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Chou HH, Lin JY, Shen GT, Huang CY. Validation of an Automated Cardiothoracic Ratio Calculation for Hemodialysis Patients. Diagnostics (Basel) 2023; 13:diagnostics13081376. [PMID: 37189477 DOI: 10.3390/diagnostics13081376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
Cardiomegaly is associated with poor clinical outcomes and is assessed by routine monitoring of the cardiothoracic ratio (CTR) from chest X-rays (CXRs). Judgment of the margins of the heart and lungs is subjective and may vary between different operators. METHODS Patients aged > 19 years in our hemodialysis unit from March 2021 to October 2021 were enrolled. The borders of the lungs and heart on CXRs were labeled by two nephrologists as the ground truth (nephrologist-defined mask). We implemented AlbuNet-34, a U-Net variant, to predict the heart and lung margins from CXR images and to automatically calculate the CTRs. RESULTS The coefficient of determination (R2) obtained using the neural network model was 0.96, compared with an R2 of 0.90 obtained by nurse practitioners. The mean difference between the CTRs calculated by the nurse practitioners and senior nephrologists was 1.52 ± 1.46%, and that between the neural network model and the nephrologists was 0.83 ± 0.87% (p < 0.001). The mean CTR calculation duration was 85 s using the manual method and less than 2 s using the automated method (p < 0.001). CONCLUSIONS Our study confirmed the validity of automated CTR calculations. By achieving high accuracy and saving time, our model can be implemented in clinical practice.
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Affiliation(s)
- Hsin-Hsu Chou
- Department of Pediatrics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600566, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413305, Taiwan
| | - Jin-Yi Lin
- Innovation and Incubation Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600566, Taiwan
| | - Guan-Ting Shen
- Innovation and Incubation Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600566, Taiwan
| | - Chih-Yuan Huang
- Division of Nephrology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600566, Taiwan
- Department of Sport Management, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan 717301, Taiwan
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Dental Diseases Increase Risk of Aortic Arch Calcification Independent of Renal Dysfunction in Older Adults: Shenzhen Community Cohort Study. Metabolites 2022; 12:metabo12121258. [PMID: 36557295 PMCID: PMC9788133 DOI: 10.3390/metabo12121258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022] Open
Abstract
Many studies have documented that dental diseases were associated with an increased risk of cardiovascular diseases. Aortic arch calcification (AoAC) is a powerful predictor of cardiovascular diseases. However, whether the status of dental health is associated with AoAC is still unknown. 9463 participants over the age of 60 from Shenzhen community centers were included in the cross-sectional analysis. Physical examination data, blood biochemical tests, and AoAC scores calculated by chest radiography were collected and analyzed. Among them, 2630 participants were followed up for AoAC progression up to 36 months. Participants with AoAC suffered more tooth loss than those without AoAC (77.62% vs. 72.91%; p < 0.001). Association rule analysis suggested a strong association between dental diseases and AoAC. Tooth loss or decay increased the risk of AoAC progression (HR 1.459; 95%CI 1.284−1.658) after adjusting other risk factors including renal dysfunction. Dental diseases are potential predictors for AoAC in elderly people, which are independent of renal dysfunction.
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Chen CY, Liu KT, Shih SR, Ye JJ, Chen YT, Pan HC, Hsu HJ, Sun CY, Lee CC, Wu CY, Lai CC, Wu IW. Neutralization Assessments Reveal High Cardiothoracic Ratio and Old Age as Independent Predictors of Low Neutralizing Antibody Titers in Hemodialysis Patients Receiving a Single Dose of COVID-19 Vaccine. J Pers Med 2022; 12:68. [PMID: 35055386 PMCID: PMC8781271 DOI: 10.3390/jpm12010068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Data are lacking regarding predictors of quantification of neutralizing antibodies (nAbs) based on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 50% neutralization titer (NT50) after a single dose of COVID-19 vaccine in hemodialysis (HD) patients. METHODS This prospective single-center study enrolled 200 HD patients and 82 healthy subjects to estimate antibodies against the SARS-CoV-2 viral spike protein 1 and receptor-binding domain after a first dose of a COVID-19 vaccine (ChAdOx1 or mRNA-1273), measured by enzyme-linked immunosorbent assay and applied spline-based generalized additive model regression analysis to predict NT50 converted to international units. RESULTS After the first dose of ChAdOx1, multiple linear regression showed that age (p = 0.011) and cardiothoracic ratio (p = 0.002) were negatively associated with NT50. Older age (OR = 0.958, p = 0.052) and higher cardiothoracic ratio (OR < 0.001, p = 0.037) could predict negative humoral response (NT50 < 35.13 IU/mL). NT50 was lower in HD patients compared with healthy controls receiving ChAdOx1 (10.68 vs. 43.01 IU/m, p < 0.001) or mRNA-1273 (36.39 vs. 262.2 IU/mL, p < 0.001). ChAdOx1 elicited lower GMTs than mRNA-1273 in the HD cohort (10.68 vs. 36.39 IU/mL, p < 0.001) and in healthy controls (43.01 vs. 262.22 IU/mL, p < 0.001). CONCLUSION High cardiothoracic ratio and old age could independently predict a decline in nAb titers in an HD cohort vaccinated with a single dose of ChAdOx1.
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Affiliation(s)
- Chun-Yu Chen
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Kuan-Ting Liu
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-T.L.); (S.-R.S.)
- Graduate Institute of Biomedical Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Shin-Ru Shih
- Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; (K.-T.L.); (S.-R.S.)
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Jung-Jr Ye
- Department of Infectious Diseases, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
| | - Yih-Ting Chen
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Heng-Chih Pan
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Heng-Jung Hsu
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chiao-Yin Sun
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chin-Chan Lee
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
| | - Chun-Ying Wu
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
| | - Chi-Chun Lai
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - I-Wen Wu
- Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan; (C.-Y.C.); (Y.-T.C.); (H.-C.P.); (H.-J.H.); (C.-Y.S.); (C.-C.L.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
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