1
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Rosenberg E, Andersen TI, Samajdar R, Petukhov A, Hoke JC, Abanin D, Bengtsson A, Drozdov IK, Erickson C, Klimov PV, Mi X, Morvan A, Neeley M, Neill C, Acharya R, Allen R, Anderson K, Ansmann M, Arute F, Arya K, Asfaw A, Atalaya J, Bardin JC, Bilmes A, Bortoli G, Bourassa A, Bovaird J, Brill L, Broughton M, Buckley BB, Buell DA, Burger T, Burkett B, Bushnell N, Campero J, Chang HS, Chen Z, Chiaro B, Chik D, Cogan J, Collins R, Conner P, Courtney W, Crook AL, Curtin B, Debroy DM, Barba ADT, Demura S, Di Paolo A, Dunsworth A, Earle C, Faoro L, Farhi E, Fatemi R, Ferreira VS, Burgos LF, Forati E, Fowler AG, Foxen B, Garcia G, Genois É, Giang W, Gidney C, Gilboa D, Giustina M, Gosula R, Dau AG, Gross JA, Habegger S, Hamilton MC, Hansen M, Harrigan MP, Harrington SD, Heu P, Hill G, Hoffmann MR, Hong S, Huang T, Huff A, Huggins WJ, Ioffe LB, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Juhas P, Kafri D, Khattar T, Khezri M, Kieferová M, Kim S, Kitaev A, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Laws L, Lee J, Lee KW, Lensky YD, Lester BJ, Lill AT, Liu W, Locharla A, Mandrà S, Martin O, Martin S, McClean JR, McEwen M, Meeks S, Miao KC, Mieszala A, Montazeri S, Movassagh R, Mruczkiewicz W, Nersisyan A, Newman M, Ng JH, Nguyen A, Nguyen M, Niu MY, O'Brien TE, Omonije S, Opremcak A, Potter R, Pryadko LP, Quintana C, Rhodes DM, Rocque C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schurkus HF, Schuster C, Shearn MJ, Shorter A, Shutty N, Shvarts V, Sivak V, Skruzny J, Smith WC, Somma RD, Sterling G, Strain D, Szalay M, Thor D, Torres A, Vidal G, Villalonga B, Heidweiller CV, White T, Woo BWK, Xing C, Yao ZJ, Yeh P, Yoo J, Young G, Zalcman A, Zhang Y, Zhu N, Zobrist N, Neven H, Babbush R, Bacon D, Boixo S, Hilton J, Lucero E, Megrant A, Kelly J, Chen Y, Smelyanskiy V, Khemani V, Gopalakrishnan S, Prosen T, Roushan P. Dynamics of magnetization at infinite temperature in a Heisenberg spin chain. Science 2024; 384:48-53. [PMID: 38574139 DOI: 10.1126/science.adi7877] [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: 05/18/2023] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
Understanding universal aspects of quantum dynamics is an unresolved problem in statistical mechanics. In particular, the spin dynamics of the one-dimensional Heisenberg model were conjectured as to belong to the Kardar-Parisi-Zhang (KPZ) universality class based on the scaling of the infinite-temperature spin-spin correlation function. In a chain of 46 superconducting qubits, we studied the probability distribution of the magnetization transferred across the chain's center, [Formula: see text]. The first two moments of [Formula: see text] show superdiffusive behavior, a hallmark of KPZ universality. However, the third and fourth moments ruled out the KPZ conjecture and allow for evaluating other theories. Our results highlight the importance of studying higher moments in determining dynamic universality classes and provide insights into universal behavior in quantum systems.
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Affiliation(s)
- E Rosenberg
- Google Research, Mountain View, CA, USA
- Department of Physics, Cornell University, Ithaca, NY, USA
| | | | - R Samajdar
- Department of Physics, Princeton University, Princeton, NJ, USA
- Princeton Center for Theoretical Science, Princeton University, Princeton, NJ, USA
| | | | - J C Hoke
- Department of Physics, Stanford University, Stanford, CA, USA
| | - D Abanin
- Google Research, Mountain View, CA, USA
| | | | - I K Drozdov
- Google Research, Mountain View, CA, USA
- Department of Physics, University of Connecticut, Storrs, CT, USA
| | | | | | - X Mi
- Google Research, Mountain View, CA, USA
| | - A Morvan
- Google Research, Mountain View, CA, USA
| | - M Neeley
- Google Research, Mountain View, CA, USA
| | - C Neill
- Google Research, Mountain View, CA, USA
| | - R Acharya
- Google Research, Mountain View, CA, USA
| | - R Allen
- Google Research, Mountain View, CA, USA
| | | | - M Ansmann
- Google Research, Mountain View, CA, USA
| | - F Arute
- Google Research, Mountain View, CA, USA
| | - K Arya
- Google Research, Mountain View, CA, USA
| | - A Asfaw
- Google Research, Mountain View, CA, USA
| | - J Atalaya
- Google Research, Mountain View, CA, USA
| | - J C Bardin
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of Massachusetts, Amherst, MA, USA
| | - A Bilmes
- Google Research, Mountain View, CA, USA
| | - G Bortoli
- Google Research, Mountain View, CA, USA
| | | | - J Bovaird
- Google Research, Mountain View, CA, USA
| | - L Brill
- Google Research, Mountain View, CA, USA
| | | | | | - D A Buell
- Google Research, Mountain View, CA, USA
| | - T Burger
- Google Research, Mountain View, CA, USA
| | - B Burkett
- Google Research, Mountain View, CA, USA
| | | | - J Campero
- Google Research, Mountain View, CA, USA
| | - H-S Chang
- Google Research, Mountain View, CA, USA
| | - Z Chen
- Google Research, Mountain View, CA, USA
| | - B Chiaro
- Google Research, Mountain View, CA, USA
| | - D Chik
- Google Research, Mountain View, CA, USA
| | - J Cogan
- Google Research, Mountain View, CA, USA
| | - R Collins
- Google Research, Mountain View, CA, USA
| | - P Conner
- Google Research, Mountain View, CA, USA
| | | | - A L Crook
- Google Research, Mountain View, CA, USA
| | - B Curtin
- Google Research, Mountain View, CA, USA
| | | | | | - S Demura
- Google Research, Mountain View, CA, USA
| | | | | | - C Earle
- Google Research, Mountain View, CA, USA
| | - L Faoro
- Google Research, Mountain View, CA, USA
| | - E Farhi
- Google Research, Mountain View, CA, USA
| | - R Fatemi
- Google Research, Mountain View, CA, USA
| | | | | | - E Forati
- Google Research, Mountain View, CA, USA
| | | | - B Foxen
- Google Research, Mountain View, CA, USA
| | - G Garcia
- Google Research, Mountain View, CA, USA
| | - É Genois
- Google Research, Mountain View, CA, USA
| | - W Giang
- Google Research, Mountain View, CA, USA
| | - C Gidney
- Google Research, Mountain View, CA, USA
| | - D Gilboa
- Google Research, Mountain View, CA, USA
| | | | - R Gosula
- Google Research, Mountain View, CA, USA
| | | | - J A Gross
- Google Research, Mountain View, CA, USA
| | | | - M C Hamilton
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA
| | - M Hansen
- Google Research, Mountain View, CA, USA
| | | | | | - P Heu
- Google Research, Mountain View, CA, USA
| | - G Hill
- Google Research, Mountain View, CA, USA
| | | | - S Hong
- Google Research, Mountain View, CA, USA
| | - T Huang
- Google Research, Mountain View, CA, USA
| | - A Huff
- Google Research, Mountain View, CA, USA
| | | | - L B Ioffe
- Google Research, Mountain View, CA, USA
| | | | - J Iveland
- Google Research, Mountain View, CA, USA
| | - E Jeffrey
- Google Research, Mountain View, CA, USA
| | - Z Jiang
- Google Research, Mountain View, CA, USA
| | - C Jones
- Google Research, Mountain View, CA, USA
| | - P Juhas
- Google Research, Mountain View, CA, USA
| | - D Kafri
- Google Research, Mountain View, CA, USA
| | - T Khattar
- Google Research, Mountain View, CA, USA
| | - M Khezri
- Google Research, Mountain View, CA, USA
| | - M Kieferová
- Google Research, Mountain View, CA, USA
- QSI, Faculty of Engineering & Information Technology, University of Technology Sydney, Ultimo, NSW, Australia
| | - S Kim
- Google Research, Mountain View, CA, USA
| | - A Kitaev
- Google Research, Mountain View, CA, USA
| | - A R Klots
- Google Research, Mountain View, CA, USA
| | - A N Korotkov
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of California, Riverside, CA, USA
| | | | | | | | - P Laptev
- Google Research, Mountain View, CA, USA
| | - K-M Lau
- Google Research, Mountain View, CA, USA
| | - L Laws
- Google Research, Mountain View, CA, USA
| | - J Lee
- Google Research, Mountain View, CA, USA
- Department of Chemistry, Columbia University, New York, NY, USA
| | - K W Lee
- Google Research, Mountain View, CA, USA
| | | | | | - A T Lill
- Google Research, Mountain View, CA, USA
| | - W Liu
- Google Research, Mountain View, CA, USA
| | | | - S Mandrà
- Google Research, Mountain View, CA, USA
| | - O Martin
- Google Research, Mountain View, CA, USA
| | - S Martin
- Google Research, Mountain View, CA, USA
| | | | - M McEwen
- Google Research, Mountain View, CA, USA
| | - S Meeks
- Google Research, Mountain View, CA, USA
| | - K C Miao
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - M Newman
- Google Research, Mountain View, CA, USA
| | - J H Ng
- Google Research, Mountain View, CA, USA
| | - A Nguyen
- Google Research, Mountain View, CA, USA
| | - M Nguyen
- Google Research, Mountain View, CA, USA
| | - M Y Niu
- Google Research, Mountain View, CA, USA
| | | | - S Omonije
- Google Research, Mountain View, CA, USA
| | | | - R Potter
- Google Research, Mountain View, CA, USA
| | - L P Pryadko
- Department of Physics and Astronomy, University of California, Riverside, CA, USA
| | | | | | - C Rocque
- Google Research, Mountain View, CA, USA
| | - N C Rubin
- Google Research, Mountain View, CA, USA
| | - N Saei
- Google Research, Mountain View, CA, USA
| | - D Sank
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - A Shorter
- Google Research, Mountain View, CA, USA
| | - N Shutty
- Google Research, Mountain View, CA, USA
| | - V Shvarts
- Google Research, Mountain View, CA, USA
| | - V Sivak
- Google Research, Mountain View, CA, USA
| | - J Skruzny
- Google Research, Mountain View, CA, USA
| | | | - R D Somma
- Google Research, Mountain View, CA, USA
| | | | - D Strain
- Google Research, Mountain View, CA, USA
| | - M Szalay
- Google Research, Mountain View, CA, USA
| | - D Thor
- Google Research, Mountain View, CA, USA
| | - A Torres
- Google Research, Mountain View, CA, USA
| | - G Vidal
- Google Research, Mountain View, CA, USA
| | | | | | - T White
- Google Research, Mountain View, CA, USA
| | - B W K Woo
- Google Research, Mountain View, CA, USA
| | - C Xing
- Google Research, Mountain View, CA, USA
| | | | - P Yeh
- Google Research, Mountain View, CA, USA
| | - J Yoo
- Google Research, Mountain View, CA, USA
| | - G Young
- Google Research, Mountain View, CA, USA
| | - A Zalcman
- Google Research, Mountain View, CA, USA
| | - Y Zhang
- Google Research, Mountain View, CA, USA
| | - N Zhu
- Google Research, Mountain View, CA, USA
| | - N Zobrist
- Google Research, Mountain View, CA, USA
| | - H Neven
- Google Research, Mountain View, CA, USA
| | - R Babbush
- Google Research, Mountain View, CA, USA
| | - D Bacon
- Google Research, Mountain View, CA, USA
| | - S Boixo
- Google Research, Mountain View, CA, USA
| | - J Hilton
- Google Research, Mountain View, CA, USA
| | - E Lucero
- Google Research, Mountain View, CA, USA
| | - A Megrant
- Google Research, Mountain View, CA, USA
| | - J Kelly
- Google Research, Mountain View, CA, USA
| | - Y Chen
- Google Research, Mountain View, CA, USA
| | | | - V Khemani
- Department of Physics, Stanford University, Stanford, CA, USA
| | | | - T Prosen
- Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia
| | - P Roushan
- Google Research, Mountain View, CA, USA
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2
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Enzler T, Nguyen A, Misleh J, Cline VJ, Johns M, Shumway N, Paulson S, Siegel R, Larson T, Messersmith W, Richards D, Chaves J, Pierce E, Zalupski M, Sahai V, Orr D, Ruste SA, Haun A, Kawabe T. A multicenter, randomized phase 2 study to establish combinations of CBP501, cisplatin and nivolumab for ≥3rd-line treatment of patients with advanced pancreatic adenocarcinoma. Eur J Cancer 2024; 201:113950. [PMID: 38422585 DOI: 10.1016/j.ejca.2024.113950] [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: 11/19/2023] [Revised: 02/04/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND There is no standard of care for ≥ 3rd-line treatment of metastatic pancreatic adenocarcinoma (PDAC). CBP501 is a novel calmodulin-binding peptide that has been shown to enhance the influx of platinum agents into tumor cells and tumor immunogenicity. This study aimed to (1) confirm efficacy of CBP501/cisplatin/nivolumab for metastatic PDAC observed in a previous phase 1 study, (2) identify combinations that yield 35% 3-month progression-free survival rate (3MPFS) and (3) define the contribution of CBP501 to the effects of combination therapy. METHODS CBP501 16 or 25 mg/m2 (CBP(16) or CBP(25)) was combined with 60 mg/m2 cisplatin (CDDP) and 240 mg nivolumab (nivo), administered at 3-week intervals. Patients were randomized 1:1:1:1 to (1) CBP(25)/CDDP/nivo, (2) CBP(16)/CDDP/nivo, (3) CBP(25)/CDDP and (4) CDDP/nivo, with randomization stratified by ECOG PS and liver metastases. A Fleming two-stage design was used, yielding a one-sided type I error rate of 2.5% and 80% power when the true 3MPFS is 35%. RESULTS Among 36 patients, 3MPFS was 44.4% in arms 1 and 2, 11.1% in arm 3% and 33.3% in arm 4. Two patients achieved a partial response in arm 1 (ORR 22.2%; none in other arms). Median PFS and OS were 2.4, 2.1, 1.5 and 1.5 months and 6.3, 5.3, 3.7 and 4.9 months, respectively. Overall, all treatment combinations were well tolerated. Most treatment-related adverse events were grade 1-2. CONCLUSIONS The combination CBP(25)/(16)/CDDP/nivo demonstrated promising signs of efficacy and a manageable safety profile for the treatment of advanced PDAC. CLINICAL TRIAL REGISTRATION NCT04953962.
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Affiliation(s)
- T Enzler
- Rogel Cancer Center, University of Michigan Health, Ann Arbor, MI, USA.
| | - A Nguyen
- Comprehensive Cancer Centers of Nevada, Henderson, NV, USA
| | - J Misleh
- Medical Hematology Oncology Consultants PA, Newark, DE, USA
| | - V J Cline
- Texas Oncology - Austin Midtown, Austin, TX, USA
| | - M Johns
- Oncology Hematology Care Eastgate, Cincinnati, OH, USA
| | - N Shumway
- Texas Oncology-San Antonio Stone Oak, San Antonio, TX, USA
| | - S Paulson
- Texas Oncology - Baylor Charles A. Sammons Cancer Center, Dallas, TX, USA
| | - R Siegel
- Illinois Cancer Specialists, Arlington Heights, IL, USA
| | - T Larson
- Minnseota Oncology Hematology PA, Minneapolis, MN, USA
| | - W Messersmith
- University of Colorado Cancer Center, Aurora, CO, USA
| | - D Richards
- Texas Oncology - Northeast Texas Cancer and Research Institute, Tyler, TX, USA
| | - J Chaves
- Northwest Medical Specialties, PLLC, Tacoma, WA, USA
| | - E Pierce
- Ochsner MD Anderson Cancer Center, New Orleans, LA, USA
| | - M Zalupski
- Rogel Cancer Center, University of Michigan Health, Ann Arbor, MI, USA
| | - V Sahai
- Rogel Cancer Center, University of Michigan Health, Ann Arbor, MI, USA
| | - D Orr
- Mary Crowley Cancer Research, Dallas, TX, USA
| | - S A Ruste
- Medical Affairs, Veristat LLC, Toronto Canada
| | - A Haun
- Medical Affairs, Veristat LLC, Toronto Canada
| | - T Kawabe
- CanBas Co., Ltd., Numazu, Shizuoka, Japan
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3
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Nagata JM, Vargas R, Sanders AE, Stuart E, Downey AE, Chaphekar AV, Nguyen A, Ganson KT, Buckelew SM, Garber AK. Clinical characteristics of hospitalized male adolescents and young adults with atypical anorexia nervosa. Int J Eat Disord 2024; 57:1008-1019. [PMID: 38205657 PMCID: PMC11018472 DOI: 10.1002/eat.24132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/22/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVE To describe the clinical characteristics of male adolescents and young adults hospitalized for medical complications of atypical anorexia nervosa (atypical AN) and to compare their clinical characteristics with females with atypical AN and males with anorexia nervosa (AN). METHOD A retrospective review of electronic medical records for patients with atypical AN and AN aged 9-25 admitted to the UCSF Eating Disorders Program from May 2012 to August 2020 was conducted. RESULTS Among 21 males with atypical AN (mean age 15.1 ± 2.7, mean %mBMI 102.0 ± 11.8), medical complications evidenced by admission laboratory values included anemia (52.9%), vitamin D insufficiency/deficiency (52.6%), and zinc deficiency (31.6%). Compared with females with atypical AN (n = 69), males with atypical AN had longer length of stay (11.4 vs 8.4 days, p = .004), higher prescribed kcal at discharge (4114 vs 3045 kcal, p < .001), lower heart rate nadir (40.0 vs 45.8, p = .038), higher aspartate transaminase (AST, 37.9 vs 26.2 U/L, p = .032), higher alanine transaminase (ALT, 30.6 vs 18.3 U/L, p = .005), and higher rates of anemia (52.9% vs 19.4%, p = .005), with no differences in vitamin D, zinc, and vital signs. Compared with males with AN (n = 40), males with atypical AN had no significant differences in vital signs or laboratory assessments during the hospitalization. DISCUSSION Atypical AN in males leads to significant medical comorbidity, and males with atypical AN require longer hospital stays compared to females with atypical AN. Rates of abnormal vital signs and abnormal serum laboratory values during hospital admissions do not differ in males with atypical AN compared to AN. PUBLIC SIGNIFICANCE Adolescent and young adult males with atypical anorexia nervosa experience significant medical complications. Males with atypical anorexia nervosa had longer hospitalizations and higher prescribed nutrition at discharge than females. Medical complications of atypical anorexia nervosa in male adolescents and young adults were generally equal to those of male adolescents and young adults with anorexia nervosa. Clinicians should be aware of unique medical complications of males with atypical anorexia nervosa.
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Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Ruben Vargas
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Austin E. Sanders
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Elena Stuart
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Amanda E. Downey
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Anita V. Chaphekar
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Anthony Nguyen
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Sara M. Buckelew
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Andrea K. Garber
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
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4
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Mi X, Michailidis AA, Shabani S, Miao KC, Klimov PV, Lloyd J, Rosenberg E, Acharya R, Aleiner I, Andersen TI, Ansmann M, Arute F, Arya K, Asfaw A, Atalaya J, Bardin JC, Bengtsson A, Bortoli G, Bourassa A, Bovaird J, Brill L, Broughton M, Buckley BB, Buell DA, Burger T, Burkett B, Bushnell N, Chen Z, Chiaro B, Chik D, Chou C, Cogan J, Collins R, Conner P, Courtney W, Crook AL, Curtin B, Dau AG, Debroy DM, Del Toro Barba A, Demura S, Di Paolo A, Drozdov IK, Dunsworth A, Erickson C, Faoro L, Farhi E, Fatemi R, Ferreira VS, Burgos LF, Forati E, Fowler AG, Foxen B, Genois É, Giang W, Gidney C, Gilboa D, Giustina M, Gosula R, Gross JA, Habegger S, Hamilton MC, Hansen M, Harrigan MP, Harrington SD, Heu P, Hoffmann MR, Hong S, Huang T, Huff A, Huggins WJ, Ioffe LB, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Juhas P, Kafri D, Kechedzhi K, Khattar T, Khezri M, Kieferová M, Kim S, Kitaev A, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Laws L, Lee J, Lee KW, Lensky YD, Lester BJ, Lill AT, Liu W, Locharla A, Malone FD, Martin O, McClean JR, McEwen M, Mieszala A, Montazeri S, Morvan A, Movassagh R, Mruczkiewicz W, Neeley M, Neill C, Nersisyan A, Newman M, Ng JH, Nguyen A, Nguyen M, Niu MY, O'Brien TE, Opremcak A, Petukhov A, Potter R, Pryadko LP, Quintana C, Rocque C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schurkus HF, Schuster C, Shearn MJ, Shorter A, Shutty N, Shvarts V, Skruzny J, Smith WC, Somma R, Sterling G, Strain D, Szalay M, Torres A, Vidal G, Villalonga B, Heidweiller CV, White T, Woo BWK, Xing C, Yao ZJ, Yeh P, Yoo J, Young G, Zalcman A, Zhang Y, Zhu N, Zobrist N, Neven H, Babbush R, Bacon D, Boixo S, Hilton J, Lucero E, Megrant A, Kelly J, Chen Y, Roushan P, Smelyanskiy V, Abanin DA. Stable quantum-correlated many-body states through engineered dissipation. Science 2024; 383:1332-1337. [PMID: 38513021 DOI: 10.1126/science.adh9932] [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: 03/27/2023] [Accepted: 02/13/2024] [Indexed: 03/23/2024]
Abstract
Engineered dissipative reservoirs have the potential to steer many-body quantum systems toward correlated steady states useful for quantum simulation of high-temperature superconductivity or quantum magnetism. Using up to 49 superconducting qubits, we prepared low-energy states of the transverse-field Ising model through coupling to dissipative auxiliary qubits. In one dimension, we observed long-range quantum correlations and a ground-state fidelity of 0.86 for 18 qubits at the critical point. In two dimensions, we found mutual information that extends beyond nearest neighbors. Lastly, by coupling the system to auxiliaries emulating reservoirs with different chemical potentials, we explored transport in the quantum Heisenberg model. Our results establish engineered dissipation as a scalable alternative to unitary evolution for preparing entangled many-body states on noisy quantum processors.
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Affiliation(s)
- X Mi
- Google Research, Mountain View, CA, USA
| | - A A Michailidis
- Department of Theoretical Physics, University of Geneva, Geneva, Switzerland
| | - S Shabani
- Google Research, Mountain View, CA, USA
| | - K C Miao
- Google Research, Mountain View, CA, USA
| | | | - J Lloyd
- Department of Theoretical Physics, University of Geneva, Geneva, Switzerland
| | | | - R Acharya
- Google Research, Mountain View, CA, USA
| | - I Aleiner
- Google Research, Mountain View, CA, USA
| | | | - M Ansmann
- Google Research, Mountain View, CA, USA
| | - F Arute
- Google Research, Mountain View, CA, USA
| | - K Arya
- Google Research, Mountain View, CA, USA
| | - A Asfaw
- Google Research, Mountain View, CA, USA
| | - J Atalaya
- Google Research, Mountain View, CA, USA
| | - J C Bardin
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of Massachusetts, Amherst, MA, USA
| | | | - G Bortoli
- Google Research, Mountain View, CA, USA
| | | | - J Bovaird
- Google Research, Mountain View, CA, USA
| | - L Brill
- Google Research, Mountain View, CA, USA
| | | | | | - D A Buell
- Google Research, Mountain View, CA, USA
| | - T Burger
- Google Research, Mountain View, CA, USA
| | - B Burkett
- Google Research, Mountain View, CA, USA
| | | | - Z Chen
- Google Research, Mountain View, CA, USA
| | - B Chiaro
- Google Research, Mountain View, CA, USA
| | - D Chik
- Google Research, Mountain View, CA, USA
| | - C Chou
- Google Research, Mountain View, CA, USA
| | - J Cogan
- Google Research, Mountain View, CA, USA
| | - R Collins
- Google Research, Mountain View, CA, USA
| | - P Conner
- Google Research, Mountain View, CA, USA
| | | | - A L Crook
- Google Research, Mountain View, CA, USA
| | - B Curtin
- Google Research, Mountain View, CA, USA
| | - A G Dau
- Google Research, Mountain View, CA, USA
| | | | | | - S Demura
- Google Research, Mountain View, CA, USA
| | | | | | | | | | - L Faoro
- Google Research, Mountain View, CA, USA
| | - E Farhi
- Google Research, Mountain View, CA, USA
| | - R Fatemi
- Google Research, Mountain View, CA, USA
| | | | | | - E Forati
- Google Research, Mountain View, CA, USA
| | | | - B Foxen
- Google Research, Mountain View, CA, USA
| | - É Genois
- Google Research, Mountain View, CA, USA
| | - W Giang
- Google Research, Mountain View, CA, USA
| | - C Gidney
- Google Research, Mountain View, CA, USA
| | - D Gilboa
- Google Research, Mountain View, CA, USA
| | | | - R Gosula
- Google Research, Mountain View, CA, USA
| | - J A Gross
- Google Research, Mountain View, CA, USA
| | | | - M C Hamilton
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA
| | - M Hansen
- Google Research, Mountain View, CA, USA
| | | | | | - P Heu
- Google Research, Mountain View, CA, USA
| | | | - S Hong
- Google Research, Mountain View, CA, USA
| | - T Huang
- Google Research, Mountain View, CA, USA
| | - A Huff
- Google Research, Mountain View, CA, USA
| | | | - L B Ioffe
- Google Research, Mountain View, CA, USA
| | | | - J Iveland
- Google Research, Mountain View, CA, USA
| | - E Jeffrey
- Google Research, Mountain View, CA, USA
| | - Z Jiang
- Google Research, Mountain View, CA, USA
| | - C Jones
- Google Research, Mountain View, CA, USA
| | - P Juhas
- Google Research, Mountain View, CA, USA
| | - D Kafri
- Google Research, Mountain View, CA, USA
| | | | - T Khattar
- Google Research, Mountain View, CA, USA
| | - M Khezri
- Google Research, Mountain View, CA, USA
| | - M Kieferová
- Google Research, Mountain View, CA, USA
- Centre for Quantum Software and Information (QSI), Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, NSW, Australia
| | - S Kim
- Google Research, Mountain View, CA, USA
| | - A Kitaev
- Google Research, Mountain View, CA, USA
| | - A R Klots
- Google Research, Mountain View, CA, USA
| | - A N Korotkov
- Google Research, Mountain View, CA, USA
- Department of Electrical and Computer Engineering, University of California, Riverside, CA, USA
| | | | | | | | - P Laptev
- Google Research, Mountain View, CA, USA
| | - K-M Lau
- Google Research, Mountain View, CA, USA
| | - L Laws
- Google Research, Mountain View, CA, USA
| | - J Lee
- Google Research, Mountain View, CA, USA
- Department of Chemistry, Columbia University, New York, NY, USA
| | - K W Lee
- Google Research, Mountain View, CA, USA
| | | | | | - A T Lill
- Google Research, Mountain View, CA, USA
| | - W Liu
- Google Research, Mountain View, CA, USA
| | | | | | - O Martin
- Google Research, Mountain View, CA, USA
| | | | - M McEwen
- Google Research, Mountain View, CA, USA
| | | | | | - A Morvan
- Google Research, Mountain View, CA, USA
| | | | | | - M Neeley
- Google Research, Mountain View, CA, USA
| | - C Neill
- Google Research, Mountain View, CA, USA
| | | | - M Newman
- Google Research, Mountain View, CA, USA
| | - J H Ng
- Google Research, Mountain View, CA, USA
| | - A Nguyen
- Google Research, Mountain View, CA, USA
| | - M Nguyen
- Google Research, Mountain View, CA, USA
| | - M Y Niu
- Google Research, Mountain View, CA, USA
| | | | | | | | - R Potter
- Google Research, Mountain View, CA, USA
| | - L P Pryadko
- Google Research, Mountain View, CA, USA
- Department of Physics and Astronomy, University of California, Riverside, CA, USA
| | | | - C Rocque
- Google Research, Mountain View, CA, USA
| | - N C Rubin
- Google Research, Mountain View, CA, USA
| | - N Saei
- Google Research, Mountain View, CA, USA
| | - D Sank
- Google Research, Mountain View, CA, USA
| | | | | | | | | | | | - A Shorter
- Google Research, Mountain View, CA, USA
| | - N Shutty
- Google Research, Mountain View, CA, USA
| | - V Shvarts
- Google Research, Mountain View, CA, USA
| | - J Skruzny
- Google Research, Mountain View, CA, USA
| | - W C Smith
- Google Research, Mountain View, CA, USA
| | - R Somma
- Google Research, Mountain View, CA, USA
| | | | - D Strain
- Google Research, Mountain View, CA, USA
| | - M Szalay
- Google Research, Mountain View, CA, USA
| | - A Torres
- Google Research, Mountain View, CA, USA
| | - G Vidal
- Google Research, Mountain View, CA, USA
| | | | | | - T White
- Google Research, Mountain View, CA, USA
| | - B W K Woo
- Google Research, Mountain View, CA, USA
| | - C Xing
- Google Research, Mountain View, CA, USA
| | - Z J Yao
- Google Research, Mountain View, CA, USA
| | - P Yeh
- Google Research, Mountain View, CA, USA
| | - J Yoo
- Google Research, Mountain View, CA, USA
| | - G Young
- Google Research, Mountain View, CA, USA
| | - A Zalcman
- Google Research, Mountain View, CA, USA
| | - Y Zhang
- Google Research, Mountain View, CA, USA
| | - N Zhu
- Google Research, Mountain View, CA, USA
| | - N Zobrist
- Google Research, Mountain View, CA, USA
| | - H Neven
- Google Research, Mountain View, CA, USA
| | - R Babbush
- Google Research, Mountain View, CA, USA
| | - D Bacon
- Google Research, Mountain View, CA, USA
| | - S Boixo
- Google Research, Mountain View, CA, USA
| | - J Hilton
- Google Research, Mountain View, CA, USA
| | - E Lucero
- Google Research, Mountain View, CA, USA
| | - A Megrant
- Google Research, Mountain View, CA, USA
| | - J Kelly
- Google Research, Mountain View, CA, USA
| | - Y Chen
- Google Research, Mountain View, CA, USA
| | - P Roushan
- Google Research, Mountain View, CA, USA
| | | | - D A Abanin
- Google Research, Mountain View, CA, USA
- Department of Theoretical Physics, University of Geneva, Geneva, Switzerland
- Department of Physics, Princeton University, Princeton, NJ, USA
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5
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Wu Y, Hughes JA, Lyrstedt AL, Hazelwood S, Brown NJ, Jones L, Douglas C, Jarugula R, Chu K, Nguyen A. Developing Robust Clinical Text Deep Learning Models - A "Painless" Approach. Stud Health Technol Inform 2024; 310:705-709. [PMID: 38269900 DOI: 10.3233/shti231056] [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] [Indexed: 01/26/2024]
Abstract
The success of deep learning in natural language processing relies on ample labelled training data. However, models in the health domain often face data inadequacy due to the high cost and difficulty of acquiring training data. Developing such models thus requires robustness and performance on new data. A generalised incremental multiphase framework is proposed for developing robust and performant clinical text deep learning classifiers. It incorporates incremental multiphases for training data size assessments, cross-validation setup to avoid test data bias, and robustness testing through inter/intra-model significance analysis. The framework's effectiveness and generalisation were confirmed by the task of identifying patients presenting in 'pain' to the emergency department.
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Affiliation(s)
- Yutong Wu
- The Australian e-Health Research Centre, CSIRO, Brisbane, Australia
| | - James A Hughes
- School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Anna-Lisa Lyrstedt
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Sarah Hazelwood
- Emergency Department, The Prince Charles Hospital, Brisbane, Australia
| | - Nathan J Brown
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Lee Jones
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Clint Douglas
- School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia
- Metro North Health, Brisbane, Australia
| | - Rajeev Jarugula
- Emergency Department, The Prince Charles Hospital, Brisbane, Australia
| | - Kevin Chu
- Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Anthony Nguyen
- The Australian e-Health Research Centre, CSIRO, Brisbane, Australia
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6
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Liu J, Capurro D, Nguyen A, Verspoor K. Uncovering Variations in Clinical Notes for NLP Modeling. Stud Health Technol Inform 2024; 310:1460-1461. [PMID: 38269696 DOI: 10.3233/shti231244] [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] [Indexed: 01/26/2024]
Abstract
Clinical text contains rich patient information and has attracted much research interest in applying Natural Language Processing (NLP) tools to model it. In this study, we quantified and analyzed the textual characteristics of five common clinical note types using multiple measurements, including lexical-level features, semantic content, and grammaticality. We found there exist significant linguistic variations in different clinical note types, while some types tend to be more similar than others.
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Affiliation(s)
- Jinghui Liu
- The University of Melbourne, Australia
- CSIRO, Australia
| | | | | | - Karin Verspoor
- RMIT University, Australia
- The University of Melbourne, Australia
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7
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Wu Y, Conlan D, Perez S, Nguyen A. Leveraging Unlabeled Clinical Data to Boost Performance of Risk Stratification Models for Suspected Acute Coronary Syndrome. AMIA Annu Symp Proc 2024; 2023:744-753. [PMID: 38222439 PMCID: PMC10785873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
The performance of deep learning models in the health domain is desperately limited by the scarcity of labeled data, especially for specific clinical-domain tasks. Conversely, there are vastly available clinical unlabeled data waiting to be exploited to improve deep learning models where their training labeled data are limited. This paper investigates the use of task-specific unlabeled data to boost the performance of classification models for the risk stratification of suspected acute coronary syndrome. By leveraging large numbers of unlabeled clinical notes in task-adaptive language model pretraining, valuable prior task-specific knowledge can be attained. Based on such pretrained models, task-specific fine-tuning with limited labeled data produces better performances. Extensive experiments demonstrate that the pretrained task-specific language models using task-specific unlabeled data can significantly improve the performance of the downstream models for specific classification tasks.
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Affiliation(s)
- Yutong Wu
- The Australian e-Health Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - David Conlan
- The Australian e-Health Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - Siegfried Perez
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Emergency Medicine, Logan Hospital, Meadowbrook, Queensland, Australia
| | - Anthony Nguyen
- The Australian e-Health Research Centre, CSIRO, Brisbane, Queensland, Australia
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Nagata JM, Chaphekar AV, Vargas R, Nguyen A, Downey AE, Patel KP, Ganson KT, Stuart E, Vendlinski S, Buckelew SM, Garber AK. Sex differences in cholesterol and triglyceride levels among hospitalized adolescents and young adults with eating disorders. Int J Eat Disord 2024; 57:184-194. [PMID: 37864342 PMCID: PMC10842641 DOI: 10.1002/eat.24072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVE To determine sex differences in cholesterol and triglyceride levels among adolescents and young adults hospitalized for medical complications of eating disorders. METHODS A retrospective electronic medical record review of patients aged 9-25 years admitted to the University of California, San Francisco Eating Disorders Program for medical stabilization, between 2012 and 2020, was conducted. Non-fasting total cholesterol and triglycerides were collected; however, LDL and HDL levels were not available. RESULTS Among 83 males and 441 females, mean ± SD age was 15.5 ± 2.8 years, 64.1% had anorexia nervosa, and admission percent median body mass index was 87.3 ± 13.9. The proportion of males and females with high total cholesterol (13.3% vs. 18.1%, Cramer's V = 0.05, p = .28) and high triglyceride levels (9.6% vs. 8.1%, Cramer's V = 0.02, p = .63) did not differ. Mean total cholesterol levels were higher in females compared to males (F 169.6 ± 41.1 mg/dL vs. M 154.5 ± 45.1 mg/dL, Cohen's d = 0.36, p = .003), although a majority were within the normal range. In adjusted linear regression models, male (compared to female) sex (B = -14.40, 95% CI -24.54, -4.27) and higher percent median body mass index (B = -0.33, 95% CI -0.60, -0.06) were associated with lower total cholesterol levels in adjusted models (R2 = 0.04). DISCUSSION Building on prior work showing equally severe complications of eating disorders in males compared to females, we did not find sex differences in those presenting with high total cholesterol or triglycerides. Future research is needed to understand the pathophysiology and role of dyslipidemia in acute malnutrition, and the impact of nutritional rehabilitation and weight restoration. PUBLIC SIGNIFICANCE We found that the proportion of male and female adolescents and young adults hospitalized for medical complications of an eating disorder with high total cholesterol did not significantly differ. Although average total cholesterol levels were higher in female compared to male patients with eating disorders, a majority of these levels remained within the normal range. Patients with more severe malnutrition had a higher risk of elevated total cholesterol levels. Clinicians should consider monitoring cholesterol levels in young people hospitalized for restrictive eating disorders.
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Affiliation(s)
- Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Anita V. Chaphekar
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Ruben Vargas
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Anthony Nguyen
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Amanda E. Downey
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Khushi P. Patel
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Elena Stuart
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Siena Vendlinski
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Sara M. Buckelew
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
| | - Andrea K. Garber
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, Box 0503 San Francisco, CA 94143, USA
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9
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Nguyen A, Crespi CM, Vergara X, Kheifets L. Pesticides as a potential independent childhood leukemia risk factor and as a potential confounder for electromagnetic fields exposure. Environ Res 2023; 238:116899. [PMID: 37598846 DOI: 10.1016/j.envres.2023.116899] [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: 06/14/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND Both pesticides and high magnetic fields are suspected to be childhood leukemia risk factors. Pesticides are utilized at commercial plant nurseries, which sometimes occupy the areas underneath high-voltage powerlines. OBJECTIVES To evaluate whether potential pesticide exposures (intended use, chemical class, active ingredient) utilized at plant nurseries act as an independent childhood leukemia risk factor or as a confounder for proximity to, or magnetic fields exposure from, high-voltage powerlines. METHODS We conducted a state-wide records-based case-control study for California with 5788 childhood leukemia cases and 5788 controls that examined specific pesticide use, magnetic field exposures and distances to both powerlines and plant nurseries. Exposure assessment incorporated geographic information systems, aerial satellite images, and other historical information. RESULTS Childhood leukemia risk was potentially elevated for several active pesticide ingredients: permethrin (odds ratio (OR) 1.49, 95% confidence interval (CI) (0.83-2.67), chlorpyrifos (OR 1.29, 95% CI 0.89-1.87), dimethoate (OR 1.79, 95% CI 0.85-3.76), mancozeb (OR 1.41, 95% CI 0.85-2.33), oxyfluorfen (OR 1.41, 95% CI 0.75-2.66), oryzalin (OR 1.60, 95% CI 0.97-2.63), and pendimethalin (OR 1.82, 95% CI 0.81-2.25). Rodenticide (OR 1.42, 95% CI 0.78-2.56) and molluscicide (OR 1.22, 95% CI 0.82-1.81) exposure also presented potentially elevated childhood leukemia risks. Childhood leukemia associations with calculated fields or powerline proximity did not materially change after adjusting for pesticide exposure. Childhood leukemia risks with powerline proximity remained similar when pesticide exposures were excluded. DISCUSSION Pesticide exposure may be an independent childhood leukemia risk factor. Childhood leukemia risks for powerline proximity and magnetic fields exposure were not explained by pesticide exposure.
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Affiliation(s)
- A Nguyen
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
| | - C M Crespi
- Department of Biostatistics, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
| | - X Vergara
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
| | - L Kheifets
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, 650 Charles E. Young Drive South, Los Angeles, CA, 90095-1772, USA.
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10
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Grovu R, Nguyen A, Sangaraju K, Wei C, Mustafa A, Slobodnick A. Anti-thrombotics and major adverse cardiovascular events in anti-phospholipid syndrome: a cross-sectional study using the 2016-2018 National Inpatient Sample database. Scand J Rheumatol 2023; 52:696-702. [PMID: 37584636 DOI: 10.1080/03009742.2023.2238402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/17/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE This study assessed the relationship between anti-thrombotics and major adverse cardiovascular events (MACE) in patients with anti-phospholipid syndrome (APS). METHOD We included 13 947 subjects with APS from the National (Nationwide) Inpatient Sample (NIS) database for 2016-2018, and collected relevant covariates and demographic data using ICD-10 codes. Our two primary outcomes were MACE and death. We performed multivariate logistic regression analysis to assess the impact of various anti-thrombotic regimens on MACE/death in our primary cohort and high-risk subgroups. RESULTS Patients on anti-coagulants had significantly reduced odds of MACE [odds ratio (OR) 0.68, 95% confidence interval (CI) 0.62-0.76, p < 0.001] as well as each of its subcomponents. Those not on any anti-coagulants had significantly increased odds of MACE (OR 1.47, 95% CI 1.24-1.72, p < 0.001). No significant association was found between anti-platelet use and the odds of MACE (p > 0.05). Patients on anti-coagulants were the only class that appeared to have a mortality benefit with reduced odds for death (OR 0.64, 95% CI 0.49-0.84, p = 0.001). In the subgroups at higher risk for MACE (those with atrial fibrillation and thrombocytopenia), full anti-coagulation therapy was also the only anti-thrombotic class that significantly affected the odds of MACE, with a protective effect on MACE, but had no mortality benefit. CONCLUSION Patients with APS are most likely to benefit from anti-coagulant therapy in reducing MACE. Furthermore, anti-platelets alone or in combination with anti-coagulants are probably not beneficial in MACE reduction and may even increase risk.
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Affiliation(s)
- R Grovu
- Internal Medicine Department, Staten Island University Hospital, New York, NY, USA
| | | | - K Sangaraju
- Internal Medicine Department, Staten Island University Hospital, New York, NY, USA
| | - C Wei
- Internal Medicine Department, Staten Island University Hospital, New York, NY, USA
| | - A Mustafa
- Internal Medicine Department, Staten Island University Hospital, New York, NY, USA
| | - A Slobodnick
- Rheumatology Department, Staten Island University Hospital, New York, NY, USA
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11
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Cho JK, Yang H, Park J, Lee H, Nguyen A, Kattih M, Rahmati M, Yon DK. Association between allergic rhinitis and despair, suicidal ideation, and suicide attempts in Korean adolescents: a nationally representative study of one million adolescents. Eur Rev Med Pharmacol Sci 2023; 27:9248-9256. [PMID: 37843338 DOI: 10.26355/eurrev_202310_33952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
OBJECTIVE There is a lack of studies establishing the association between allergic rhinitis (AR) and despair, suicidal thinking, and suicide attempts in adolescents and children at a population level. This study aimed to investigate whether there are associations between allergic rhinitis and despair, suicidal thinking, and suicide attempts. PATIENTS AND METHODS The study utilized data from middle through high school adolescents from 2005-2021 who enrolled in the Korea Youth Risk Behavior Web-based Survey (KYRBS; 1,067,169). We assessed despair, suicidal thinking, and suicide attempts in the context of both non-atopic and atopic AR. Multivariable analysis was used to determine the association of variables. RESULTS The prevalence of allergic rhinitis was 28.0%. 1,067,169 enrolled participants were included in the final analysis. There were 299,468 individuals with allergic rhinitis and 767,701 without. In the context of AR, adolescents were more likely to have despair [adjusted odds ratio (aOR), 1.16; 95% CI, 1.15-1.17], suicidal thoughts (aOR, 1.12; 95% CI, 1.11-1.13 for model 2), and suicide attempts (aOR, 1.13; 95% CI, 1.10-1.15 for model 2). Individuals with atopic AR were more likely in almost all measures to have despair, suicidal thinking, and suicide attempts than individuals with non-atopic AR. Females with AR were more likely to have suicide attempts and middle school students were more likely to have despair, suicidal thoughts, and suicide attempts. CONCLUSIONS The results of this study warrant future studies investigating why AR is so closely associated with despair, suicidal ideation, and suicide attempts, with the goal of establishing suicide prevention strategies as well as improving overall mental health for adolescents.
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Affiliation(s)
- J K Cho
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea.
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12
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Liu L, Perez-Concha O, Nguyen A, Bennett V, Jorm L. Automated ICD coding using extreme multi-label long text transformer-based models. Artif Intell Med 2023; 144:102662. [PMID: 37783551 DOI: 10.1016/j.artmed.2023.102662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/20/2023] [Accepted: 09/04/2023] [Indexed: 10/04/2023]
Abstract
Encouraged by the success of pretrained Transformer models in many natural language processing tasks, their use for International Classification of Diseases (ICD) coding tasks is now actively being explored. In this study, we investigated two existing Transformer-based models (PLM-ICD and XR-Transformer) and proposed a novel Transformer-based model (XR-LAT), aiming to address the extreme label set and long text classification challenges that are posed by automated ICD coding tasks. The Transformer-based model PLM-ICD, which currently holds the state-of-the-art (SOTA) performance on the ICD coding benchmark datasets MIMIC-III and MIMIC-II, was selected as our baseline model for further optimisation on both datasets. In addition, we extended the capabilities of the leading model in the general extreme multi-label text classification domain, XR-Transformer, to support longer sequences and trained it on both datasets. Moreover, we proposed a novel model, XR-LAT, which was also trained on both datasets. XR-LAT is a recursively trained model chain on a predefined hierarchical code tree with label-wise attention, knowledge transferring and dynamic negative sampling mechanisms. Our optimised PLM-ICD models, which were trained with longer total and chunk sequence lengths, significantly outperformed the current SOTA PLM-ICD models, and achieved the highest micro-F1 scores of 60.8 % and 50.9 % on MIMIC-III and MIMIC-II, respectively. The XR-Transformer model, although SOTA in the general domain, did not perform well across all metrics. The best XR-LAT based models obtained results that were competitive with the current SOTA PLM-ICD models, including improving the macro-AUC by 2.1 % and 5.1 % on MIMIC-III and MIMIC-II, respectively. Our optimised PLM-ICD models are the new SOTA models for automated ICD coding on both datasets, while our novel XR-LAT models perform competitively with the previous SOTA PLM-ICD models.
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Affiliation(s)
- Leibo Liu
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia.
| | - Oscar Perez-Concha
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Anthony Nguyen
- The Australian e-Health Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - Vicki Bennett
- Metadata, Information Management and Classifications Unit (MIMCU), Australian Institute of Health and Welfare, Canberra, Australian Capital Territory, Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
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Hoke JC, Ippoliti M, Rosenberg E, Abanin D, Acharya R, Andersen TI, Ansmann M, Arute F, Arya K, Asfaw A, Atalaya J, Bardin JC, Bengtsson A, Bortoli G, Bourassa A, Bovaird J, Brill L, Broughton M, Buckley BB, Buell DA, Burger T, Burkett B, Bushnell N, Chen Z, Chiaro B, Chik D, Cogan J, Collins R, Conner P, Courtney W, Crook AL, Curtin B, Dau AG, Debroy DM, Del Toro Barba A, Demura S, Di Paolo A, Drozdov IK, Dunsworth A, Eppens D, Erickson C, Farhi E, Fatemi R, Ferreira VS, Burgos LF, Forati E, Fowler AG, Foxen B, Giang W, Gidney C, Gilboa D, Giustina M, Gosula R, Gross JA, Habegger S, Hamilton MC, Hansen M, Harrigan MP, Harrington SD, Heu P, Hoffmann MR, Hong S, Huang T, Huff A, Huggins WJ, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Juhas P, Kafri D, Kechedzhi K, Khattar T, Khezri M, Kieferová M, Kim S, Kitaev A, Klimov PV, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Laws L, Lee J, Lee KW, Lensky YD, Lester BJ, Lill AT, Liu W, Locharla A, Martin O, McClean JR, McEwen M, Miao KC, Mieszala A, Montazeri S, Morvan A, Movassagh R, Mruczkiewicz W, Neeley M, Neill C, Nersisyan A, Newman M, Ng JH, Nguyen A, Nguyen M, Niu MY, O’Brien TE, Omonije S, Opremcak A, Petukhov A, Potter R, Pryadko LP, Quintana C, Rocque C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schurkus HF, Schuster C, Shearn MJ, Shorter A, Shutty N, Shvarts V, Skruzny J, Smith WC, Somma R, Sterling G, Strain D, Szalay M, Torres A, Vidal G, Villalonga B, Heidweiller CV, White T, Woo BWK, Xing C, Yao ZJ, Yeh P, Yoo J, Young G, Zalcman A, Zhang Y, Zhu N, Zobrist N, Neven H, Babbush R, Bacon D, Boixo S, Hilton J, Lucero E, Megrant A, Kelly J, Chen Y, Smelyanskiy V, Mi X, Khemani V, Roushan P. Measurement-induced entanglement and teleportation on a noisy quantum processor. Nature 2023; 622:481-486. [PMID: 37853150 PMCID: PMC10584681 DOI: 10.1038/s41586-023-06505-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/01/2023] [Indexed: 10/20/2023]
Abstract
Measurement has a special role in quantum theory1: by collapsing the wavefunction, it can enable phenomena such as teleportation2 and thereby alter the 'arrow of time' that constrains unitary evolution. When integrated in many-body dynamics, measurements can lead to emergent patterns of quantum information in space-time3-10 that go beyond the established paradigms for characterizing phases, either in or out of equilibrium11-13. For present-day noisy intermediate-scale quantum (NISQ) processors14, the experimental realization of such physics can be problematic because of hardware limitations and the stochastic nature of quantum measurement. Here we address these experimental challenges and study measurement-induced quantum information phases on up to 70 superconducting qubits. By leveraging the interchangeability of space and time, we use a duality mapping9,15-17 to avoid mid-circuit measurement and access different manifestations of the underlying phases, from entanglement scaling3,4 to measurement-induced teleportation18. We obtain finite-sized signatures of a phase transition with a decoding protocol that correlates the experimental measurement with classical simulation data. The phases display remarkably different sensitivity to noise, and we use this disparity to turn an inherent hardware limitation into a useful diagnostic. Our work demonstrates an approach to realizing measurement-induced physics at scales that are at the limits of current NISQ processors.
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14
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Strickland M, Nguyen A, Wu S, Suen SC, Mu Y, Del Rio Cuervo J, Shin BJ, Kalakuntla T, Ghafil C, Matsushima K. Assessment of Machine Learning Methods to Predict Massive Blood Transfusion in Trauma. World J Surg 2023; 47:2340-2346. [PMID: 37389644 PMCID: PMC10474168 DOI: 10.1007/s00268-023-07098-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Accurately predicting which patients are most likely to benefit from massive transfusion protocol (MTP) activation may help patients while saving blood products and limiting cost. The purpose of this study is to explore the use of modern machine learning (ML) methods to develop and validate a model that can accurately predict the need for massive blood transfusion (MBT). METHODS The institutional trauma registry was used to identify all trauma team activation cases between June 2015 and August 2019. We used an ML framework to explore multiple ML methods including logistic regression with forward and backward selection, logistic regression with lasso and ridge regularization, support vector machines (SVM), decision tree, random forest, naive Bayes, XGBoost, AdaBoost, and neural networks. Each model was then assessed using sensitivity, specificity, positive predictive value, and negative predictive value. Model performance was compared to that of existing scores including the Assessment of Blood Consumption (ABC) and the Revised Assessment of Bleeding and Transfusion (RABT). RESULTS A total of 2438 patients were included in the study, with 4.9% receiving MBT. All models besides decision tree and SVM attained an area under the curve (AUC) of above 0.75 (range: 0.75-0.83). Most of the ML models have higher sensitivity (0.55-0.83) than the ABC and RABT score (0.36 and 0.55, respectively) while maintaining comparable specificity (0.75-0.81; ABC 0.80 and RABT 0.83). CONCLUSIONS Our ML models performed better than existing scores. Implementing an ML model in mobile computing devices or electronic health record has the potential to improve the usability.
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Affiliation(s)
- Matt Strickland
- Department of Surgery, University of Southern California, LAC+USC Medical Center (The work was done at LAC+USC Medical Center), Los Angeles, CA USA
- Department of Surgery, University of Alberta, Edmonton, AB Canada
| | - Anthony Nguyen
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA USA
| | - Shinyi Wu
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA USA
| | - Sze-Chuan Suen
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA USA
| | - Yanda Mu
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA USA
| | - Juan Del Rio Cuervo
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California, Los Angeles, CA USA
| | - Brandon J. Shin
- Department of Surgery, University of Southern California, LAC+USC Medical Center (The work was done at LAC+USC Medical Center), Los Angeles, CA USA
| | - Tej Kalakuntla
- Department of Surgery, University of Southern California, LAC+USC Medical Center (The work was done at LAC+USC Medical Center), Los Angeles, CA USA
| | - Cameron Ghafil
- Department of Surgery, University of Southern California, LAC+USC Medical Center (The work was done at LAC+USC Medical Center), Los Angeles, CA USA
| | - Kazuhide Matsushima
- Department of Surgery, University of Southern California, LAC+USC Medical Center (The work was done at LAC+USC Medical Center), Los Angeles, CA USA
- Division of Acute Care Surgery, Department of Surgery, University of Southern California, 2051 Marengo Street, Inpatient Tower, C5L100, Los Angeles, CA 90033 USA
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Nguyen A, Sung Y, Lee SH, Martin CE, Srikanth S, Chen W, Kang MK, Kim RH, Park NH, Gwack Y, Kim Y, Shin KH. Orai3 Calcium Channel Contributes to Oral/Oropharyngeal Cancer Stemness through the Elevation of ID1 Expression. Cells 2023; 12:2225. [PMID: 37759448 PMCID: PMC10527097 DOI: 10.3390/cells12182225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/24/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
Emerging evidence indicates that intracellular calcium (Ca2+) levels and their regulatory proteins play essential roles in normal stem cell proliferation and differentiation. Cancer stem-like cells (CSCs) are subpopulations of cancer cells that retain characteristics similar to stem cells and play an essential role in cancer progression. Recent studies have reported that the Orai3 calcium channel plays an oncogenic role in human cancer. However, its role in CSCs remains underexplored. In this study, we explored the effects of Orai3 in the progression and stemness of oral/oropharyngeal squamous cell carcinoma (OSCC). During the course of OSCC progression, the expression of Orai3 exhibited a stepwise augmentation. Notably, Orai3 was highly enriched in CSC populations of OSCC. Ectopic Orai3 expression in non-tumorigenic immortalized oral epithelial cells increased the intracellular Ca2+ levels, acquiring malignant growth and CSC properties. Conversely, silencing of the endogenous Orai3 in OSCC cells suppressed the CSC phenotype, indicating a pivotal role of Orai3 in CSC regulation. Moreover, Orai3 markedly increased the expression of inhibitor of DNA binding 1 (ID1), a stemness transcription factor. Orai3 and ID1 exhibited elevated expression within CSCs compared to their non-CSC counterparts, implying the functional importance of the Orai3/ID1 axis in CSC regulation. Furthermore, suppression of ID1 abrogated the CSC phenotype in the cell with ectopic Orai3 overexpression and OSCC. Our study reveals that Orai3 is a novel functional CSC regulator in OSCC and further suggests that Orai3 plays an oncogenic role in OSCC by promoting cancer stemness via ID1 upregulation.
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Affiliation(s)
- Anthony Nguyen
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (A.N.)
| | - Youngjae Sung
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (A.N.)
| | - Sung Hee Lee
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (A.N.)
| | - Charlotte Ellen Martin
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (A.N.)
| | - Sonal Srikanth
- Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Wei Chen
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (A.N.)
| | - Mo K. Kang
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (A.N.)
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA
| | - Reuben H. Kim
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (A.N.)
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA
| | - No-Hee Park
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (A.N.)
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Yousang Gwack
- Department of Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Yong Kim
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA
- Laboratory of Stem Cell and Cancer Epigenetics, UCLA School of Dentistry, Los Angeles, CA 90095, USA
- UCLA Broad Stem Cell Research Center, Los Angeles, CA 90095, USA
| | - Ki-Hyuk Shin
- The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA 90095, USA; (A.N.)
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, USA
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16
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Gonzalez SMC, Nguyen A, Soto JM, Shan Y. Ring-Enhancing Progressive Multifocal Leukoencephalopathy Mimicking Glioma in a Presumed Immunocompetent Patient With a History of Multiple Sclerosis: A Case Report and Review of the Literature. Cureus 2023; 15:e45543. [PMID: 37868479 PMCID: PMC10585186 DOI: 10.7759/cureus.45543] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
The differential diagnoses of ring-enhancing lesions of the brain parenchyma is broad, but complete ring-enhancing lesions often indicate a neoplastic or infectious process. We present a case of a 70-year-old female with a history of multiple sclerosis (MS) who was not on current disease-modifying therapy (DMT) and was found to have a ring-enhancing lesion that mimicked a high-grade glioma. The patient underwent gross total resection, and histopathologic and molecular analysis revealed a diagnosis of progressive multifocal leukoencephalopathy (PML). A subsequent medical workup on the patient was unrevealing aside from mild lymphopenia. This is a unique case that highlights both an unusual clinical presentation and radiographic appearance of PML. There is a known associated increased risk of PML with the use of some DMTs for MS. However, this case raises the question of the possibility of developing PML years after interferon beta-1a therapy in a patient without overt immunosuppression.
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Affiliation(s)
| | - Anthony Nguyen
- Neurosurgery, Baylor Scott & White Medical Center - Temple, Temple, USA
| | - Jose M Soto
- Neurosurgery, Baylor Scott & White Medical Center - Temple, Temple, USA
| | - Yuan Shan
- Pathology, Baylor Scott & White Medical Center - Temple, Temple, USA
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17
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Liu J, Capurro D, Nguyen A, Verspoor K. Attention-based multimodal fusion with contrast for robust clinical prediction in the face of missing modalities. J Biomed Inform 2023; 145:104466. [PMID: 37549722 DOI: 10.1016/j.jbi.2023.104466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/09/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE With the increasing amount and growing variety of healthcare data, multimodal machine learning supporting integrated modeling of structured and unstructured data is an increasingly important tool for clinical machine learning tasks. However, it is non-trivial to manage the differences in dimensionality, volume, and temporal characteristics of data modalities in the context of a shared target task. Furthermore, patients can have substantial variations in the availability of data, while existing multimodal modeling methods typically assume data completeness and lack a mechanism to handle missing modalities. METHODS We propose a Transformer-based fusion model with modality-specific tokens that summarize the corresponding modalities to achieve effective cross-modal interaction accommodating missing modalities in the clinical context. The model is further refined by inter-modal, inter-sample contrastive learning to improve the representations for better predictive performance. We denote the model as Attention-based cRoss-MOdal fUsion with contRast (ARMOUR). We evaluate ARMOUR using two input modalities (structured measurements and unstructured text), six clinical prediction tasks, and two evaluation regimes, either including or excluding samples with missing modalities. RESULTS Our model shows improved performances over unimodal or multimodal baselines in both evaluation regimes, including or excluding patients with missing modalities in the input. The contrastive learning improves the representation power and is shown to be essential for better results. The simple setup of modality-specific tokens enables ARMOUR to handle patients with missing modalities and allows comparison with existing unimodal benchmark results. CONCLUSION We propose a multimodal model for robust clinical prediction to achieve improved performance while accommodating patients with missing modalities. This work could inspire future research to study the effective incorporation of multiple, more complex modalities of clinical data into a single model.
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Affiliation(s)
- Jinghui Liu
- Australian e-Health Research Centre, CSIRO, Queensland, Australia; School of Computing and Information Systems, The University of Melbourne, Victoria, Australia
| | - Daniel Capurro
- School of Computing and Information Systems, The University of Melbourne, Victoria, Australia; Centre for Digital Transformation of Health, The University of Melbourne, Victoria, Australia
| | - Anthony Nguyen
- Australian e-Health Research Centre, CSIRO, Queensland, Australia
| | - Karin Verspoor
- School of Computing and Information Systems, The University of Melbourne, Victoria, Australia; School of Computing Technologies, RMIT University, Victoria, Australia.
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18
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Liu L, Perez-Concha O, Nguyen A, Bennett V, Blake V, Gallego B, Jorm L. Web-Based Application Based on Human-in-the-Loop Deep Learning for Deidentifying Free-Text Data in Electronic Medical Records: Development and Usability Study. Interact J Med Res 2023; 12:e46322. [PMID: 37624624 PMCID: PMC10492176 DOI: 10.2196/46322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/31/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND The narrative free-text data in electronic medical records (EMRs) contain valuable clinical information for analysis and research to inform better patient care. However, the release of free text for secondary use is hindered by concerns surrounding personally identifiable information (PII), as protecting individuals' privacy is paramount. Therefore, it is necessary to deidentify free text to remove PII. Manual deidentification is a time-consuming and labor-intensive process. Numerous automated deidentification approaches and systems have been attempted to overcome this challenge over the past decade. OBJECTIVE We sought to develop an accurate, web-based system deidentifying free text (DEFT), which can be readily and easily adopted in real-world settings for deidentification of free text in EMRs. The system has several key features including a simple and task-focused web user interface, customized PII types, use of a state-of-the-art deep learning model for tagging PII from free text, preannotation by an interactive learning loop, rapid manual annotation with autosave, support for project management and team collaboration, user access control, and central data storage. METHODS DEFT comprises frontend and backend modules and communicates with central data storage through a filesystem path access. The frontend web user interface provides end users with a user-friendly workspace for managing and annotating free text. The backend module processes the requests from the frontend and performs relevant persistence operations. DEFT manages the deidentification workflow as a project, which can contain one or more data sets. Customized PII types and user access control can also be configured. The deep learning model is based on a Bidirectional Long Short-Term Memory-Conditional Random Field (BiLSTM-CRF) with RoBERTa as the word embedding layer. The interactive learning loop is further integrated into DEFT to speed up the deidentification process and increase its performance over time. RESULTS DEFT has many advantages over existing deidentification systems in terms of its support for project management, user access control, data management, and an interactive learning process. Experimental results from DEFT on the 2014 i2b2 data set obtained the highest performance compared to 5 benchmark models in terms of microaverage strict entity-level recall and F1-scores of 0.9563 and 0.9627, respectively. In a real-world use case of deidentifying clinical notes, extracted from 1 referral hospital in Sydney, New South Wales, Australia, DEFT achieved a high microaverage strict entity-level F1-score of 0.9507 on a corpus of 600 annotated clinical notes. Moreover, the manual annotation process with preannotation demonstrated a 43% increase in work efficiency compared to the process without preannotation. CONCLUSIONS DEFT is designed for health domain researchers and data custodians to easily deidentify free text in EMRs. DEFT supports an interactive learning loop and end users with minimal technical knowledge can perform the deidentification work with only a shallow learning curve.
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Affiliation(s)
- Leibo Liu
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Oscar Perez-Concha
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Anthony Nguyen
- Australian e-Health Research Centre (AEHRC), Commonwealth Scientific and Industrial Research Organisation (CSIRO), Brisbane, Australia
| | - Vicki Bennett
- Metadata, Information Management and Classifications Unit (MIMCU), Australian Institute of Health and Welfare, Canberra, Australia
| | - Victoria Blake
- Eastern Heart Clinic, Prince of Wales Hospital, Randwick, Australia
| | - Blanca Gallego
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
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19
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Ajala RT, Nguyen A, Lyon K, Qaiser R. Indirect Bypass With Pericranial Transposition for Moyamoya Syndrome in an Infant. Cureus 2023; 15:e44073. [PMID: 37750109 PMCID: PMC10518035 DOI: 10.7759/cureus.44073] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 08/23/2023] [Indexed: 09/27/2023] Open
Abstract
Moyamoya syndrome (MMS) is a progressive disease that can result in debilitating strokes. Surgical revascularization is the mainstay of treatment. Selection of the proper bypass technique depends on the vascular anatomy and location of the hypoperfused cerebral territory. We describe here a case of successful indirect bypass utilizing a pericranial flap as well as dural inversion. A seven-month-old female was transferred from an outside facility to our institution for further evaluation and surgical treatment of MMS. She presented with bilateral brain infarcts worse on the left, with right-sided body weakness. After medical stabilization and hyperhydration, she was taken to the operating room for a left-sided indirect bypass. The superficial temporal artery (STA) was traced utilizing doppler but was determined to be too diminutive for transposition, so the decision was made to proceed with encephalo-duro-pericranio-synangiosis (EDPS). A pericranial graft was successfully affixed to the cortical surface in the hypoperfused middle cerebral artery (MCA) territory, and the dura was inverted. Postoperatively, the patient developed a pseudomeningocele, so a revision surgery was performed. She was discharged shortly after this and returned for encephalo-duro-arterio-synangiosis (EDAS) of the contralateral side. She followed up three months after her initial bypass surgery at age 10 months and was crawling without any focal deficits. She was lost to follow-up thereafter. EDPS is a safe technique for infants with MMS whose STA is too diminutive to be used for bypass surgery. This may be an effective method for indirect bypass in these patients.
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Affiliation(s)
- Rodiyah T Ajala
- Surgery, Texas A&M School of Medicine, Bryan, USA
- Neurosurgery, Baylor Scott & White Medical Center, Temple, USA
| | - Anthony Nguyen
- Neurosurgery, Baylor Scott & White Medical Center, Temple, USA
| | - Kristopher Lyon
- Neurosurgery, Baylor Scott & White Medical Center, Temple, USA
| | - Rabia Qaiser
- Neurosurgery, Baylor Scott & White Medical Center, Temple, USA
- Neurological Surgery, Indiana University School of Medicine, Indianapolis, USA
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Aalbers J, Akerib DS, Akerlof CW, Al Musalhi AK, Alder F, Alqahtani A, Alsum SK, Amarasinghe CS, Ames A, Anderson TJ, Angelides N, Araújo HM, Armstrong JE, Arthurs M, Azadi S, Bailey AJ, Baker A, Balajthy J, Balashov S, Bang J, Bargemann JW, Barry MJ, Barthel J, Bauer D, Baxter A, Beattie K, Belle J, Beltrame P, Bensinger J, Benson T, Bernard EP, Bhatti A, Biekert A, Biesiadzinski TP, Birch HJ, Birrittella B, Blockinger GM, Boast KE, Boxer B, Bramante R, Brew CAJ, Brás P, Buckley JH, Bugaev VV, Burdin S, Busenitz JK, Buuck M, Cabrita R, Carels C, Carlsmith DL, Carlson B, Carmona-Benitez MC, Cascella M, Chan C, Chawla A, Chen H, Cherwinka JJ, Chott NI, Cole A, Coleman J, Converse MV, Cottle A, Cox G, Craddock WW, Creaner O, Curran D, Currie A, Cutter JE, Dahl CE, David A, Davis J, Davison TJR, Delgaudio J, Dey S, de Viveiros L, Dobi A, Dobson JEY, Druszkiewicz E, Dushkin A, Edberg TK, Edwards WR, Elnimr MM, Emmet WT, Eriksen SR, Faham CH, Fan A, Fayer S, Fearon NM, Fiorucci S, Flaecher H, Ford P, Francis VB, Fraser ED, Fruth T, Gaitskell RJ, Gantos NJ, Garcia D, Geffre A, Gehman VM, Genovesi J, Ghag C, Gibbons R, Gibson E, Gilchriese MGD, Gokhale S, Gomber B, Green J, Greenall A, Greenwood S, van der Grinten MGD, Gwilliam CB, Hall CR, Hans S, Hanzel K, Harrison A, Hartigan-O'Connor E, Haselschwardt SJ, Hernandez MA, Hertel SA, Heuermann G, Hjemfelt C, Hoff MD, Holtom E, Hor JYK, Horn M, Huang DQ, Hunt D, Ignarra CM, Jacobsen RG, Jahangir O, James RS, Jeffery SN, Ji W, Johnson J, Kaboth AC, Kamaha AC, Kamdin K, Kasey V, Kazkaz K, Keefner J, Khaitan D, Khaleeq M, Khazov A, Khurana I, Kim YD, Kocher CD, Kodroff D, Korley L, Korolkova EV, Kras J, Kraus H, Kravitz S, Krebs HJ, Kreczko L, Krikler B, Kudryavtsev VA, Kyre S, Landerud B, Leason EA, Lee C, Lee J, Leonard DS, Leonard R, Lesko KT, Levy C, Li J, Liao FT, Liao J, Lin J, Lindote A, Linehan R, Lippincott WH, Liu R, Liu X, Liu Y, Loniewski C, Lopes MI, Lopez Asamar E, López Paredes B, Lorenzon W, Lucero D, Luitz S, Lyle JM, Majewski PA, Makkinje J, Malling DC, Manalaysay A, Manenti L, Mannino RL, Marangou N, Marzioni MF, Maupin C, McCarthy ME, McConnell CT, McKinsey DN, McLaughlin J, Meng Y, Migneault J, Miller EH, Mizrachi E, Mock JA, Monte A, Monzani ME, Morad JA, Morales Mendoza JD, Morrison E, Mount BJ, Murdy M, Murphy ASJ, Naim D, Naylor A, Nedlik C, Nehrkorn C, Neves F, Nguyen A, Nikoleyczik JA, Nilima A, O'Dell J, O'Neill FG, O'Sullivan K, Olcina I, Olevitch MA, Oliver-Mallory KC, Orpwood J, Pagenkopf D, Pal S, Palladino KJ, Palmer J, Pangilinan M, Parveen N, Patton SJ, Pease EK, Penning B, Pereira C, Pereira G, Perry E, Pershing T, Peterson IB, Piepke A, Podczerwinski J, Porzio D, Powell S, Preece RM, Pushkin K, Qie Y, Ratcliff BN, Reichenbacher J, Reichhart L, Rhyne CA, Richards A, Riffard Q, Rischbieter GRC, Rodrigues JP, Rodriguez A, Rose HJ, Rosero R, Rossiter P, Rushton T, Rutherford G, Rynders D, Saba JS, Santone D, Sazzad ABMR, Schnee RW, Scovell PR, Seymour D, Shaw S, Shutt T, Silk JJ, Silva C, Sinev G, Skarpaas K, Skulski W, Smith R, Solmaz M, Solovov VN, Sorensen P, Soria J, Stancu I, Stark MR, Stevens A, Stiegler TM, Stifter K, Studley R, Suerfu B, Sumner TJ, Sutcliffe P, Swanson N, Szydagis M, Tan M, Taylor DJ, Taylor R, Taylor WC, Temples DJ, Tennyson BP, Terman PA, Thomas KJ, Tiedt DR, Timalsina M, To WH, Tomás A, Tong Z, Tovey DR, Tranter J, Trask M, Tripathi M, Tronstad DR, Tull CE, Turner W, Tvrznikova L, Utku U, Va'vra J, Vacheret A, Vaitkus AC, Verbus JR, Voirin E, Waldron WL, Wang A, Wang B, Wang JJ, Wang W, Wang Y, Watson JR, Webb RC, White A, White DT, White JT, White RG, Whitis TJ, Williams M, Wisniewski WJ, Witherell MS, Wolfs FLH, Wolfs JD, Woodford S, Woodward D, Worm SD, Wright CJ, Xia Q, Xiang X, Xiao Q, Xu J, Yeh M, Yin J, Young I, Zarzhitsky P, Zuckerman A, Zweig EA. First Dark Matter Search Results from the LUX-ZEPLIN (LZ) Experiment. Phys Rev Lett 2023; 131:041002. [PMID: 37566836 DOI: 10.1103/physrevlett.131.041002] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/06/2023] [Accepted: 06/07/2023] [Indexed: 08/13/2023]
Abstract
The LUX-ZEPLIN experiment is a dark matter detector centered on a dual-phase xenon time projection chamber operating at the Sanford Underground Research Facility in Lead, South Dakota, USA. This Letter reports results from LUX-ZEPLIN's first search for weakly interacting massive particles (WIMPs) with an exposure of 60 live days using a fiducial mass of 5.5 t. A profile-likelihood ratio analysis shows the data to be consistent with a background-only hypothesis, setting new limits on spin-independent WIMP-nucleon, spin-dependent WIMP-neutron, and spin-dependent WIMP-proton cross sections for WIMP masses above 9 GeV/c^{2}. The most stringent limit is set for spin-independent scattering at 36 GeV/c^{2}, rejecting cross sections above 9.2×10^{-48} cm at the 90% confidence level.
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Affiliation(s)
- J Aalbers
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - D S Akerib
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - C W Akerlof
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - A K Al Musalhi
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - F Alder
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - A Alqahtani
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S K Alsum
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - C S Amarasinghe
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - A Ames
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - T J Anderson
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - N Angelides
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - H M Araújo
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J E Armstrong
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - M Arthurs
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - S Azadi
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - A J Bailey
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Baker
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J Balajthy
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - S Balashov
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Bang
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J W Bargemann
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - M J Barry
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Barthel
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Bauer
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Baxter
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - K Beattie
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Belle
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - P Beltrame
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J Bensinger
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - T Benson
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - E P Bernard
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - A Bhatti
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - A Biekert
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - T P Biesiadzinski
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - H J Birch
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - B Birrittella
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - G M Blockinger
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - K E Boast
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - B Boxer
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R Bramante
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - C A J Brew
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - P Brás
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - J H Buckley
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - V V Bugaev
- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - S Burdin
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - J K Busenitz
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M Buuck
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - R Cabrita
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - C Carels
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - D L Carlsmith
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - B Carlson
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - M C Carmona-Benitez
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - M Cascella
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - C Chan
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Chawla
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - H Chen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J J Cherwinka
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - N I Chott
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - A Cole
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Coleman
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M V Converse
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - A Cottle
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - G Cox
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - W W Craddock
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - O Creaner
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Curran
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - A Currie
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - J E Cutter
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - C E Dahl
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
| | - A David
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - J Davis
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - T J R Davison
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - J Delgaudio
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - S Dey
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - L de Viveiros
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - A Dobi
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J E Y Dobson
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - E Druszkiewicz
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - A Dushkin
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - T K Edberg
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - W R Edwards
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M M Elnimr
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - W T Emmet
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
| | - S R Eriksen
- University of Bristol, H.H. Wills Physics Laboratory, Bristol, BS8 1TL, United Kingdom
| | - C H Faham
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Fan
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - S Fayer
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - N M Fearon
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - S Fiorucci
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - H Flaecher
- University of Bristol, H.H. Wills Physics Laboratory, Bristol, BS8 1TL, United Kingdom
| | - P Ford
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - V B Francis
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - E D Fraser
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - T Fruth
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R J Gaitskell
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - N J Gantos
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Garcia
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Geffre
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - V M Gehman
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Genovesi
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - C Ghag
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R Gibbons
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - E Gibson
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - M G D Gilchriese
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - S Gokhale
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - B Gomber
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - J Green
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - A Greenall
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - S Greenwood
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | | | - C B Gwilliam
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - C R Hall
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - S Hans
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - K Hanzel
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - A Harrison
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - E Hartigan-O'Connor
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S J Haselschwardt
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - M A Hernandez
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - S A Hertel
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
| | - G Heuermann
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
| | - C Hjemfelt
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - M D Hoff
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - E Holtom
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - J Y-K Hor
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M Horn
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Q Huang
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Hunt
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - C M Ignarra
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - R G Jacobsen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - O Jahangir
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - R S James
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - S N Jeffery
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - W Ji
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J Johnson
- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
| | - A C Kaboth
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - A C Kamaha
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
- University of Califonia, Los Angeles, Department of Physics and Astronomy, Los Angeles, California 90095-1547
| | - K Kamdin
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - V Kasey
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - K Kazkaz
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - J Keefner
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - D Khaitan
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - M Khaleeq
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - A Khazov
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - I Khurana
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - Y D Kim
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - C D Kocher
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Kodroff
- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
| | - L Korley
- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - E V Korolkova
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - J Kras
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - H Kraus
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - S Kravitz
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - H J Krebs
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - L Kreczko
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - B Krikler
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - V A Kudryavtsev
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - S Kyre
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - B Landerud
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - E A Leason
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - C Lee
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J Lee
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - D S Leonard
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - R Leonard
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - K T Lesko
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - C Levy
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - J Li
- IBS Center for Underground Physics (CUP), Yuseong-gu, Daejeon, Korea
| | - F-T Liao
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - J Liao
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - J Lin
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - A Lindote
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - R Linehan
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - W H Lippincott
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - R Liu
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - X Liu
- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
| | - Y Liu
- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - C Loniewski
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - M I Lopes
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - E Lopez Asamar
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - B López Paredes
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
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- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
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- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
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- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - J M Lyle
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
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- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
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- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
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- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
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- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
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- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
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- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
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- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
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- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
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- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
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- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
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- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
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- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
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- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
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- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
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- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
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- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
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- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- Vatican Observatory, Castel Gandolfo, V-00120, Vatican City State
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- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
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- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
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- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
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- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
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- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
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- University of California, Davis, Department of Physics, Davis, California 95616-5270, USA
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- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
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- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
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- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
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- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
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- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
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- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
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- University of Edinburgh, SUPA, School of Physics and Astronomy, Edinburgh EH9 3FD, United Kingdom
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- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
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- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
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- Washington University in St. Louis, Department of Physics, St. Louis, Missouri 63130-4862, USA
| | - K C Oliver-Mallory
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
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| | - J Orpwood
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
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- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
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- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
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- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
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- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
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- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
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- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
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- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
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- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
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- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
| | - D Porzio
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - S Powell
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R M Preece
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
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- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
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- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
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- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
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- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
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- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
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- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - A Richards
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - G R C Rischbieter
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| | - J P Rodrigues
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
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- Black Hills State University, School of Natural Sciences, Spearfish, South Dakota 57799-0002, USA
| | - H J Rose
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - R Rosero
- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
| | - P Rossiter
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - T Rushton
- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
| | - G Rutherford
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - D Rynders
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
| | - J S Saba
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D Santone
- Royal Holloway, University of London, Department of Physics, Egham, TW20 0EX, United Kingdom
| | - A B M R Sazzad
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - R W Schnee
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - P R Scovell
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- STFC Rutherford Appleton Laboratory (RAL), Didcot, OX11 0QX, United Kingdom
| | - D Seymour
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - S Shaw
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - T Shutt
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
| | - J J Silk
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
| | - C Silva
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - G Sinev
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - K Skarpaas
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
| | - W Skulski
- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
| | - R Smith
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - M Solmaz
- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
| | - V N Solovov
- Laboratório de Instrumentação e Física Experimental de Partículas (LIP), University of Coimbra, P-3004 516 Coimbra, Portugal
| | - P Sorensen
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - J Soria
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - I Stancu
- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
| | - M R Stark
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - A Stevens
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - T M Stiegler
- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
| | - K Stifter
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
| | - R Studley
- Brandeis University, Department of Physics, Waltham, Massachusetts 02453, USA
| | - B Suerfu
- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
| | - T J Sumner
- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
| | - P Sutcliffe
- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
| | - N Swanson
- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
| | - M Szydagis
- University at Albany (SUNY), Department of Physics, Albany, New York 12222-0100, USA
| | - M Tan
- University of Oxford, Department of Physics, Oxford OX1 3RH, United Kingdom
| | - D J Taylor
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
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- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
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- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
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- Northwestern University, Department of Physics & Astronomy, Evanston, Illinois 60208-3112, USA
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- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
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- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
| | - D R Tiedt
- University of Maryland, Department of Physics, College Park, Maryland 20742-4111, USA
- South Dakota Science and Technology Authority (SDSTA), Sanford Underground Research Facility, Lead, South Dakota 57754-1700, USA
- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
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- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
| | - W H To
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, Stanford, California 94305-4085 USA
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- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
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- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
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- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
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- University of Sheffield, Department of Physics and Astronomy, Sheffield S3 7RH, United Kingdom
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- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
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- South Dakota School of Mines and Technology, Rapid City, South Dakota 57701-3901, USA
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
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- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
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- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
- Yale University, Department of Physics, New Haven, Connecticut 06511-8499, USA
- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
| | - U Utku
- University College London (UCL), Department of Physics and Astronomy, London WC1E 6BT, United Kingdom
| | - J Va'vra
- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
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- Imperial College London, Physics Department, Blackett Laboratory, London SW7 2AZ, United Kingdom
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- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
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- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
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- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
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- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
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- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
- University of Massachusetts, Department of Physics, Amherst, Massachusetts 01003-9337, USA
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
- University of California, Berkeley, Department of Physics, Berkeley, California 94720-7300, USA
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- Lawrence Berkeley National Laboratory (LBNL), Berkeley, California 94720-8099, USA
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- University of California, Santa Barbara, Department of Physics, Santa Barbara, California 93106-9530, USA
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- Texas A&M University, Department of Physics and Astronomy, College Station, Texas 77843-4242, USA
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- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
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- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
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- University of Michigan, Randall Laboratory of Physics, Ann Arbor, Michigan 48109-1040, USA
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- SLAC National Accelerator Laboratory, Menlo Park, California 94025-7015, USA
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- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
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- University of Liverpool, Department of Physics, Liverpool L69 7ZE, United Kingdom
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- Pennsylvania State University, Department of Physics, University Park, Pennsylvania 16802-6300, USA
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- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
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- University of Wisconsin-Madison, Department of Physics, Madison, Wisconsin 53706-1390, USA
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- Lawrence Livermore National Laboratory (LLNL), Livermore, California 94550-9698, USA
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- Brookhaven National Laboratory (BNL), Upton, New York 11973-5000, USA
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- University of Rochester, Department of Physics and Astronomy, Rochester, New York 14627-0171, USA
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- Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510-5011, USA
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- University of Alabama, Department of Physics and Astronomy, Tuscaloosa, Alabama 34587-0324, USA
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- Brown University, Department of Physics, Providence, Rhode Island 02912-9037, USA
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- University of Califonia, Los Angeles, Department of Physics and Astronomy, Los Angeles, California 90095-1547
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Castillo DR, Park D, Jeon WJ, Joung B, Lee J, Yang C, Pham B, Hino C, Chong E, Shields A, Nguyen A, Brothers J, Liu Y, Zhang KK, Cao H. Unveiling the Prognostic Significance of BCL6+/CD10+ Mantle Cell Lymphoma: Meta-Analysis of Individual Patients and Systematic Review. Int J Mol Sci 2023; 24:10207. [PMID: 37373354 DOI: 10.3390/ijms241210207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/01/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Mantle cell lymphoma (MCL) is a type of non-Hodgkin lymphoma (NHL) characterized by a hallmark translocation of t (11; 14). CD10 negativity has been used to differentiate MCL from other NHL types; however, recently, there has been an increase in the number of reported cases of CD10-positive MCL. This warrants further investigation into this rarer immunophenotype and its clinical significance. BCL6, which is a master transcription factor for the regulation of cell proliferation and key oncogene in B cell lymphomagenesis, has been reported to have co-expression with CD10 in MCL. The clinical significance of this aberrant antigen expression remains unknown. We conducted a systematic review by searching four databases and selected five retrospective analyses and five case series. Two survival analyses were conducted to determine if BCL6 positivity conferred a survival difference: 1. BCL6+ vs. BCL6- MCL. 2. BCL6+/CD10+ vs. BCL6-/CD10+ MCL. Correlation analysis was conducted to determine if BCL6 positivity correlated with the Ki67 proliferation index (PI). Overall survival (OS) rates were performed by the Kaplan-Meier method and log-rank test. Our analyses revealed that BCL6+ MCL had significantly shorter overall survival (median OS: 14 months vs. 43 months; p = 0.01), BCL6+/CD10+ MCL had an inferior outcome vs. BCL6+/CD10- MCL (median OS: 20 months vs. 55 months p = 0.1828), BCL6+ MCL had significantly higher percentages of Ki67% (Ki67% difference: 24.29; p = 0.0094), and BCL6 positivity had a positive correlation with CD10+ status with an odds ratio 5.11 (2.49, 10.46; p = 0.0000286). Our analysis showed that BCL6 expression is correlated with CD10 positivity in MCL, and BCL6 expression demonstrated an inferior overall survival. The higher Ki67 PI in BCL6+ MCL compared to BCL6- MCL further supports the idea that the BCL6+ immunophenotype may have prognostic value in MCL. MCL management should consider incorporating prognostic scoring systems adjusted for BCL6 expression. Targeted therapies against BCL6 may offer potential therapeutic options for managing MCL with aberrant immunophenotypes.
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Affiliation(s)
- Dani Ran Castillo
- Department of Oncology/Hematology, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA
| | - Daniel Park
- Department of Internal Medicine, School of Medicine, University of California San Francisco-Fresno, Fresno, CA 93701, USA
| | - Won Jin Jeon
- Department of Internal Medicine, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA
| | - Bowon Joung
- Department of Internal Medicine, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA
| | - Jae Lee
- School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA
| | - Chieh Yang
- Department of Internal Medicine, School of Medicine, University of California Riverside, Riverside, CA 92521, USA
| | - Bryan Pham
- Department of Internal Medicine, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA
| | - Christopher Hino
- Department of Internal Medicine, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA
| | - Esther Chong
- Department of Oncology/Hematology, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA
| | - Andrea Shields
- Department of Pathology, Loma Linda University, Loma Linda, CA 92354, USA
| | - Anthony Nguyen
- Department of Nutrition, Texas A&M University, College Station, TX 77030, USA
| | - Joel Brothers
- Department of Oncology/Hematology, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA
| | - Yan Liu
- Department of Pathology, Loma Linda University, Loma Linda, CA 92354, USA
| | - Ke K Zhang
- Department of Nutrition, Texas A&M University, College Station, TX 77030, USA
- Center for Epigenetics & Disease Prevention, Institute of Biosciences & Technology, College of Medicine, Texas A&M University, Houston, TX 77030, USA
| | - Huynh Cao
- Department of Oncology/Hematology, School of Medicine, Loma Linda University, Loma Linda, CA 92354, USA
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22
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Andersen TI, Lensky YD, Kechedzhi K, Drozdov IK, Bengtsson A, Hong S, Morvan A, Mi X, Opremcak A, Acharya R, Allen R, Ansmann M, Arute F, Arya K, Asfaw A, Atalaya J, Babbush R, Bacon D, Bardin JC, Bortoli G, Bourassa A, Bovaird J, Brill L, Broughton M, Buckley BB, Buell DA, Burger T, Burkett B, Bushnell N, Chen Z, Chiaro B, Chik D, Chou C, Cogan J, Collins R, Conner P, Courtney W, Crook AL, Curtin B, Debroy DM, Del Toro Barba A, Demura S, Dunsworth A, Eppens D, Erickson C, Faoro L, Farhi E, Fatemi R, Ferreira VS, Burgos LF, Forati E, Fowler AG, Foxen B, Giang W, Gidney C, Gilboa D, Giustina M, Gosula R, Dau AG, Gross JA, Habegger S, Hamilton MC, Hansen M, Harrigan MP, Harrington SD, Heu P, Hilton J, Hoffmann MR, Huang T, Huff A, Huggins WJ, Ioffe LB, Isakov SV, Iveland J, Jeffrey E, Jiang Z, Jones C, Juhas P, Kafri D, Khattar T, Khezri M, Kieferová M, Kim S, Kitaev A, Klimov PV, Klots AR, Korotkov AN, Kostritsa F, Kreikebaum JM, Landhuis D, Laptev P, Lau KM, Laws L, Lee J, Lee KW, Lester BJ, Lill AT, Liu W, Locharla A, Lucero E, Malone FD, Martin O, McClean JR, McCourt T, McEwen M, Miao KC, Mieszala A, Mohseni M, Montazeri S, Mount E, Movassagh R, Mruczkiewicz W, Naaman O, Neeley M, Neill C, Nersisyan A, Newman M, Ng JH, Nguyen A, Nguyen M, Niu MY, O’Brien TE, Omonije S, Petukhov A, Potter R, Pryadko LP, Quintana C, Rocque C, Rubin NC, Saei N, Sank D, Sankaragomathi K, Satzinger KJ, Schurkus HF, Schuster C, Shearn MJ, Shorter A, Shutty N, Shvarts V, Skruzny J, Smith WC, Somma R, Sterling G, Strain D, Szalay M, Torres A, Vidal G, Villalonga B, Heidweiller CV, White T, Woo BWK, Xing C, Yao ZJ, Yeh P, Yoo J, Young G, Zalcman A, Zhang Y, Zhu N, Zobrist N, Neven H, Boixo S, Megrant A, Kelly J, Chen Y, Smelyanskiy V, Kim EA, Aleiner I, Roushan P. Non-Abelian braiding of graph vertices in a superconducting processor. Nature 2023; 618:264-269. [PMID: 37169834 DOI: 10.1038/s41586-023-05954-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/14/2023] [Indexed: 06/09/2023]
Abstract
Indistinguishability of particles is a fundamental principle of quantum mechanics1. For all elementary and quasiparticles observed to date-including fermions, bosons and Abelian anyons-this principle guarantees that the braiding of identical particles leaves the system unchanged2,3. However, in two spatial dimensions, an intriguing possibility exists: braiding of non-Abelian anyons causes rotations in a space of topologically degenerate wavefunctions4-8. Hence, it can change the observables of the system without violating the principle of indistinguishability. Despite the well-developed mathematical description of non-Abelian anyons and numerous theoretical proposals9-22, the experimental observation of their exchange statistics has remained elusive for decades. Controllable many-body quantum states generated on quantum processors offer another path for exploring these fundamental phenomena. Whereas efforts on conventional solid-state platforms typically involve Hamiltonian dynamics of quasiparticles, superconducting quantum processors allow for directly manipulating the many-body wavefunction by means of unitary gates. Building on predictions that stabilizer codes can host projective non-Abelian Ising anyons9,10, we implement a generalized stabilizer code and unitary protocol23 to create and braid them. This allows us to experimentally verify the fusion rules of the anyons and braid them to realize their statistics. We then study the prospect of using the anyons for quantum computation and use braiding to create an entangled state of anyons encoding three logical qubits. Our work provides new insights about non-Abelian braiding and, through the future inclusion of error correction to achieve topological protection, could open a path towards fault-tolerant quantum computing.
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23
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Awan RU, Gangu K, Nguyen A, Chourasia P, Borja Montes OF, Butt MA, Muzammil TS, Afzal RM, Nabeel A, Shekhar R, Sheikh AB. COVID-19 and Clostridioides difficile Coinfection Outcomes among Hospitalized Patients in the United States: An Insight from National Inpatient Database. Infect Dis Rep 2023; 15:279-291. [PMID: 37218819 DOI: 10.3390/idr15030028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023] Open
Abstract
The incidence of Clostridioides difficile infection (CDI) has been increasing compared to pre-COVID-19 pandemic levels. The COVID-19 infection and CDI relationship can be affected by gut dysbiosis and poor antibiotic stewardship. As the COVID-19 pandemic transitions into an endemic stage, it has become increasingly important to further characterize how concurrent infection with both conditions can impact patient outcomes. We performed a retrospective cohort study utilizing the 2020 NIS Healthcare Cost Utilization Project (HCUP) database with a total of 1,659,040 patients, with 10,710 (0.6%) of those patients with concurrent CDI. We found that patients with concurrent COVID-19 and CDI had worse outcomes compared to patients without CDI including higher in-hospital mortality (23% vs. 13.4%, aOR: 1.3, 95% CI: 1.12-1.5, p = 0.01), rates of in-hospital complications such as ileus (2.7% vs. 0.8%, p < 0.001), septic shock (21.0% vs. 7.2%, aOR: 2.3, 95% CI: 2.1-2.6, p < 0.001), length of stay (15.1 days vs. 8 days, p < 0.001) and overall cost of hospitalization (USD 196,012 vs. USD 91,162, p < 0.001). Patients with concurrent COVID-19 and CDI had increased morbidity and mortality, and added significant preventable burden on the healthcare system. Optimizing hand hygiene and antibiotic stewardship during in-hospital admissions can help to reduce worse outcomes in this population, and more efforts should be directly made to reduce CDI in hospitalized patients with COVID-19 infection.
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Affiliation(s)
- Rehmat Ullah Awan
- Department of Internal Medicine, Ochsner Rush Medical Center, Meridian, MS 39301, USA
| | - Karthik Gangu
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Anthony Nguyen
- Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Prabal Chourasia
- Department of Hospital Medicine, Mary Washington Hospital, Fredericksburg, VA 22401, USA
| | - Oscar F Borja Montes
- Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Muhammad Ali Butt
- Department of Internal Medicine, Allegheny Health Network, Pittsburgh, PA 15212, USA
| | | | - Rao Mujtaba Afzal
- Department of Internal Medicine, University of Pittsburg Medical Center, Pittsburgh, PA 15213, USA
| | - Ambreen Nabeel
- Department of Internal Medicine, Ochsner Rush Medical Center, Meridian, MS 39301, USA
| | - Rahul Shekhar
- Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Abu Baker Sheikh
- Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
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Nguyen A, Khafagy R, Gao Y, Meerasa A, Roshandel D, Anvari M, Lin B, Cherney DZI, Farkouh ME, Shah BR, Paterson AD, Dash S. Erratum. Association Between Obesity and Chronic Kidney Disease: Multivariable Mendelian Randomization Analysis and Observational Data From a Bariatric Surgery Cohort. Diabetes 2023;72:496-510. Diabetes 2023:148944. [PMID: 37200064 PMCID: PMC10382645 DOI: 10.2337/db23-er08a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
In Table 2 of the article cited above, the univariable MR analyses for microalbuminuria were erroneously cited as inverse variance weighted analyses. The row headings in Table 2 have been revised to show the correct analyses performed: MR-Egger, weighted median and mode, and simple mode analyses. In Fig. 3, the confidence intervals were erroneously plotted as error bars. Fig. 3 has been updated with the correct confidence intervals from the text. The revised online version of the article can be accessed at https://doi.org/10.2337/db22-0696.
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25
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Jeon WJ, Mehta A, Hudson J, Castillo DR, Wang J, Nguyen A, Akhtari M. Portal vein thrombosis as the presenting manifestation of JAK2 positive myeloproliferative neoplasm. Am J Med Sci 2023; 365:457-461. [PMID: 36632865 DOI: 10.1016/j.amjms.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/28/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
Deep venous thrombosis (DVT) is a complication of myeloproliferative neoplasms (MPNs). However, DVTs in unusual sites such as portal vein thrombosis (PVT) are rare and may be the first clinical manifestation of occult MPNs. There is a need for increasing awareness of such manifestations; so, here we discuss a patient who presented with new portal vein thrombosis, underwent further studies, was ultimately diagnosed with JAK2 positive MPN, and started on appropriate treatment with improvement of thrombosis and controlled hematocrit.
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Affiliation(s)
- Won Jin Jeon
- Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Akhil Mehta
- Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Jessica Hudson
- Department of Anatomic and Clinical Pathology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Dani Ran Castillo
- Division of Medical Oncology/ Hematology, Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA.
| | - Jun Wang
- Department of Anatomic and Clinical Pathology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Anthony Nguyen
- Moores Cancer Center, UC San Diego Health, La Jolla, CA, USA
| | - Mojtaba Akhtari
- Division of Medical Oncology/ Hematology, Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, USA
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26
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Hughes JA, Douglas C, Jones L, Brown NJ, Nguyen A, Jarugula R, Lyrstedt AL, Hazelwood S, Wu Y, Chu K. Identifying patients presenting in pain to the adult emergency department: A binary classification task and description of prevalence. Int Emerg Nurs 2023. [DOI: 10.1016/j.ienj.2023.101272] [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: 03/16/2023]
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27
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Liang C, Suen SC, Nguyen A, Moucheraud C, Hsu L, Holloway IW, Charlebois ED, Steward WT. Impact of COVID-19 Response on the HIV Epidemic in Men Who Have Sex With Men in San Francisco County: The Importance of Rapid Return to Normalcy. J Acquir Immune Defic Syndr 2023; 92:370-377. [PMID: 36728397 PMCID: PMC9988211 DOI: 10.1097/qai.0000000000003156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/16/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND In response to the COVID-19 pandemic, San Francisco County (SFC) had to shift many nonemergency health care resources to COVID-19, reducing HIV control resources. We sought to quantify COVID-19 effects on HIV burden among men who have sex with men (MSM) as SFC returns to pre-COVID service levels and progresses toward the Ending the HIV Epidemic (EHE) goals. SETTING Microsimulation model of MSM in SFC tracking HIV progression and treatment. METHODS Scenario analysis where services affected by COVID-19 [testing, care engagement, pre-exposure prophylaxis (PrEP) uptake, and retention] return to pre-COVID levels by the end of 2022 or 2025, compared against a counterfactual where COVID-19 changes never occurred. We also examined scenarios where resources are prioritized to reach new patients or retain of existing patients from 2023 to 2025 before all services return to pre-COVID levels. RESULTS The annual number of MSM prescribed PrEP, newly acquired HIV, newly diagnosed, and achieving viral load suppression (VLS) rebound quickly after HIV care returns to pre-COVID levels. However, COVID-19 service disruptions result in measurable reductions in cumulative PrEP use, VLS person-years, incidence, and an increase in deaths over the 2020-2035 period. The burden is statistically significantly larger if these effects end in 2025 instead of 2022. Prioritizing HIV care/prevention initiation over retention results in more person-years of PrEP but less VLS person-years and more deaths, influencing EHE PrEP outcomes. CONCLUSIONS Earlier HIV care return to pre-COVID levels results in lower cumulative HIV burdens. Resource prioritization decisions may differentially affect different EHE goals.
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Affiliation(s)
- Citina Liang
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California Viterbi School of Engineering, LA
| | - Sze-Chuan Suen
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California Viterbi School of Engineering, LA
| | - Anthony Nguyen
- Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California Viterbi School of Engineering, LA
| | - Corrina Moucheraud
- Department of Health Policy and Management, University of California Los Angeles Fielding School of Public Health, LA.,The Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), University of California Los Angeles, Los Angeles, CA
| | - Ling Hsu
- San Francisco Department of Public Health, HIV Surveillance Unit, San Francisco, CA
| | - Ian W Holloway
- The Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), University of California Los Angeles, Los Angeles, CA.,Department of Social Welfare, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA; and
| | - Edwin D Charlebois
- Department of Medicine, University of California, San Francisco, San Francisco, CA
| | - Wayne T Steward
- Department of Medicine, University of California, San Francisco, San Francisco, CA
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28
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Nguyen A, Khafagy R, Gao Y, Meerasa A, Roshandel D, Anvari M, Lin B, Cherney DZI, Farkouh ME, Shah BR, Paterson AD, Dash S. Association Between Obesity and Chronic Kidney Disease: Multivariable Mendelian Randomization Analysis and Observational Data From a Bariatric Surgery Cohort. Diabetes 2023; 72:496-510. [PMID: 36657976 DOI: 10.2337/db22-0696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/10/2023] [Indexed: 01/21/2023]
Abstract
Obesity is postulated to independently increase chronic kidney disease (CKD), even after adjusting for type 2 diabetes (T2D) and hypertension. Dysglycemia below T2D thresholds, frequently seen with obesity, also increases CKD risk. Whether obesity increases CKD independent of dysglycemia and hypertension is unknown and likely influences the optimal weight loss (WL) needed to reduce CKD. T2D remission rates plateau with 20-25% WL after bariatric surgery (BS), but further WL increases normoglycemia and normotension. We undertook bidirectional inverse variance weighted Mendelian randomization (IVWMR) to investigate potential independent causal associations between increased BMI and estimated glomerular filtration rate (eGFR) in CKD (CKDeGFR) (<60 mL/min/1.73 m2) and microalbuminuria (MA). In 5,337 BS patients, we assessed whether WL influences >50% decline in eGFR (primary outcome) or CKD hospitalization (secondary outcome), using <20% WL as a comparator. IVWMR results suggest that increased BMI increases CKDeGFR (b = 0.13, P = 1.64 × 10-4; odds ratio [OR] 1.14 [95% CI 1.07, 1.23]) and MA (b = 0.25; P = 2.14 × 10-4; OR 1.29 [1.13, 1.48]). After adjusting for hypertension and fasting glucose, increased BMI did not significantly increase CKDeGFR (b = -0.02; P = 0.72; OR 0.98 [0.87, 1.1]) or MA (b = 0.19; P = 0.08; OR 1.21 [0.98, 1.51]). Post-BS WL significantly reduced the primary outcome with 30 to <40% WL (hazard ratio [HR] 0.53 [95% CI 0.32, 0.87]) but not 20 to <30% WL (HR 0.72 [0.44, 1.2]) and ≥40% WL (HR 0.73 [0.41, 1.30]). For CKD hospitalization, progressive reduction was seen with increased WL, which was significant for 30 to <40% WL (HR 0.37 [0.17, 0.82]) and ≥40% WL (HR 0.24 [0.07, 0.89]) but not 20 to <30% WL (HR 0.60 [0.29, 1.23]). The data suggest that obesity is likely not an independent cause of CKD. WL thresholds previously associated with normotension and normoglycemia, likely causal mediators, may reduce CKD after BS.
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Affiliation(s)
- Anthony Nguyen
- Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Rana Khafagy
- Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Divisions of Epidemiology and Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Yiding Gao
- Division of Endocrinology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Ameena Meerasa
- Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Delnaz Roshandel
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mehran Anvari
- Department of Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada
| | - Boxi Lin
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - David Z I Cherney
- Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | - Michael E Farkouh
- Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Baiju R Shah
- Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
- Division of Endocrinology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Andrew D Paterson
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Divisions of Epidemiology and Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Satya Dash
- Department of Medicine, University Health Network and University of Toronto, Toronto, Ontario, Canada
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Loethen A, Lavelle R, Sadzak M, Bucio J, Sarswat N, Chung B, Smith B, Kalantari S, Grinstein J, Nguyen A, Belkin M, Murks C, Riley T, Powers J, Jones A, Kim G, Pinney S. Use of Complement-Fixing Assays to Expand the Donor Pool for Highly Sensitized Heart Transplant Recipients - The Role of C1q Testing. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1659] [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: 04/05/2023] Open
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30
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Patel S, Uriel N, Nguyen A, Silvia B, Wolf-Doty T, Tian W, Qu K, Pinney S. Relationship Between Absolute Quantification of Donor-Derived Cell-Free DNA and Donor-Derived Cell-Free DNA Fraction for Detection of Allograft Rejection in Heart Transplant Patients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1107] [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: 04/05/2023] Open
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31
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Guertin MP, Lee Y, Stewart SJ, Ramirez J, Nguyen A, Paraliticci G, Pretell-Mazzini JA. Soft Tissue Sarcomas in Octogenarian Patients: Are Treatment Options and Oncological Outcomes Different? A SEER Retrospective Study. Clin Oncol (R Coll Radiol) 2023; 35:269-277. [PMID: 36710153 DOI: 10.1016/j.clon.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
AIMS As the US population continues to age, oncological strategies and outcomes for soft tissue sarcomas (STSs) should continue to be examined for varying age groups. The aim of this study was analyse and compare treatment strategies and oncological outcomes for octogenarian patients with STSs. MATERIALS AND METHODS Data from the Surveillance, Epidemiology and End Results (SEER) national database were used. Varying treatment modalities were studied when utilised for specific tumour staging with respect to the eighth edition of the American Joint Committee on Cancer. RESULTS In total, 24 666 patients were included for analysis, where 3341 (14%) were 80 years old or older. The octogenarian group was diagnosed with more advanced disease (stages II-IV), relative to their younger counterparts (85% versus 75%, P < 0.001). However, a smaller proportion of the older patients underwent surgical resection (74% versus 86%, P < 0.001). Likewise, the octogenarians received less chemotherapy (4% versus 21%, P < 0.001) and radiotherapy (29% versus 42%, P = 0.010). Surgical resection and chemotherapy significantly improved overall survival for those older patients with stage II STS, whereas surgical resection and radiotherapy improved mortality in this cohort with both stage III and IV STS. Overall survival at 1 and 5 years of follow-up was lower within the octogenarian group compared with the younger group (1 year: 68% versus 88%, P < 0.001 and 5 years: 7% versus 58%, P < 0.001). CONCLUSIONS Octogenarian patients, in most cases, are diagnosed with stage III or metastatic disease. Surgical resection of the primary tumour was beneficial in both age cohorts, with radiotherapy correlating to better overall survival when used in those patients with higher stage STS. Chemotherapy was associated with better mortality in the younger cohort with respect to tumour stage. The octogenarian overall survival at 1 and 5 years was lower than for younger patients.
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Affiliation(s)
- M P Guertin
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
| | - Y Lee
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - S J Stewart
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - J Ramirez
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - A Nguyen
- University of Illinois College of Medicine, Chicago, Illinois, USA
| | - G Paraliticci
- Musculoskeletal Oncology Division, Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA
| | - J A Pretell-Mazzini
- Musculoskeletal Oncology Division, Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA
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Lavelle R, Loethen A, Murks C, Riley T, Powers J, Jones A, Belkin M, Nguyen A, Grinstein J, Chung B, Kalantari S, Smith B, Sarswat N, Kim G, Pinney S. Impact of Early Belatacept Use on 1-Year CAV Progression in Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1358] [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: 04/05/2023] Open
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Watanabe T, Nemoto A, Nguyen A, Grinstein J, Chung B, Smith B, Kalantari S, Sarswat N, Kim G, Pinney S, Onsager D, Song T, Salerno C, Jeevanandam V, Ota T. Impact on Non-Cardiac Surgery for Patients with Lvad Support. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1585] [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: 04/05/2023] Open
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34
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Han J, Nguyen A, Tian W, Nguyen A, Zeng J, Shen L, DePasquale E, Patel S. Effect of Pre-Transplant Sensitization on Gene Expression Profiling and Donor Derived Cell Free DNA Results. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.572] [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: 04/05/2023] Open
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35
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Loethen A, Lavelle R, Sarswat N, Chung B, Smith B, Kalantari S, Grinstein J, Nguyen A, Belkin M, Murks C, Riley T, Powers J, Jones A, Kim G, Pinney S. Efficacy and Tolerability of Belatacept in Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.179] [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: 04/05/2023] Open
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Han J, Dela Cruz M, Lin H, Adler E, Khalid M, Cantoral J, Moran A, Sundararajan A, Sidebottom A, Alegre M, Pamer E, Nguyen A. Pre-Transplant Sensitization is Associated with Lower Levels of Immunomodulatory Metabolite Concentrations after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1657] [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: 04/05/2023] Open
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Han J, Nguyen A, Zhou M, Nguyen A, Fu Y, Shen L, Patel S, DePasquale E. Association of Early Testing of Donor Derived Cell-Free DNA with the Risk of Antibody Mediated Rejection in Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1581] [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: 04/05/2023] Open
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Loethen A, Lavelle R, Sarswat N, Chung B, Smith B, Kalantari S, Grinstein J, Nguyen A, Belkin M, Kim G, Pinney S. Successful Use of Carfilzomib and Belatacept to Lower Alloantibodies Prior to Heart Transplant: A Case Series. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1359] [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: 04/05/2023] Open
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Nemoto A, Belkin M, Sarswat N, Chung B, Nguyen A, Smith B, Kalantari S, Kim G, Grinstein J, Pinney S, Onsager D, Song T, Salerno C, Jeevanandam V, Ota T. Impact of Surgical Techniques on Survival and Hemodynamics after Orthotopic Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1535] [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: 04/05/2023] Open
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Massager N, Nguyen A, Pouleau HB, Dethy S, Morelli D. Deviation of DBS Recording Microelectrodes during Insertion Assessed by Intraoperative CT. Stereotact Funct Neurosurg 2023:1-9. [PMID: 36996782 DOI: 10.1159/000528202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/13/2022] [Indexed: 04/01/2023]
Abstract
INTRODUCTION Intraoperative microelectrodes recording with the Ben Gun microdrive system are often used during DBS surgery. An accurate location of these microelectrodes will directly influence the interest of this recording. We have studied the imprecision of implantation of these microelectrodes. METHODS We have analyzed the stereotactic position of 135 microelectrodes implanted with the Ben Gun microdrive during DBS surgery of 16 patients with advanced Parkinson's disease. An intracranial CT was obtained and integrated to a stereotactic planification system. We recorded the stereotactic coordinates of the 5 microelectrodes inserted simultaneously in a cross-shape. The coordinates of each microelectrode were compared with coordinates of the other 4 electrodes inserted simultaneously with the Ben Gun and visible on the same iCT image. Thus, this procedure avoids errors from image fusion and from brain shift. We calculate (1) the three-dimensional Euclidian deviation of microelectrodes, (2) the deviation in X- and Y-axes on reconstructed probe's eye view MR images, and (3) the deviation from the 2-mm theoretical distance between the central electrode and 4 satellite microelectrodes. RESULTS The median deviation was 0.64 mm in 3-D and 0.58 mm in 2-D probe's eye view. Satellite electrodes were located from the central electrode theoretically at 2.0 mm and practically within the range 1.9-2.1 mm, 1.5-2.5 mm, 1.0-3.0 mm, and 0.5-3.5 mm for, respectively, 9.3%, 53.7%, 88.0%, and 98.1%, thus highlighting the significant deviation from the theoretical distance. Position imprecisions were similar for the 4 satellite microelectrodes. The imprecision was similar in X-axis and Y-axes and statistically less in Z-axis. For bilateral implantation, the second implantation of the same patient was not associated with a greater risk of deviation of the microelectrodes than for the first side implanted. CONCLUSION A significant percentage of microelectrodes for MER can deviate substantially from their theoretical target during DBS procedures. An iCT can be used to estimate the potential deviation of microelectrodes and improve the interpretation of MER during the procedure.
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Affiliation(s)
- Nicolas Massager
- Department of Neurological Surgery, University Hospital Tivoli, La Louvière, Belgium
- Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Anthony Nguyen
- Department of Neurological Surgery, University Hospital Tivoli, La Louvière, Belgium
- Department of Neurology, University Hospital Tivoli, La Louvière, Belgium
| | | | - Sophie Dethy
- Faculty of Medicine, Université Libre de Bruxelles, Bruxelles, Belgium
- Department of Neurology, University Hospital Tivoli, La Louvière, Belgium
| | - Daniele Morelli
- Department of Neurological Surgery, University Hospital Tivoli, La Louvière, Belgium
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Liang B, Zhang Y, Lyon K, Soto JM, Nguyen A, Huang JH, Feng D. Successful Management of Iatrogenic Cranial Pseudomeningocele With Subgaleal Shunt. Cureus 2023; 15:e34513. [PMID: 36874315 PMCID: PMC9984227 DOI: 10.7759/cureus.34513] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Iatrogenic pseudomeningocele is a common complication of cranial surgeries. However, there are no evidence-based guidelines on how to manage this condition. We report two cases of iatrogenic postoperative cranial pseudomeningocele that failed conservative management including compressive head dressing. Subgaleal shunt placement was utilized with successful resolution in both cases. We postulate that subgaleal shunt placement may be an effective method in the management of iatrogenic subgaleal pseudomeningocele.
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Affiliation(s)
- Buqing Liang
- Neurosurgery, Baylor Scott & White Health, Temple, USA
| | - Yilu Zhang
- Neurosurgery, Baylor Scott & White Health, Temple, USA
| | | | - Jose M Soto
- Neurosurgery, Baylor Scott & White Health, Temple, USA
| | | | - Jason H Huang
- Neurosurgery, Baylor Scott & White Health, Temple, USA
| | - Dongxia Feng
- Neurosurgery, Baylor Scott & White Health, Temple, USA
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Gearhart S, Nguyen A, Vance AZ. Cerebral Fat Embolism Syndrome in a Patient With an Aortic Dissection and Orthopedic Injuries: A Case Report. Cureus 2023; 15:e34500. [PMID: 36874307 PMCID: PMC9981479 DOI: 10.7759/cureus.34500] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 01/22/2023] [Indexed: 02/04/2023] Open
Abstract
Traumatic brain injury is a significant cause of morbidity and mortality in adults and can be associated with severe secondary complications, including post-traumatic cerebral infarction. One potential cause of post-traumatic cerebral infarction is cerebral fat embolism syndrome (FES). We present a case in which a male in his twenties was involved in a motorcycle collision with a truck. He sustained numerous injuries, including bilateral femur fractures, left acetabular, open left tibial and fibular fractures, and a type A aortic dissection. Before orthopedic fixation, his Glasgow Coma Score (GCS) was 10. Following open reduction and internal fixation, his GCS was noted to be 4, with a stable computed tomography scan of the head. The differential included embolic strokes related to his dissection, an unrecognized cervical spine injury, and cerebral FES. Stat magnetic resonance imaging of the head demonstrated a starfield pattern of restricted diffusion consistent with cerebral FES. An intracranial pressure (ICP) monitor was placed, and his ICP acutely spiked to over 100 mmHg despite maximal medical management. This case highlights several key learning points, namely, that cerebral FES should remain in the mind of any physician treating high-energy multisystem traumas. While it is a rare syndrome, its effects can lead to significant morbidity and mortality as treatment is controversial and can conflict with the treatment of other systemic injuries. Further research into prevention and treatment is warranted to continue optimizing outcomes following cerebral FES.
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Affiliation(s)
- Samuel Gearhart
- Neurosurgery, Baylor Scott & White Medical Center - Temple, Temple, USA
| | - Anthony Nguyen
- Neurosurgery, Baylor Scott & White Medical Center - Temple, Temple, USA
| | - Awais Z Vance
- Neurosurgery, Baylor Scott & White Medical Center - Temple, Temple, USA
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Jeon WJ, Nguyen J, Castillo DR, Park K, Brothers J, Nguyen A, Mirshahidi H. Recurrent and atypical immune checkpoint inhibitor-induced pneumonitis. J Oncol Pharm Pract 2023:10781552221150936. [PMID: 36648206 DOI: 10.1177/10781552221150936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Pembrolizumab (Keytruda) is a monoclonal antibody against the programmed cell death-1 (PD-1) receptor on lymphocytes, which is one of the immune checkpoint inhibitors (ICIs) approved for multiple solid and hematologic malignancies. Although ICIs have proven to be more effective and less toxic compared to chemotherapy, there are reports of adverse side effects with ICIs. For example, pneumonitis is a potentially lethal side effect occurring in 1%-5% of patients who received ICIs in clinical trials, and there are case reports with clinical and radiological features of checkpoint inhibitor-pneumonitis (CIP). CASE REPORT We report an unusual case of pneumonitis with atypical imaging in a patient who received pembrolizumab for metastatic p16-positive squamous cell carcinoma of the base of the tongue. We discuss the approach to the recognition and management of atypical CIP in patients on pembrolizumab with the intent to standardize workup and increase awareness among healthcare providers in the new era of immunotherapy. MANAGEMENT AND OUTCOME Serologic workup including laboratory studies for complete blood count (CBC), lactate, procalcitonin, SARS-CoV-2 (COVID-19), Legionella, Cytomegalovirus (CMV), Coccidioides, Coxiella, and viral respiratory panel were negative for infectious processes. Since CIP was suspected, the patient was started on steroid therapy. Interval computed tomography (CT) of the chest without contrast showed a resolution of pneumonitis. DISCUSSION In this case report, we discuss our workup of CIP and initial testing to rule out other possible causes of the patient's symptoms and radiographic findings, and management of the patient's diagnosis of atypical CIP which led to complete clinical recovery from CIP.
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Affiliation(s)
- Won Jin Jeon
- Department of Internal Medicine, Department of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Jasmine Nguyen
- Department of Internal Medicine, Department of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Dani Ran Castillo
- Department of Oncology/Hematology, Department of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Kiwon Park
- Department of Pharmacy, Loma Linda University, Loma Linda, CA, USA
| | - Joel Brothers
- Department of Oncology/Hematology, Department of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Anthony Nguyen
- Department of Oncology/Hematology, UC San Diego Health, La Jolla, San Diego, CA, USA
| | - Hamid Mirshahidi
- Department of Oncology/Hematology, Department of Medicine, Loma Linda University, Loma Linda, CA, USA
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Hussain N, Boulos R, Malik TM, Abd-Elsayed A, Essandoh MK, Khan S, Nguyen A, Weaver TE. Identifying Predictors for Early Percutaneous Spinal Cord Stimulator Explant at One and Two Years: A Retrospective Database Analysis. Neuromodulation 2023; 26:124-130. [PMID: 35367127 DOI: 10.1016/j.neurom.2022.01.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 10/15/2021] [Revised: 12/06/2021] [Accepted: 01/11/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Placement of percutaneous spinal cord stimulator (SCS) implant has become a therapeutic option for various chronic pain conditions; however, early surgical explant still occurs. Unfortunately, evidence regarding the incidence of early surgical explant, and patient-specific factors and comorbidities associated with such, is limited and mixed. The objective of this retrospective analysis was to elucidate the incidence and predictors of percutaneous SCS explant within the first two years of device placement. MATERIALS AND METHODS The PearlDiver-Mariner Patient Record Database of all payer claims was used to identify patients who underwent percutaneous lead SCS implant (leads and generator) with subsequent explant within two years of initial device implant. The primary outcome was to determine the incidence of SCS explant within the first two years of device placement. Secondary outcomes included evaluating the effects of several patient-specific comorbidities on explant rates using univariate regression analysis. RESULTS Across the database, a total of 52,070 patients who underwent percutaneous lead SCS implant were included, of whom 3104 (5.96%) had SCS explant within the first two years. Most explants occurred within the first-year time interval at 72.8% (2260 patients), whereas only 27.2% (844 patients) had SCS explant between years one and two. At the one-year time interval, covariates associated with an increased odds ratio (OR) (95% CI) of SCS explant were 1) depression (1.39 [1.26, 1.52]), 2) chronic preoperative (1.27 [1.16, 1.39]) or postoperative (1.23 [1,13, 1.36]) opioid use, 3) cannabis abuse (1.58 [1.20, 2.02]), 4) tobacco use (1.13 [1.04, 1.23]), and 5) coagulopathy (1.22 [1.07, 1.38]). In contrast, the OR of explant was lower in patients who were older, men, or had diabetes (complicated or uncomplicated). All associated covariates became nonsignificant after the first year of SCS implant (ie, between the first and second years), and only depression and tobacco use remained as associated factors for device explant. CONCLUSIONS Our retrospective analysis highlights that the rate of percutaneous SCS explant appears to considerably decrease after the first year of device implant. Furthermore, this analysis sheds additional insights into patients who may be at risk of early percutaneous SCS explant, especially within the first year of device placement, and underscores the importance of a continued multidimensional/biopsychologic assessment in patients with chronic pain.
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Affiliation(s)
- Nasir Hussain
- Department of Anesthesiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Racha Boulos
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Tarik M Malik
- Department of Pain Medicine, University of Chicago, Chicago, IL, USA
| | - Alaa Abd-Elsayed
- Department of Anesthesiology and Pain Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Michael K Essandoh
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Safdar Khan
- Department of Orthopedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Anthony Nguyen
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Tristan E Weaver
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Nguyen A, Khafagy R, Hashemy H, Kuo KHM, Roshandel D, Paterson AD, Dash S. Investigating the association between fasting insulin, erythrocytosis and HbA1c through Mendelian randomization and observational analyses. Front Endocrinol (Lausanne) 2023; 14:1146099. [PMID: 37008938 PMCID: PMC10064082 DOI: 10.3389/fendo.2023.1146099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Insulin resistance (IR) with associated compensatory hyperinsulinemia (HI) are early abnormalities in the etiology of prediabetes (preT2D) and type 2 diabetes (T2D). IR and HI also associate with increased erythrocytosis. Hemoglobin A1c (HbA1c) is commonly used to diagnose and monitor preT2D and T2D, but can be influenced by erythrocytosis independent of glycemia. METHODS We undertook bidirectional Mendelian randomization (MR) in individuals of European ancestry to investigate potential causal associations between increased fasting insulin adjusted for BMI (FI), erythrocytosis and its non-glycemic impact on HbA1c. We investigated the association between the triglyceride-glucose index (TGI), a surrogate measure of IR and HI, and glycation gap (difference between measured HbA1c and predicted HbA1c derived from linear regression of fasting glucose) in people with normoglycemia and preT2D. RESULTS Inverse variance weighted MR (IVWMR) suggested that increased FI increases hemoglobin (Hb, b=0.54 ± 0.09, p=2.7 x 10-10), red cell count (RCC, b=0.54 ± 0.12, p=5.38x10-6) and reticulocyte (RETIC, b=0.70 ± 0.15, p=2.18x10-6). Multivariable MR indicated that increased FI did not impact HbA1c (b=0.23 ± 0.16, p=0.162) but reduced HbA1c after adjustment for T2D (b=0.31 ± 0.13, p=0.016). Increased Hb (b=0.03 ± 0.01, p=0.02), RCC (b=0.02 ± 0.01, p=0.04) and RETIC (b=0.03 ± 0.01, p=0.002) might modestly increase FI. In the observational cohort, increased TGI associated with decreased glycation gap, (i.e., measured HbA1c was lower than expected based on fasting glucose, (b=-0.09 ± 0.009, p<0.0001)) in people with preT2D but not in those with normoglycemia (b=0.02 ± 0.007, p<0.0001). CONCLUSIONS MR suggests increased FI increases erythrocytosis and might potentially decrease HbA1c by non-glycemic effects. Increased TGI, a surrogate measure of increased FI, associates with lower-than-expected HbA1c in people with preT2D. These findings merit confirmatory studies to evaluate their clinical significance.
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Affiliation(s)
- Anthony Nguyen
- Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Rana Khafagy
- Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON, Canada
- Divisions of Epidemiology and Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Habiba Hashemy
- Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Kevin H. M. Kuo
- Division of Medical Oncology and Haematology, Department of Medicine, University Health Network, Toronto, ON, Canada
- Division of Haematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Delnaz Roshandel
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Andrew D. Paterson
- Genetics and Genome Biology Program, The Hospital for Sick Children, Toronto, ON, Canada
- Divisions of Epidemiology and Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Satya Dash
- Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
- *Correspondence: Satya Dash,
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Nguyen A, Draggoo B, Tobias B, DuBose P, Polasek K. Electrically-evoked referred sensations induce embodiment of rubber limb. J Rehabil Assist Technol Eng 2023; 10:20556683231183633. [PMID: 37426038 PMCID: PMC10328156 DOI: 10.1177/20556683231183633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 06/06/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Electrical stimulation is increasingly relevant in a variety of medical treatments. In this study, the quality of referred sensations evoked using surface electrical stimulation was evaluated using the rubber hand and foot illusions. Methods The rubber hand and foot illusions were attempted under 4 conditions: (1) multi-location tapping; (2) one-location tapping; (3) electrical stimulation of sensation referred to the hand or foot; (4) asynchronous control. The strength of each illusion was quantified using a questionnaire and proprioceptive drift, where a stronger response suggested embodiment of the rubber limb. Results 45 able-bodied individuals and two individuals with amputations participated in this study. Overall, the illusion evoked by nerve stimulation was not as strong as illusions evoked by physically tapping but stronger than the control illusion. Conclusion This study has found that the rubber hand and foot illusion can be performed without touching the distal limb of the participant. Electrical stimulation that produced referred sensation in the distal extremity was realistic enough to partially incorporate the rubber limb into a person's body image.
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Affiliation(s)
- Anthony Nguyen
- Department of Engineering, Hope College, Holland, MI, USA
| | - Brooke Draggoo
- Department of Engineering, Hope College, Holland, MI, USA
| | | | - Payton DuBose
- Department of Engineering, Hope College, Holland, MI, USA
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St Clair B, Jorgensen M, Nguyen A, Georgiou A. A Scoping Review of Adverse Incidents Research in Aged Care Homes: Learnings, Gaps, and Challenges. Gerontol Geriatr Med 2022; 8:23337214221144192. [PMID: 36568485 PMCID: PMC9772958 DOI: 10.1177/23337214221144192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background: Adverse incidents are well studied within acute care settings, less so within aged care homes. The aim of this scoping review was to define the types of adverse incidents studied in aged care homes and highlight strengths, gaps, and challenges of this research. Methods: An expanded definition of adverse incidents including physical, social, and environmental impacts was used in a scoping review based on the PRISMA Extension for Scoping Reviews Checklist. MEDLINE, CINAHL, and EBSCOhost were searched for English language, peer-reviewed studies conducted in aged care home settings between 2000 and 2020. Forty six articles across 12 countries were identified, charted, and analyzed using descriptive statistics and narrative summary methods. Results: Quantitative studies (n = 42, 91%) dominated adverse incidents literature. The majority of studies focused on physical injuries (n = 29, 63%), with fewer examining personal/interpersonal (15%) and environmental factors (22%). Many studies did not describe the country's aged care system (n = 26, 56%). Only five studies (11%) included residents' voices. Discussion: This review highlights a need for greater focus on resident voices, qualitative research, and interpersonal/environmental perspectives in adverse event research in aged care homes. Addressing these gaps, future research may contribute to better understanding of adverse incidents within this setting.
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Affiliation(s)
- B. St Clair
- Macquarie University, Sydney, NSW, Australia,B. St Clair, Faculty of Medicine and Health Sciences, Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW 2109, Australia.
| | | | - A. Nguyen
- Macquarie University, Sydney, NSW, Australia,UNSW Sydney, NSW, Australia
| | - A. Georgiou
- Macquarie University, Sydney, NSW, Australia
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Kapuria D, Gangu K, Chourasia P, Boba A, Nguyen A, Ryu M, Peicher M, Flores M, Chela HK, Daglilar ES, Sheikh AB, Shekhar R. COVID-19 Alcoholic Cirrhosis and Non-Alcoholic Steatohepatitis Cirrhosis Outcomes among Hospitalized Patients in the United States: Insight from National Inpatient Sample Database. Trop Med Infect Dis 2022; 7:421. [PMID: 36548676 PMCID: PMC9786037 DOI: 10.3390/tropicalmed7120421] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Patients with co-morbidities like cirrhosis are at risk of worse outcome from COVID-19 infection. Given limited prior studies, we evaluated outcomes associated with COVID-19 infection in alcoholic and non-alcoholic steatohepatitis cirrhotic (CC+) versus cirrhotic without COVID-19 (CC−). We performed retrospective analysis of 822,604 patients including 28,610 COVID-19 patients from the National Inpatient Sample database with alcoholic and NASH cirrhosis enrolled between 1 January 2020 to 31 December 2020, with univariate and multivariate regression analyses. Primary outcome was mortality and secondary outcomes was mechanical ventilation, vasopressor use, length of stay, hospitalization expense and predictors of mortality. In-hospital mortality was three time higher in the CC+ group compared to those in the CC− group(18.6% vs. 5.96%, p < 0.001, adjusted odds ratio (OR)3.39 (95% 3.08−3.74 CI). Hospitalization was more likely for underrepresented racial and ethnic groups with COVID-19 and cirrhosis. CC+ group had over twice the rates of mechanical ventilation (19.92% vs. 9.07%, adjusted OR 2.71 2.71 (95% 2.51−2.93 CI)),1.7 times likelihood of receiving vasopressors (4.12% vs. 2.45%, p < 0.001, adjusted OR 1.71 (95% CI 1.46−2.01). COVID-19 is associated with increased mortality in patients with alcoholic and NASH cirrhosis, and patients with alcoholic cirrhosis and COVID-19 have a slightly higher mortality compared to NASH cirrhosis.
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Affiliation(s)
- Devika Kapuria
- Division of Gastroenterology, Washington University, St. Louis, MO 63130, USA
| | - Karthik Gangu
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Prabal Chourasia
- Department of Hospital Medicine, Mary Washington Hospital, Fredericksburg, VA 22401, USA
| | - Aniesh Boba
- Department of Medicine, John H Stronger Hospital, Cook County, Chicago, IL 60612, USA
| | - Anthony Nguyen
- Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Moon Ryu
- Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Mark Peicher
- Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Mario Flores
- Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Harleen Kaur Chela
- Department of Internal Medicine, Division of Gastroenterology, Charleston, WV 26506, USA
| | - Ebubekir S. Daglilar
- Department of Internal Medicine, Division of Gastroenterology, Charleston, WV 26506, USA
| | - Abu Baker Sheikh
- Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
| | - Rahul Shekhar
- Division of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM 87106, USA
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Lavergne A, Dumont A, Deshayes S, Boutemy J, Maigné G, Martin-Silva N, Nguyen A, Aouba A, De Boysson H. Évaluation dans des conditions de vie réelle de l’efficacité et de la tolérance du méthotrexate dans l’artérite à cellules géantes. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.119] [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: 12/12/2022]
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50
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Dumont A, Labombarda F, Gallou S, Deshayes S, Nguyen A, Boutemy J, Martin-Silva N, Maigné G, Aouba A, De Boysson H. Effet préventif des bêta-bloquants sur le développement d’une dilatation aortique dans l’artérite à cellules géantes associée à une aortite. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.117] [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: 12/12/2022]
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