B, Sorabjee J, Sakle A, Potdar M, Mane D, Sale H, Abdul-Gaffar M, Kazi M, Chabukswar S, Anju M, Gaikwad D, Harshe A, Blessymole S, Nair P, Khanna D, Chacko F, Rajalakshmi A, Mubarak A, Kharbanda M, Kumar S, Mathur P, Saranya S, Abubakar F, Sampat S, Raut V, Biswas S, Kelkar R, Divatia J, Chakravarthy M, Gokul B, Sukanya R, Pushparaj L, Thejasvini A, Rangaswamy S, Saini N, Bhattacharya C, Das S, Sanyal S, Chaudhury B, Rodrigues C, Khanna G, Dwivedy A, Binu S, Shetty S, Eappen J, Valsa T, Sriram A, Todi S, Bhattacharyya M, Bhakta A, Ramachandran B, Krupanandan R, Sahoo P, Mohanty N, Sahu S, Misra S, Ray B, Pattnaik S, Pillai H, Warrier A, Ranganathan L, Mani A, Rajagopal S, Abraham B, Venkatraman R, Ramakrishnan N, Devaprasad D, Siva K, Divekar D, Satish Kavathekar M, Suryawanshi M, Poojary A, Sheeba J, Patil P, Kukreja S, Varma K, Narayanan S, Sohanlal T, Agarwal A, Agarwal M, Nadimpalli G, Bhamare S, Thorat S, Sarda O, Nadimpalli P, Nirkhiwale S, Gehlot G, Bhattacharya S, Pandya N, Raphel A, Zala D, Mishra S, Patel M, Aggarwal D, Jawadwal B, Pawar N, Kardekar S, Manked A, Tamboli A, Manked A, Khety Z, Singhal T, Shah S, Kothari V, Naik R, Narain R, Sengupta S, Karmakar A, Mishra S, Pati B, Kantroo V, Kansal S, Modi N, Chawla R, Chawla A, Roy I, Mukherjee S, Bej M, Mukherjee P, Baidya S, Durell A, Vadi S, Saseedharan S, Anant P, Edwin J, Sen N, Sandhu K, Pandya N, Sharma S, Sengupta S, Palaniswamy V, Sharma P, Selvaraj M, Saurabh L, Agarwal M, Punia D, Soni D, Misra R, Harsvardhan R, Azim A, Kambam C, Garg A, Ekta S, Lakhe M, Sharma C, Singh G, Kaur A, Singhal S, Chhabra K, Ramakrishnan G, Kamboj H, Pillai S, Rani P, Singla D, Sanaei A, Maghsudi B, Sabetian G, Masjedi M, Shafiee E, Nikandish R, Paydar S, Khalili H, Moradi A, Sadeghi P, Bolandparvaz S, Mubarak S, Makhlouf M, Awwad M, Ayyad O, Shaweesh A, Khader M, Alghazawi A, Hussien N, Alruzzieh M, Mohamed Y, ALazhary M, Abdul Aziz O, Alazmi M, Mendoza J, De Vera P, Rillorta A, de Guzman M, Girvan M, Torres M, Alzahrani N, Alfaraj S, Gopal U, Manuel M, Alshehri R, Lessing L, Alzoman H, Abdrahiem J, Adballah H, Thankachan J, Gomaa H, Asad T, AL-Alawi M, Al-Abdullah N, Demaisip N, Laungayan-Cortez E, Cabato A, Gonzales J, Al Raey M, Al-Darani S, Aziz M, Al-Manea B, Samy E, AlDalaton M, Alaliany M, Alabdely H, Helali N, Sindayen G, Malificio A, Al-Dossari H, Kelany A, Algethami A, Mohamed D, Yanne L, Tan A, Babu S, Abduljabbar S, Al-Zaydani M, Ahmed H, Al Jarie A, Al-Qathani A, Al-Alkami H, AlDalaton M, Alih S, Alaliany M, Gasmin-Aromin R, Balon-Ubalde E, Diab H, Kader N, Hassan-Assiry I, Kelany A, Albeladi E, Aboushoushah S, Qushmaq N, Fernandez J, Hussain W, Rajavel R, Bukhari S, Rushdi H, Turkistani A, Mushtaq J, Bohlega E, Simon S, Damlig E, Elsherbini S, Abraham S, Kaid E, Al-Attas A, Hawsawi G, Hussein B, Esam B, Caminade Y, Santos A, Abdulwahab M, Aldossary A, Al-Suliman S, AlTalib A, Albaghly N, HaqlreMia M, Kaid E, Altowerqi R, Ghalilah K, Alradady M, Al-Qatri A, Chaouali M, Shyrine E, Philipose J, Raees M, AbdulKhalik N, Madco M, Acostan C, Safwat R, Halwani M, Abdul-Aal N, Thomas A, Abdulatif S, Ali-Karrar M, Al-Gosn N, Al-Hindi A, Jaha R, AlQahtani S, Ayugat E, Al-Hussain M, Aldossary A, Al-Suliman S, Al-Talib A, Albaghly N, Haqlre-Mia M, Briones S, Krishnan R, Tabassum K, Alharbi L, Madani A, Al-Hindi A, Al-Gethamy M, Alamri D, Spahija G, Gashi A, Kurian A, George S, Mohamed A, Ramapurath R, Varghese S, Abdo N, Foda-Salama M, Al-Mousa H, Omar A, Salama M, Toleb M, Khamis S, Kanj S, Zahreddine N, Kanafani Z, Kardas T, Ahmadieh R, Hammoud Z, Zeid I, Al-Souheil A, Ayash H, Mahfouz T, Kondratas T, Grinkeviciute D, Kevalas R, Dagys A, Mitrev Z, Bogoevska-Miteva Z, Jankovska K, Guroska S, Petrovska M, Popovska K, Ng C, Hoon Y, Hasan YM, Othman-Jailani M, Hadi-Jamaluddin M, Othman A, Zainol H, Wan-Yusoff W, Gan C, Lum L, Ling C, Aziz F, Zhazali R, Abud-Wahab M, Cheng T, Elghuwael I, Wan-Mat W, Abd-Rahman R, Perez-Gomez H, Kasten-Monges M, Esparza-Ahumada S, Rodriguez-Noriega E, Gonzalez-Diaz E, Mayoral-Pardo D, Cerero-Gudino A, Altuzar-Figueroa M, Perez-Cruz J, Escobar-Vazquez M, Aragon D, Coronado-Magana H, Mijangos-Mendez J, Corona-Jimenez F, Aguirre-Avalos G, Lopez-Mateos A, Martinez-Marroquin M, Montell-Garcia M, Martinez-Martinez A, Leon-Sanchez E, Gomez-Flores G, Ramirez M, Gomez M, Lozano M, Mercado V, Zamudio-Lugo I, Gomez-Gonzalez C, Miranda-Novales M, Villegas-Mota I, Reyes-Garcia C, Ramirez-Morales M, Sanchez-Rivas M, Cureno-Diaz M, Matias-Tellez B, Gonzalez-Martinez J, Juarez-Vargas R, Pastor-Salinas O, Gutierrez-Munoz V, Conde-Mercado J, Bruno-Carrasco G, Manrique M, Monroy-Colin V, Cruz-Rivera Z, Rodriguez-Pacheco J, Cruz N, Hernandez-Chena B, Guido-Ramirez O, Arteaga-Troncoso G, Guerra-Infante F, Lopez-Hurtado M, Caleco JD, Leyva-Medellin E, Salamanca-Meneses A, Cosio-Moran C, Ruiz-Rendon R, Aguilar-Angel L, Sanchez-Vargas M, Mares-Morales R, Fernandez-Alvarez L, Castillo-Cruz B, Gonzalez-Ma M, Zavala-Ramír M, Rivera-Reyna L, del-Moral-Rossete L, Lopez-Rubio C, Valadez-de-Alba M, Bat-Erdene A, Chuluunchimeg K, Baatar O, Batkhuu B, Ariyasuren Z, Bayasgalan G, Baigalmaa S, Uyanga T, Suvderdene P, Enkhtsetseg D, Suvd-Erdene D, Chimedtseye E, Bilguun G, Tuvshinbayar M, Dorj M, Khajidmaa T, Batjargal G, Naranpurev M, Bat-Erdene A, Bolormaa T, Battsetseg T, Batsuren C, Batsaikhan N, Tsolmon B, Saranbaatar A, Natsagnyam P, Nyamdawa O, Madani N, Abouqal R, Zeggwagh A, Berechid K, Dendane T, Koirala A, Giri R, Sainju S, Acharya S, Paul N, Parveen A, Raza A, Nizamuddin S, Sultan F, Imran X, Sajjad R, Khan M, Sana F, Tayyab N, Ahmed A, Zaman G, Khan I, Khurram F, Hussain A, Zahra F, Imtiaz A, Daud N, Sarwar M, Roop Z, Yusuf S, Hanif F, Shumaila X, Zeb J, Ali S, Demas S, Ariff S, Riaz A, Hussain A, Kanaan A, Jeetawi R, Castaño E, Moreno-Castillo L, García-Mayorca E, Prudencio-Leon W, Vivas-Pardo A, Changano-Rodriguez M, Castillo-Bravo L, Aibar-Yaranga K, Marquez-Mondalgo V, Mueras-Quevedo J, Meza-Borja C, Flor J, Fernandez-Camacho Y, Banda-Flores C, Pichilingue-Chagray J, Castaneda-Sabogal A, Caoili J, Mariano M, Maglente R, Santos S, de-Guzman G, Mendoza M, Javellana O, Tajanlangit A, Tapang A, Sg-Buenaflor M, Labro E, Carma R, Dy A, Fortin J, Navoa-Ng J, Cesar J, Bonifacio B, Llames M, Gata H, Tamayo A, Calupit H, Catcho V, Bergosa L, Abuy M, Barteczko-Grajek B, Rojek S, Szczesny A, Domanska M, Lipinska G, Jaroslaw J, Wieczoreka A, Szczykutowicza A, Gawor M, Piwoda M, Rydz-Lutrzykowska J, Grudzinska M, Kolat-Brodecka P, Smiechowicz K, Tamowicz B, Mikstacki A, Grams A, Sobczynski P, Nowicka M, Kretov V, Shalapuda V, Molkov A, Puzanov S, Utkin I, Tchekulaev A, Tulupova V, Vasiljevic S, Nikolic L, Ristic G, Eremija J, Kojovic J, Lekic D, Simic A, Hlinkova S, Lesnakova A, Kadankunnel S, Abdo-Ali M, Pimathai R, Wanitanukool S, Supa N, Prasan P, Luxsuwong M, Khuenkaew Y, Lamngamsupha J, Siriyakorn N, Prasanthai V, Apisarnthanarak A, Borgi A, Bouziri A, Cabadak H, Tuncer G, Bulut C, Hatipoglu C, Sebnem F, Demiroz A, Kaya A, Ersoz G, Kuyucu N, Karacorlu S, Oncul O, Gorenek L, Erdem H, Yildizdas D, Horoz O, Guclu E, Kaya G, Karabay O, Altindis M, Oztoprak N, Sahip Y, Uzun C, Erben N, Usluer G, Ozgunes I, Ozcelik M, Ceyda B, Oral M, Unal N, Cigdem Y, Bayar M, Bermede O, Saygili S, Yesiler I, Memikoglu O, Tekin R, Oncul A, Gunduz A, Ozdemir D, Geyik M, Erdogan S, Aygun C, Dilek A, Esen S, Turgut H, Sungurtekin H, Ugurcan D, Yarar V, Bilir Y, Bayram N, Devrim I, Agin H, Ceylan G, Yasar N, Oruc Y, Ramazanoglu A, Turhan O, Cengiz M, Yalcin A, Dursun O, Gunasan P, Kaya S, Senol G, Kocagoz A, Al-Rahma H, Annamma P, El-Houfi A, Vidal H, Perez F, D-Empaire G, Ruiz Y, Hernandez D, Aponte D, Salinas E, Vidal H, Navarrete N, Vargas R, Sanchez E, Ngo Quy C, Thu T, Nguyet L, Hang P, Hang T, Hanh T, Anh D. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2012-2017: Device-associated module. Am J Infect Control 2020; 48:423-432. [PMID: 31676155 DOI: 10.1016/j.ajic.2019.08.023] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/20/2019] [Accepted: 08/21/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2012 to December 2017 in 523 intensive care units (ICUs) in 45 countries from Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS During the 6-year study period, prospective data from 532,483 ICU patients hospitalized in 242 hospitals, for an aggregate of 2,197,304 patient days, were collected through the INICC Surveillance Online System (ISOS). The Centers for Disease Control and Prevention-National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI) were applied. RESULTS Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the medical-surgical ICUs, the pooled central line-associated bloodstream infection rate was higher (5.05 vs 0.8 per 1,000 central line-days); the ventilator-associated pneumonia rate was also higher (14.1 vs 0.9 per 1,000 ventilator-days,), as well as the rate of catheter-associated urinary tract infection (5.1 vs 1.7 per 1,000 catheter-days). From blood cultures samples, frequencies of resistance, such as of Pseudomonas aeruginosa to piperacillin-tazobactam (33.0% vs 18.3%), were also higher. CONCLUSIONS Despite a significant trend toward the reduction in INICC ICUs, DA-HAI rates are still much higher compared with CDC-NHSN's ICUs representing the developed world. It is INICC's main goal to provide basic and cost-effective resources, through the INICC Surveillance Online System to tackle the burden of DA-HAIs effectively.
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Jootun N, Sengupta S, Cunningham C, Charlton P, Betts M, Weaver A, Jacobs C, Hompes R, Muirhead R. Neoadjuvant radiotherapy in rectal cancer - less is more? Colorectal Dis 2020; 22:261-268. [PMID: 31556218 DOI: 10.1111/codi.14863] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 09/06/2019] [Indexed: 12/12/2022]
Abstract
AIM There is significant international variation in the use of neoadjuvant radiation prior to total mesorectal excision. The MERCURY group advocate selective neoadjuvant chemoradiotherapy (CRT). We have performed a retrospective, single-centre study of patients treated with CRT, where only the circumferential resection margin is threatened, with the aim of identifying whether a more selective approach to CRT provides acceptable local relapse rates (LRRs). METHOD All consecutive patients who underwent radical surgery for rectal adenocarcinoma over a 5-year period (2007-2012) in the Oxford University Trust were considered. Electronic hospital systems were reviewed to obtain patient and tumour demographics, treatment and follow-up information. All patients were classified into risk categories according to National Institute for Health and Care Excellence guidance. Data were analysed using Microsoft Excel and R. RESULTS Two hundred and seventy-two patients were identified: 123, 89 and 60 in the high-, intermediate- and low-risk categories, respectively. Seventy-nine per cent of those in the high-risk group, 6% in the intermediate and 5% in the low-risk group underwent CRT. The overall 5-year LRR and distant recurrence rate (DRR) were 5.2% and 17.8%, respectively. The 5-year LRR for those who went straight to surgery was 2.0% and for those who had neoadjuvant CRT it was 7.4%. The DRR for these two groups was 8.5% and 18.9%, respectively. CONCLUSION Our series demonstrates that the use of CRT only in margin-threatening tumours, results in an exceptionally low LRR for those without margin-threatening disease. In routine clinical care, this strategy can minimize the significant morbidity of multimodal treatment and allow earlier introduction of systemic therapy to minimize distant recurrence.
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Affiliation(s)
- N Jootun
- Department of Colorectal Surgery, Nuffield Department of Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - S Sengupta
- Green Templeton College, University of Oxford, Oxford, UK
| | - C Cunningham
- Department of Colorectal Surgery, Nuffield Department of Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - P Charlton
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - M Betts
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - A Weaver
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - C Jacobs
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - R Hompes
- Department of Colorectal Surgery, Nuffield Department of Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Department of Surgery, Cancer Centre Amsterdam, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - R Muirhead
- Department of Oncology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Parihar V, Sopena-Falco J, Leung E, Benz E, Cooney A, Keohane J, Sengupta S. R0 Resection Margin, A New Quality Measure in the Era of National Bowel Screening? Ir Med J 2020; 113:7. [PMID: 32298567] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Aims To determine the completeness of polyp resection (i.e. achieving an R0 margin) and its relation with Endoscopists, histopathologist, size, location and technique of polypectomy in an NSS cohort. The definition of R0 margin is complete macroscopic resection with a negative microscopic margin at polypectomy. Method NCCS (National Colon Cancer Screening) colonoscopies are offered to bowel cancer screening patients after a positive faecal immunochemical test (FIT) test in a Joint Advisory Group (JAG) accredited Gastrointestinal Endoscopy centre. We histologically evaluated the polyp margins for complete resection, which was defined as the absence of adenomatous or hyperplastic tissue in the resected polyp margins in a cohort of faecal immunochemical test positive patients. Results A total of 186 consecutive NCCS colonoscopies out of a total of 542 performed between 2013 and 2017 were included in this study. Of the polyps excised 152(27%) had a R0 margin histologically, and 30(5%) had involvement of the margin. Surprisingly in 373(67%) of polyps pathologists were unable to assess the margin. Conclusion Achieving an R0 margin should be a key performance indicator for endoscopists performing polypectomy. At the same time more studies on polyp margins are recommended.
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Affiliation(s)
- V Parihar
- Department of Gastroenterology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - J Sopena-Falco
- Department of Gastroenterology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - E Leung
- Department of Gastroenterology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - E Benz
- Department of Gastroenterology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - A Cooney
- Department of Gastroenterology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - J Keohane
- Department of Gastroenterology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
| | - S Sengupta
- Department of Gastroenterology, Our Lady of Lourdes Hospital, Drogheda, Co. Louth, Ireland
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Horwich A, Babjuk M, Bellmunt J, Bruins HM, De Reijke TM, De Santis M, Gillessen S, James N, Maclennan S, Palou J, Powles T, Ribal MJ, Shariat SF, Van Der Kwast T, Xylinas E, Agarwal N, Arends T, Bamias A, Birtle A, Black PC, Bochner BH, Bolla M, Boormans JL, Bossi A, Briganti A, Brummelhuis I, Burger M, Castellano D, Cathomas R, Chiti A, Choudhury A, Compérat E, Crabb S, Culine S, De Bari B, DeBlok W, De Visschere PJL, Decaestecker K, Dimitropoulos K, Dominguez-Escrig JL, Fanti S, Fonteyne V, Frydenberg M, Futterer JJ, Gakis G, Geavlete B, Gontero P, Grubmüller B, Hafeez S, Hansel DE, Hartmann A, Hayne D, Henry AM, Hernandez V, Herr H, Herrmann K, Hoskin P, Huguet J, Jereczek-Fossa BA, Jones R, Kamat AM, Khoo V, Kiltie AE, Krege S, Ladoire S, Lara PC, Leliveld A, Linares-Espinós E, Løgager V, Lorch A, Loriot Y, Meijer R, Carmen Mir M, Moschini M, Mostafid H, Müller AC, Müller CR, N'Dow J, Necchi A, Neuzillet Y, Oddens JR, Oldenburg J, Osanto S, Oyen WJG, Pacheco-Figueiredo L, Pappot H, Patel MI, Pieters BR, Plass K, Remzi M, Retz M, Richenberg J, Rink M, Roghmann F, Rosenberg JE, Rouprêt M, Rouvière O, Salembier C, Salminen A, Sargos P, Sengupta S, Sherif A, Smeenk RJ, Smits A, Stenzl A, Thalmann GN, Tombal B, Turkbey B, Vahr Lauridsen S, Valdagni R, Van Der Heijden AG, Van Poppel H, Vartolomei MD, Veskimäe E, Vilaseca A, Vives Rivera FA, Wiegel T, Wiklund P, Williams A, Zigeuner R, Witjes JA. EAU-ESMO consensus statements on the management of advanced and variant bladder cancer-an international collaborative multi-stakeholder effort: under the auspices of the EAU and ESMO Guidelines Committees†. Ann Oncol 2019; 30:1697-1727. [PMID: 31740927 PMCID: PMC7360152 DOI: 10.1093/annonc/mdz296] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial. OBJECTIVE To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management. DESIGN A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts before voting during a consensus conference. SETTING Online Delphi survey and consensus conference. PARTICIPANTS The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus). RESULTS AND LIMITATIONS Overall, 116 statements were included in the Delphi survey. Of these, 33 (28%) statements achieved level 1 consensus and 49 (42%) statements achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease and the evolving role of checkpoint inhibitor therapy in metastatic disease. CONCLUSIONS These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time where further evidence is available to guide our approach.
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Affiliation(s)
- A Horwich
- Emeritus Professor, The Institute of Cancer Research, London, UK; Emeritus Professor, The Institute of Cancer Research, London, UK.
| | - M Babjuk
- Depatment of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria
| | - J Bellmunt
- IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Harvard Medical School, Boston, USA
| | - H M Bruins
- Department of Urology, Radboud University Medical Center, Nijmegen
| | - T M De Reijke
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - M De Santis
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Charité University Hospital, Berlin, Germany
| | - S Gillessen
- Division of Cancer Sciences, University of Manchester, Manchester; The Christie NHS Foundation Trust, Manchester, UK; Division of Oncology and Haematology, Kantonsspital St Gallen, St Gallen; University of Bern, Bern, Switzerland
| | - N James
- University Hospitals Birmingham NHS Foundation Trust, Birmingham; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham
| | - S Maclennan
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
| | - J Palou
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - T Powles
- The Royal Free NHS Trust, London; Barts Cancer Institute, Queen Mary University of London, London, UK
| | - M J Ribal
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - S F Shariat
- Depatment of Urology, 2nd Faculty of Medicine, Hospital Motol, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York; Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - T Van Der Kwast
- Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - E Xylinas
- Department of Urology, Bichat-Claude Bernard Hospital, Assistance Publique Hôpitaux de Paris, Paris; Paris Descartes University, Paris, France
| | - N Agarwal
- Huntsman Cancer Institute, University of Utah (NCI-CCC), Salt Lake City, USA
| | - T Arends
- Urology Department, Canisius-Wilhelmina Ziekenhuis Nijmegen, Nijmegen, The Netherlands
| | - A Bamias
- 2nd Propaedeutic Dept of Internal Medicine, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - A Birtle
- Division of Cancer Sciences, University of Manchester, Manchester; Rosemere Cancer Centre, Lancashire Teaching Hospitals, Preston, UK
| | - P C Black
- Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, Canada
| | - B H Bochner
- Department of Urology, Weill Cornell Medical College, New York; Urology Service, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M Bolla
- Emeritus Professor of Radiation Oncology, Grenoble - Alpes University, Grenoble, France
| | - J L Boormans
- Department of Urology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - A Bossi
- Department of Radiation Oncology, Gustave Roussy Institute, Villejuif, France
| | - A Briganti
- Department of Urology, Urological Research Institute, Milan; Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - I Brummelhuis
- Department of Urology, Radboud University Medical Center, Nijmegen
| | - M Burger
- Department of Urology, Caritas-St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - D Castellano
- Medical Oncology Department, 12 de Octubre University Hospital (CIBERONC), Madrid, Spain
| | - R Cathomas
- Department Innere Medizin, Abteilung Onkologie und Hämatologie, Kantonsspital Graubünden, Chur, Switzerland
| | - A Chiti
- Department of Biomedical Sciences, Humanitas University, Milan; Humanitas Research Hospital, Milan, Italy
| | - A Choudhury
- Division of Cancer Sciences, University of Manchester, Manchester; The Christie NHS Foundation Trust, Manchester, UK
| | - E Compérat
- Department of Pathology, Tenon Hospital, HUEP, Paris; Sorbonne University, Paris, France
| | - S Crabb
- Cancer Sciences Unit, University of Southampton, Southampton, UK
| | - S Culine
- Department of Cancer Medicine, Hôpital Saint Louis, Paris
| | - B De Bari
- Radiation Oncology Department, Centre Hospitalier Régional Universitaire "Jean Minjoz" of Besançon, INSERM UMR 1098, Besançon, France; Radiation Oncology Department, Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland
| | - W DeBlok
- Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P J L De Visschere
- Department of Radiology and Nuclear Medicine, Division of Genitourinary Radiology and Mammography, Ghent University Hospital, Ghent
| | - K Decaestecker
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - K Dimitropoulos
- Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - J L Dominguez-Escrig
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - S Fanti
- Department of Nuclear Medicine, Policlinico S Orsola, University of Bologna, Bologna, Italy
| | - V Fonteyne
- Department of Radiotherapy Oncology, Ghent University Hospital, Ghent, Belgium
| | - M Frydenberg
- Department of Surgery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | - J J Futterer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - G Gakis
- Department of Urology and Paediatric Urology, University Hospital of Würzburg, Julius-Maximillians University, Würzburg, Germany
| | - B Geavlete
- Department of Urology, Saint John Emergency Clinical Hospital, Bucharest, Romania
| | - P Gontero
- Division of Urology, Molinette Hospital, University of Studies of Torino, Torino, Italy
| | - B Grubmüller
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - S Hafeez
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London; Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, UK
| | - D E Hansel
- Department of Urology, University of California, San Diego Pathology, La Jolla, USA
| | - A Hartmann
- Institute of Pathology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - D Hayne
- Department of Urology, UWA Medical School, University of Western Australia, Perth, Australia
| | - A M Henry
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - V Hernandez
- Department of Urology, Hospital Universitario Fundación de Alcorcón, Madrid, Spain
| | - H Herr
- Urology Service, Department of Urology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - K Herrmann
- Department of Nuclear Medicine, Universitätsklinikum Essen, Essen, Germany
| | - P Hoskin
- Division of Cancer Sciences, University of Manchester, Manchester; The Christie NHS Foundation Trust, Manchester, UK; Mount Vernon Centre for Cancer Treatment, London, UK
| | - J Huguet
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - B A Jereczek-Fossa
- Department of Oncology and Hemato-oncology, University of Milan, Milan; Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, Milan, Italy
| | - R Jones
- Institute of Cancer Sciences, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - A M Kamat
- Department of Urology - Division of Surgery, The University of Texas, MD Anderson Cancer Center, Houston, USA
| | - V Khoo
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London; Department of Clinical Oncology, The Royal Marsden NHS Foundation Trust, London, UK; Department of Medicine, University of Melbourne, Melbourne; Monash University, Melbourne, Australia
| | - A E Kiltie
- CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK
| | - S Krege
- Department of Urology, Pediatric Urology and Urologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - S Ladoire
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - P C Lara
- Department of Oncology, Hospital Universitario San Roque, Canarias; Universidad Fernando Pessoa, Canarias, Spain
| | - A Leliveld
- Department of Urology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - V Løgager
- Department of Radiology, Copenhagen University Hospital Herlev and Gentofte, Herlev, Denmark
| | - A Lorch
- Department of Medical Oncology and Hematology, University Hospital Zürich, Zürich, Switzerland
| | - Y Loriot
- Département de Médecine Oncologique, Gustave Roussy, INSERM U981, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - R Meijer
- UMC Utrecht Cancer Center, MS Oncologic Urology, Utrecht, The Netherlands
| | - M Carmen Mir
- Servicio de Urología, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - M Moschini
- Department of Urology, Luzerner Kantonsspital, Luzern, Switzerland
| | - H Mostafid
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
| | - A-C Müller
- Department of Radiation Oncology, Eberhard Karls University, Tübingen, Germany
| | - C R Müller
- Cancer Treatment Centre, Sorlandet Hospital, Kristiansand, Norway
| | - J N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - A Necchi
- Department of Medical Oncology, Istituto Nazionale Tumori of Milan, Milan, Italy
| | - Y Neuzillet
- Department of Urology, Hospital Foch, University of Versailles-Saint-Quentin-en-Yvelines, Suresnes, France
| | - J R Oddens
- Department of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - J Oldenburg
- Department of Oncology, Akershus University Hospital, Lørenskog; Faculty of Medicine, University of Oslo, Oslo, Norway
| | - S Osanto
- Department of Clinical Oncology, Leiden University Medical Center, Leiden
| | - W J G Oyen
- Department of Biomedical Sciences, Humanitas University, Milan; Humanitas Research Hospital, Milan, Italy; Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands
| | - L Pacheco-Figueiredo
- Department of Urology, Centro Hospitalar São João, Porto; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - H Pappot
- Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - M I Patel
- Department of Urology, Westmead Hospital, University of Sydney, Sydney, Australia
| | - B R Pieters
- Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam
| | - K Plass
- EAU Guidelines Office, Arnhem, The Netherlands
| | - M Remzi
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - M Retz
- Department of Urology, Rechts der Isar Medical Center, Technical University of Munich, Munich, Germany
| | - J Richenberg
- Department of Imaging and Nuclear Medicine, Royal Sussex County Hospital, Brighton; Brighton and Sussex Medical School, Brighton, UK
| | - M Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - F Roghmann
- Department of Urology, Ruhr-University Bochum, Marien Hospital, Herne, Germany
| | - J E Rosenberg
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York; Weill Cornell Medical College, New York, USA
| | - M Rouprêt
- Department of Urology, Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris
| | - O Rouvière
- Hospices Civils de Lyon, Service d'Imagerie Urinaire et Vasculaire, Hôpital Edouard Herriot, Lyon; Université de Lyon, Université Lyon 1, Faculté de Médecine Lyon Est, Lyon, France
| | - C Salembier
- Department of Radiation Oncology, Europe Hospitals Brussels, Brussels, Belgium
| | - A Salminen
- Department of Urology, University Hospital of Turku, Turku, Finland
| | - P Sargos
- Department of Radiotherapy, Institut Bergonié, Bordeaux, France
| | - S Sengupta
- Department of Surgery, Austin Health, University of Melbourne, Melbourne; Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - A Sherif
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - R J Smeenk
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Smits
- Department of Urology, Radboud University Medical Center, Nijmegen
| | - A Stenzl
- Department of Urology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - G N Thalmann
- Department of Urology, Inselspital, Bern University Hospital, Berne, Switzerland
| | - B Tombal
- Division of Urology, IREC, Cliniques Universitaires Saint Luc, UCL, Brussels, Belgium
| | - B Turkbey
- Molecular Imaging Program, National Cancer Institute, Bethesda, USA
| | - S Vahr Lauridsen
- Department of Urology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - R Valdagni
- Department of Oncology and Hemato-oncology, Università degli Studi di Milano, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - H Van Poppel
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - M D Vartolomei
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures, Romania
| | - E Veskimäe
- Department of Urology, Tampere University Hospital, Tampere, Finland
| | - A Vilaseca
- Uro-Oncology Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - F A Vives Rivera
- Clinica HematoOncologica Bonadona Prevenir, Universidad Metropolitana, Clinica Club de Leones, Barranquilla, Colombia
| | - T Wiegel
- Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany
| | - P Wiklund
- Icahn School of Medicine, Mount Sinai Health System, New York City, USA; Department of Urology, Karolinska Institutet, Stockholm, Sweden
| | - A Williams
- Department of Urology, Auckland City Hospital, Auckland, New Zealand
| | - R Zigeuner
- Department of Urology, Medizinische Universität Graz, Graz, Austria
| | - J A Witjes
- Department of Urology, Radboud University Medical Center, Nijmegen
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Haldar A, Sengupta S, Das D, Sarkar S, Sett S. Role of interactome development in evaluation of refractory epilepsy: A case report. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1821] [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: 10/25/2022]
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Li MM, Sengupta S, Hanigan MD. Using artificial neural networks to predict pH, ammonia, and volatile fatty acid concentrations in the rumen. J Dairy Sci 2019; 102:8850-8861. [PMID: 31378500 DOI: 10.3168/jds.2018-15964] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 05/15/2019] [Indexed: 11/19/2022]
Abstract
The objectives of this study were (1) to predict ruminal pH and ruminal ammonia and volatile fatty acid (VFA) concentrations by developing artificial neural networks (ANN) using dietary nutrient compositions, dry matter intake, and body weight as input variables; and (2) to compare accuracy and precision of ANN model predictions with that of a multiple linear regression model (MLR). Data were collected from 229 published papers with 938 treatment means. The data set was randomly split into a training data set containing 70% of the observations and a test data set with the remaining observations. A series of ANN with a range of 1 to 9 artificial neurons in 1 hidden layer were examined, and the best one was selected to compare with the best-fitted MLR model. The performance of model predictions was evaluated by root mean square errors (RMSE) and concordance correlation coefficients (CCC) using cross-evaluations with 100 iterations. When using the ANN to predict ruminal pH and concentrations of ammonia, total VFA, acetate, propionate, and butyrate, the RMSE were 4.2, 41.4, 20.9, 22.3, 32.9, and 29.7% of observed means, respectively. The RMSE for the MLR were 4.2, 37.8, 18.3, 19.9, 29.8, and 26.6% of the observed means. The CCC for ruminal pH, ruminal concentrations of ammonia, total VFA, acetate, propionate, and butyrate were 0.57, 0.49, 0.45, 0.40, 0.52, and 0.40, using the ANN, and 0.37, 0.48, 0.40, 0.29, 0.43, and 0.35, using the MLR. Evaluations of the MLR and the ANN indicated that these 2 model forms exhibited similar prediction errors, with 4.2, 39.6, 19.6, 21.1, 31.3, and 28.1% of observed means for pH, ammonia, total VFA, acetate, propionate, and butyrate. Although the ANN increased the precision of predictions related to ruminal metabolism, it failed to improve the accuracy compared with the linear regression model.
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Affiliation(s)
- Meng M Li
- Department of Dairy Science, Virginia Polytechnic Institute and State University, Blacksburg 24061
| | - Srijan Sengupta
- Department of Statistics, Virginia Polytechnic Institute and State University, Blacksburg 24061
| | - Mark D Hanigan
- Department of Dairy Science, Virginia Polytechnic Institute and State University, Blacksburg 24061.
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Jiang J, Bradford G, Hossain SI, Brown M, Cooper J, Miller E, Huang Y, Miao H, Parrell JA, White M, Hunt A, Sengupta S, Revur R, Shen T, Kametani F, Trociewitz UP, Hellstrom EE, Larbalestier DC. High Performance Bi-2212 Round Wires Made with Recent Powders. IEEE Trans Appl Supercond 2019; 29:6400405. [PMID: 33737796 PMCID: PMC7968414 DOI: 10.1109/tasc.2019.2895197] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Multifilamentary Bi2Sr2CaCu2Ox (Bi-2212) wire made by the powder-in-tube technique is the only high temperature superconductor made in the round shape preferred by magnet builders. The critical current density (J C ) of Bi-2212 round wire was improved significantly by the development of overpressure heat treatment in the past few years. Bi-2212 wire is commercially available in multiple architectures and kilometer-long pieces and a very promising conductor for very high field NMR and accelerator magnets. We studied the effects of precursor powder and heat treatment conditions on the superconducting properties and microstructure of recent Bi-2212 wires. Short samples of recent wire with optimized overpressure processing showed J C (4.2 K, 15 T) = 6640 A/mm2 and J C (4.2 K, 30 T) = 4670 A/mm2, which correspond to engineering critical current densities J E (4.2 K, 15 T) = 1320 A/mm2 and J E (4.2 K, 30 T) = 930 A/mm2.
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Affiliation(s)
- J Jiang
- Applied Superconductivity Center, National High Magnetic Laboratory, Tallahassee, FL 32310, USA and also with Florida State University
| | - G Bradford
- Applied Super-conductivity Center, National High Magnetic Laboratory, Tallahassee, FL 32310, USA and also with Florida State University
| | - S I Hossain
- Applied Super-conductivity Center, National High Magnetic Laboratory, Tallahassee, FL 32310, USA and also with Florida State University
| | - M Brown
- Applied Super-conductivity Center, National High Magnetic Laboratory, Tallahassee, FL 32310, USA and also with Florida State University
| | - J Cooper
- Applied Super-conductivity Center, National High Magnetic Laboratory, Tallahassee, FL 32310, USA and also with Florida State University
| | - E Miller
- Applied Super-conductivity Center, National High Magnetic Laboratory, Tallahassee, FL 32310, USA and also with Florida State University
| | - Y Huang
- Bruker OST, Carteret, NJ 07008, USA
| | - H Miao
- Bruker OST, Carteret, NJ 07008, USA
| | | | - M White
- nGimat LLC, 2436 Over Dr. Lexington, KY 40511, USA
| | - A Hunt
- nGimat LLC, 2436 Over Dr. Lexington, KY 40511, USA
| | - S Sengupta
- MetaMateria, 870 Kaderly Dr, Columbus, OH 43228, USA
| | - R Revur
- MetaMateria, 870 Kaderly Dr, Columbus, OH 43228, USA
| | - T Shen
- Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
| | - F Kametani
- Applied Super-conductivity Center, National High Magnetic Laboratory, Tallahassee, FL 32310, USA and also with Florida State University
| | - U P Trociewitz
- Applied Super-conductivity Center, National High Magnetic Laboratory, Tallahassee, FL 32310, USA and also with Florida State University
| | - E E Hellstrom
- Applied Super-conductivity Center, National High Magnetic Laboratory, Tallahassee, FL 32310, USA and also with Florida State University
| | - D C Larbalestier
- Applied Super-conductivity Center, National High Magnetic Laboratory, Tallahassee, FL 32310, USA and also with Florida State University
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Löhner A, Kunsel T, Röhr MIS, Jansen TLC, Sengupta S, Würthner F, Knoester J, Köhler J. Spectral and Structural Variations of Biomimetic Light-Harvesting Nanotubes. J Phys Chem Lett 2019; 10:2715-2724. [PMID: 31059268 DOI: 10.1021/acs.jpclett.9b00303] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Bioinspired, self-assembled nanotubes have been investigated by low-temperature, polarization-resolved single-tube spectroscopy. These assemblies are based on zinc chlorin monomers and are considered as model systems that resemble the secondary structural elements in the natural light-harvesting systems of green (non)sulfur bacteria. Compared to the natural systems, the spectral parameters extracted from the single-nanotube spectra feature distributions with significantly smaller widths, which is ascribed to a tremendous reduction of structural heterogeneity in the artificial systems. Employing quantum chemical molecular modeling the spectra of individual nanotubes can be explained consistently only for a molecular packing model that is fundamentally different from those considered so far for the natural systems. Subsequent theoretical simulations reveal that the remaining spectral variations between single nanotubes can be traced back to small variations of the mutual orientations of the monomer transition dipole moments that are far beyond the resolving power of high-resolution electron microscopy imaging techniques.
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Affiliation(s)
- A Löhner
- Spectroscopy of Soft Matter , University of Bayreuth , Universitätsstraße 30 , 94557 Bayreuth , Germany
| | - T Kunsel
- University of Groningen , Zernike Institute for Advanced Materials , Nijenborgh 4 , 9747 AG Groningen , The Netherlands
| | - M I S Röhr
- Center for Nanosystems Chemistry , Universität Würzburg , Theodor-Boveri-Weg , 97074 Würzburg , Germany
| | - T L C Jansen
- University of Groningen , Zernike Institute for Advanced Materials , Nijenborgh 4 , 9747 AG Groningen , The Netherlands
| | - S Sengupta
- Center for Nanosystems Chemistry , Universität Würzburg , Theodor-Boveri-Weg , 97074 Würzburg , Germany
| | - F Würthner
- Center for Nanosystems Chemistry , Universität Würzburg , Theodor-Boveri-Weg , 97074 Würzburg , Germany
- Bavarian Polymer Institute , Theodor-Boveri-Weg , 97074 Würzburg , Germany
| | - J Knoester
- University of Groningen , Zernike Institute for Advanced Materials , Nijenborgh 4 , 9747 AG Groningen , The Netherlands
| | - J Köhler
- Spectroscopy of Soft Matter , University of Bayreuth , Universitätsstraße 30 , 94557 Bayreuth , Germany
- Bavarian Polymer Institute , Universitätsstraße 30 , 94557 Bayreuth , Germany
- Bayreuth Institute of Macromolecular Research (BIMF) , University of Bayreuth , Universitätsstraße 30 , 94557 Bayreuth , Germany
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Singh SK, Sengupta S, Antony R, Bhattacharya S, Mukhopadhyay C, Ramasubramanian V, Sharma A, Sahu S, Nirkhiwale S, Gupta S, Rohit A, Sharma S, Raghavan V, Barman P, Sood S, Mamtora D, Rengaswamy S, Arora A, Goossens H, Versporten A. Variations in antibiotic use across India: multi-centre study through Global Point Prevalence survey. J Hosp Infect 2019; 103:280-283. [PMID: 31170422 DOI: 10.1016/j.jhin.2019.05.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 05/28/2019] [Indexed: 11/29/2022]
Abstract
The aim of the study was to assess antimicrobial prescribing patterns, and variation in practice, in India. A point prevalence survey (PPS) was conducted in October to December 2017 in 16 tertiary care hospitals across India. The survey included all inpatients receiving an antimicrobial on the day of PPS and collected data were analysed using a web-based application of the University of Antwerp. In all, 1750 patients were surveyed, of whom 1005 were receiving a total of 1578 antimicrobials. Among the antimicrobials prescribed, 26.87% were for community-acquired infections; 19.20% for hospital-acquired infections; 17.24% for medical prophylaxis; 28.70% for surgical prophylaxis; and 7.99% for other or undetermined reasons. Antibiotic prescribing quality indicators, such as reason in notes and post-prescription review score, were low. This PPS showed widespread antibiotic usage, underlining the need for antibiotic stewardship to promote evidence-based practice.
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Affiliation(s)
- S K Singh
- Amrita Institute of Medical Sciences, Kochi, India.
| | - S Sengupta
- Medanta - The Medicity Hospital, Gurgaon, India
| | - R Antony
- Amrita Institute of Medical Sciences, Kochi, India
| | | | | | | | | | - S Sahu
- Apollo Hospital, Bhubaneswar, India
| | | | - S Gupta
- Mahatma Gandhi Medical College & Hospital, Jaipur, India
| | - A Rohit
- Madras Medical Mission Hospital, Chennai, India
| | - S Sharma
- Indian Spinal Injuries Centre, Delhi, India
| | - V Raghavan
- Sundaram Medical Foundation, Chennai, India
| | - P Barman
- BLK Super Speciality Hospital, Delhi, India
| | - S Sood
- CK Birla Hospitals - Rukmani Birla Hospital, Jaipur, India
| | | | | | - A Arora
- Fortis Hospital, New Delhi, India
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Sengupta S, Handoo A. Optimizing the impact of POCT: Eliminating errors before they hit you!! Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1389] [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: 10/26/2022]
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Sengupta S, Handoo A. Pre-analytical errors in the clinical laboratory: A risk assessment analysis. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1058] [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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Sevigny CM, Sengupta S, Luo Z, Jin L, Pearce D, Clarke R. Abstract P2-06-14: The role of SLC7A5 (LAT1) in endocrine therapy-resistant breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-06-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Endocrine therapies are commonly used to treat estrogen receptor-positive (ER+) breast cancers, which comprise 70% of all new breast cancer cases. Unfortunately, emergence of resistance to these therapies presents a major clinical challenge. Cancer cells can adapt to the dysregulation of cellular metabolism induced by endocrine therapy in order to evade cell death.Central to this adaptation is the scavenging of free-formed amino acids from the tumor microenvironment. For example, we found 109 solute carrier (SLC) mRNAs to be differentially expressed between endocrine-sensitive and resistant cells. We began our mechanistic studies of these genes with SLC family 7 member 5 (SLC7A5 or LAT1). SLC7A5 is a key component of a transmembrane transporter, which can complex with CD98 and increase the uptake of large, neutral amino acids (such as leucine or tyrosine).
We used a panel of endocrine therapy-resistant (LCC9) and sensitive (MCF7; LCC1) breast cancer cells. SLC7A5 expression was upregulated by estrogen in MCF7 and LCC1 cells; this induction was blocked by fulvestrant treatment. Basal expression of the SLC7A5 protein in the absence of estrogen was 2.75-fold higher in LCC9 cells compared with MCF7 cells; SLC7A5 mRNA expression was 71-fold higher. Fulvestrant treatment did not significantly alter SLC7A5 mRNA or protein expression in LCC9 cells. Inhibiting SLC7A5 function using either a pharmacological inhibitor (JPH203), or depleting expression using siRNA, led to significant suppression of LCC9 cell growth. Cell cycle analysis revealed that SLC7A5 depletion caused cells to accumulate in the G1-phase, with a concurrent reduction of cells in S-phase. In four publicly available datasets of ER+, tamoxifen treated breast cancer patients, high expression of SLC7A5 was significantly associated with poor relapse-free survival.
This study uncovers a novel adaptive mechanism in endocrine therapy-resistant breast cancer cells that is facilitated by increased expression of SLC7A5, which enables them to supplement their increased metabolic needs and promoting cell growth. Blocking the functions of SLC7A5, perhaps in conjunction with inhibition of autophagy, may therefore offer a new avenue of potential therapeutic intervention against endocrine therapy-resistant breast cancers.
Citation Format: Sevigny CM, Sengupta S, Luo Z, Jin L, Pearce D, Clarke R. The role of SLC7A5 (LAT1) in endocrine therapy-resistant breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-06-14.
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Affiliation(s)
- CM Sevigny
- Georgetown University, Washington, DC; The University of Edinburgh, Edinburgh, United Kingdom
| | - S Sengupta
- Georgetown University, Washington, DC; The University of Edinburgh, Edinburgh, United Kingdom
| | - Z Luo
- Georgetown University, Washington, DC; The University of Edinburgh, Edinburgh, United Kingdom
| | - L Jin
- Georgetown University, Washington, DC; The University of Edinburgh, Edinburgh, United Kingdom
| | - D Pearce
- Georgetown University, Washington, DC; The University of Edinburgh, Edinburgh, United Kingdom
| | - R Clarke
- Georgetown University, Washington, DC; The University of Edinburgh, Edinburgh, United Kingdom
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Clarke R, Dixon M, Jin L, Pearce D, Turnbull A, Selli C, Hu R, Zwart A, Wang Y, Xuan J, Sengupta S, Sims A, Liu MC. Abstract P5-04-17: Local network topology differences between early and late recurrence in ER+ breast cancers. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-04-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Late recurrence is characteristic of ER+ breast cancers. Despite an apparently effective adjuvant endocrine therapy, many breast cancers recur years after their initial endocrine treatment. Why some tumors recur early (<3 years) and some recur later (>5 years) is poorly understood. If systemic endocrine therapies killed all cells, recurrence would reflect only the appearance of new disease. Thus, we hypothesized that cells that survive and lie dormant may be driven, in part, by altered wiring of their cell death signaling. We, therefore, studied how cell death signaling is differentially wired in primary tumors that will recur early versus those that will recur later.
Method: Genes involved in apoptosis, autophagy, ferroptosis, necrosis, and pyroptosis were identified from KEGG to initiate network feature analysis of gene expression data from public and our first in-house gene expression dataset. Data were collected from ER+ breast cancer pre-endocrine treatment samples with up to 20 years follow-up. Publicly available datasets used were GSE6532, GSE2034, GSE7390, GSE17705, GSE12093, and TCGA. We applied our Knowledge-fused Differential Dependency Network (KDDN) analysis tool to the public datasets; KDDN has provided powerful new insights into signaling in breast and other cancers. Common gene-gene interactions (edges) predicted in at least two different datasets were extracted from all KDDN analyses results. To strengthen the relevance of these features, predicted network edges that represent known protein-protein interactions (PPI) were identified from the STRING database, and these edges were noted in the signaling graphs. Final network graphs were constructed using the common edges from all overlaid networks. We conducted IPA analysis on all nodes in the final network and selected those incorporating network hubs. We took a similar approach to our second in-house dataset, which we used for independent testing. Here, patients were included if their tumor exhibited an initial reduction in volume of at least 40% by four months in response to neo-adjuvant Letrozole. Patients were then classified into two groups during follow-up of up to 3.7 years: i) initial tumor size reduction followed by continued response (expected to recur late); ii) initial reduction followed by tumor regrowth (expected to recur early). KDDN analysis was performed on pretreatment samples from these two groups and a network created annotated with PPI information.
Results: MAPK8 and CYCS (Molecular Mechanisms of Cancer, p=1.58E-52), TNFRSF1A Neuroinflammation Signaling Pathway, p=1.26E-54), RELA, and NFKB1 (Colorectal Cancer Metastasis Signaling, p=7.94E-35), were identified as hubs. Hubs may be critical signaling components driving the differences between tumors that will become dormant and recur late. Connections between SLC25A6 and SQSTM1 (p = 0.008), BIRC2 and GABARAP (p = 0.021) in the early group, and AKT3 and IRS2 (p = 0.014) in the late group, were shared between the two final networks. With longer follow-up time on the second in-house dataset, we will better define the two groups and identify additional common phenotype specific gene-gene interactions.
Citation Format: Clarke R, Dixon M, Jin L, Pearce D, Turnbull A, Selli C, Hu R, Zwart A, Wang Y, Xuan J, Sengupta S, Sims A, Liu MC. Local network topology differences between early and late recurrence in ER+ breast cancers [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-04-17.
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Affiliation(s)
- R Clarke
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - M Dixon
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - L Jin
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - D Pearce
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - A Turnbull
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - C Selli
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - R Hu
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - A Zwart
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - Y Wang
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - J Xuan
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - S Sengupta
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - A Sims
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
| | - MC Liu
- Georgetown University, Washington, DC; University of Edinburgh, Edinburgh, Scotland, United Kingdom; Breast Cancer Now Research Labs, Edinburgh, Scotland, United Kingdom; Virginia Tech Research Center, Arlington, VA; Mayo Clinic, Rochester, MN
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Zhao MJ, Driscoll AR, Sengupta S, Stevens NT, Fricker RD, Woodall WH. The effect of temporal aggregation level in social network monitoring. PLoS One 2018; 13:e0209075. [PMID: 30566509 PMCID: PMC6300332 DOI: 10.1371/journal.pone.0209075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 11/29/2018] [Indexed: 11/19/2022] Open
Abstract
Social networks have become ubiquitous in modern society, which makes social network monitoring a research area of significant practical importance. Social network data consist of social interactions between pairs of individuals that are temporally aggregated over a certain interval of time, and the level of such temporal aggregation can have substantial impact on social network monitoring. There have been several studies on the effect of temporal aggregation in the process monitoring literature, but no studies on the effect of temporal aggregation in social network monitoring. We use the degree corrected stochastic block model (DCSBM) to simulate social networks and network anomalies and analyze these networks in the context of both count and binary network data. In conjunction with this model, we use the Priebe scan method as the monitoring method. We demonstrate that temporal aggregation at high levels leads to a considerable decrease in the ability to detect an anomaly within a specified time period. Moreover, converting social network communication data from counts to binary indicators can result in a significant loss of information, hindering detection performance. Aggregation at an appropriate level with count data, however, can amplify the anomalous signal generated by network anomalies and improve detection performance. Our results provide both insights on the practical effects of temporal aggregation and a framework for the study of other combinations of network models, surveillance methods, and types of anomalies.
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Affiliation(s)
- Meng J. Zhao
- Department of Statistics, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States of America
- * E-mail:
| | - Anne R. Driscoll
- Department of Statistics, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States of America
| | - Srijan Sengupta
- Department of Statistics, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States of America
| | - Nathaniel T. Stevens
- Department of Mathematics and Statistics, University of San Francisco, San Francisco, California, United States of America
| | - Ronal D. Fricker
- Department of Statistics, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States of America
| | - William H. Woodall
- Department of Statistics, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States of America
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Sengupta S. Admissible unbiased estimation of finite population variance under a randomized response model. COMMUN STAT-THEOR M 2018. [DOI: 10.1080/03610926.2017.1386311] [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: 10/18/2022]
Affiliation(s)
- S. Sengupta
- Department of Statistics, University of Calcutta, 35, Ballygunge Circular Road, Kolkata, India
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Pramanik A, Datta AK, Das D, Kumbhakar DV, Ghosh B, Mandal A, Gupta S, Saha A, Sengupta S. Assessment of Nanotoxicity (Cadmium Sulphide and Copper Oxide) Using Cytogenetical Parameters in Coriandrum sativum L. (Apiaceae). CYTOL GENET+ 2018. [DOI: 10.3103/s0095452718040084] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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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Ghosh S, Ghosh S, Sinha M, Sadhasivam S, Bhattacharyya A, Samanta R, Nandy A, Saini S, Mishra M, Sengupta S. 1108 Preclinical evaluation of a novel fluoroquinolone for its multi-dimensional therapeutic effects against drug-resistant Propionibacterium acnes induced acne. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1121] [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: 10/17/2022]
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Lalani N, Paszat L, Sutradhar R, Gu S, Fong C, Nofech-Mozes S, Hanna W, Tuck A, Youngson B, Miller N, Done SJ, Chang MC, Sengupta S, Elavathil L, Jani PA, Bonin M, Rakovitch E. Abstract P4-15-05: The presence of one or multiple foci of microinvasion is not associated with an increased risk of local recurrence in women with ductal carcinoma in situ treated with breast conserving therapy. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-15-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Ductal Carcinoma in Situ (DCIS) is a non-invasive breast cancer often treated with breast-conserving surgery (BCS) with or without radiotherapy (RT). It is unclear if the presence of microinvasion (MI) (invasion ≤1mm) is associated with an increased risk of LR (DCIS or invasive) or invasive LR compared to women with pure DCIS. In addition, the impact of multiple foci (>2) of MI compared to pure DCIS is also unknown; therefore, it is unclear if some women with MI require more aggressive treatment. We evaluated the impact of the presence of MI and the number of foci of MI on the risks of any LR and invasive LR in a population of women with DCIS with and without MI treated with BCS.
Methods: The cohort includes all women diagnosed with pure DCIS or DCIS with MI in Ontario from 1994-2003 treated with BCS +/- RT. All cases had systematic pathology review to confirm the presence and number of foci of MI. Treatment and outcomes were ascertained through administrative databases and validated by chart review. Cox proportional hazards model was used to evaluate the impact of MI and the number of foci of MI (1 vs >2 foci) on the development of any LR and invasive LR compared to cases with pure DCIS. The 10-yr local recurrence-free survival (LRFS) and invasive LRFS rates were calculated using the Kaplan-Meier approach with differences compared using the log-rank test.
Results: The population cohort includes 2,988 women with DCIS treated by BCS (N=2,721 pure DCIS, N= 267 DCIS with MI). Median follow-up (12 years; p=.23) and median age at diagnosis (58 years; p=.17) were similar in both groups. RT was given in 58% of cases with MI and 51% of cases with pure DCIS (p=.03). Hormonal therapy was utilized in 7.1% of women with MI and 5.3% of women with pure DCIS (p=.22). LR developed in 59 (22.1%) cases with MI and 530 (19.6%) cases of pure DCIS. Women with MI were more likely to have high nuclear grade (p<.001), and larger tumor size (p<.001) compared to those without MI. On multivariable analyses adjusted for age, the presence of 1 focus of MI(HR=.92, 95% CI: .64-1.33) or ≥2 foci of MI (HR=1.26, 95% CI: .85-1.85) was not associated with an increased risk of any LR compared to cases with pure DCIS. Factors associated with any LR were age <50 years at diagnosis, RT, multifocality and high nuclear grade. The presence of 1 focus of MI (HR=.86, 95% CI: .52-1.40) or > 2 foci of MI (HR=1.45, 95% CI: .90-2.32) was also not associated with an increased risk of invasive LR compared to cases of pure DCIS. Among women treated with BCS alone, the 10 year LRFS rates were 80%, 75% and 73% for women with pure DCIS, 1 focus, >2 foci of MI (p=.10). The invasive LRFS rates were 89%, 91% and 85% (p=.26). Among women treated with BCS+RT, the 10 year LRFS rates were 87%, 88% and 80% (p=0.32) for women with pure DCIS, 1 focus or ≥2 foci of MI. The invasive LRFS rates were 93%, 90% and 86% (p=.44). There was no interaction between the presence of MI and RT.
Conclusions: Women with DCIS with one or multiple foci of microinvasion (<1mm) treated by breast conserving therapy do not have an increased risk of LR or invasive LR compared to women with pure DCIS.
Citation Format: Lalani N, Paszat L, Sutradhar R, Gu S, Fong C, Nofech-Mozes S, Hanna W, Tuck A, Youngson B, Miller N, Done SJ, Chang MC, Sengupta S, Elavathil L, Jani PA, Bonin M, Rakovitch E. The presence of one or multiple foci of microinvasion is not associated with an increased risk of local recurrence in women with ductal carcinoma in situ treated with breast conserving therapy [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-15-05.
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Affiliation(s)
- N Lalani
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - L Paszat
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - R Sutradhar
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - S Gu
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - C Fong
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - S Nofech-Mozes
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - W Hanna
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - A Tuck
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - B Youngson
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - N Miller
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - SJ Done
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - MC Chang
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - S Sengupta
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - L Elavathil
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - PA Jani
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - M Bonin
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - E Rakovitch
- University of Toronto, Toronto, ON, Canada; Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; London Health Sciences Centre, London, ON, Canada; University Health Network, Toronto, ON, Canada; Kingston General Hospital, Kingston, ON, Canada; Juravinski Cancer Centre, Hamilton, ON, Canada; Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada; Sudbury Regional Hospital, Sudbury, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
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