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He H, Shi M, Yang X, Zhan J, Lin Y, Guo Z, Liao Z, Lai C, Ren X, Huang B, Pan X. Dissolved organic matter accelerates microbial degradation of 17 alpha-ethinylestradiol in the presence of iron mineral. J Environ Sci (China) 2024; 139:364-376. [PMID: 38105062 DOI: 10.1016/j.jes.2023.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/30/2023] [Accepted: 05/30/2023] [Indexed: 12/19/2023]
Abstract
Dissolved organic matter (DOM) and iron minerals widely existing in the natural aquatic environment can mediate the migration and transformation of organic pollutants. However, the mechanism of interaction between DOM and iron minerals in the microbial degradation of pollutants deserves further investigation. In this study, the mechanism of 17 alpha-ethinylestradiol (EE2) biodegradation mediated by humic acid (HA) and three kinds of iron minerals (goethite, magnetite, and pyrite) was investigated. The results found that HA and iron minerals significantly accelerated the biodegradation process of EE2, and the highest degradation efficiency of EE2 (48%) was observed in the HA-mediated microbial system with pyrite under aerobic conditions. Furthermore, it had been demonstrated that hydroxyl radicals (HO•) was the main active substance responsible for the microbial degradation of EE2. HO• is primarily generated through the reaction between hydrogen peroxide secreted by microorganisms and Fe(II), with aerobic conditions being more conducive. The presence of iron minerals and HA could change the microbial communities in the EE2 biodegradation system. These findings provide new information for exploring the migration and transformation of pollutants by microorganisms in iron-rich environments.
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Affiliation(s)
- Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Min Shi
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xiaoxia Yang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Juhong Zhan
- Research Institute for Environmental Innovation (Suzhou) Tsinghua, Suzhou 215163, China.
| | - Yanting Lin
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Ziwei Guo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Chaochao Lai
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xiaomin Ren
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Lab of Soil Carbon Sequestration and Pollution Control, Kunming 650500, China.
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Lab of Soil Carbon Sequestration and Pollution Control, Kunming 650500, China
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Liao Z, He H, Wang Y, Liu F, Cui D, Cui J, Guo Z, Lai C, Huang B, Sun H, Pan X. Algal Extracellular Organic Matter Induced Photochemical Oxidation of Mn(II) to Solid Mn Oxide: Role of Mn(III)-EOM Complex and Its Ability to Remove 17α-Ethinylestradiol. Environ Sci Technol 2024; 58:5832-5843. [PMID: 38511412 DOI: 10.1021/acs.est.3c07970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Photosensitizer-mediated abiotic oxidation of Mn(II) can yield soluble reactive Mn(III) and solid Mn oxides. In eutrophic water systems, the ubiquitous algal extracellular organic matter (EOM) is a potential photosensitizer and may have a substantial impact on the oxidation of Mn(II). Herein, we focused on investigating the photochemical oxidation process from Mn(II) to solid Mn oxide driven by EOM. The results of irradiation experiments demonstrated that the generation of Mn(III) intermediate was crucial for the successful photo oxidization of Mn(II) to solid Mn oxide mediated by EOM. EOM can serve as both a photosensitizer and a ligand, facilitating the formation of the Mn(III)-EOM complex. The complex exhibited excellent efficiency in removing 17α-ethinylestradiol. Furthermore, the complex underwent decomposition as a result of reactions with reactive intermediates, forming a solid Mn oxide. The presence of nitrate can enhance the photochemical oxidation process, facilitating the conversion of Mn(II) to Mn(III) and then to solid Mn oxide. This study deepens our grasp of Mn(II) geochemical processes in eutrophic water and its impact on organic micropollutant fate.
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Affiliation(s)
- Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
- Southwest United Graduate School, Kunming 650092, China
| | - Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Yiying Wang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Feiyuan Liu
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Danni Cui
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Jingye Cui
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Ziwei Guo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Chaochao Lai
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Hongwen Sun
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China
- Southwest United Graduate School, Kunming 650092, China
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
- Southwest United Graduate School, Kunming 650092, China
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Guo Z, He H, Yang G, Liu K, Xi Y, Li Z, Luo Y, Liao Z, Dao G, Ren X, Huang B, Pan X. The environmental risks of antiviral drug arbidol in eutrophic lake: Interactions with Microcystis aeruginosa. J Hazard Mater 2024; 466:133609. [PMID: 38310846 DOI: 10.1016/j.jhazmat.2024.133609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/08/2024] [Accepted: 01/21/2024] [Indexed: 02/06/2024]
Abstract
The environmental risks resulting from the increasing antivirals in water are largely unknown, especially in eutrophic lakes, where the complex interactions between algae and drugs would alter hazards. Herein, the environmental risks of the antiviral drug arbidol towards the growth and metabolism of Microcystis aeruginosa were comprehensively investigated, as well as its biotransformation mechanism by algae. The results indicated that arbidol was toxic to Microcystis aeruginosa within 48 h, which decreased the cell density, chlorophyll-a, and ATP content. The activation of oxidative stress increased the levels of reactive oxygen species, which caused lipid peroxidation and membrane damage. Additionally, the synthesis and release of microcystins were promoted by arbidol. Fortunately, arbidol can be effectively removed by Microcystis aeruginosa mainly through biodegradation (50.5% at 48 h for 1.0 mg/L arbidol), whereas the roles of bioadsorption and bioaccumulation were limited. The biodegradation of arbidol was dominated by algal intracellular P450 enzymes via loss of thiophenol and oxidation, and a higher arbidol concentration facilitated the degradation rate. Interestingly, the toxicity of arbidol was reduced after algal biodegradation, and most of the degradation products exhibited lower toxicity than arbidol. This study revealed the environmental risks and transformation behavior of arbidol in algal bloom waters.
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Affiliation(s)
- Ziwei Guo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China.
| | - Gui Yang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Kunqian Liu
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Yanting Xi
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Zihui Li
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Yu Luo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Guohua Dao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xiaomin Ren
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China.
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
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Cui D, He H, Xie W, Yang S, Guo Z, Liao Z, Liu F, Lai C, Ren X, Huang B, Pan X. Occurrence and cycle of dissolved iron mediated by humic acids resulting in continuous natural photodegradation of 17α-ethinylestradiol. J Hazard Mater 2024; 465:133155. [PMID: 38091802 DOI: 10.1016/j.jhazmat.2023.133155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/16/2023] [Accepted: 11/29/2023] [Indexed: 02/08/2024]
Abstract
17α-ethinylestradiol (EE2), a synthetic endocrine-disrupting chemical, can degrade in natural waters where humic acids (HA) and dissolved iron (DFe) are present. The iron is mostly bound in Fe(III)-HA complexes, the formation process of Fe(III)-HA complexes and their effect on EE2 degradation were explored in laboratory experiments. The mechanism of ferrihydrite facilitated by HA was explored with results indicating that HA facilitated the dissolution of ferrihydrite and the generation of Fe(III)-HA complexes with the stable chemical bonds such as C-O, CO in neutral, alkaline media with a suitable Fe/C ratio. 1O2, •OH, and 3HA* were all found to be important in the photodegradation of EE2 mediated by Fe(III)-HA complexes. Fe(III)-HA complexes could produce Fe(II) and hydrogen peroxide (H2O2) to create conditions suitable for photo-Fenton reactions at neutral pH. HA helped to maintain higher dissolved iron concentrations and alter the Fe(III)/Fe(II) cycling. The natural EE2 photodegradation pathway elucidated here provides a theoretical foundation for investigating the natural transformation of other trace organic contaminants in aquatic environments.
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Affiliation(s)
- Danni Cui
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China.
| | - Wenxiao Xie
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Shanshan Yang
- School of Water Resources and Environment, China University of Geosciences, Beijing 100083, China
| | - Ziwei Guo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Southwest United Graduate School, Kunming 650092, China
| | - Feng Liu
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Chaochao Lai
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xiaomin Ren
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Southwest United Graduate School, Kunming 650092, China
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Deng X, Liao Z. A machine-learning model based on dynamic contrast-enhanced MRI for preoperative differentiation between hepatocellular carcinoma and combined hepatocellular-cholangiocarcinoma. Clin Radiol 2024:S0009-9260(24)00093-X. [PMID: 38413354 DOI: 10.1016/j.crad.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/31/2024] [Accepted: 02/04/2024] [Indexed: 02/29/2024]
Abstract
AIM To establish a machine-learning model based on dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) to differentiate combined hepatocellular-cholangiocarcinoma (cHCC-CC) from hepatocellular carcinoma (HCC) before surgery. MATERIALS AND METHODS Clinical and MRI data of 194 patients with histopathologically diagnosed cHCC-CC (n=52) or HCC (n=142) were analysed retrospectively. ITK-SNAP software was used to delineate three-dimensional (3D) lesions and extract high-throughput features. Feature selection was carried out based on Pearson's correlation coefficient and least absolute shrinkage and selection operator (LASSO) regression analysis. A radiomics model (radiomics features), a clinical model (i.e., clinical-image features), and a fusion model (i.e., radiomics features + clinical-image features) were established using six machine-learning classifiers. The performance of each model in distinguishing between cHCC-CC and HCC was evaluated with the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC), sensitivity, and specificity. RESULTS Significant differences in liver cirrhosis, tumour number, shape, edge, peritumoural enhancement in the arterial phase, and lipid were identified between cHCC-CC and HCC patients (p<0.05). The AUC of the fusion model based on logistic regression was 0.878 (95% CI: 0.766-0.949) in the arterial phase in the test set, and the sensitivity/specificity was 0.844/0.714; however, the AUC of the clinical and radiomics models was 0.759 (95% CI: 0.663-0.861) and 0.838 (95% CI: 0.719-0.921) in the test set, respectively. CONCLUSION The fusion model based on DCE-MRI in the arterial phase can significantly improve the diagnostic rate of cHCC-CC and HCC as compared with conventional approaches.
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Affiliation(s)
- X Deng
- Medical Imaging Center, Ganzhou People's Hospital, 16th Meiguan Avenue, Ganzhou 341000, China; Ganzhou Institute of Medical Imaging, Ganzhou 341000, China; Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Ganzhou 341000, China
| | - Z Liao
- Medical Imaging Center, Ganzhou People's Hospital, 16th Meiguan Avenue, Ganzhou 341000, China; Ganzhou Institute of Medical Imaging, Ganzhou 341000, China; Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Ganzhou 341000, China.
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6
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Guo Z, He H, Liu K, Yang S, Li Z, Lai C, Liao Z, Ren X, Huang B, Pan X. Sunlight-induced degradation of COVID-19 antivirals arbidol in natural aquatic environments: Mechanisms, pathways and toxicity. J Environ Manage 2023; 347:119113. [PMID: 37769471 DOI: 10.1016/j.jenvman.2023.119113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/19/2023] [Accepted: 08/30/2023] [Indexed: 09/30/2023]
Abstract
Insights into COVID-19 antivirals' environmental fate and ecological risk are urgently required due to their increasing concentrations in aquatic environments, which have rarely been studied. Herein, we first investigated the photochemical transformation and the resulting alterations in toxicity of arbidol, an antiviral drug with relatively higher toxicity. The photolysis of arbidol was rapid with a rate constant of 0.106 min-1 due to its superior ultraviolet light absorption, in which the direct photolysis was predominated with a contribution of 91.5%. Despite its substantial photolysis, only 14.45% of arbidol was mineralized after 100 min, implying that arbidol and its products might have a long-term impact on aquatic environment. It was inferred that arbidol was photolyzed mainly via the loss of thiophenol, bromine, and alkylamine, based on twelve photolytic products identified. Notably, the experimental results demonstrated that the photolysis process increased the acute toxicity of arbidol, and the toxicity prediction indicated that the ecotoxicity of two photolytic products was very high with LC50 values below 0.1 mg/L. Due to the co-effect of multiple constituents, the photolytic rate observed in wastewater treatment plant effluent and in river water was comparable to that in ultra-pure water, while it was slightly enhanced in lake water. The presence of dissolved organic matter suppressed arbidol photolysis, while NO3- exhibited a promotion effect. These results would be of great significance to assess the fate and risk of COVID-19 antivirals in natural aquatic environments.
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Affiliation(s)
- Ziwei Guo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Kunqian Liu
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Shicheng Yang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Zihui Li
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Chaochao Lai
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Xiaomin Ren
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China.
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China.
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Altan M, Soto F, Xu T, Wilson N, Franco-Vega MC, Simbaqueba Clavijo CA, Shannon VR, Faiz SA, Gandhi S, Lin SH, Lopez P, Zhong L, Akhmedzhanov F, Godoy MCB, Shroff GS, Wu J, Khawaja F, Kim ST, Naing A, Heymach JV, Daniel-Macdougall C, Liao Z, Sheshadri A. Pneumonitis After Concurrent Chemoradiation and Immune Checkpoint Inhibition in Patients with Locally Advanced Non-small Cell Lung Cancer. Clin Oncol (R Coll Radiol) 2023; 35:630-639. [PMID: 37507279 DOI: 10.1016/j.clon.2023.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/20/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
AIMS Pneumonitis is a common and potentially deadly complication of combined chemoradiation and immune checkpoint inhibition (CRT-ICI) in patients with locally advanced non-small cell lung cancer (LA-NSCLC). In this study we sought to identify the risk factors for pneumonitis with CRT-ICI therapy in LA-NSCLC cases and determine its impact on survival. MATERIALS AND METHODS We conducted a retrospective chart review of 140 patients with LA-NSCLC who underwent curative-intent CRT-ICI with durvalumab between 2018 and 2021. Pneumonitis was diagnosed by a multidisciplinary team of clinical experts. We used multivariable cause-specific hazard models to identify risk factors associated with grade ≥2 pneumonitis. We constructed multivariable Cox proportional hazard models to investigate the impact of pneumonitis on all-cause mortality. RESULTS The median age of the cohort was 67 years; most patients were current or former smokers (86%). The cumulative incidence of grade ≥2 pneumonitis was 23%. Among survivors, 25/28 patients had persistent parenchymal scarring. In multivariable analyses, the mean lung dose (hazard ratio 1.14 per Gy, 95% confidence interval 1.03-1.25) and interstitial lung disease (hazard ratio 3.8, 95% confidence interval 1.3-11.0) increased the risk for pneumonitis. In adjusted models, grade ≥2 pneumonitis (hazard ratio 2.5, 95% confidence interval 1.0-6.2, P = 0.049) and high-grade (≥3) pneumonitis (hazard ratio 8.3, 95% confidence interval 3.0-23.0, P < 0.001) were associated with higher all-cause mortality. CONCLUSIONS Risk factors for pneumonitis in LA-NSCLC patients undergoing CRT-ICI include the mean radiation dose to the lung and pre-treatment interstitial lung disease. Although most cases are not fatal, pneumonitis in this setting is associated with markedly increased mortality.
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Affiliation(s)
- M Altan
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F Soto
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - T Xu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - N Wilson
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M C Franco-Vega
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C A Simbaqueba Clavijo
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - V R Shannon
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S A Faiz
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S Gandhi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - P Lopez
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Zhong
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F Akhmedzhanov
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - M C B Godoy
- Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - G S Shroff
- Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Wu
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - F Khawaja
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - S T Kim
- Department of Rheumatology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A Naing
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J V Heymach
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Daniel-Macdougall
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - A Sheshadri
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Cavazos A, Iskander GM, Cox V, Cheng H, Ejezie CL, Perez S, Nguyen J, Beddar S, Liao Z, Yeboa DN. Protocol in a Day: An Educational Institutional Workshop for Protocol Development. Int J Radiat Oncol Biol Phys 2023; 117:e557-e558. [PMID: 37785710 DOI: 10.1016/j.ijrobp.2023.06.1871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The Protocol-in-a-Day (PIAD) workshop was developed to support junior faculty and residents with clinical trial protocol design, with the main goal of providing initial feedback during development to reduce time for review and approval from institutional oversight committees. Our objectives are to mentor and educate participants and to evaluate the time to institutional approval by oversight committees. MATERIALS/METHODS PIAD provided concurrent educational feedback on 6 key elements of trial design. These included: (1) regulatory aspects; (2) institutional scientific review committee (SRC) and institutional review board (IRB); (3) clinical research and data coordination (including nursing); (4) statistics; (5) correlatives including imaging, biospecimens, and health services research/patient-reported outcomes; and (6) operations. The average number of days from submission to IRB approval or study activation for PIAD protocols was compared to other protocols submitted between January 2018 - January 2022 within the Division of Radiation Oncology. Participants were also given a 15-question survey to assess their perspective of the impact of the workshop. RESULTS A total of 25 protocols went through the PIAD workshop between January 2018-January 2022. Of the 25 protocols, 7 (28%) were excluded from this study due to not being submitted possibly after participants benefited from education on the limitations of their design. Eighteen protocols were included in our final analyses. These protocols included phase II (n = 11), phase 1 (n = 5), and phase III (n = 2). At the time of this report, all protocols (n = 18) have received IRB approval and have been activated. Protocol elements that could impact study activation included protocols requiring investigational new drug (IND) approval (n = 8) and multicenter studies (n = 1). Analyzing the time of submission to request for activation showed a decrease in time for protocols that went through PIAD vs those that did not [PIAD protocols, 254 days vs All other protocols, 262 days]. Likewise, those who attended PIAD had a lower average time from submission to IRB Approval [ PIAD protocols, 40 days vs All other protocols, 59 days]. All participants (100%) of the PIAD workshop responded that the educational program "improved the overall quality of the study design." The most commonly cited changes were protocol language (n = 17), statistics (n = 15), consent language (n = 8), and study design (n = 8). Aspects participants identified as the most educational included mentorship from regulatory, clinical research finance, and IRB review. CONCLUSION PIAD from participant surveys provided high educational value in the areas of improving trial quality, language and statistical design. When analyzing the average time, from 'submission to IRB initial approval' and 'submission to activation', PIAD protocols had a shorter time for approval, and thus suggests PIAD is effective in improving the overall design of protocols.
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Affiliation(s)
- A Cavazos
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G M Iskander
- MD Anderson Cancer Center, Houston, TX; Tillman J Fertitta Family College of Medicine, Houston, TX
| | - V Cox
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - H Cheng
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; UT Southwestern Medical Center, Dallas, TX
| | - C L Ejezie
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Perez
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Beddar
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - D N Yeboa
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Dudzinski SO, Cabanillas ME, Busaidy NL, Hu MI, Dadu R, Gunn GB, Reddy J, Phan J, Beckham T, Waguespack SG, Sherman S, Ying AK, Gandhi S, Wang C, Liao Z, Chang JY, Ludmir EB, Chen AB, Welsh JW, Ning MS. Definitive Radiotherapy for Oligometastatic and Oligoprogressive Thyroid Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e579. [PMID: 37785759 DOI: 10.1016/j.ijrobp.2023.06.1918] [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) Local consolidative radiotherapy (LCT) for oligometastatic disease is a promising paradigm improving outcomes for various malignancies but has been underexplored for metastatic thyroid cancer. We hypothesize that LCT to distant sites with definitive RT doses can yield favorable outcomes and defer systemic therapy escalation for these patients. MATERIALS/METHODS We reviewed 96 thyroid cancer patients who received 175 LCT courses from 2010-2022 to 228 metastatic sites, including: thorax (45%), bone (40%), brain (6%), head/neck (5%), and abdomen (3%). Common prescriptions were 50-55Gy/4-5fxs or 56-70Gy/8-10fxs for lung; 52.5-60Gy/15fxs for mediastinum; and 18-24Gy/1fx or 27-30Gy/3fxs for bone. RECIST v1.1 and CTCAE v5.0 were used to define progression and toxicities, respectively. Outcomes were evaluated via Kaplan-Meier and associations examined via Cox proportional hazards modeling. RESULTS Median age was 63 years (range: 26-92), with 62 oligometastatic cases (total 1-5 sites) and 34 oligoprogressive (with 1-5 growing sites). Primary disease was controlled in all patients, with 39% receiving post-op RT and 66% prior RAI. Histologies included papillary (40%), anaplastic (25%), follicular (12%), medullary (9%), Hurthle (7%), and poorly-differentiated (7%). Median time from initial diagnosis to LCT was 3 yrs (IQR 1-8), and median follow-up from 1st LCT was 21 mos (IQR 9-51). Patients received an average 2 LCT courses (range 1-8) treating 1-4 sites. Median survival (OS) from 1st LCT was 9 yrs (95% CI = 5-14). On multivariable analysis (MVA), worse OS was associated with anaplastic histology (HR 4.6, p<.01), but longer OS was associated with prior RAI (HR 0.33, p = .02) and oligometastatic disease (HR 0.3, p = .01). For anaplastic histology, median OS was 1.2 years vs. 9.3 years for non-anaplastic; 3-yr OS was 36% vs. 88% (log-rank, p<.01). Five-year OS for oligometastatic cases was 75% vs 53% for oligoprogressive (log-rank, p = .04). Median progression free survival (PFS) from 1st LCT was 15.5 mos (95% C I = 11-20). On MVA for all LCT courses, time to any progression (TTP) was negatively associated with anaplastic histology (HR 1.7, p = .02) and 2nd or higher LCT course (HR 1.45, p = .05), but favorably associated with thoracic site (HR 0.49, p<.01). Following later LCT courses, median TTP was 11 mos vs 17 mos for initial LCT course (log-rank, p = .03). After LCT to lung/chest, TTP was 18.6 mos vs 9.5 mos for non-thoracic sites (log-rank, p<.01). Only 6% of failures occurred at previously treated lesions. Most LCT courses (67%) were without ongoing chemotherapy, while 25% entailed continuing the same regimen and 9% had planned treatment post-RT. There were 2 Grade 3 toxicities (pneumonitis and esophagitis) and no Grade 4-5 events. CONCLUSION With high local control rates and minimal toxicity, LCT can be a feasible strategy to defer systemic therapy escalation for oligometastatic and oligoprogressive thyroid cancer.
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Affiliation(s)
- S O Dudzinski
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M E Cabanillas
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - N L Busaidy
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - M I Hu
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - R Dadu
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - G B Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Reddy
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - T Beckham
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S G Waguespack
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Sherman
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - A K Ying
- Department of Endocrine Neoplasia & Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Gandhi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - C Wang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Y Chang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - E B Ludmir
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A B Chen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J W Welsh
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M S Ning
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Abana CO, Carriere PP, Damen P, van Rossum PSN, Bravo PL, Wei X, Pollard JM, Nitsch PL, Murphy MB, Hofstetter W, Liao Z, Lin SH. Long-Term Outcomes and Toxicity in Esophageal Cancer Patients after Neoadjuvant or Definitive Concurrent Chemotherapy with Proton Beam Therapy. Int J Radiat Oncol Biol Phys 2023; 117:e280-e281. [PMID: 37785050 DOI: 10.1016/j.ijrobp.2023.06.1262] [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) Proton-beam therapy (PT) is increasingly utilized over three dimensional-conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) photon irradiation for the treatment of various malignancies due to better toxicity reduction. We investigated the long-term outcomes and toxicity in esophageal cancer (EC) patients treated with PT as part of their neoadjuvant concurrent chemoradiation followed by surgery (nCRT) or definitive concurrent chemoradiation (dCRT) treatment regimen. MATERIALS/METHODS All consecutively treated, American Joint Committee on Cancer 7th edition clinical stage I-IV EC patients from 2006 to 2022 were retrospectively analyzed. Standard RT dose for most patients was 50.4 Gy/28 fractions. nCRT patients had surgery within 4 months post-RT. Kaplan-Meier method was used to determine overall survival (OS), locoregional recurrence-free survival (LRRFS) and distant metastatic-free survival (DMFS). Acute and chronic RT-related toxicities were graded with Common Terminology Criteria for Adverse Events version 4.0. RESULTS There were 510 EC PT patients: 204 (40%) had nCRT and 306 (60%) had dCRT. Most lesions were located in the lower esophagus, of adenocarcinoma histology and treated with passive scatter PT. Overall median follow-up was 72 months. Median, 3- and 5-year OS for all patients were 43 months, 54.1% and 44.9%, respectively. Median LRRFS and DMFS were not reached. Esophagitis was the most common grade ≥3 (G3+) toxicity (59 patients; 28.9%, including a G4 and a G5 toxicity), followed by nausea (29 patients; 14.2%) and esophageal stricture (26 patients, 12.7%). With nCRT, median, 3- and 5-year OS were 80 months, 64.7% and 56.1%, respectively, while the median LRRFS and DMFS were not reached again. Their most common G3+ toxicity was esophagitis in 14 patients (6.9%) followed by nausea (8 patients; 3.9%). An nCRT patient developed G4 RT pneumonitis. Pathological complete response (pCR) was observed in 58 patients (28.4%). Surgery-related pulmonary, cardiac and gastrointestinal complications were reported in 38 (18.6%), 40 (19.6%) and 43 (21.1%) patients, respectively. dCRT patients had a median follow-up of 65 months, and median, 3- and 5-year OS of 32 months, 46.7% and 37.0%, respectively. Although the median LRRFS was not reached, the median DMFS was 74 months. The most observed dCRT G3+ toxicity was esophagitis (45 patients, 22.1%: including both G4 and G5 patients) and then esophageal stricture (23 patients, 11.3%). A dCRT patient developed G4 fistula. CONCLUSION To our knowledge, this is the largest single-institutional study on EC long-term outcomes and toxicity using PT. Our cohort reveals good outcomes and mostly mild CRT-related toxicities. Trimodality nCRT with protons demonstrates excellent outcomes relative to the CROSS trial (49.4 months) with identical pCR rate (29% in CROSS) and similar toxicity profile. nCRT with protons should be studied rigorously in the current randomized phase III trial NRG GI006.
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Affiliation(s)
- C O Abana
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P P Carriere
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P Damen
- Department of Radiation Oncology, The University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - P S N van Rossum
- Department of Radiation Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - P Lopez Bravo
- Department of Radiation Oncology Clinical Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - X Wei
- Department of Radiation Oncology Clinical Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J M Pollard
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P L Nitsch
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Blum Murphy
- Department of Gastrointestinal Medical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX
| | - W Hofstetter
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Sasaki YM, Xu T, Koutroumpakis S, Sheshadri A, Deswal A, Nguyen QN, Gandhi S, Cascone T, Le X, Altan M, Chen AB, Liao Z. Comorbidities and Their Impact on Treatment Tolerance and Outcome in Elderly NSCLC Patients Treated with Concurrent Chemoradiation Using Proton or Photon Followed by Immunotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e54-e55. [PMID: 37785668 DOI: 10.1016/j.ijrobp.2023.06.767] [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) To investigate comorbidities and their impact on treatment tolerance and survival for elderly NSCLC patients treated with concurrent chemoradiation using proton beam therapy (PBT) or intensity modulated radiation therapy (IMRT) followed by immunotherapy (IO). MATERIALS/METHODS This is a retrospective study in senior patients (≥ 65 years) with inoperable locally advanced- NSCLC (LA-NSCLC) who received concurrent chemoradiation (CRT) therapy followed by adjuvant IO. Comorbidities are listed in table 1 and scored according to hazard ratios (HRs) of death. Treatment tolerance and comorbidities were compared between modalities using Fisher's exact test. Association between comorbidities and treatment tolerance was analyzed using logistic regression; association between comorbidities and survival was analyzed by Cox proportional hazards regression. RESULTS Total 218 patients were included with median age of 72 (range 65-86) years. Fifty-three (24.3%) were PBT and 165 (75.7%) were IMRT. Majority patients were white ethnics, had stage III adenocarcinoma disease and good performance score, and received RT dose 60-66 Gy. The median follow-up time for the whole group was 23 months. A 97% of patients had ≥1, and 62% had ≥4 comorbidities. The combined comorbidity scores ranged from 0 to 25. No significant difference in comorbidities between modalities except IMRT had more patients with COPD (36% vs. 51%, p = 0.047). Rates of hospitalization and ER visit during CRT+IO were 28% and 5%, respectively. Rates of IO discontinuation and interruption were 55% and 8%, respectively. Patients received >6 months IO had significantly lower risk of death (HR: 0.25, p<0.001). No significant difference in treatment tolerance between modalities. In multivariable analysis, atrial fibrillation, pulmonary disease, and depression were the comorbidities associated with hospitalization during CRT+IO (p<0.05); dementia was the comorbidity associated with IO interruption (p = 0.042); heart failure, COPD, asthma, osteoporosis and HIV were the comorbidities associated with poor OS (p<0.05). Combined comorbidity score was associated with OS with HR of 1.13 (p<0.001) with adjustment of race, GTV and induction chemotherapy. CONCLUSION Comorbidities were associated with hospitalization and IO interruption during the whole course of CRT and IO therapy, with increased IO discontinuation which negatively impacted survival. Evaluating and scoring comorbidities at diagnosis could be a useful method to predict risk of death before treatment start.
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Affiliation(s)
- Y M Sasaki
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - T Xu
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Koutroumpakis
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A Sheshadri
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A Deswal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Q N Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S Gandhi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - T Cascone
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - X Le
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Altan
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A B Chen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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12
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Damen P, van Rossum PSN, Chen Y, Liao Z, Hofstetter W, Hobbs BP, Mohan R, Lin SH. Comparing 90-Day Post-Operative Mortality after Neoadjuvant Proton-Based vs. Photon-Based Chemoradiotherapy for Esophageal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e346-e347. [PMID: 37785204 DOI: 10.1016/j.ijrobp.2023.06.2415] [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) Standard of treatment for locally advanced esophageal cancer consists of chemoradiotherapy (CRT) followed by surgery. Evidence suggests that proton beam therapy (PBT) results in lower toxicity and fewer post-operative complications compared to photon-based radiotherapy (RT). Mortality in the first 90 days after surgery is a rare event occurring in 2-8% of patients, with higher reported rates (of up to 17%) in older patients. This 90-day mortality (90DM) rate is an important measure of post-operative (non-oncologic) mortality as a proxy of quality of care. We hypothesize that PBT could reduce the incidence of 90DM compared to photon-based RT. MATERIALS/METHODS From a single-center retrospectively acquired database patients with esophageal cancer treated with neoadjuvant CRT and esophagectomy in 1998-2022 were selected. Univariable logistic regression analyses were used to study the associations of RT modality and other patient- and treatment-related characteristics with 90DM. Subsequently, 3 separate methods were applied to adjust for confounding bias. These included multivariable logistic regression, 1:1 nearest-neighbor propensity score matching (PSM), and inverse probability of treatment weighting (IPTW). Finally, stratified analyses for patient groups aged ≥67 vs. <67 years were performed. RESULTS A total of 894 eligible patients were included (PBT, n = 202; photon-based RT, n = 692). PBT patients had a significantly higher age, better performance score, and a higher number of comorbidities. The 90DM rate was 5 (2.5%) in the PBT group and 29 (4.2%) in the photon-based RT group (p = 0.262). Significant univariable predictors of 90DM included higher age and tumor location. After multivariable adjustment, PBT vs. photon therapy was not significantly associated with 90DM (OR 0.49, 95% CI 0.18-1.31). The 90DM rates in the PSM cohort (n = 181 vs. n = 181) were 2.8% for PBT and 3.3% for photon-based RT (p = 0.379). The 90DM rates in the IPTW cohort were 2.8% for PBT and 4.1% for photon-based RT (p = 0.427). In the full cohort, stratified analysis for age groups revealed that in patients aged ≥67 years, PBT was associated with a decreased risk of 90DM compared to photon-based RT (1.3% vs. 8.8%; p = 0.046), which was not the case in patients aged <67 years. In the PSM cohort, a comparable (but non-significant) difference was observed in favor of PBT in patients aged ≥67 years (i.e., 1.5% vs. 7.5%; p = 0.099). Within-group analyses in the original cohort demonstrated that a higher age significantly increased the risk of 90DM within the photon-based RT group (8.8% vs. 2.7% for age ≥67 vs. <67 years; p = 0.001), but not within the PBT group (1.3% vs. 3.2%; p = 0.398). CONCLUSION Post-operative 90DM after esophagectomy for cancer was not significantly different between PBT and photon-based neoadjuvant CRT. However, among older patients we observed a signal that PBT may reduce the risk of 90DM. Higher age increased the risk of 90DM in patients who underwent photon-based RT, but not in patients who underwent PBT.
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Affiliation(s)
- P Damen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Radiation Oncology, The University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - P S N van Rossum
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Radiation Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Y Chen
- Department of Biostatistics and Data Science, University of Texas Health Science Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - W Hofstetter
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B P Hobbs
- Department of Population Health, The University of Austin Dell Medical School, Austin, TX
| | - R Mohan
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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13
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Liu Y, Hobbs BP, Hofstetter W, Murphy MB, Gandhi S, Nguyen QN, Chang JY, Liao Z, Diehn M, Ma J, Lin SH. Prospective Trial of Using Imaging to Predict Pathologic Response and Clinical Outcomes in Locally Advanced Esophageal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:S12-S13. [PMID: 37784311 DOI: 10.1016/j.ijrobp.2023.06.227] [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) Trimodality therapy with chemoradiation (CRT) followed by esophagectomy is the standard of care for locally advanced esophageal cancer. An unresolved question is whether pathologic complete response (pCR) can be assessed non-invasively for patients post-CRT. In this study, we assessed whether diffusion-weighted imaging (DWI) with MRI or PET can be used as predictors of pCR and other clinical outcomes after CRT. MATERIALS/METHODS Patients were enrolled on a single-arm institutional trial (PA13-0380) assessing the role of imaging in predicting outcomes in potentially resectable esophageal patients undergoing trimodality therapy. All patients received neoadjuvant CRT, and 29 patients had subsequent surgery. DWI MRI and PET scans were obtained at baseline, 2 weeks after the start of CRT (interim) and 4 to 6 weeks after completion of CRT (follow up). Apparent diffusion coefficients (ADCs) were calculated based on DWI images. Circulating tumor DNA was obtained for 27 patients post-radiation using CAPP-Seq. Mann-Whitney tests compared imaging changes associated with pCR. Discrimination of pCR by imaging changes was quantified by received operating characteristics. Youden's index was applied to select optimal thresholds. Kaplan-Meier analysis was performed to assess differences in overall survival (OS) and progression-free survival (PFS) by changes in DWI, PET, and ctDNA parameters. RESULTS Our cohort of 60 patients had a median follow up of 42.7 months, age of 65.4 yrs, and ECOG of 1 at completion of CRT. 90% were male, 58% had a history of smoking, and 85% were white. 83% had adenocarcinoma with the rest squamous cell carcinoma. Stages of the patients ranged from IIA to IIIB. All had moderately (47%) or poorly (53%) differentiated disease. All received 41.4-50.4 Gy in 1.8 Gy fractions with the majority receiving 50.4 Gy (95%). 29 patients underwent surgery after CRT of which 8 (27.6%) had pCR. Mean ΔADC from baseline to mid-treatment was most associated with pCR (AUC = 0.98, p<0.001) for patients undergoing surgery. Max ΔADC from baseline to first follow-up was most associated with OS (p = 0.002) and PFS (p<0.001) for the whole cohort. 27 patients had ctDNA analyzed after RT with the presence of ctDNA significantly associated with worse OS (HR = 0.12, p = 0.05) and PFS (HR = 0.10, p = 0.002). Combining ctDNA and max ΔADC generated a model that was more predictive of OS and PFS than either alone. We found that neither the PET parameters of TLG or SUV max at baseline or changes in these parameters from baseline to mid-treatment or first follow-up were as predictive as DWI. CONCLUSION We show that changes in DWI is associated with pCR, OS, and PFS in resectable esophageal cancer patients undergoing CRT. DWI was more predictive than PET and a model combining DWI and ctDNA was the most predictive of clinical outcomes. This study shows the significant promise of using DWI in potentially guiding treatment decisions in esophageal cancer patients and will require validation in a larger cohort.
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Affiliation(s)
- Y Liu
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - B P Hobbs
- Department of Population Health, The University of Austin Dell Medical School, Austin, TX
| | - W Hofstetter
- Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Blum Murphy
- Department of Gastrointestinal Medical Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX
| | - S Gandhi
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Q N Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J Y Chang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z Liao
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M Diehn
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - J Ma
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - S H Lin
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Liao Z, Qiu L, Zhang Q, Wei X, Chen Y, Yin M. Investigation of the luminescence properties and energy transfer mechanisms in Gd 3TaO 7:Bi 3+,Eu 3+ phosphors for their potential application in full-spectrum WLEDs. Dalton Trans 2023; 52:12504-12516. [PMID: 37605932 DOI: 10.1039/d3dt02065g] [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: 08/23/2023]
Abstract
In recent years, there has been increasing effort devoted to the development of single-phase white phosphors due to drawbacks such as severe reabsorption and color deviation in traditional white light-emitting diodes (WLEDs). A new feasible strategy has emerged for achieving white light emission through the Bi3+-Eu3+ energy transfer in suitable single-phase phosphors. Therefore, a series of Gd3TaO7:xBi3+ and Gd3TaO7:0.01Bi3+,yEu3+ phosphors were synthesized via a high-temperature solid-state method, and their properties were systematically characterized. In Gd3TaO7, Bi3+ occupies two kinds of Gd3+ site, resulting in two broad emission bands peaking at 427 nm and 500 nm respectively under ultraviolet (UV) excitation, which arise from 3P1 → 1S0 transitions. By adjusting the concentration of Eu3+ in Gd3TaO7:0.01Bi3+,yEu3+, effective energy transfer can occur between Bi3+ and Eu3+, thus enabling the regulation of green-white-red luminescence under 332 nm excitation and blue-white-red luminescence under 365 nm UV light irradiation. Upon stimulation with a 365 nm UV chip, Gd3TaO7:0.01Bi3+,0.02Eu3+ emits white light with CIE coordinates of (0.3509, 0.3202), a color temperature of 4629 K, and an impressive color rendering index of 87.96. The above results indicate the potential of Gd3TaO7:0.01Bi3+,yEu3+ phosphor as a viable candidate for WLED applications.
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Affiliation(s)
- Zhicheng Liao
- CAS Key Laboratory of Microscale Magnetic Resonance, and School of Physical Sciences, University of Science and Technology of China, Hefei 230026, China
| | - Liting Qiu
- Key Laboratory of Strongly-Coupled Quantum Matter Physics, Chinese Academy of Sciences, School of Physical Sciences, University of Science and Technology of China, Hefei 230026, PR China.
| | - Qian Zhang
- Key Laboratory of Strongly-Coupled Quantum Matter Physics, Chinese Academy of Sciences, School of Physical Sciences, University of Science and Technology of China, Hefei 230026, PR China.
| | - Xiantao Wei
- Physics Experiment Teaching Center, School of Physical Sciences, University of Science and Technology of China, Hefei 230026, PR China
| | - Yonghu Chen
- Key Laboratory of Strongly-Coupled Quantum Matter Physics, Chinese Academy of Sciences, School of Physical Sciences, University of Science and Technology of China, Hefei 230026, PR China.
| | - Min Yin
- Key Laboratory of Strongly-Coupled Quantum Matter Physics, Chinese Academy of Sciences, School of Physical Sciences, University of Science and Technology of China, Hefei 230026, PR China.
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15
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Liao Z, Hua X, Cheng X, Ning X, Liu Z, Chen G. Dynamic simulation of a motor longitudinally mounted on a centralized electric drive systems for pure electric vehicles under torque ripple and transmission error excitations. Sci Prog 2023; 106:368504231201330. [PMID: 37722870 PMCID: PMC10510364 DOI: 10.1177/00368504231201330] [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] [Indexed: 09/20/2023]
Abstract
The dynamic characteristics of electric drive systems are crucial in electric vehicles. Based on the dynamic finite element method and previous studies, this study proposes and analyzes a new mathematical model for a motor longitudinally mounted on a centralized electric drive system of a pure electric vehicle. First, we analyze the largest torque ripple of a fractional slot concentrated winding inner-mounted permanent magnet synchronous motor designed for commercial electric vehicles. This torque ripple is identified as one of the excitations influencing the dynamic performance of the electric drive system. Second, a new dynamic mathematical model for the electric drive system is established. Third, we investigate the linear vibration responses of the system subject to torque ripple and transmission error. Finally, the relationships between critical motor parameters and dynamic mesh force are revealed. The results demonstrate that the proposed theoretical method can effectively determine the dynamic characteristics of the electric drive system, thereby providing valuable theoretical guidance for the design and optimization of the motor and electric drive system.
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Affiliation(s)
- Zhicheng Liao
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Xia Hua
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Xiangle Cheng
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Xiaobin Ning
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Zhengqing Liu
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, Zhejiang, China
| | - Gang Chen
- College of Engineering and Computer Sciences, Marshall University, Huntington, WV, USA
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16
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Guo Z, He H, Liu K, Li Z, Yang S, Liao Z, Lai C, Ren X, Huang B, Pan X. The photolytic behavior of COVID-19 antivirals ribavirin in natural waters and the increased environmental risk. J Hazard Mater 2023; 452:131320. [PMID: 37002997 PMCID: PMC10043975 DOI: 10.1016/j.jhazmat.2023.131320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 05/03/2023]
Abstract
Increasing drug residues in aquatic environments have been caused by the abuse of antivirals since the global spread of the COVID-19 epidemic, whereas research on the photolytic mechanism, pathways and toxicity of these drugs is limited. The concentration of COVID-19 antivirals ribavirin in rivers has been reported to increase after the epidemic. Its photolytic behavior and environmental risk in actual waters such as wastewater treatment plant (WWTP) effluent, river water and lake water were first investigated in this study. Direct photolysis of ribavirin in these media was limited, but indirect photolysis was promoted in WWTP effluent and lake water by dissolved organic matter and NO3-. Identification of photolytic intermediates suggested that ribavirin was photolyzed mainly via C-N bond cleavage, splitting of the furan ring and oxidation of the hydroxyl group. Notably, the acute toxicity was increased after ribavirin photolysis owing to the higher toxicity of most of the products. Additionally, the overall toxicity was greater when ARB photolysis in WWTP effluent and lake water. These findings emphasize the necessity to concern about the toxicity of ribavirin transformation in natural waters, as well as to limit its usage and discharge.
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Affiliation(s)
- Ziwei Guo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China.
| | - Kunqian Liu
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Zihui Li
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Shicheng Yang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Chaochao Lai
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xiaomin Ren
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Lab of Soil Carbon Sequestration and Pollution Control, Kunming 650500, China.
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Lab of Soil Carbon Sequestration and Pollution Control, Kunming 650500, China
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Liao Z, He H, Cui D, Cui J, Yang X, Guo Z, Chen H, Dao G, Huang B, Sun H, Pan X. Algal organic matter and dissolved Mn cooperatively accelerate 17α-ethinylestradiol photodegradation: Role of photogenerated reactive Mn(III). Water Res 2023; 236:119980. [PMID: 37080107 DOI: 10.1016/j.watres.2023.119980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
Algal extracellular organic matter (EOM), a major fraction of the dissolved organic matter found in eutrophic plateau lakes, can act as a photosensitizer to drive the abiotic oxidation of Mn(II). This process has the potential to generate reactive Mn(III) and influence the fate of organic pollutants. In this study, the photodegradation of 17α-ethinylestradiol (EE2) in the presence of Mn(II) and EOM was investigated with emphasis on the photogeneration mechanism of Mn(III). The results indicated that Mn(II) can accelerate EE2 photodegradation in EOM solution owing to the photogeneration of reactive Mn(III), and the enhancement was greater at higher Mn(II) concentrations. The generation of reactive Mn(III) was mainly attributable to the action of superoxide radical generated by photosensitization of EOM. In addition, the photodegradation of EE2 was slower at higher pH, possibly because of the deactivation of Mn(III) under alkaline conditions. Single-electron transfer was an indispensable process in the photodegradation. The differences in fluorophore content, pH, and NO3- concentrations are all important determinants for EE2 photodegradation in natural waters. The information obtained in this research would contribute to the understanding of reactions between Mn(II) and EOM, and provide new insights into the behaviors of reactive Mn(III) in eutrophic water irradiated by sunlight.
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Affiliation(s)
- Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Southwest United Graduate School, Kunming 650092, China
| | - Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China.
| | - Danni Cui
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Jingye Cui
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xiaoxia Yang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Ziwei Guo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Hao Chen
- Center for Pharmaceutical Sciences, Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming 650500, China
| | - Guohua Dao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Lab of Soil Carbon Sequestration and Pollution Control, Kunming 650500, China.
| | - Hongwen Sun
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin 300350, China
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Lab of Soil Carbon Sequestration and Pollution Control, Kunming 650500, China
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18
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Lai C, He H, Liao Z, Guo Z, Ren X, Huang B, Pan X. Variation in photochemical properties of dissolved black carbon during bio-transformation and iron mineral fractionation process. Sci Total Environ 2023:164529. [PMID: 37268117 DOI: 10.1016/j.scitotenv.2023.164529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/26/2023] [Accepted: 05/27/2023] [Indexed: 06/04/2023]
Abstract
The excellent photochemical properties of dissolved black carbon (DBC) have been proven to be a significant contributor to the removal of organic pollutants in environment. However, the photochemical properties of DBC will inevitably be changed during biotic and abiotic processes. Herein, the structures and compositions of DBC during bio-transformation and goethite adsorption processes were comprehensively studied, and their corresponding photochemical properties were also evaluated. Bio-transformed DBC (B-DBC) contained more aromatic, high molecular weight, and phenolic substances compared with pristine DBC (P-DBC). The photodegradation of 17α-ethynylestradiol (EE2) was significantly promoted by B-DBC because of its superior capacity for producing 3DBC*. Moreover, the subsequent goethite fractionation selectively reduced the parts of components with high aromaticity and carboxylic functional groups in B-DBC. The interaction between B-DBC and goethite resulted in the release of Fe2+ into goethite-fractionated DBC (G-DBC), which induced the photodegradation mechanism of EE2 shifting from a single-electron transfer driven by 3DBC⁎ to the oxidation of •OH. This study provides valuable insights into the changes in photochemical behavior of DBC resulting from biotic or abiotic processes, and enhances our understanding of the role of DBC in the fate of organic pollutants.
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Affiliation(s)
- Chaochao Lai
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China.
| | - Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Ziwei Guo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xiaomin Ren
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Lab of Soil Carbon Sequestration and Pollution Control, Kunming 650500, China
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Lab of Soil Carbon Sequestration and Pollution Control, Kunming 650500, China
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He H, Liu K, Guo Z, Li F, Liao Z, Yang X, Ren X, Huang H, Huang B, Pan X. Photoaging mechanisms of microplastics mediated by dissolved organic matter in an iron-rich aquatic environment. Sci Total Environ 2023; 860:160488. [PMID: 36436646 DOI: 10.1016/j.scitotenv.2022.160488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/07/2022] [Accepted: 11/21/2022] [Indexed: 06/16/2023]
Abstract
As emerging pollutants, microplastics (MPs) have aroused worldwide concern due to their ubiquitous distribution, environmental persistence, and potential ecological risks. However, the ageing mechanisms, environmental behaviours and risks of photoaged MPs mediated by environmental factors remain obscure. Herein, systems containing a light source, humic acid (HA) and Fe were established to investigate the natural photoaging process of MPs including polyvinyl chloride (PVC) and polyethylene terephthalate (PET). The dehydrochlorination reaction of PVC-MP was inhibited by HA and Fe, which resulted from the coeffect of photon competition, excited state quenching, radical deactivation or transformation, and defect structure destruction. In contrast, the enhanced fluorescence effect suggested that the photooxidation reactions of PET-MP were promoted by HA and Fe. Therefore, the presence of HA and Fe in the environment inhibited the photoreduction of MPs while favoring the photooxidative process. Additionally, the adsorption capacity for 17α-ethinylestradiol and the cytotoxicity of MPs were increased after ageing in the hv + HA and hv + HA + Fe systems, which was attributed to the changes in morphology, elements and functional groups. This study provided new insight into the ageing behaviours of MPs in the natural environment with widespread dissolved organic matter and Fe.
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Affiliation(s)
- Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Kunqian Liu
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Ziwei Guo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Fan Li
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xiaoxia Yang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China.
| | - Xiaomin Ren
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Huang Huang
- Guangdong Provincial Key Laboratory of Environmental Pollution Control and Remediation Technology, Sun Yat-sen University, Guangzhou 510275, China
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Laboratory of Carbon Sequestration and Pollution Control in Soils, Kunming 650500, China.
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Laboratory of Carbon Sequestration and Pollution Control in Soils, Kunming 650500, China
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20
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He H, Zhang C, Yang X, Huang B, Zhe J, Lai C, Liao Z, Pan X. The efficient treatment of mature landfill leachate using tower bipolar electrode flocculation-oxidation combined with electrochemical biofilm reactors. Water Res 2023; 230:119544. [PMID: 36603307 DOI: 10.1016/j.watres.2022.119544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Mature landfill leachate contains high concentrations of organic and inorganic compounds that inhibit the performance of conventional biological treatment. Nowadays, few single treatment techniques could fulfill the requirements of cleaning mature landfill leachate. In this study, a tower bipolar electrode flocculation-oxidation (BEF-O) reactor and an electrochemical biofilm reactor (EBR) combine device was constructed to effectively treat mature landfill leachate. And the removal efficiency and mechanism of various pollutants using the BEF-O reactor were investigated. The BEF-O system with the current density of 100 mA/cm2 shows excellent treatment efficiency, which can roundly remove most pollutants (NH4+-N, COD and heavy metals, etc.), and increase the bioavailability of the effluent to facilitate subsequent EBR treatment. Benefiting from the metabolic stimulation and population selection effect of electric current on microorganisms, EBR has a denser biofilm, stronger anti-pollution load capacity, superior, and stable pollution treatment efficiency. More importantly, the combined device can reduce the concentrations of COD and NH4+-N from 6410 to 338 mg/L and 4065 to 4 mg/L, respectively, and has an economical energy consumption of 32.02 kWh/(kg COD) and 54.04 kWh/ (kg NH4+-N). To summarize, this research could provide an innovative and industrial application prospect technology for the mature landfill leachate treatment.
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Affiliation(s)
- Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Chen Zhang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xiaoxia Yang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China.
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Laboratory of Carbon Sequestration and Pollution Control in Soils, Kunming 650500, China.
| | - Jiangyun Zhe
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Chaochao Lai
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Laboratory of Carbon Sequestration and Pollution Control in Soils, Kunming 650500, China
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21
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Weng J, Dabaja B, Das P, Gunn G, Chronowski G, Bloom E, Lee P, Koong A, Ning M, Semien K, Sanders C, Ritchey R, Nguyen K, Hoffman K, Robinson I, Kerr A, Brokaw J, Liao Z, Nguyen Q. Radiation Therapy Decision Making Process and Operations for COVID-19 Positive Patients. Int J Radiat Oncol Biol Phys 2022. [PMCID: PMC9595469 DOI: 10.1016/j.ijrobp.2022.07.1722] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose/Objective(s) A challenging clinical dilemma during the COVID-19 pandemic is management of cancer patients who test positive for COVID. Given the need to balance the risk of disease progression with the risk of transmission to other patients and staff, radiation therapy for these patients requires careful consideration and modification of standard workflows. It is also critical to develop processes to mitigate radiation treatment interruption, which can affect patient outcomes. The objective of this study was to report the clinical operations and outcomes for COVID positive patients receiving radiation therapy during the pandemic at a tertiary cancer center including 2 network locations. Materials/Methods During March 2020 to March 2022, the Radiation Oncology COVID committee (RO COVID) developed an integrated process to triage patients, provide treatment recommendations, and implement infection control procedures to safely deliver radiation therapy to COVID positive patients. Policies were created for each center with multidisciplinary input from infectious disease, radiation oncology, radiation therapy, and nursing. All COVID positive patients were presented to the RO COVID group and evaluated for clinical urgency, benefit with radiation, and life expectancy. If deemed necessary, a limited planned break or hypofractionated regimen was recommended to minimize staff exposure. We conducted a retrospective review of COVID positive patients with different primary malignancies treated through the COVID positive pathway. Results A total of 68 COVID positive patients were treated with the COVID positive pathway (HN 15, Breast 9, CNS 8, GU 8, GYN, 7, Thoracic 6, GI 5, HEME 5, PED 3, SARC 2). The median age was 57.1 years (IQR 45.8-63.4) and 47% were female. There were 39 patients (57%) who were asymptomatic and were tested for routine pre-radiation screening or due to concerns of COVID exposure. Twenty-three (34%) patients were treated with palliative intent and 8 (12%) were treated for an emergent indication (i.e., spinal cord compression, bleeding). Thirteen (19%) patients were receiving radiation treatment, had a treatment break (7-21 days), and then resumed their radiation course. All treatments were successfully completed without known nosocomial spread of COVID to staff or other patients. Among this heterogenous group of patients, 58 (85%) were alive with a median follow up of 2 months (IQR 0.5-7.5). COVID infection may have contributed to 3 out of 10 deaths (4% of total cohort). The remaining deaths were due to progression of disease or other non-COVID causes. Conclusion In this study, COVID positive patients were safely treated with radiation therapy through a comprehensive decision making and clinical operations pathway taking into account evolving COVID guidelines for three different variant surges. Although limited in follow up, patient outcomes are promising with few COVID-related deaths and low overall mortality rates, even with hypofractionated regimens.
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Affiliation(s)
- J. Weng
- MD Anderson Cancer Center, Houston, TX,Corresponding author:
| | - B. Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - P. Das
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - G.B. Gunn
- MD Anderson Cancer Center, Houston, TX
| | - G.M. Chronowski
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - P. Lee
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A.C. Koong
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M.S. Ning
- MD Anderson Cancer Center, Houston, TX
| | - K. Semien
- MD Anderson Cancer Center, Houston, TX
| | | | | | - K. Nguyen
- MD Anderson Cancer Center, Houston, TX
| | - K.E. Hoffman
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - I. Robinson
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - A. Kerr
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - J. Brokaw
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Z. Liao
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Q.N. Nguyen
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
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Moore Z, Huang X, Lobaugh S, Geyer A, Gelblum D, Shepherd A, Shaverdian N, Wu A, Chaft J, Zauderer M, Rudin C, Chawla M, Jones D, Sopka D, Mak R, Liao Z, Gomez D, Zhang Z, Paik P, Rimner A. Biomarkers Associated with Pulmonary Exacerbations in a Prospective, Placebo-Controlled, Randomized Trial of Nintedanib for the Treatment of Radiation Pneumonitis. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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23
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Odwuor A, Lee P, Chang J, Liao Z, Gandhi S, Jeter M, Lin S, Chen A, Welsh J, Nguyen Q, O'Reilly M, Chun S, Ning M. Outcomes and Toxicity Following Three or More Definitive Courses of Thoracic Radiation Therapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Odwuor A, Lee P, Chang J, Liao Z, Gandhi S, Jeter M, Lin S, Chen A, Welsh J, Nguyen Q, O'Reilly M, Chun S, Ning M. Salvage Re-Irradiation with Proton Beam Therapy for New or Locoregionally Recurrent Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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25
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He Y, Adair A, Cazoulat G, Yepes P, Titt U, Wu C, Mirkovic D, Balter P, Pollard J, Cardenas C, Liao Z, Mohan R, Brock K. Modeling Variable Proton Relative Biological Effectiveness (RBE) Using Voxel-Level Image Density Change for Non-Small Cell Lung Cancer (NSCLC) Patients Treated with Passive Scattering Proton Therapy (PSPT) or Intensity Modulated Photon Therapy (IMRT). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Dorraki M, Liao Z, Abbott D, Psaltis PJ, Baker E, Bidargaddi N, Van Den Hengel A, Narula J, Verjans JW. Cardiovascular disease risk prediction via machine learning using mental health data. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2784] [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: 11/14/2022] Open
Abstract
Abstract
Background
Robust and accurate risk prediction models are much needed in cardiovascular disease. It is well-known that mental health is associated with the risk of developing cardiovascular disease. It is unknown whether mental health markers can enhance existing risk prediction models for cardiovascular disease.
Purpose
The main purpose of this study was to assess capability of mental health factors along with traditional risk factors to be used in cardiovascular predictive machine learning models, and to develop a combined machine learning approach using both traditional risk and psychological factors in 375,145 participants of the UK Biobank.
Methods
A comprehensive Pearson correlation analysis is carried out on UK Biobank data. Subsequently, an ensemble model containing decision tree, random forest, XGBoost, support vector machine (SVM), and deep neural network (DNN) classification approaches was built to predict cardiovascular diseases (CVD) in UK Biobank participants. The model was first trained using traditional cardiovascular risk factors, and subsequently trained using a combination of cardiovascular risk and psychological factors.
Results
The correlation analysis revealed that there is a correlation between CVD and mental health factors suggesting the potential of mental health application for machine learning models. Our ensemble machine learning model was able to predict CVD with an accuracy of 73.49% using CVD risk factors alone. However, by combining psychological factors with CVD risk factors in the training data, an improved accuracy of 95.70% was achieved. The accuracy and robustness of ensemble machine learning model outperformed any of five constituent learning algorithms alone.
Conclusions
Our results suggest that mental health assessment data along with traditional risk factors provides a powerful, safe and affordable machine learning model enrichment that can be used for state-of-the-art prediction of CVD.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Dorraki
- South Australian Health and Medical Research Institute , Adelaide , Australia
| | - Z Liao
- University of Adelaide, Australian Institute for Machine Learning , Adelaide , Australia
| | - D Abbott
- University of Adelaide, School of Electrical and Electronic Engineering , Adelaide , Australia
| | - P J Psaltis
- South Australian Health and Medical Research Institute , Adelaide , Australia
| | - E Baker
- University of Adelaide, Australian Institute for Machine Learning , Adelaide , Australia
| | - N Bidargaddi
- Flinders University, College of Medicine and Public Health , Adelaide , Australia
| | - A Van Den Hengel
- University of Adelaide, Australian Institute for Machine Learning , Adelaide , Australia
| | - J Narula
- Mount Sinai Medical Center , New York , United States of America
| | - J W Verjans
- South Australian Health and Medical Research Institute , Adelaide , Australia
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de Baere T, Shen C, Ducassou A, Bonvalot S, Chajon E, Farber L, Vivar O, Tyan P, Koay E, Lin S, Liao Z, Dicker A, Hoffmann C, Le Tourneau C. 489P Analysis of 3-dimensional volumetric distribution and dispersion of the radioenhancer NBTXR3 in various solid malignancies. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.617] [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] Open
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28
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Wan X, Liao Z, He H, Shi M, Yu G, Zhao F, Lai C, Wang Y, Huang B, Pan X. The desorption mechanism of dissolved organic matter on pollutants and the change of biodiversity during sediment dredging. Environ Res 2022; 212:113574. [PMID: 35636464 DOI: 10.1016/j.envres.2022.113574] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/15/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
Sediment dredging is an effective means to control the endogenous pollution of lakes, which could significantly change the concentration and composition of organic matter, especially dissolved organic matter (DOM) in the lake. DOM is particularly important for the release of endogenous pollutants, which will inevitably bring an impact on aquatic biodiversity. Nevertheless, in recent research little attention has been paid to the desorption mechanism of DOM on pollutants and the change of biodiversity during dredging. This study investigated the physicochemical properties of DOM in the sediment by taking a sediment dredging project in Dianchi Lake in China for example. The correlations of DOM properties with the desorption behavior of nitrogen (N), phosphorus (P), cadmium (Cd), lead (Pb) and the biodiversity of aquatic organisms were analyzed. The results show that the aromaticity and humification of DOM were improved after dredging, and the high molecular weight DOM was degraded into low molecular weight substance. The desorption amount of N, P and heavy metals (Cd, Pb) were decreased as the pH values increased. Moreover, NH4+-N promoted the release of Pb2+ from DOM, while the release of PO43--P was inhibited. Correlation analysis shows that the physicochemical properties of DOM exactly affected the release of N, P, Cd and Pb. It was easier to desorb pollutants with low aromaticity and humification of DOM, leading to a decrease in the diversity of aquatic organisms. This study identified the desorption mechanism of endogenous pollutants in DOM and the ecological risk to aquatic organisms, providing a theoretical basis for the prevention and control of water pollution.
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Affiliation(s)
- Xing Wan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China.
| | - Min Shi
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Guoxi Yu
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Fenqing Zhao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Chaochao Lai
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Yan Wang
- Key Laboratory of Ecological Environment Evolution and Pollution Control in Mountainous and Rural Areas of Yunnan Province, Kunming, 650224, China
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China; Yunnan Provincial Key Laboratory of Carbon Sequestration and Pollution Control in Soils, Kunming, 650500, China.
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, China; Yunnan Provincial Key Laboratory of Carbon Sequestration and Pollution Control in Soils, Kunming, 650500, China
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Wan X, Huang H, Liao Z, He H, Yue Q, Zhao F, Huang H, Huang B, Pan X. The distribution and risk of microplastics discharged from sewage treatment plants in terrestrial and aquatic compartment. J Environ Manage 2022; 314:115067. [PMID: 35452883 DOI: 10.1016/j.jenvman.2022.115067] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/26/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
Many microplastics (MPs) were produced in daily life, which would enter sewage treatment plants (STPs) with the wastewater. Although the STPs has a good interception effect on these MPs, there will still be a part of MPs entering the environment with the effluent and sludge treatment, causing a certain ecological risk. This study investigated the abundance, characteristics and retention of MPs in different STPs, as well as the ecological risks caused by MPs entering the environment. The abundance of MPs in influent and effluent was ranged from 2.02 to 2.50 items L-1 and 0.27-0.48 items L-1, respectively. The abundance of MPs in dewatered sludge and sediment of Lake Dianchi was ranged from 3.719-6.949 × 103 items (kg Ds)-1 and 1.84-5.23 × 103 items (kg Ds)-1, respectively. So roughly 80% of the MPs were trapped and transferred into the dewatered sludge. The observed colors of MPs were transparent, black, blue, red, pale brown, green and gray, and their main species were polypropylene (PP) and polyethylene (PE). To further evaluate the ecological risks of MPs, the oyster mushroom was cultivated in a medium supplemented with MPs. It was found that MPs could be absorbed by oyster mushrooms with a 7-11% of absorption rate, the fibers were widely distributed in the stipes and the pileus. This study had theoretical significance for exploring the distribution of MPs in STPs and clarifying the ecological risk posed by MPs in the environment.
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Affiliation(s)
- Xing Wan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Haiyou Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Zhicheng Liao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Huan He
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China.
| | - Qingsong Yue
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Fenqing Zhao
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Huang Huang
- Guangdong Provincial Key Laboratory of Environmental Pollution Control and Remediation Technology (Sun Yat-sen University), Guangzhou 510275, China
| | - Bin Huang
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Laboratory of Carbon Sequestration and Pollution Control in Soils, Kunming 650500, China.
| | - Xuejun Pan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Key Laboratory of Carbon Sequestration and Pollution Control in Soils, Kunming 650500, China
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Jiang Y, Wu X, Liao Z, Qi J, Gu J. AB1043 IDENTIFICATION OF UNUSUAL TOPHI ANTERIOR TO THE THYROID CARTILAGE USING DIFFERENT IMAGING METHODS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1311] [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: 11/04/2022]
Abstract
BackgroundInadequately treated gout patients could develop tophi. However, tophi could appear as atypical mass, leading to difficulty in differential diagnosis.ObjectivesThe objectives of the study were to describe an unusual case with tophi anterior to the Thyroid Cartilage using different imaging methods.MethodsClinical information of the case was presented. Ultrasound, dual energy Computed Tomography (DECT) and CT scan were compared to describe the tophi.ResultsA 66-year-old man with a 30-year history of gout was admitted. He had received urate-lowering drugs intermittently over the past few years. Physical examination revealed multiple tophi on the hands, feet, and other auricular surfaces. Moreover, there was a subcutaneous mass above the thyroid cartilage (Figure 1A). Ultrasound revealed hyperechoic nodule anterior to the thyroid cartilage, 11*7cm in size, with uneven internal echo, no blood flow signal inside, and a close relationship between the barrier of the nodule and the thyroid cartilage (Figure 1B). DECT of the neck confirmed that the mass anterior to the thyroid cartilage were tophi (Figure 1C-D). A plain radiographic evaluation demonstrated soft-tissue swellings and para-articular erosions involving hands (Figure 1E-F). The serum creatinine and uric acid levels were elevated as follows, creatinine, 562 μmol per liter (normal range, 31.8 to 116); and uric acid, 621 μmol per liter (normal range, 90 to 420).Figure 1.Tophi detected by different imaging methods. A.A picture of the mass anterior to the thyroid cartilage; B. A mass anterior to the thyroid cartilage detected by ultrasound; C. The mass anterior to the thyroid cartilage detected by dual energy CT; D. The mass anterior to the thyroid cartilage detected by CT scan; E. a picture of tophi in the hands; F. a plain radiograph of tophi in the hands.ConclusionDECT has more advantages over ultrasound and CT for detection of atypical tophi in gout patients.Disclosure of InterestsYutong Jiang Grant/research support from: Scientific and Technological Planning Project of Guangzhou City [grant number 202102020150], Xinyu Wu: None declared, Zetao Liao: None declared, Jun Qi: None declared, Jieruo Gu: None declared
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Chen Z, Tan J, Cheng T, Wu X, Gu J, Liao Z. POS0014 EFFICACY AND SAFETY OF JAK INHIBITORS IN REFRACTORY OR INITIAL TREATMENT OF ADULT ONSET STILL’S DISEASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundInappropriate activation of pro-inflammatory cytokines such as interleukin (IL)-1, IL-6 or IL-18, is a pathogenic cornerstone in adult onset Still’s disease (AOSD). Beyond therapies targeting IL-1 and IL-6, Janus kinases (JAK) inhibitors have been suggested to be efficient in refractory AOSD patients [1].ObjectivesTo assess the efficacy and safety of JAK inhibitors in the treatment of AOSD patient refractory to, or with initial treatment.MethodsThis retrospective study was based on our single center of the department of rheumatology and immunology. The data was collected from the patients’ medical records using a standardized questionnaire and analyzed at different time points. The response to JAK inhibitors was categorized as complete remission (CR), partial remission (PR) or failure (F) [2].Results7 patients were recruited (Table 1), including 4 refractory patients and 3 initial patients. Mean age at JAK inhibitor treatment start was 27.5 years for refractory patients and 35 years for initial patients; and mean disease duration was 66.5 months and 1 month respectively. All patients had fever and polyarthritis, 5 patents had rash. In addition, pulmonary hypertension, abnormal liver function tests, abdominal pain, and heart failure were also observed in our patients. Response to corticosteroids, conventional synthetic or biological Disease Modifying Anti-Rheumatic Drugs (DMARDs) had been considered inadequate in 4 refractory patients. Tofacitinib was added in the initial treatment for 3 patients for high disease activity. In total, baricitinib was used in 2 patients and tofacitinib in 5 patients. Steroids were concurrently used in 6 patients, MTX in three, SASP and NSAIDs in one. At a mean follow up of 3.8 months, complete remission was observed in one patient (with tofacitinib), partial remission was in 5 patients (4 patients with tofacitinib and one with baricitinib), and failure in one (patients with baricitinib). At the last visit, steroids could be decreased but not stopped in those 6 patients. Tolerance of JAK inhibitors was excellent, none infectious disease or other severe side effect were observed.Table 1.Characteristics of the AOSD patientsNo.SexAge (year)Disease Duration (Month)Main symptomsTreatments before JAKionsetJAKiSteroids at onsetConconmitant treatmentSteroids at the end of F-UF-U(month)Outcome1M2629Fever, polyarthritisPred+MTXTofacitinib0MTX04PR2M259Fever, polyarthritis, rash, pulmonary hypertensionPred+MTXBaricitinib16MTX+Pred124F3M3812Fever, polyarthritis, rashPred+MTX+CsA+NSAIDsTofacitinib24Pred123PR4M21216Fever, polyarthritisPred+MTX+SASP+NSAIDs+TNFiBaricitinib4Pred+MTX+SASP+NSAIDs43PR5F331Fever, polyarthritis, rash, abnormal liver function testsPredTofacitinib40Pred25CR6F471Fever, polyarthritis, rash, abdominal painPredTofacitinib36Pred45PR7F251Fever, polyarthritis, rash, heart failurePredTofacitinib40Pred123PRPred: prednisone; MTX: Methotrexate; SASP: salicylazosulfapyridine; CsA: ciclosporin A; NSAIDs: Non-Steroidal Antiinflammatory Drugs; TNFi: Tumor necrosis factor inhibitor. CR: complete remission; PR: partial remission; F: failure.ConclusionJAK inhibitors treatment may be helpful for some patients with refractory AOSD, or patients with severe disease activity at initial treatment. Different treatment responses were observed in these short series of cases, which might be due to the phenotype of patients. However, the scale of patients in our study was too low to draw a conclusion. Further study and additional information are needed to evaluate more precisely the risk-benefit ratio of this treatment, and a possible difference in efficacy among the different groups of patients or JAK inhibitors.References[1]Aosd T, Table E. Ann Rheum Dis 2020;79:842–4.[2]Vercruysse F, Barnetche T, Lazaro E, et al. Arthritis Res Ther 2019;21:1–11. doi:10.1186/s13075-019-1838-6.Figure 1.Changes in laboratory test (A) WBC; (B) CRP; (C) ESR;(D) Ferritin. M0: baseline; M1: month 1; M3: month 3; M5: month 5.AcknowledgementsNoneDisclosure of InterestsNone declared
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Abstract
BackgroundPro-inflammatory cytokines such as interleukin 6 (IL-6) are involved in the pathogenesis of adult-onset Still’s disease (AOSD). Anti-IL-6 agents such as tocilizumab have been tried to treat AOSD successfully.ObjectivesTo access the efficacy of tocilizumab in the treatment of AOSD patient refractory to,or with initial treatment.MethodsWe reviewed three cases with refractory AOSD treated with tocilizumab. All patients fulfill the Cush criteria for AOSD. All patients performed blood culture, auto-antibodies test and bone marrow test to exclude infectious diseases, other rheumatic diseases and tumors. All patients received broad-spectrum antibiotics and had no response. All patients received glucocorticoid therapy and at least one kind of anti-cytokine therapies but didn’t have full response. Then the three patients received intravenous tocilizumab treatment of 8mg/kg every 2 weeks or 4 weeks.ResultsThe first patient, a 21-year-old woman, performed positron emission tomography (PET-CT) and lymphoglandula pathology in addition to routine tests. She received high dose methylprednisolone (500mg per day for 3 days and followed by 80mg per day), gamma globulin injection (20g per day for 3 days) and baricitinib 4mg per day for 12 days, but had no response to the treatment. Then she received tocilizumab of 8mg/kg every 2 weeks and stopped baricitinib. And the symptoms and blood tests improved gradually, and the methylprednisolone dose reduced to 16mg per day at the last follow-up.The second patient is a 52-year-old man, and performed bone marrow cytology and PET-CT to excluded hematological diseases. He received methylprednisolone 80mg per day, adalimumab and tofacitinib treatment. But the patients still got recurrent fever, high ESR, CRP and serum ferritin. Then he stopped adalimumab and tofacitinib, and received tocilizumab of 8mg/kg every 2 weeks and reduced to 8mg/kg every 4 weeks because of economic factors. The patient did not develop fever and the inflammatory indexes such as ESR/CRP gradually decreased to normal range. And methylprednisolone dose reduced to 32mg nowadays.The third patient is a 30-year-old woman and has recurrent AOSD for 15 years. She had tried glucocorticoids, methotrexate, iguratimod, baritinib and entanercept successively. Yet she still had recurrent arthritis on hand and knee, and elevated ESR/CRP/serum ferritin. Additionally she suffered femoral head necrosis because of excessive doses of glucocorticoid. The patient received tocilizumab 8mg/kg every 4 weeks, then joint symptoms and inflammatory indicators improved significantly. The methylprednisolone dose was also successfully reduced to 4mg/d.The Figure 1 showed the main course of disease evolution.Figure 1.ConclusionTocilizumab may be an effective candidate in refractory AOSD despite no response to other treatments.Disclosure of InterestsNone declared
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Monti S, Cella L, Xu T, Mohan R, Liao Z, Palma G. MO-0875 Thoracic regions contributing to radiation induced lymphocyte depletion in lung cancer patients. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02441-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Palma G, Monti S, Xu T, Mohan R, Liao Z, Cella L. MO-0881 Dose patterns associated to radiation induced esophagitis in locally advanced NSCLC patients. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02447-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Weiß A, Löck S, Xu T, Liao Z, Troost E. PD-0663 Do structural parameters of the dose distribution improve the prediction of RP in NSCLC patients? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02910-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hua X, Zatar W, Gadedesi A, Liao Z. Assessment technologies of rail systems' structural adequacy - A review from mechanical engineering perspectives. Sci Prog 2022; 105:368504221099877. [PMID: 35581733 PMCID: PMC10450495 DOI: 10.1177/00368504221099877] [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] [Indexed: 11/17/2022]
Abstract
The structural adequacy challenges of railroad track structures have received considerable attention globally. Track defects and failures due to weak strength and buckling effect account for one-third of all railroad accidents. The current paper provides a comprehensive study of the recent work on the structural adequacy/bearing capacity of rail systems from mechanical engineering perspectives; existing techniques for track stiffness/modulus evaluations, including standstill and continuous methods. Further, this paper demonstrates the current techniques for track stiffness/modulus evaluation. Prevailing track modulus techniques, while accurate but time-taking, effortful, requires a track closure and provides only single-point information. Also, this review provides a suggestion on the non-destructive and non-invasive technologies for example Ground-penetrating radar (GPR) and evaluation of the substructures of tracks as they have great potential for image subsurface features.
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Affiliation(s)
- Xia Hua
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, China
| | - Wael Zatar
- College of Engineering and Computer Sciences, Marshall University, Huntington, WV, USA
| | - Alisha Gadedesi
- College of Engineering and Computer Sciences, Marshall University, Huntington, WV, USA
| | - Zhicheng Liao
- College of Mechanical Engineering, Zhejiang University of Technology, Hangzhou, China
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TANG J, Liao Z, Luo L, Deng S, Hu X, Li X. POS-400 CD16+ MONOCYTES RECRUITED BY GLOMERULAR ENDOTHELIAL CELLS VIA THE CX3CL1-CX3CR1 AXIS CONTROBUTE TO RENAL DAMAGE IN MPO-AAV. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.422] [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: 10/19/2022] Open
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Khan E, Lambrakis K, Liao Z, Gerlach J, Verjans J, Dykes L, Chew D. Developing a Machine Learning (ML) Model for Digital Phenotyping of Myocardial Infarction (MI) and Injury Amongst Patients Presenting With Suspected Acute Coronary Syndrome (ACS). Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.526] [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: 10/16/2022]
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Qiu L, Wang P, Mao J, Liao Z, Chi F, Chen Y, Wei X, Yin M. Cr 3+-doped InTaO 4 phosphor for multi-mode temperature sensing with high sensitivity in physiological temperature range. Inorg Chem Front 2022. [DOI: 10.1039/d2qi00660j] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
With the increasing demand for non-contact temperature sensing, the development of optical thermometer with excellent performance is more and more compelling. Cr3+-doped InTaO4 phosphor was prepared for the implementation of...
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Cella L, Monti S, Xu T, Durante M, Liuzzi R, Mohan R, Liao Z, Palma G. Spatial dose patterns associated to cardiac toxicity and survival in patients treated with photons and protons for lung cancer. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00130-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Lin S, Augustyn A, He J, Qiao Y, Xu T, Liao Z, Gardner K, Moran J, Tang C, Adams D. Sequential Monitoring of PD-L1 on Circulating Tumor Stromal Cells Predicts Survival Outcomes for Unresectable Stage 3 NSCLC Treated With Immunotherapies After Definitive Chemoradiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.058] [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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Liao Z, Allott K, Anderson JFI, Killackey E, Cotton SM. Quality of life in first episode psychosis: a cluster analytic approach. Qual Life Res 2021; 31:1807-1817. [PMID: 34661805 DOI: 10.1007/s11136-021-03014-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Quality of life is increasingly recognised as an important outcome for young people with first episode psychosis (FEP). The first aim was to determine whether distinct homogenous subgroups of young people with FEP could be delineated based on profiles on quality of life domains (Physical Health, Psychological, Social relationships and Environmental). The second aim was to examine the discriminant validity of these subgroups with respect to demographic, functioning and clinical features of FEP. METHOD Quality of life, demographic characteristics, clinical characteristics, cognition and functioning were assessed in 145 people with FEP. Cluster analysis using Ward's methods and Squared Euclidean Distance with a k-means verification were employed to identify subgroups with homogenous quality of life profiles. The clusters were externally validated using multinomial logistic regressions. RESULTS Three distinct quality of life profiles were identified: one with good quality of life across all domains (30%), one with poor quality of life particularly in Psychological and Social relationships domains (28%), and one 'intermediate' group with comparatively low Psychological quality of life (42%). Depression, semantic verbal fluency, social inclusion and social/occupational functioning showed associations with group membership. CONCLUSION Our results suggest the potential of maintaining relatively good quality of life despite the experience of FEP. Future research on interventions to improve quality of life may consider the potential of addressing depression, social inclusion and social/occupational functioning.
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Affiliation(s)
- Z Liao
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - K Allott
- Orygen, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10 (35 Poplar Road), Parkville, Melbourne, VIC, 3052, Australia
| | - J F I Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - E Killackey
- Orygen, Parkville, Melbourne, VIC, 3052, Australia.,Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10 (35 Poplar Road), Parkville, Melbourne, VIC, 3052, Australia
| | - S M Cotton
- Orygen, Parkville, Melbourne, VIC, 3052, Australia. .,Centre for Youth Mental Health, The University of Melbourne, Locked Bag 10 (35 Poplar Road), Parkville, Melbourne, VIC, 3052, Australia.
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Chen N, Wu H, Deng Z, Liao Z, Feng S, Luo Z, Chu Y, Qiu G, Li X, Jin Y, Rong S, Wang F, Gan L, Chen R, Zhao L. [An optimized protocol of meniscus cell extraction for single-cell RNA sequencing]. Nan Fang Yi Ke Da Xue Xue Bao 2021; 41:1310-1318. [PMID: 34658344 DOI: 10.12122/j.issn.1673-4254.2021.09.04] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To optimize the protocol of meniscus cell extraction to enhance the efficiency of cell suspension preparation and maintain a high cell viability for single-cell RNA sequencing. METHODS We compared the efficiency of the routine cell extraction methods (short-time digestion and long-time digestion) and the optimized protocol for obtaining meniscus cell suspensions by evaluating the cell number obtained and the cell viability. Single-cell RNA sequencing datasets were analyzed to evaluate the stability of the cell suspension prepared using the optimized protocol. The reliability of the optimized protocol was assessed by comparing the single-cell RNA sequencing dataset obtained by the optimized protocol with published single-cell RNA sequencing datasets of the meniscus. RESULTS The optimized protocol harvested a greater number of cells (over 1×105) than the routine protocols. The cell suspension prepared with the optimized protocol showed a cell viability higher than 80%, the highest among the 3 methods. Analysis of single-cell RNA sequencing datasets showed that the ratio of the mitochondrial genes was below 20% in over 80% of the cells. CD34+ cells, MCAM+ cells and COL1A1+ cells were identified in the datasets. Comparison with the publish datasets showed that the optimized protocol was capable of harvesting COL3A1+, COL1A1+, MYLK+, BMP2+, CD93+ and CDK1+ cells. CONCLUSION Single-cell suspension prepared from the meniscus can be stably obtained using the optimized protocol for single-cell RNA sequencing using the 10× Genomics platform.
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Affiliation(s)
- N Chen
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - H Wu
- Zhujiang Hospital, Southern Medical University, Guangzhou 510080, China
| | - Z Deng
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Z Liao
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - S Feng
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Z Luo
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Y Chu
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - G Qiu
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X Li
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Y Jin
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - S Rong
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - F Wang
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - L Gan
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - R Chen
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - L Zhao
- Department of Orthopedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Palma G, Monti S, Pacelli R, Liao Z, Deasy J, Mohan R, Cella L. OC-0641 Radiation pneumonitis in thoracic cancer patients: multi-center voxel-based analysis. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06997-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Monti S, Cella L, Xu T, Mohan R, Liao Z, Palma G. OC-0637 Thoracic dose patterns associated with radiation induced lymphopenia in patients treated for NSCLC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06993-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Yu C, Gu J, Liao Z, Feng S. Prediction of spinal anesthesia-induced hypotension during elective cesarean section: a systematic review of prospective observational studies. Int J Obstet Anesth 2021; 47:103175. [PMID: 34034957 DOI: 10.1016/j.ijoa.2021.103175] [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] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 04/15/2021] [Accepted: 04/25/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Spinal anesthesia is the standard for elective cesarean section but spinal anesthesia-induced hypotension remains an important problem. Accurate prediction of hypotension could enhance clinical decision-making, alter management, and facilitate early intervention. We performed a systematic review of predictors of spinal anesthesia-induced hypotension and their predictive value during cesarean section. METHODS PubMed, Embase, Cochrane Library, Google Scholar and Web of Science databases were searched for prospective observational studies assessing the diagnostic accuracy of predictors of spinal anesthesia-induced hypotension in elective cesarean section. The quality of studies was assessed and predictors were grouped in domains based on the type of predictor. RESULTS Thirty-eight studies (n=3086 patients) were included. In most studies, patients received 500-1000 mL crystalloid preload or 500-2000 mL crystalloid coload. Vasopressors for post-spinal hypotension were boluses of ephedrine 5-15 mg and/or phenylephrine 25-100 µg in most studies. The hypotension rate varied from 29% to 80% based on the definition. For analysis, >30 predictors were classified into seven domains: demographic characteristics, baseline hemodynamic variables, baseline sympathovagal balance, postural stress testing, peripheral perfusion indices, blood volume and fluid responsiveness indices, and genetic polymorphism. CONCLUSIONS Environmental and individual factors increased outcome variability, which restricted the value of the autonomic nervous system and peripheral perfusion indices for prediction of spinal anesthesia-induced hypotension. Supine stress tests may reflect parturients' cardiovascular tolerance during hemodynamic fluctuations and may optimize the predictive value of static state predictors. Future research for predicting spinal anesthesia-induced hypotension should focus on composite and dynamic parameters during the supine stress tests.
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Affiliation(s)
- C Yu
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - J Gu
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Z Liao
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - S Feng
- Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
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Wong SL, Alshaikhi J, Grimes H, Amos RA, Poynter A, Rompokos V, Gulliford S, Royle G, Liao Z, Sharma RA, Mendes R. Retrospective Planning Study of Patients with Superior Sulcus Tumours Comparing Pencil Beam Scanning Protons to Volumetric-Modulated Arc Therapy. Clin Oncol (R Coll Radiol) 2021; 33:e118-e131. [PMID: 32798157 PMCID: PMC7883303 DOI: 10.1016/j.clon.2020.07.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/30/2020] [Accepted: 07/22/2020] [Indexed: 12/25/2022]
Abstract
AIMS Twenty per cent of patients with non-small cell lung cancer present with stage III locally advanced disease. Precision radiotherapy with pencil beam scanning (PBS) protons may improve outcomes. However, stage III is a heterogeneous group and accounting for complex tumour motion is challenging. As yet, it remains unclear as to whom will benefit. In our retrospective planning study, we explored if patients with superior sulcus tumours (SSTs) are a select cohort who might benefit from this treatment. MATERIALS AND METHODS Patients with SSTs treated with radical radiotherapy using four-dimensional planning computed tomography between 2010 and 2015 were identified. Tumour motion was assessed and excluded if greater than 5 mm. Photon volumetric-modulated arc therapy (VMAT) and PBS proton single-field optimisation plans, with and without inhomogeneity corrections, were generated retrospectively. Robustness analysis was assessed for VMAT and PBS plans involving: (i) 5 mm geometric uncertainty, with an additional 3.5% range uncertainty for proton plans; (ii) verification plans at maximal inhalation and exhalation. Comparative dosimetric and robustness analyses were carried out. RESULTS Ten patients were suitable. The mean clinical target volume D95 was 98.1% ± 0.4 (97.5-98.8) and 98.4% ± 0.2 (98.1-98.9) for PBS and VMAT plans, respectively. All normal tissue tolerances were achieved. The same four PBS and VMAT plans failed robustness assessment. Inhomogeneity corrections minimally impacted proton plan robustness and made it worse in one case. The most important factor affecting target coverage and robustness was the clinical target volume entering the spinal canal. Proton plans significantly reduced the mean lung dose (by 21.9%), lung V5, V10, V20 (by 47.9%, 36.4%, 12.1%, respectively), mean heart dose (by 21.4%) and thoracic vertebra dose (by 29.2%) (P < 0.05). CONCLUSIONS In this planning study, robust PBS plans were achievable in carefully selected patients. Considerable dose reductions to the lung, heart and thoracic vertebra were possible without compromising target coverage. Sparing these lymphopenia-related organs may be particularly important in this era of immunotherapy.
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Affiliation(s)
- S-L Wong
- University College London Cancer Institute, London, UK; Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
| | - J Alshaikhi
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK; Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK; Saudi Particle Therapy Centre, Riyadh, Saudi Arabia
| | - H Grimes
- Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK
| | - R A Amos
- Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK; Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK; Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - A Poynter
- Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK
| | - V Rompokos
- Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK
| | - S Gulliford
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK; Department of Radiotherapy Physics, University College London Hospitals NHS Foundation Trust, London, UK
| | - G Royle
- Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Z Liao
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - R A Sharma
- University College London Cancer Institute, London, UK; Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK; NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - R Mendes
- Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
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Chen X, Liao Z, Shen Y, Dong B, Hou L, Hao Q. The Relationship between Pre-Admission Waiting Time and the Surgical Outcomes after Hip Fracture Operation in the Elderly. J Nutr Health Aging 2021; 25:951-955. [PMID: 34545913 DOI: 10.1007/s12603-021-1656-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To investigate the association between pre-admission waiting time and postoperative complications, length of stay (LOS), and costs during hospitalization. METHOD This was a single-center, observational study. The subjects of this study were elderly hip fracture patients who were admitted to the Department of Orthopedics, West China Hospital, Sichuan University, from December 2010 to June 14, 2017, and that underwent internal fixation or joint replacement surgery. The pre-admission waiting time was treated as a categorical variable according to median and first quartile values. Outcomes included postoperative complications (pneumonia and other complications [urinary tract infection, heart failure, non-A-grade healing]), LOS, and costs during hospitalization. LOS and costs during hospitalization were converted into binary outcomes based upon median values. Binary logistic regression analyses were used to analyze correlations between pre-admission waiting time and patient outcomes. RESULTS A total of 889 patients 60 years of age and older were enrolled in this study, of whom 65.47% were females and 34.53% were males. The proportion of patients with pre-admission waiting times less than 8 h, 8 - 24 h, and ≥ 24 h were 24.3%, 17.32%, and 58.38%, respectively. Postoperative pneumonia and other complications affected 12.04% and 6.30% of patients, respectively. Relative to patients with the pre-admission waiting times of less than 8 h, those with longer pre-admission waiting times exhibited a higher risk of postoperative pneumonia (8 - 24 h: OR = 2.72,95% CI: 1.29-5.74, p = 0.009; ≥ 24 h: OR = 2.76,95% CI: 1.48-5.14, p = 0.001). Patients with the pre-admission waiting time ≥ 24 h also exhibited a higher risk of the other complications (OR = 2.55, 95% CI: 1.53-4.26, p <0.001), a longer LOS (OR = 1.43, 95% CI:1.02-2.01, p = 0.036), and higher costs during hospitalization (OR = 1.51, 95% CI:1.05 - 2.17, p = 0.026) relative to patients with a waiting time less than 8 hours. CONCLUSION Pre-admission waiting time was associated with postoperative complications, LOS, and hospitalization costs among older Chinese patients undergoing surgery to treat hip fractures.
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Affiliation(s)
- X Chen
- Qiukui Hao, MD, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China; ; Telephone: ++86-28-85422321
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Sparks FT, Liao Z, Li W, Grosmark A, Soltesz I, Losonczy A. Hippocampal adult-born granule cells drive network activity in a mouse model of chronic temporal lobe epilepsy. Nat Commun 2020; 11:6138. [PMID: 33262339 PMCID: PMC7708476 DOI: 10.1038/s41467-020-19969-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023] Open
Abstract
Temporal lobe epilepsy (TLE) is characterized by recurrent seizures driven by synchronous neuronal activity. The reorganization of the dentate gyrus (DG) in TLE may create pathological conduction pathways for synchronous discharges in the temporal lobe, though critical microcircuit-level detail is missing from this pathophysiological intuition. In particular, the relative contribution of adult-born (abGC) and mature (mGC) granule cells to epileptiform network events remains unknown. We assess dynamics of abGCs and mGCs during interictal epileptiform discharges (IEDs) in mice with TLE as well as sharp-wave ripples (SPW-Rs) in healthy mice, and find that abGCs and mGCs are desynchronized and differentially recruited by IEDs compared to SPW-Rs. We introduce a neural topic model to explain these observations, and find that epileptic DG networks organize into disjoint, cell-type specific pathological ensembles in which abGCs play an outsized role. Our results characterize identified GC subpopulation dynamics in TLE, and reveal a specific contribution of abGCs to IEDs.
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Affiliation(s)
- F T Sparks
- Department of Neuroscience, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
- The Kavli Institute for Brain Science, Columbia University, New York, NY, USA
| | - Z Liao
- Department of Neuroscience, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
- The Kavli Institute for Brain Science, Columbia University, New York, NY, USA
| | - W Li
- Department of Neuroscience, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
- The Kavli Institute for Brain Science, Columbia University, New York, NY, USA
| | - A Grosmark
- Department of Neuroscience, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA
- The Kavli Institute for Brain Science, Columbia University, New York, NY, USA
| | - I Soltesz
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - A Losonczy
- Department of Neuroscience, Columbia University, New York, NY, USA.
- Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, USA.
- The Kavli Institute for Brain Science, Columbia University, New York, NY, USA.
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Palma G, Monti S, Stanzione A, Xu T, Durante M, Mohan R, Liao Z, Cella L. Disentangling Contributions from Heart and Lung Anatomical Substructures to Radiation Induced Toxicities: Characterization of Spatial Properties of Dosimetric Data for Voxel-Based Analyses. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.704] [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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