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Amgad M, Atteya LA, Hussein H, Mohammed KH, Hafiz E, Elsebaie MAT, Alhusseiny AM, AlMoslemany MA, Elmatboly AM, Pappalardo PA, Sakr RA, Mobadersany P, Rachid A, Saad AM, Alkashash AM, Ruhban IA, Alrefai A, Elgazar NM, Abdulkarim A, Farag AA, Etman A, Elsaeed AG, Alagha Y, Amer YA, Raslan AM, Nadim MK, Elsebaie MAT, Ayad A, Hanna LE, Gadallah A, Elkady M, Drumheller B, Jaye D, Manthey D, Gutman DA, Elfandy H, Cooper LAD. NuCLS: A scalable crowdsourcing approach and dataset for nucleus classification and segmentation in breast cancer. Gigascience 2022; 11:6586817. [PMID: 35579553 PMCID: PMC9112766 DOI: 10.1093/gigascience/giac037] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/24/2021] [Accepted: 03/18/2022] [Indexed: 01/20/2023] Open
Abstract
Background Deep learning enables accurate high-resolution mapping of cells and tissue structures that can serve as the foundation of interpretable machine-learning models for computational pathology. However, generating adequate labels for these structures is a critical barrier, given the time and effort required from pathologists. Results This article describes a novel collaborative framework for engaging crowds of medical students and pathologists to produce quality labels for cell nuclei. We used this approach to produce the NuCLS dataset, containing >220,000 annotations of cell nuclei in breast cancers. This builds on prior work labeling tissue regions to produce an integrated tissue region- and cell-level annotation dataset for training that is the largest such resource for multi-scale analysis of breast cancer histology. This article presents data and analysis results for single and multi-rater annotations from both non-experts and pathologists. We present a novel workflow that uses algorithmic suggestions to collect accurate segmentation data without the need for laborious manual tracing of nuclei. Our results indicate that even noisy algorithmic suggestions do not adversely affect pathologist accuracy and can help non-experts improve annotation quality. We also present a new approach for inferring truth from multiple raters and show that non-experts can produce accurate annotations for visually distinctive classes. Conclusions This study is the most extensive systematic exploration of the large-scale use of wisdom-of-the-crowd approaches to generate data for computational pathology applications.
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Affiliation(s)
- Mohamed Amgad
- Department of Pathology, Northwestern University, 750 N Lake Shore Dr., Chicago, IL 60611, USA
| | - Lamees A Atteya
- Cairo Health Care Administration, Egyptian Ministry of Health, 3 Magles El Shaab Street, Cairo, Postal code 222, Egypt
| | - Hagar Hussein
- Department of Pathology, Nasser institute for research and treatment, 3 Magles El Shaab Street, Cairo, Postal code 222, Egypt
| | - Kareem Hosny Mohammed
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, 3620 Hamilton Walk M163, Philadelphia, PA 19104, USA
| | - Ehab Hafiz
- Department of Clinical Laboratory Research, Theodor Bilharz Research Institute, 1 El-Nile Street, Imbaba Warrak El-Hadar, Giza, Postal code 12411, Egypt
| | - Maha A T Elsebaie
- Department of Medicine, Cook County Hospital, 1969 W Ogden Ave, Chicago, IL 60612, USA
| | - Ahmed M Alhusseiny
- Department of Pathology, Baystate Medical Center, University of Massachusetts, 759 Chestnut St, Springfield, MA 01199, USA
| | - Mohamed Atef AlMoslemany
- Faculty of Medicine, Menoufia University, Gamal Abd El-Nasir, Qism Shebeen El-Kom, Shibin el Kom, Menofia Governorate, Postal code: 32511, Egypt
| | - Abdelmagid M Elmatboly
- Faculty of Medicine, Al-Azhar University, 15 Mohammed Abdou, El-Darb El-Ahmar, Cairo Governorate, Postal code 11651, Egypt
| | - Philip A Pappalardo
- Consultant for The Center for Applied Proteomics and Molecular Medicine (CAPMM), George Mason University, 10920 George Mason Circle Institute for Advanced Biomedical Research Room 2008, MS1A9 Manassas, Virginia 20110, USA
| | - Rokia Adel Sakr
- Department of Pathology, National Liver Institute, Gamal Abd El-Nasir, Qism Shebeen El-Kom, Shibin el Kom, Menofia Governorate, Postal code: 32511, Egypt
| | - Pooya Mobadersany
- Department of Pathology, Northwestern University, 750 N Lake Shore Dr., Chicago, IL 60611, USA
| | - Ahmad Rachid
- Faculty of Medicine, Ain Shams University, 38 Abbassia, Next to the Al-Nour Mosque, Cairo, Postal code: 1181, Egypt
| | - Anas M Saad
- Cleveland Clinic Foundation, 9500 Euclid Ave. Cleveland, Ohio 44195, USA
| | - Ahmad M Alkashash
- Department of Pathology, Indiana University, 635 Barnhill Drive Medical Science Building A-128 Indianapolis, IN 46202, USA
| | - Inas A Ruhban
- Faculty of Medicine, Damascus University, Damascus, Damaskus, PO Box 30621, Syria
| | - Anas Alrefai
- Faculty of Medicine, Ain Shams University, 38 Abbassia, Next to the Al-Nour Mosque, Cairo, Postal code: 1181, Egypt
| | - Nada M Elgazar
- Faculty of Medicine, Mansoura University, 1 El Gomhouria St, Dakahlia Governorate 35516, Egypt
| | - Ali Abdulkarim
- Faculty of Medicine, Cairo University, Kasr Al Ainy Hospitals, Kasr Al Ainy St., Cairo, Postal code: 11562, Egypt
| | - Abo-Alela Farag
- Faculty of Medicine, Ain Shams University, 38 Abbassia, Next to the Al-Nour Mosque, Cairo, Postal code: 1181, Egypt
| | - Amira Etman
- Faculty of Medicine, Menoufia University, Gamal Abd El-Nasir, Qism Shebeen El-Kom, Shibin el Kom, Menofia Governorate, Postal code: 32511, Egypt
| | - Ahmed G Elsaeed
- Faculty of Medicine, Mansoura University, 1 El Gomhouria St, Dakahlia Governorate 35516, Egypt
| | - Yahya Alagha
- Faculty of Medicine, Cairo University, Kasr Al Ainy Hospitals, Kasr Al Ainy St., Cairo, Postal code: 11562, Egypt
| | - Yomna A Amer
- Faculty of Medicine, Menoufia University, Gamal Abd El-Nasir, Qism Shebeen El-Kom, Shibin el Kom, Menofia Governorate, Postal code: 32511, Egypt
| | - Ahmed M Raslan
- Department of Anaesthesia and Critical Care, Menoufia University Hospital, Gamal Abd El-Nasir, Qism Shebeen El-Kom, Shibin el Kom, Menofia Governorate, Postal code: 32511, Egypt
| | - Menatalla K Nadim
- Department of Clinical Pathology, Ain Shams University, 38 Abbassia, Next to the Al-Nour Mosque, Cairo, Postal code: 1181, Egypt
| | - Mai A T Elsebaie
- Faculty of Medicine, Ain Shams University, 38 Abbassia, Next to the Al-Nour Mosque, Cairo, Postal code: 1181, Egypt
| | - Ahmed Ayad
- Research Department, Oncology Consultants, 2130 W. Holcombe Blvd, 10th Floor, Houston, Texas 77030, USA
| | - Liza E Hanna
- Department of Pathology, Nasser institute for research and treatment, 3 Magles El Shaab Street, Cairo, Postal code 222, Egypt
| | - Ahmed Gadallah
- Faculty of Medicine, Ain Shams University, 38 Abbassia, Next to the Al-Nour Mosque, Cairo, Postal code: 1181, Egypt
| | - Mohamed Elkady
- Siparadigm Diagnostic Informatics, 25 Riverside Dr no. 2, Pine Brook, NJ 07058, USA
| | - Bradley Drumheller
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA 30322, USA
| | - David Jaye
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA 30322, USA
| | - David Manthey
- Kitware Inc., 1712 Route 9. Suite 300. Clifton Park, New York 12065, USA
| | - David A Gutman
- Department of Neurology, Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA 30322, USA
| | - Habiba Elfandy
- Department of Pathology, National Cancer Institute, Kasr Al Eini Street, Fom El Khalig, Cairo, Postal code: 11562, Egypt.,Department of Pathology, Children's Cancer Hospital Egypt (CCHE 57357), 1 Seket Al-Emam Street, El-Madbah El-Kadeem Yard, El-Saida Zenab, Cairo, Postal code: 11562, Egypt
| | - Lee A D Cooper
- Department of Pathology, Northwestern University, 750 N Lake Shore Dr., Chicago, IL 60611, USA.,Lurie Cancer Center, Northwestern University, 675 N St Clair St Fl 21 Ste 100, Chicago, IL 60611, USA.,Center for Computational Imaging and Signal Analytics, Northwestern University Feinberg School of Medicine, 750 N Lake Shore Dr., Chicago, IL 60611, USA
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Hammadah M, Al Mheid I, Wilmot K, Ramadan R, Abdelhadi N, Alkhoder A, Obideen M, Pimple PM, Levantsevych O, Kelli HM, Shah A, Sun YV, Pearce B, Kutner M, Long Q, Ward L, Ko YA, Hosny Mohammed K, Lin J, Zhao J, Bremner JD, Kim J, Waller EK, Raggi P, Sheps D, Quyyumi AA, Vaccarino V. Telomere Shortening, Regenerative Capacity, and Cardiovascular Outcomes. Circ Res 2016; 120:1130-1138. [PMID: 27956416 PMCID: PMC5376244 DOI: 10.1161/circresaha.116.309421] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 11/22/2016] [Accepted: 12/12/2016] [Indexed: 01/04/2023]
Abstract
RATIONALE Leukocyte telomere length (LTL) is a biological marker of aging, and shorter LTL is associated with adverse cardiovascular outcomes. Reduced regenerative capacity has been proposed as a mechanism. Bone marrow-derived circulating progenitor cells are involved in tissue repair and regeneration. OBJECTIVE Main objective of this study was to examine the relationship between LTL and progenitor cells and their impact on adverse cardiovascular outcomes. METHODS AND RESULTS We measured LTL by quantitative polymerase chain reaction in 566 outpatients (age: 63±9 years; 76% men) with coronary artery disease. Circulating progenitor cells were enumerated by flow cytometry. After adjustment for age, sex, race, body mass index, smoking status, and previous myocardial infarction, a shorter LTL was associated with a lower CD34+ cell count: for each 10% shorter LTL, CD34+ levels were 5.2% lower (P<0.001). After adjustment for the aforementioned factors, both short LTL (<Q1) and low CD34+ levels (<Q1) predicted adverse cardiovascular outcomes (death, myocardial infarction, coronary revascularization, or cerebrovascular events) independently of each other, with a hazard ratio of 1.8 and 95% confidence interval of 1.1 to 2.0, and a hazard ratio of 2.1 and 95% confidence interval of 1.3 to 3.0, respectively, comparing Q1 to Q2-4. Patients who had both short LTL (<Q1) and low CD34+ cell count (<Q1) had the greatest risk of adverse outcomes (hazard ratio =3.5; 95% confidence interval, 1.7-7.1). CONCLUSIONS Although shorter LTL is associated with decreased regenerative capacity, both LTL and circulating progenitor cell levels are independent and additive predictors of adverse cardiovascular outcomes in coronary artery disease patients. Our results suggest that both biological aging and reduced regenerative capacity contribute to cardiovascular events, independent of conventional risk factors.
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Affiliation(s)
- Muhammad Hammadah
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Ibhar Al Mheid
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Kobina Wilmot
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Ronnie Ramadan
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Naser Abdelhadi
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Ayman Alkhoder
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Malik Obideen
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Pratik M Pimple
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Oleksiy Levantsevych
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Heval M Kelli
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Amit Shah
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Yan V Sun
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Brad Pearce
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Michael Kutner
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Qi Long
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Laura Ward
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Yi-An Ko
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Kareem Hosny Mohammed
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Jue Lin
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Jinying Zhao
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - J Douglas Bremner
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Jinhee Kim
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Edmund K Waller
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Paolo Raggi
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - David Sheps
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Arshed A Quyyumi
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.)
| | - Viola Vaccarino
- From the Division of Cardiology, Department of Medicine (M.H., I.A.M., K.W., R.R., N.A., A.A., M.O., H.M.K., A.S., K.H.M., A.A.Q., V.V.) and Department of Psychiatry and Behavioral Sciences (J.D.B.), Emory University School of Medicine, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health (P.M.P., O.L., A.S., Y.V.S., B.P., V.V.), Department of Biostatistics and Bioinformatics, Rollins School of Public Health (Y.V.S., M.K., Q.L., L.W., Y.-A.K.), and Department of Hematology and Oncology, Winship Cancer Institute (J.K., E.K.W.), Emory University, Atlanta, GA; Department of Biochemistry and Biophysics, University of California, San Francisco (J.L.); Department of Epidemiology, Tulane University School of Public Health, New Orleans, LA (J.Z.); Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada (P.R.); and Department of Epidemiology, University of Florida, Gainesville (D.S.).
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