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Gupta A, Tran D, Nguyen D, Bridwell E, Thompson H, Ahmed F, Brueckner-Collins JK, Frieboes H, Kim I, Spurlin B. Bluegrass Biodesign: Why an Integrated Biomedical Engineering Curriculum is Crucial for Medical Education. Cureus 2023; 15:e47261. [PMID: 38021638 PMCID: PMC10655623 DOI: 10.7759/cureus.47261] [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] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background Medical education often overlooks the significance of design and innovation literacy, resulting in a knowledge gap in undergraduate medical education (UME) regarding formal training in these areas. Incorporating innovation into UME's core curriculum is crucial as future physicians will encounter evolving technologies, and fostering a transdisciplinary approach can enable collaborative problem-solving and improve patient health outcomes. Methodology We developed a comprehensive medical biodesign curriculum focused on innovation, including problem identification, prototype testing, and product commercialization. Participants were selected based on applications, interviews, and diverse criteria. A survey was conducted before and after the program to assess students' biodesign experiences and knowledge, with data analyzed using descriptive statistics and paired t-tests. Results Of the 41 participants, 24 (58.5%) completed both pre- and post-program surveys. These five-point Likert surveys showed a significant shift from pre-program to responses demonstrating increased "comfort levels in explaining and applying biodesign principles" (p < 0.0001). Specifically, the "comfort level in taking a product to market" increased from 33% to 67% (p = 0.01), while the "comfort level in applying the biodesign process" increased from 29% to 92% (p < 0.0001). Moreover, 58.3% of participants expressed interest in continuing their current projects, and 70.8% of students stated feeling confident in generating ideas and solutions with their team members. Conclusions The medical biodesign curriculum demonstrated success in exposing undergraduate medical and engineering students to the concepts of medical innovation and biodesign. The program has led to a significant improvement in students' knowledge and comfort levels in applying the biodesign process and taking a product to market. The high level of interest and participation in the program highlight the need for incorporating innovative training in UME to foster creativity and prepare future physicians to contribute to the advancements in healthcare.
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Affiliation(s)
- Ankur Gupta
- Department of Medical Education, University of Louisville School of Medicine, Louisville, USA
| | - Danh Tran
- Department of Emergency Medicine, Duke University, Durham, USA
| | - Daniel Nguyen
- Department of Medical Education, University of Louisville School of Medicine, Louisville, USA
| | - Elizabeth Bridwell
- Department of Medical Education, University of Louisville School of Medicine, Louisville, USA
| | - Hanna Thompson
- Department of Medical Education, University of Louisville School of Medicine, Louisville, USA
| | - Faizan Ahmed
- Department of Medical Education, University of Louisville School of Medicine, Louisville, USA
| | - Jennifer K Brueckner-Collins
- Department of Anatomical Sciences and Neurobiology, University of Louisville School of Medicine, Louisville, USA
| | - Hermann Frieboes
- Department of Bioengineering, University of Louisville, Louisville, USA
| | - In Kim
- Department of Pediatric Emergency Medicine, University of Louisville School of Medicine, Louisville, USA
| | - Beth Spurlin
- Department of Pediatric Emergency Medicine, University of Louisville School of Medicine, Louisville, USA
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Schulze A, Tran D, Daum MTJ, Kisilenko A, Maier-Hein L, Speidel S, Distler M, Weitz J, Müller-Stich BP, Bodenstedt S, Wagner M. Ensuring privacy protection in the era of big laparoscopic video data: development and validation of an inside outside discrimination algorithm (IODA). Surg Endosc 2023:10.1007/s00464-023-10078-x. [PMID: 37145173 PMCID: PMC10338566 DOI: 10.1007/s00464-023-10078-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/10/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Laparoscopic videos are increasingly being used for surgical artificial intelligence (AI) and big data analysis. The purpose of this study was to ensure data privacy in video recordings of laparoscopic surgery by censoring extraabdominal parts. An inside-outside-discrimination algorithm (IODA) was developed to ensure privacy protection while maximizing the remaining video data. METHODS IODAs neural network architecture was based on a pretrained AlexNet augmented with a long-short-term-memory. The data set for algorithm training and testing contained a total of 100 laparoscopic surgery videos of 23 different operations with a total video length of 207 h (124 min ± 100 min per video) resulting in 18,507,217 frames (185,965 ± 149,718 frames per video). Each video frame was tagged either as abdominal cavity, trocar, operation site, outside for cleaning, or translucent trocar. For algorithm testing, a stratified fivefold cross-validation was used. RESULTS The distribution of annotated classes were abdominal cavity 81.39%, trocar 1.39%, outside operation site 16.07%, outside for cleaning 1.08%, and translucent trocar 0.07%. Algorithm training on binary or all five classes showed similar excellent results for classifying outside frames with a mean F1-score of 0.96 ± 0.01 and 0.97 ± 0.01, sensitivity of 0.97 ± 0.02 and 0.0.97 ± 0.01, and a false positive rate of 0.99 ± 0.01 and 0.99 ± 0.01, respectively. CONCLUSION IODA is able to discriminate between inside and outside with a high certainty. In particular, only a few outside frames are misclassified as inside and therefore at risk for privacy breach. The anonymized videos can be used for multi-centric development of surgical AI, quality management or educational purposes. In contrast to expensive commercial solutions, IODA is made open source and can be improved by the scientific community.
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Affiliation(s)
- A Schulze
- Department for General, Visceral and Transplant Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- National Center for Tumor Diseases, Heidelberg, Germany
| | - D Tran
- Department for General, Visceral and Transplant Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- National Center for Tumor Diseases, Heidelberg, Germany
| | - M T J Daum
- Department for General, Visceral and Transplant Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- National Center for Tumor Diseases, Heidelberg, Germany
| | - A Kisilenko
- Department for General, Visceral and Transplant Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany
- National Center for Tumor Diseases, Heidelberg, Germany
| | - L Maier-Hein
- Division of Intelligent Medical Systems, German Cancer Research Center (Dkfz), Heidelberg, Germany
| | - S Speidel
- Department for Translational Surgical Oncology, National Center for Tumor Diseases, Partner Site Dresden, Dresden, Germany
- Center for the Tactile Internet With Human in the Loop (CeTI), Technische Universität Dresden, Dresden, Germany
| | - M Distler
- Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J Weitz
- Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - B P Müller-Stich
- Clarunis, University Center for Gastrointestinal and Liver Disease, Basel, Switzerland
| | - S Bodenstedt
- Department for Translational Surgical Oncology, National Center for Tumor Diseases, Partner Site Dresden, Dresden, Germany
- Center for the Tactile Internet With Human in the Loop (CeTI), Technische Universität Dresden, Dresden, Germany
| | - M Wagner
- Department for General, Visceral and Transplant Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Germany.
- National Center for Tumor Diseases, Heidelberg, Germany.
- Center for the Tactile Internet With Human in the Loop (CeTI), Technische Universität Dresden, Dresden, Germany.
- Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
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Tran D, Nguyen DH, Nguyen HK, Nguyen-Thanh VA, Dong-Van H, Nguyen MD. Diagnostic performance of MRI perfusion and spectroscopy for brainstem glioma grading. Eur Rev Med Pharmacol Sci 2022; 26:7938-7948. [PMID: 36394742 DOI: 10.26355/eurrev_202211_30145] [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: 06/16/2023]
Abstract
OBJECTIVE This study investigated the roles of dynamic susceptibility contrast (DSC) perfusion and multivoxel magnetic resonance spectroscopy (MRS) in grading brainstem glioma (BSG). PATIENTS AND METHODS Our retrospective study comprised 12 patients, including 6 with pathology verified low-grade BSGs and 6 with high-grade BSGs. We examined differences in age, relative cerebral blood volume (rCBV), regional cerebral blood flow (rCBF), and the metabolite ratios of choline (Cho)/N-acetyl aspartate (NAA) and Cho/creatine (Cr) between these two groups using the Mann-Whitney U test and Chi-square test. Receiver operating characteristic (ROC) curve analysis was used to establish cutoff values and assess their usefulness in grading BSG. RESULTS The Cho/NAA metabolite ratio had the strongest preoperative predictive performance for identifying the correct histological grade among BSGs, with an area under the ROC curve (AUC) value of 0.944 (cutoff: 3.88, sensitivity [Se]: 83.3%; specificity [Sp]: 100%), followed by the Cho/Cr ratio (cutoff: 3.08; AUC: 0.917; Se: 83.3%; Sp: 100%), rCBF (cutoff: 3.56, AUC: 0.917; Se: 83.3%; Sp: 100%), rCBV (cutoff: 3.16, AUC: 0.889; Se: 100%; Sp: 66.7%), and age (cutoff: 9.5 years, AUC: 0.889; Se: 100%; Sp: 83.3%). CONCLUSIONS rCBF and rCBV values comparing solid tumors with the normal brain parenchyma and the metabolite ratios for Cho/NAA and Cho/Cre may serve as useful indices for establishing BSG grading and provide important information when determining treatment planning and prognosis in patients with BSG.
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Affiliation(s)
- D Tran
- Neurosurgery Center, Viet Duc Hospital, Hanoi, Vietnam.
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Pleasants D, Zak R, Ashbrook LH, Zhang L, Tang C, Tran D, Wang M, Tabatabai S, Leung JM. Processed electroencephalography: impact of patient age and surgical position on intraoperative processed electroencephalogram monitoring of burst-suppression. J Clin Monit Comput 2022; 36:1099-1107. [PMID: 34245405 PMCID: PMC11046414 DOI: 10.1007/s10877-021-00741-w] [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: 03/06/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
We previously reported that processed EEG underestimated the amount of burst suppression compared to off-line visual analysis. We performed a follow-up study to evaluate the reasons for the discordance. Forty-five patients were monitored intraoperatively with processed EEG. A computer algorithm was used to convert the SedLine® (machine)-generated burst suppression ratio into a raw duration of burst suppression. The reference standard was a precise off-line measurement by two neurologists. We measured other potential variables that may affect machine accuracy such as age, surgery position, and EEG artifacts. Overall, the median duration of bust suppression for all study subjects was 15.4 min (Inter-quartile Range [IQR] = 1.0-20.1) for the machine vs. 16.1 min (IQR = 0.3-19.7) for the neurologists' assessment; the 95% limits of agreement fall within - 4.86 to 5.04 s for individual 30-s epochs. EEG artifacts did not affect the concordance between the two methods. For patients in prone surgical position, the machine estimates had significantly lower overall sensitivity (0.86 vs. 0.97; p = 0.038) and significantly wider limits of agreement ([- 4.24, 3.82] seconds vs. [- 1.36, 1.13] seconds, p = 0.001) than patients in supine position. Machine readings for younger patients (age < 65 years) had higher sensitivity (0.96 vs 0.92; p = 0.021) and specificity (0.99 vs 0.88; p = 0.007) for older patients. The duration of burst suppression estimated by the machine generally had good agreement compared with neurologists' estimation using a more precise off-line measurement. Factors that affected the concordance included patient age and position during surgery, but not EEG artifacts.
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Affiliation(s)
- D Pleasants
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - R Zak
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - L H Ashbrook
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - L Zhang
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - C Tang
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - D Tran
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - M Wang
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - S Tabatabai
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - J M Leung
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA.
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Aliste J, Layera S, Bravo D, Aguilera G, Erpel H, García A, Lizama M, Finlayson RJ, Tran D. Randomized comparison between perineural dexamethasone and combined perineural dexamethasone-dexmedetomidine for ultrasound-guided infraclavicular block. Reg Anesth Pain Med 2022; 47:rapm-2022-103760. [PMID: 35728840 DOI: 10.1136/rapm-2022-103760] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 06/09/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND This randomized trial compared perineural dexamethasone with combined perineural dexamethasone-dexmedetomidine for ultrasound-guided infraclavicular block. We hypothesized that the combination of perineural adjuvants would result in a longer motor block. METHODS Fifty patients undergoing upper limb surgery with ultrasound-guided infraclavicular block (using 35 mL of lidocaine 1%-bupivacaine 0.25% with epinephrine 5 µg/mL) were randomly allocated to receive perineural dexamethasone (2 mg) or combined perineural dexamethasone (2 mg)-dexmedetomidine (50 µg). After the performance of the block, a blinded observer assessed the success rate (defined as a minimal sensorimotor composite score of 14 out of 16 points at 30 min), the onset time (defined as the time required to reach a minimal composite score of 14 points) as well as the incidence of surgical anesthesia (defined as the ability to complete surgery without local infiltration, supplemental blocks, intravenous opioids or general anesthesia).Postoperatively, the blinded observer contacted patients with successful blocks to inquire about the duration of motor block, sensory block and postoperative analgesia. RESULTS No intergroup differences were observed in terms of success rate, onset time and surgical anesthesia. Compared with dexamethasone alone, combined dexamethasone-dexmedetomidine provided longer durations of motor block (21.5 (2.7) vs 17.0 (3.9) hours; p<0.001; 95% CI 2.6 to 6.4), sensory block (21.6 (3.6) vs 17.2 (3.6) hours; p<0.001; 95% CI 2.2 to 6.5), and postoperative analgesia (25.5 (9.4) vs 23.5 (5.6) hours; p=0.038; 95% CI 1.0 to 7.7). CONCLUSION Compared with perineural dexamethasone (2 mg) alone, combined perineural dexamethasone (2 mg)-dexmedetomidine (50 µg) results in longer durations of sensorimotor block and analgesia. Further studies are required to determine the optimal dosing combination for dexamethasone-dexmedetomidine. TRIAL REGISTRATION NUMBER ClinicalTrials.gov identifier: NCT04875039.
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Affiliation(s)
- Julián Aliste
- Department of Anesthesiology and Perioperative Medicine, University of Chile, Santiago de Chile, Chile
| | - Sebastián Layera
- Department of Anesthesiology and Perioperative Medicine, University of Chile, Santiago de Chile, Chile
| | - Daniela Bravo
- Department of Anesthesiology and Perioperative Medicine, University of Chile, Santiago de Chile, Chile
| | - Germán Aguilera
- Department of Anesthesiology and Perioperative Medicine, University of Chile, Santiago de Chile, Chile
| | - Hans Erpel
- Department of Anesthesiology and Perioperative Medicine, University of Chile, Santiago de Chile, Chile
| | - Armando García
- Department of Orthopedic Surgery, University of Chile, Santiago de Chile, Chile
| | - Marcelo Lizama
- Department of Orthopedic Surgery, University of Chile, Santiago de Chile, Chile
| | - Roderick J Finlayson
- Bill Nelems Pain and Research Center, The University of British Columbia Okanagan, Kelowna, British Columbia, Canada
| | - D Tran
- Department of Anesthesia, McGill University, Montreal, Quebec, Canada
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Moltó A, Ajrouche A, Tran D, Roux B, Costedoat-Chalumeau N, Elefant E, Tsatsaris V, Fresson J, Bader-Meunier B, Fautrel B, Tubach F. POS1405 LESS THAN 50% FEMALES WITH CHRONIC RHEUMATIC INFLAMMATORY DISEASES CONTINUE A DMARD DURING PREGNANCY: A DESCRIPTIVE ANALYSIS OF THE NATIONAL FRENCH SOCIAL SECURITY DATABASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundTreatment of patients with chronic rheumatic inflammatory diseases (CRID) during pregnancy has changed in the last decade, namely due to the availability of new DMARDs labelled to be used during pregnancy.ObjectivesTo describe the anti-rheumatic drug use during pregnancy in women with CRID (i.e. rheumatoid arthritis (RA) or spondyloarthritis (SpA)) in France over the past decade.MethodsThis is a retrospective cohort study within the French Healthcare database (SNDS), which covers 98% of the French population. Adult women were included if they had RA or SpA according to CIM-10 codes, had started a singleton pregnancy between 2008 and 2017 (index date), and were continuously covered by this health insurance from 1-year before pregnancy onset to 1-year after end of the pregnancy or death (whichever comes first). The treatment exposures of interest were: NSAIDs, oral corticosteroids, csDMARD (methotrexate, leflunomide, sulfasalazine, azathioprine, hydroxychloroquine), biologics (anti-TNF, rituximab, abatacept, tocilizumab, ustekinumab, anakinra). Exposure during pregnancy was defined as at least one drug reimbursement from the 6 months before the last menstrual period (LMP) to the end of pregnancy period.ResultsAmong the 35,737 adult women with a CIRD (40.7% with RA and 59.3% with SpA) who had a past history of DMARD reimbursement, 11,274 (41.7%) started a singleton pregnancy during the study period. In total, during preconception and pregnancy, 4,773 (42.3%) women were not delivered any DMARD nor corticosteroids, 769 (6.8%) were delivered corticosteroids alone, 3,639 (32.2%) a csDMARD alone and 2,862 (25.4%) a biologic (among whom 33.1% associated a csDMARD). Biologics delivered during pregnancy were mainly anti-TNFs (92.1%).Exposure to NSAIDs was more frequent during the first trimester (30% patients) of pregnancy but occurred all along the pregnancy (6% and 2% in the second and third trimesters, respectively). Conversely, exposure to oral corticosteroids was stable during the pregnancy (33% to 27%); however, more than half of the prescriptions corresponded to doses higher than 10mg. Exposure to DMARDs including bDMARDs during pregnancy was more frequent during the first trimester, compared to the rest of the pregnancy (see graph).ConclusionOverall, less than 50% of women with a CRID who received a DMARD prior to the pregnancy continued to retrieve such treatment during pregnancy, and overall less than 20% were delivered biologics during pregnancy. Whether the withdrawal of DMARDs led to unfavorable maternal and pregnancy outcomes needs to be evaluated.AcknowledgementsThis study was conducted thanks to a grant from the French Ministry of Health - Programme Hospitalier de Recherche CliniqueDisclosure of InterestsAnna Moltó Consultant of: UCB, Abbvie, Lilly, Pfizer, BMS, MSD, Novartis, Biogen, Janssen, Grant/research support from: UCB, Aya Ajrouche: None declared, Diep Tran: None declared, Barbara Roux: None declared, Nathalie Costedoat-Chalumeau Grant/research support from: UCB, Elisabeth Elefant: None declared, Vassilis Tsatsaris: None declared, Jeanne Fresson: None declared, Brigitte Bader-Meunier: None declared, Bruno Fautrel: None declared, Florence Tubach: None declared
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Moltó A, Ajrouche A, Tran D, Roux B, Costedoat-Chalumeau N, Elefant E, Tsatsaris V, Fresson J, Bader-Meunier B, Fautrel B, Tubach F. AB1391 19% PATIENTS WITH CHRONIC RHEUMATIC INFLAMMATORY DISEASES PRESENT AN UNFAVORABLE PREGNANCY OUTCOME: A DESCRIPTIVE ANALYSIS OF THE NATIONAL FRENCH SOCIAL SECURITY DATABASE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Backgroundpatients with chronic rheumatic inflammatory diseases (CRID, i.e. rheumatoid arthritis (RA) or spondyloarthritis (SpA)) have been reported to have poorer pregnancy outcomes than the general population.Objectivesto describe the pregnancy outcomes of singleton in patients with CRID in France in the past decade.Methodsthis is an analysis of the French Health Insurance claims database (SNDS), which represents 87% of the French population) from 2008 to 2016. To be included in the analysis patients had to be identified as RA or SpA according to existing diagnostic algorithms, to have at least one pregnancy declaration in the database, and to have continuous health insurance from 1-year before pregnancy onset to 1-year after end of the pregnancy or until death (if death occured before the 1-year-period after the end of pregnancy) to be included. Only the first singleton pregnancy occurring during the study period was included in this analysis. Both maternal and pregnancy outcomes were considered. Outcomes were identified either by ICM-10 codes or hospital discharge summaries discharge between 2008-2016.ResultsAmong the 35 737 identified adult females with a CRID diagnosis (40.7% with RA and 59.3% with SpA), 27 722 (78%) had a pregnancy during the study period. 11 274 (42%) had received at least one DMARD prior to the pregnancy and were included in the analysis. Among them, only 4025 (36%) were exposed to DMARDs during pregnancy.Mean (SD) age of females at the start of the pregnancy was 32 (5) years, and mean (SD) disease duration was 4 (4) years. Pregnancy ended before 13 WG in 21% and after 37 WG in 70% cases. Live-birth represented the most frequent pregnancy outcome (76.9%), and overall 34.7% patients presented at least one unfavorable outcome (see Table 1).Table 1.Unfavourable outcomeN(%)Pregnancy outcomesMiscarriage (<22WG)579 (5.3%)Abortion91 (0.8%)Stillbirth48 (0.4%)Preterm delivery (>= 22WG and <37 WG)779 (7.1%)Low weight at birth (<3th percentile)287 (2.6%)Perinatal mortality (22WG to 6 days of life)2 (0%)Maternal outcomesSevere maternal infection*211 (1.9%)Newborn outcomesHospitalisation in neonatal intensive care > 48h in full-term newborns (after 37 WG)95 (0.8%)Neonatal mortality (27 first days of life)2 (0%)Severe infection * during first year603 (5.3%)ConclusionMore than 75% pregnancies in patients with CRID resulted in a live-birth. Prevalence of miscarriage was surprisingly low, probably related to under-coding. Maternal and infant outcomes seemed comparable to general population. Whether medications had an impact on such outcomes is currently under evaluation.Disclosure of InterestsNone declared
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Chakraborty P, Parikh RY, Choi S, Tran D, Gooz M, Hedley ZT, Kim DS, Pytel D, Kang I, Nadig SN, Beeson GC, Ball L, Mehrotra M, Wang H, Berto S, Palanisamy V, Li H, Chatterjee S, Rodriguez PC, Maldonado EN, Diehl JA, Gangaraju VK, Mehrotra S. Carbon Monoxide Activates PERK-Regulated Autophagy to Induce Immunometabolic Reprogramming and Boost Antitumor T-cell Function. Cancer Res 2022; 82:1969-1990. [PMID: 35404405 PMCID: PMC9117468 DOI: 10.1158/0008-5472.can-21-3155] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [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: 09/18/2021] [Revised: 01/27/2022] [Accepted: 03/17/2022] [Indexed: 11/16/2022]
Abstract
Mitochondria and endoplasmic reticulum (ER) share structural and functional networks and activate well-orchestrated signaling processes to shape cells' fate and function. While persistent ER stress (ERS) response leads to mitochondrial collapse, moderate ERS promotes mitochondrial function. Strategies to boost antitumor T-cell function by targeting ER-mitochondria cross-talk have not yet been exploited. Here, we used carbon monoxide (CO), a short-lived gaseous molecule, to test whether engaging moderate ERS conditions can improve mitochondrial and antitumor functions in T cells. In melanoma antigen-specific T cells, CO-induced transient activation of ERS sensor protein kinase R-like endoplasmic reticulum kinase (PERK) significantly increased antitumor T-cell function. Furthermore, CO-induced PERK activation temporarily halted protein translation and induced protective autophagy, including mitophagy. The use of LC3-GFP enabled differentiation between the cells that prepare themselves to undergo active autophagy (LC3-GFPpos) and those that fail to enter the process (LC3-GFPneg). LC3-GFPpos T cells showed strong antitumor potential, whereas LC3-GFPneg cells exhibited a T regulatory-like phenotype, harbored dysfunctional mitochondria, and accumulated abnormal metabolite content. These anomalous ratios of metabolites rendered the cells with a hypermethylated state and distinct epigenetic profile, limiting their antitumor activity. Overall, this study shows that ERS-activated autophagy pathways modify the mitochondrial function and epigenetically reprogram T cells toward a superior antitumor phenotype to achieve robust tumor control. SIGNIFICANCE Transient activation of ER stress with carbon monoxide drives mitochondrial biogenesis and protective autophagy that elicits superior antitumor T-cell function, revealing an approach to improving adoptive cell efficacy therapy.
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Affiliation(s)
- Paramita Chakraborty
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Rasesh Y Parikh
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Seungho Choi
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Danh Tran
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Monika Gooz
- Department of Drug Discovery and Biomedical Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Zachariah T Hedley
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Do-Sung Kim
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Dariusz Pytel
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Inhong Kang
- Department of Pathology & Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Satish N Nadig
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Gyda C Beeson
- Department of Drug Discovery and Biomedical Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Lauren Ball
- Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, South Carolina
| | - Meenal Mehrotra
- Department of Pathology & Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Hongjun Wang
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Stefano Berto
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina
| | - Viswanathan Palanisamy
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Hong Li
- Department of Public Health, Medical University of South Carolina, Charleston, South Carolina
| | - Shilpak Chatterjee
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Paulo C Rodriguez
- Department of Immunology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Eduardo N Maldonado
- Department of Drug Discovery and Biomedical Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - J Alan Diehl
- Department of Biochemistry, Case Western University, Cleveland, Ohio
| | - Vamsi K Gangaraju
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina
| | - Shikhar Mehrotra
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
- Department of Microbiology & Immunology, Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
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Mosele M, Lusque A, Dieras V, Deluche E, Ducoulombier A, Pistilli B, Bachelot T, Viret F, Levy C, Signolle N, Tran D, Garberis I, Le-Bescond L, Dien AT, Droin N, Kobayashi M, Kakegawa T, Jimenez M, Lacroix-Triki M, André F. LBA1 Unraveling the mechanism of action and resistance to trastuzumab deruxtecan (T-DXd): Biomarker analyses from patients from DAISY trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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10
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Pacheco C, Tremblay-Gravel M, Marquis-Gravel G, Couture E, Avram R, Desplantie O, Bibas L, Simard F, Malhamé I, Poulin A, Tran D, Senechal M, Afilalo J, Farand P, Bérubé L, Jolicoeur E, Ducharme A, Tournoux F. Association between Right Ventricular Dysfunction and Adverse Outcomes in Peripartum Cardiomyopathy: Insights from the retrospective BRO-HF Quebec Cohort Study. CJC Open 2022; 4:913-920. [DOI: 10.1016/j.cjco.2022.05.004] [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] [Received: 01/19/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022] Open
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11
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Guillo S, Tran D, Auvin S, de Rycke Y, Tubach F. Utilisation des médicaments antiépileptiques dans les épilepsies pédiatriques en France : une étude de cohorte historique dans le Système national des données de santé. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.01.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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12
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Roux B, Molto A, Tran D, Ajrouche A, Tubach F. Issues de la grossesse chez des femmes atteintes de rhumatismes inflammatoires chroniques en France : une étude de cohorte populationnelle. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.01.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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13
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Tran H, Nguyen S, Nguyen K, Pham D, Le A, Nguyen G, Tran D, Shu X, Osarogiagbon R, Tran T. OA18.01 Lung Cancer in Vietnam. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Aliste J, Layera S, Bravo D, Jara Á, Muñoz G, Barrientos C, Wulf R, Brañes J, Finlayson RJ, Tran D. Reply to Brown et al. Reg Anesth Pain Med 2021; 47:199-200. [PMID: 34452983 DOI: 10.1136/rapm-2021-103106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 08/14/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Julián Aliste
- Department of Anesthesiology and Perioperative Medicine, University of Chile, Santiago, Chile
| | - Sebastián Layera
- Department of Anesthesiology and Perioperative Medicine, University of Chile, Santiago, Chile
| | - Daniela Bravo
- Department of Anesthesiology and Perioperative Medicine, University of Chile, Santiago, Chile
| | - Álvaro Jara
- Department of Anesthesiology and Perioperative Medicine, University of Chile, Santiago, Chile
| | - Gonzalo Muñoz
- Department of Anesthesiology and Perioperative Medicine, University of Chile, Santiago, Chile
| | | | - Rodrigo Wulf
- Department of Orthopedic Surgery, University of Chile, Santiago, Chile
| | - Julián Brañes
- Department of Orthopedic Surgery, University of Chile, Santiago, Chile
| | - Roderick J Finlayson
- Pain and Research Center, The University of British Columbia, Kelowna, British Columbia, Canada
| | - D Tran
- Department of Anesthesiology, McGill University, Montreal, Quebec, Canada
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15
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Beca JM, Dai WF, Pataky RE, Tran D, Dvorani E, Isaranuwatchai W, Peacock S, Alvi R, Cheung WY, Earle CC, Gavura S, Chan KKW. Real-world Safety of Bevacizumab with First-line Combination Chemotherapy in Patients with Metastatic Colorectal Cancer: Population-based Retrospective Cohort Studies in Three Canadian Provinces. Clin Oncol (R Coll Radiol) 2021; 34:e7-e17. [PMID: 34456106 DOI: 10.1016/j.clon.2021.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 07/16/2021] [Accepted: 08/12/2021] [Indexed: 11/03/2022]
Abstract
AIMS To examine the real-world safety of adding bevacizumab to first-line irinotecan-based chemotherapy for patients with metastatic colorectal cancer (mCRC). MATERIALS AND METHODS Patients diagnosed with CRC in three Canadian provinces (Ontario, Saskatchewan and British Columbia) who received publicly funded bevacizumab and/or irinotecan from 2000 to 2016 were identified from cancer registries. Propensity score 1:1 matching (PSM) and inverse probability of treatment weighting (IPTW) were performed to contemporaneous and historical controls, adjusting for baseline demographic and clinical characteristics. Safety end points evaluated during first-line treatment plus 30 days included mortality within 30 days and all-cause-, chemotherapy- and bevacizumab-related hospitalisations. Chemotherapy- and bevacizumab-related visits were defined as hospitalisations for specific conditions commonly associated with chemotherapy (e.g. infections) or bevacizumab (e.g. arteriovenous thromboembolism) using most responsible diagnosis codes. In PSM and IPTW-weighted cohorts, we assessed event frequencies using odds ratios from logistic regressions and event rate ratios using negative binomial regression models. The results from each province and comparison were pooled using random-effects meta-analysis. RESULTS We identified 16 250 mCRC patients who received first-line irinotecan-based treatment. In PSM cohorts, bevacizumab was associated with fewer deaths within 30 days of treatment compared with contemporaneous (pooled odds ratio = 0.62; 95% confidence interval 0.50-0.75) and historical controls (pooled odds ratio = 0.73; 95% confidence interval 0.58-0.93). Hospitalisations were more frequent among patients treated with bevacizumab compared with historical controls but similar to contemporaneous controls. As patients receiving bevacizumab were exposed to a longer average treatment duration, across their full treatment duration, patients receiving bevacizumab had significantly lower rates of hospitalisations (contemporaneous pooled rate ratio = 0.56; 95% confidence interval 0.47-0.67; historical pooled rate ratio = 0.73; 95% confidence interval 0.56-0.95). Similar trends were observed for chemotherapy- and bevacizumab-related hospitalisations and in IPTW-weighted cohorts. DISCUSSION We did not observe any increase in rates of hospitalisation or death within 30 days of treatment among mCRC patients treated with bevacizumab plus chemotherapy versus chemotherapy alone; these findings should be interpreted with caution due to the risk of residual confounding.
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Affiliation(s)
- J M Beca
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada; Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada.
| | - W F Dai
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - R E Pataky
- Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada; BC Cancer, Vancouver, British Columbia, Canada
| | - D Tran
- Saskatchewan Cancer Agency, Saskatoon, Saskatchewan, Canada
| | - E Dvorani
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - W Isaranuwatchai
- Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada; St. Michael's Hospital, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - S Peacock
- Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada; BC Cancer, Vancouver, British Columbia, Canada; Simon Fraser University, Burnaby, British Columbia, Canada
| | - R Alvi
- Saskatchewan Cancer Agency, Saskatoon, Saskatchewan, Canada
| | - W Y Cheung
- Cancer Control Alberta, Tom Baker Cancer Centre, Calgary, Alberta, Canada
| | - C C Earle
- Canadian Partnership Against Cancer, Toronto, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada; Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
| | - S Gavura
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - K K W Chan
- Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada; Canadian Centre for Applied Research in Cancer Control, Toronto, Ontario, Canada; Sunnybrook Odette Cancer Centre, Toronto, Ontario, Canada
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16
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Beylot-Barry M, Seneschal J, Tran D, Bachelez H, Beneton N, Dupuy A, Joly P, Jullien D, Mahé E, Paul C, Richard MA, Sbidian E, Viguier M, Chosidow O, Tubach F. Characteristics of patients with psoriasis with Psoriasis Area and Severity Index < 10 treated with biological agents: results from the French PsoBioTeq cohort. Br J Dermatol 2021; 185:1052-1054. [PMID: 34128543 DOI: 10.1111/bjd.20585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/13/2021] [Accepted: 06/13/2021] [Indexed: 01/20/2023]
Affiliation(s)
- M Beylot-Barry
- Dermatology Department, Bordeaux University Hospital, Bordeaux, France
| | - J Seneschal
- Dermatology Department, Bordeaux University Hospital, Bordeaux, France
| | - D Tran
- INSERM, Pierre Louis Institute for Epidemiology and Public Health, AP-HP, Paris, France.,Sorbonne University, Pitié Salpêtrière Hospitals, Public Health Department, Pharmacoepidemiology Centre, CIC-1422, Paris, France
| | - H Bachelez
- Dermatology Department, Saint-Louis Hospital, AP-HP, Université de Paris, Paris, France
| | - N Beneton
- Dermatology Department, Le Mans Hospital, Le Mans, France
| | - A Dupuy
- Dermatology Department, Rennes University Hospital, Rennes, France
| | - P Joly
- Dermatology Department, Rouen University Hospital, Rouen, France
| | - D Jullien
- Dermatology Department, Edouard Herriot Hospital, Lyon, France
| | - E Mahé
- Dermatology Department, Victor Dupouy Hospital, Argenteuil, France
| | - C Paul
- Dermatology Department, Toulouse University and University Hospital, Toulouse, France
| | - M-A Richard
- Dermatology Department, Marseille University Hospital, Marseille, France
| | - E Sbidian
- Dermatology Department, AP-HP, Henri Mondor University Hospitals, Paris-Est Créteil University, INSERM CIC1430, Créteil, France.,EpiDermE EA7379, Créteil, France
| | - M Viguier
- Dermatology-Venereology Department, Reims University Hospital, Reims, France
| | - O Chosidow
- Dermatology Department, AP-HP, Henri Mondor University Hospitals, Paris-Est Créteil University, INSERM CIC1430, Créteil, France.,Research Group Dynamic, EA7380, Créteil Health Faculty, Alfort National Veterinary School, USC ANSES, Paris-Est Créteil University, Créteil, France
| | - F Tubach
- INSERM, Pierre Louis Institute for Epidemiology and Public Health, AP-HP, Paris, France.,Sorbonne University, Pitié Salpêtrière Hospitals, Public Health Department, Pharmacoepidemiology Centre, CIC-1422, Paris, France
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Tran D, Cooke S, Illingworth PJ, Gardner DK. Reply: Can deep learning automatically predict fetal heart pregnancy with almost perfect accuracy? Hum Reprod 2021; 35:1474. [PMID: 32457996 DOI: 10.1093/humrep/deaa084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Tran
- Harrison AI, Barangaroo, NSW, Australia
| | - S Cooke
- IVF Australia, Greenwich, NSW, Australia
| | | | - D K Gardner
- Melbourne IVF, East Melbourne, VIC, Australia
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18
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Tran D, Nguyen C, Nguyen T. PCV5 Cost-Effectiveness Analysis of Apixaban in Treatment of Atrial Fibrillation: A Systematic Review. Value Health Reg Issues 2020. [DOI: 10.1016/j.vhri.2020.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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19
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Tran D, Cooke S, Illingworth PJ, Gardner DK. Reply: Deep learning as a predictive tool for fetal heart pregnancy following time-lapse incubation and blastocyst transfer. Hum Reprod 2020; 35:483. [PMID: 32053191 DOI: 10.1093/humrep/dez264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Tran
- 8 Milton Ave, Eastwood, Sydney, NSW Australia
| | - S Cooke
- IVFAustralia Greenwich, Greenwich, NSW, Australia
| | | | - D K Gardner
- Melbourne IVF, East Melbourne, Victoria, Australia
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20
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Kamaladasa Y, Tran D, Phillip M, Kotchetkova I, D’Souza M, Celermajer D, Maiorana A, Cordina R. 661 Estimating Exercise Intensity Using Heart Rate in Adolescents and Adults With Congenital Heart Disease: Are Established Methods Valid? Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Tran D, Rodrigues C, du Plessis K, Zannino D, Davis G, Celermajer D, d'Udekem Y, Cordina R. 673 Not an Inevitable Decline: Exercise Capacity Trajectory of the Australian and New Zealand Fontan Population. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Barthélémy I, Cauchois X, Drougard C, Tran D, Porte-Thomé F, Blot S. P.317Rimeporide, a repositioned NHE-1 inhibitor for DMD: a preclinical trial in GRMD dogs. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.431] [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: 12/01/2022]
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23
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Tran D, Cooke S, Illingworth PJ, Gardner DK. Deep learning as a predictive tool for fetal heart pregnancy following time-lapse incubation and blastocyst transfer. Hum Reprod 2019; 34:1011-1018. [PMID: 31111884 PMCID: PMC6554189 DOI: 10.1093/humrep/dez064] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/07/2019] [Indexed: 12/11/2022] Open
Abstract
STUDY QUESTION Can a deep learning model predict the probability of pregnancy with fetal heart (FH) from time-lapse videos? SUMMARY ANSWER We created a deep learning model named IVY, which was an objective and fully automated system that predicts the probability of FH pregnancy directly from raw time-lapse videos without the need for any manual morphokinetic annotation or blastocyst morphology assessment. WHAT IS KNOWN ALREADY The contribution of time-lapse imaging in effective embryo selection is promising. Existing algorithms for the analysis of time-lapse imaging are based on morphology and morphokinetic parameters that require subjective human annotation and thus have intrinsic inter-reader and intra-reader variability. Deep learning offers promise for the automation and standardization of embryo selection. STUDY DESIGN, SIZE, DURATION A retrospective analysis of time-lapse videos and clinical outcomes of 10 638 embryos from eight different IVF clinics, across four different countries, between January 2014 and December 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS The deep learning model was trained using time-lapse videos with known FH pregnancy outcome to perform a binary classification task of predicting the probability of pregnancy with FH given time-lapse video sequence. The predictive power of the model was measured using the average area under the curve (AUC) of the receiver operating characteristic curve over 5-fold stratified cross-validation. MAIN RESULTS AND THE ROLE OF CHANCE The deep learning model was able to predict FH pregnancy from time-lapse videos with an AUC of 0.93 [95% CI 0.92-0.94] in 5-fold stratified cross-validation. A hold-out validation test across eight laboratories showed that the AUC was reproducible, ranging from 0.95 to 0.90 across different laboratories with different culture and laboratory processes. LIMITATIONS, REASONS FOR CAUTION This study is a retrospective analysis demonstrating that the deep learning model has a high level of predictability of the likelihood that an embryo will implant. The clinical impacts of these findings are still uncertain. Further studies, including prospective randomized controlled trials, are required to evaluate the clinical significance of this deep learning model. The time-lapse videos collected for training and validation are Day 5 embryos; hence, additional adjustment would need to be made for the model to be used in the context of Day 3 transfer. WIDER IMPLICATIONS OF THE FINDINGS The high predictive value for embryo implantation obtained by the deep learning model may improve the effectiveness of previous approaches used for time-lapse imaging in embryo selection. This may improve the prioritization of the most viable embryo for a single embryo transfer. The deep learning model may also prove to be useful in providing the optimal order for subsequent transfers of cryopreserved embryos. STUDY FUNDING/COMPETING INTEREST(S) D.T. is the co-owner of Harrison AI that has patented this methodology in association with Virtus Health. P.I. is a shareholder in Virtus Health. S.C., P.I. and D.G. are all either employees or contracted with Virtus Health. D.G. has received grant support from Vitrolife, the manufacturer of the Embryoscope time-lapse imaging used in this study. The equipment and time for this study have been jointly provided by Harrison AI and Virtus Health.
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Affiliation(s)
- D Tran
- Medical AI, Harrison AI, Barangaroo, NSW, Australia
| | - S Cooke
- Embryology, IVF Australia, Greenwich, NSW, Australia
| | | | - D K Gardner
- Embryology, Melbourne IVF, East Melbourne, Victoria, Australia
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Cervera P, Dupeux M, Tran D, Scriva A, Gimenez de Mestral S, Fabiani B, Coppo P. MORPHOLOGICAL EVALUATION OF THE IMMUNE PROFILE IN A SERIES OF DIFFUSE LARGE B CELLS LYMPHOMA IN TISSUE MICROARRAYS: PRELIMINARY RESULTS. Hematol Oncol 2019. [DOI: 10.1002/hon.20_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- P. Cervera
- 75, APHP; Sorbonne University; Paris France
| | - M. Dupeux
- 75, APHP; Sorbonne University; Paris France
| | - D. Tran
- 75, APHP; Sorbonne University; Paris France
| | - A. Scriva
- 75, APHP; Sorbonne University; Paris France
| | | | - B. Fabiani
- 75, APHP; Sorbonne University; Paris France
| | - P. Coppo
- 75, APHP; Sorbonne University; Paris France
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Salvo EM, Samjoo IA, Tran D, Cameron C. Letter to the editor concerning the article: "An indirect treatment comparison of the efficacy of patisiran and tafamidis for the treatment of hereditary transthyretin-mediated amyloidosis with polyneuropathy". Expert Opin Pharmacother 2019; 20:1527-1528. [PMID: 31124724 DOI: 10.1080/14656566.2019.1620983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- E M Salvo
- Cornerstone Research Group Inc. , Burlington , ON , Canada
| | - I A Samjoo
- Cornerstone Research Group Inc. , Burlington , ON , Canada
| | - D Tran
- Cornerstone Research Group Inc. , Burlington , ON , Canada
| | - C Cameron
- Cornerstone Research Group Inc. , Sydney , NS, Canada
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26
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Chakraborty P, Chatterjee S, Tran D, Nadig S, Atkinson C, Mehrotra S. Suboptimal ER stress Induced Autophagy Potentiates Anti-tumor T Cell Response. The Journal of Immunology 2019. [DOI: 10.4049/jimmunol.202.supp.137.5] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Endoplasmic reticulum (ER) stress induced by external or internal stimuli, activates a number of well-orchestrated cellular signaling processes aiming either to promote cell apoptosis or to restore cellular function and resolve the stress. In tumor microenvironment, induction of ER stress is known to dampen the antitumor activity of T cells by reducing their mitochondrial function. However, if magnitude of ER stress governs the T cell fate and function is unknown. Using melanoma antigen gp100 reactive T cells, we found that low level of ER stress enhances T cell stemness and promotes mitochondrial biogenesis, whereas high level of ER stress triggers T cell death. Moreover, upon adoptive transfer, T cells treated with low dose ER stress inducer are able to form long-lived memory in vivo, express reduced level of co-inhibitory molecule, and demonstrate superior anti-tumor immunity by increasing overall survival of B16 melanoma bearing mouse. Mechanistically, we discovered that, upon ER insult at suboptimal level, a protective autophagy pathway is induced to promote cell survival and maintain stemness through the protein kinase R-like endoplasmic reticulum kinase (PERK)/ activating transcription factor-4 (ATF4)-dependent manner. Conversely, knockdown of PERK abrogates autophagy activation, hampers mitochondrial biogenesis in response to suboptimal ER stress, which in-turn compromises the antitumor function of melanoma antigen specific T cells. Overall, these preclinical data highlights that, low level of ER stress is important for healthy cellular function and therapeutically, ER stress pathways can be manipulated in T cells in order to regulate their antitumor potential.
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Affiliation(s)
| | | | - Danh Tran
- 1Medical University of South Carolina
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Tang S, Koh E, Rai R, Otton J, Tran D, Delaney G, Holloway L, Schmitt B, Liney G. EP-1333 Myocardial changes detected using Cardiac MRI in left breast patients treated with Radiation. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31753-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ho LTS, Lenihan M, McVey MJ, Karkouti K, Wijeysundera DN, Rao V, Crowther M, Grocott HP, Pinto R, Scales DC, Achen B, Brar S, Morrison D, Wong D, Bussières JS, Waal T, Harle C, Médicis É, McAdams C, Syed S, Tran D, Waters T. The association between platelet dysfunction and adverse outcomes in cardiac surgical patients. Anaesthesia 2019; 74:1130-1137. [PMID: 30932171 DOI: 10.1111/anae.14631] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2019] [Indexed: 11/30/2022]
Abstract
Haemostatic activation during cardiopulmonary bypass is associated with prothrombotic complications. Although it is not possible to detect and quantify haemostatic activation directly, platelet dysfunction, as measured with point-of-care-assays, may be a useful surrogate. In this study, we assessed the association between cardiopulmonary bypass-associated platelet dysfunction and adverse outcomes in 3010 cardiac surgical patients. Platelet dysfunction, as measured near the end of the rewarming phase of cardiopulmonary bypass, was calculated as the proportion of non-functional platelets after activation with collagen. Logistic regression and multivariable analyses were applied to assess the relationship between platelet dysfunction and a composite of in-hospital death; myocardial infarction; stroke; deep vein thrombosis or pulmonary embolism; and acute kidney injury (greater than a two-fold increase in creatinine). The outcome occurred in 251 (8%) of 3010 patients. The median (IQR [range]) percentage platelet dysfunction was less for those without the outcome as compared with those with the outcome; 14% (8-28% [1-99%]) vs. 19% (11-45% [2-98%]), p < 0.001. After risk adjustment, platelet dysfunction was independently associated with the composite outcome (p < 0.001), such that for each 1% increase in platelet dysfunction there was an approximately 1% increase in the composite outcome (OR 1.012; 95%CI 1.006-1.018). This exploratory study suggests that cardiopulmonary bypass-associated platelet dysfunction has prognostic value and may be a useful clinical measure of haemostatic activation in cardiac surgery.
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Affiliation(s)
- L T S Ho
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, ON, Canada
| | - M Lenihan
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, ON, Canada
| | - M J McVey
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, University of Toronto, ON, Canada
| | - K Karkouti
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, ON, Canada.,Toronto General Research Institute and the Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, ON, Canada
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Tang S, Otton J, Koh E, Rai R, Delaney G, Tran D, Thomas L, Holloway L, Liney G. Longitudinal Results of Cardiac MRI Left Ventricular Mapping Following Tangential Left Breast Radiotherapy. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tang S, Koh E, Rai R, Otton J, Herschtal A, Tran D, Delaney G, Holloway L, Thomas L, Schmitt B, Liney G, Ananthapadmanachan S. Changes in Cardiac MRI Derived Left Ventricular Segmental Strain in Left Sided Breast Cancer Patients Treated with Tangential Radioation Therapy Alone Correlated with Dose. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Moldaver D, Hurry M, Tran D, Evans W, Cheema P, Sangha R, Burkes R, Melosky B, Orava E, Grima D. P2.15-09 The Impact of Treatment Evolution in NSCLC (iTEN) Model: Survival and Cost of Treating Patients with Advanced NSCLC in 2017. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Moldaver D, Hurry M, Tran D, Evans W, Cheema P, Sangha R, Burkes R, Melosky B, Orava E, Grima D. MA18.02 The Impact of Treatment Evolution in NSCLC (iTEN) Model: Development and Validation. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Islam S, Mackie A, Kaul P, Tran D. HEALTHCARE RESOURCE UTILIZATION AMONG CHILDREN WITH CONGENITAL HEART DISEASE: A POPULATION-BASED STUDY. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Potluri R, Tran D, Carter P, Welsh RC, Kaul P, Bainey K. P6046Temporal trends of ST-elevation myocardial infarction incidence and 30-day mortality: a transatlantic comparison between Alberta, Canada and Northern England, United Kingdom. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R Potluri
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - D Tran
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - P Carter
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - R C Welsh
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - P Kaul
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - K Bainey
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
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Bainey K, Tran D, Potluri R, Carter P, Welsh RC, Kaul P. P6049Regional differences in process of care and clinical outcome among patients with ST-elevation myocardial infarction in Canada and the United Kingdom. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K Bainey
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - D Tran
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - R Potluri
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - P Carter
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - R C Welsh
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
| | - P Kaul
- University of Alberta, Canadian VIGOUR Centre, Edmonton, Canada
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Castrec J, Soudant P, Payton L, Tran D, Miner P, Lambert C, Le Goïc N, Huvet A, Quillien V, Boullot F, Amzil Z, Hégaret H, Fabioux C. Bioactive extracellular compounds produced by the dinoflagellate Alexandrium minutum are highly detrimental for oysters. Aquat Toxicol 2018; 199:188-198. [PMID: 29653309 DOI: 10.1016/j.aquatox.2018.03.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 06/08/2023]
Abstract
Blooms of the dinoflagellate Alexandrium spp., known as producers of paralytic shellfish toxins (PSTs), are regularly detected on the French coastline. PSTs accumulate into harvested shellfish species, such as the Pacific oyster Crassostrea gigas, and can cause strong disorders to consumers at high doses. The impacts of Alexandrium minutum on C. gigas have often been attributed to its production of PSTs without testing separately the effects of the bioactive extracellular compounds (BECs) with allelopathic, hemolytic, cytotoxic or ichthyotoxic properties, which can also be produced by these algae. The BECs, still uncharacterized, are excreted within the environment thereby impacting not only phytoplankton, zooplankton but also marine invertebrates and fishes, without implicating any PST. The aim of this work was to compare the effects of three strains of A. minutum producing either only PSTs, only BECs, or both PSTs and BECs, on the oyster C. gigas. Behavioral and physiological responses of oysters exposed during 4 days were monitored and showed contrasted behavioral and physiological responses in oysters supposedly depending on produced bioactive substances. The non-PST extracellular-compound-producing strain primarily strongly modified valve-activity behavior of C. gigas and induced hemocyte mobilization within the gills, whereas the PST-producing strain caused inflammatory responses within the digestive gland and disrupted the daily biological rhythm of valve activity behavior. BECs may therefore have a significant harmful effect on the gills, which is one of the first organ in contact with the extracellular substances released in the water by A. minutum. Conversely, the PSTs impact the digestive gland, where they are released and mainly accumulated, after degradation of algal cells during digestion process of bivalves. This study provides a better understanding of the toxicity of A. minutum on oyster and highlights the significant role of BECs in this toxicity calling for further chemical characterization of these substances.
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Affiliation(s)
- J Castrec
- LEMAR UMR 6539 CNRS/UBO/IRD/Ifremer, IUEM, rue Dumont d'Urville, 29280 Plouzané, France.
| | - P Soudant
- LEMAR UMR 6539 CNRS/UBO/IRD/Ifremer, IUEM, rue Dumont d'Urville, 29280 Plouzané, France
| | - L Payton
- CNRS, EPOC, UMR 5805, F-33120 Arcachon, France
| | - D Tran
- CNRS, EPOC, UMR 5805, F-33120 Arcachon, France
| | - P Miner
- Ifremer, LEMAR UMR 6539 CNRS/UBO/IRD/Ifremer, Centre de Bretagne, CS 10070, 29280 Plouzané, France
| | - C Lambert
- LEMAR UMR 6539 CNRS/UBO/IRD/Ifremer, IUEM, rue Dumont d'Urville, 29280 Plouzané, France
| | - N Le Goïc
- LEMAR UMR 6539 CNRS/UBO/IRD/Ifremer, IUEM, rue Dumont d'Urville, 29280 Plouzané, France
| | - A Huvet
- Ifremer, LEMAR UMR 6539 CNRS/UBO/IRD/Ifremer, Centre de Bretagne, CS 10070, 29280 Plouzané, France
| | - V Quillien
- Ifremer, LEMAR UMR 6539 CNRS/UBO/IRD/Ifremer, Centre de Bretagne, CS 10070, 29280 Plouzané, France
| | - F Boullot
- LEMAR UMR 6539 CNRS/UBO/IRD/Ifremer, IUEM, rue Dumont d'Urville, 29280 Plouzané, France
| | - Z Amzil
- Ifremer, Laboratoire Phycotoxines, BP 21105, F-44311 Nantes, France
| | - H Hégaret
- LEMAR UMR 6539 CNRS/UBO/IRD/Ifremer, IUEM, rue Dumont d'Urville, 29280 Plouzané, France
| | - C Fabioux
- LEMAR UMR 6539 CNRS/UBO/IRD/Ifremer, IUEM, rue Dumont d'Urville, 29280 Plouzané, France
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Lee C, Li S, Tran D, Zhu A, Kim J, Kwong B, Chang A. 526 Association of tumor response to PD-1/PD-L1 immunotherapy and type of dermatitis that arises after the immunotherapy. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Fichten C, Tran D, Rizzo D, Bailes S, Jorgensen M, Creti L, Conrod K, Grad R, Baltzan M, Pavilanis A, Harvison M, Libman E. 0365 Insomnia Subtypes Before And After Cpap Treatment Of Sleep Apnea. Sleep 2018. [DOI: 10.1093/sleep/zsy061.364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Fichten
- Jewish General Hospital, Montreal, QC, CANADA
| | - D Tran
- Jewish General Hospital, Montreal, QC, CANADA
| | - D Rizzo
- Jewish General Hospital, Montréal, QC, CANADA
| | - S Bailes
- Jewish General Hospital, Montreal, QC, CANADA
| | | | - L Creti
- Jewish General Hospital, Montreal, QC, CANADA
| | - K Conrod
- Jewish General Hospital, Montreal, QC, CANADA
| | - R Grad
- Jewish General Hospital, Montreal, QC, CANADA
| | - M Baltzan
- Mount-Sinai Hospital, Montreal, QC, CANADA
| | | | | | - E Libman
- Jewish General Hospital, Montreal, QC, CANADA
- Jewish General Hospital, Montreal, QC, CANADA
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Rizzo D, Lavigne G, Bailes S, Baltzan M, Creti L, Tran D, Fichten C, Libman E. 1076 Good Driving Behavior: A Reasonable Predictor Of Cpap Adherence? Sleep 2018. [DOI: 10.1093/sleep/zsy061.1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Rizzo
- Jewish general hospital, Montreal, QC, CANADA
| | - G Lavigne
- Université de Montréal, Montreal, QC, CANADA
| | - S Bailes
- Jewish General Hospital, Montreal, QC, CANADA
| | - M Baltzan
- Mount-Sinai Hospital, Montreal, QC, CANADA
| | - L Creti
- Jewish General Hospital, Montreal, QC, CANADA
| | - D Tran
- Jewish General Hospital, Montreal, QC, CANADA
| | - C Fichten
- Jewish General Hospital, Montreal, QC, CANADA
| | - E Libman
- Jewish General Hospital, Montreal, QC, CANADA
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Bailes S, Rizzo D, Tran D, Creti L, Grad R, Baltzan M, Pavilanis A, Fichten C, Libman E. 1073 What Happens To Patients After A Diagnosis Of Sleep Apnea? Sleep 2018. [DOI: 10.1093/sleep/zsy061.1072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Bailes
- Jewish General Hospital, Montreal, QC, CANADA
| | - D Rizzo
- Jewish General Hospital, Montréal, QC, CANADA
| | - D Tran
- Jewish General Hospital, Montréal, QC, CANADA
| | - L Creti
- Jewish General Hospital, Montreal, QC, CANADA
| | - R Grad
- Jewish General Hospital, Montreal, QC, CANADA
| | - M Baltzan
- Mount-Sinai Hospital, Montréal, QC, CANADA
| | | | - C Fichten
- Jewish General Hospital, Montreal, QC, CANADA
| | - E Libman
- Jewish General Hospital, Montreal, QC, CANADA
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Price A, Tran D, Kim Y, Kerlan R, Kohi M, Kohlbrenner R, Kolli K, Lehrman E, Taylor A, Fidelman N. Abstract No. 629 Does the anastomosis matter? Outcomes of transjugular liver biopsies in OLT patients with bicaval and piggyback hepatic vein anastomoses. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Ngu J, Tran D, Rubens F. Effect of Sex on Incidence of Post-Operative Atrial Fibrillation in Cardiac Surgery Patients. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Pasrija C, Sorensen E, Sawan M, Voorhees H, Tran D, Wang L, DiChiacchio L, Ton V, Feller E, Griffith B, Kon Z, Kaczorowski D. Inflow Cannula Position is Associated with Improvement in Mitral Regurgitation After Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Abstract
Statement of the problem Digital workflows (CAD/CAM) have been introduced in dentistry during recent years. No published information exists on dentists' use and reporting of this technology.Purpose The purpose of this survey was to identify the infiltration of CAD/CAM technology in UK dental practices and to investigate the relationship of various demographic factors to the answers regarding use or non-use of this technology.Materials and methods One thousand and thirty-one online surveys were sent to a sample of UK dentists composing of both users and non-users of CAD/CAM. It aimed to reveal information regarding type of usage, materials, perceived benefits, barriers to access, and disadvantages of CAD/CAM dentistry. Statistical analysis was undertaken to test the influence of various demographic variables such as country of work, dentist experience, level of training and type of work (NHS or private).Results The number of completed responses totalled 385. Most of the respondents did not use any part of a digital workflow, and the main barriers to CAD/CAM use were initial costs and a lack of perceived benefit over conventional methods. Dentists delivering mostly private work were most likely to have adopted CAD/CAM technology (P <0.001). Further training also correlated with a greater likelihood of CAD/CAM usage (P <0.001). Most users felt that the technology had led to a change in the use of dental materials, leading to increased use of, for example, zirconia and lithium disilicate. Most users were trained either by companies or self-trained, and a third felt that their training was insufficient. The majority of respondents (89%) felt that CAD/CAM had a big role to play in the future.Conclusion Most of the respondents did not use any part of a digital workflow. However, the majority of surveyed dentists were interested in incorporating CAD/CAM into their workflow, while most believed that it will have a big role in the future. There are still some concerns from dentists about the quality of chairside CAD/CAM restorations while the costs are still in the main hugely prohibitive (especially for NHS dentistry).
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Affiliation(s)
- D Tran
- Department of Restorative Dentistry
| | | | - H Petridis
- Department of Restorative Dentistry, Prosthodontics Unit, UCL Eastman Dental Institute, 256 Grey's Inn Road, London, WC1X 8LD
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Zhu P, Atkinson C, Dixit S, Cheng Q, Tran D, Patel K, Jiang YL, Esckilsen S, Miller K, Bazzle G, Allen P, Moore A, Broome AM, Nadig SN. Organ preservation with targeted rapamycin nanoparticles: a pre-treatment strategy preventing chronic rejection in vivo. RSC Adv 2018; 8:25909-25919. [PMID: 30220998 PMCID: PMC6124302 DOI: 10.1039/c8ra01555d] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/24/2018] [Indexed: 12/20/2022] Open
Abstract
Hypothermic preservation is the standard of care for storing organs prior to transplantation. Endothelial and epithelial injury associated with hypothermic storage causes downstream graft injury and, as such, the choice of an ideal donor organ preservation solution remains controversial. Cold storage solutions, by design, minimize cellular necrosis and optimize cellular osmotic potential, but do little to assuage immunological cell activation or immune cell priming post transplantation. Thus, here we explore the efficacy of our previously described novel Targeted Rapamycin Micelles (TRaM) as an additive to standard-of-care University of Wisconsin preservation solution as a means to alter the immunological microenvironment post transplantation using in vivo models of tracheal and aortic allograft transplantation. In all models of transplantation, grafts pre-treated with 100 ng mL-1 of TRaM augmented preservation solution ex vivo showed a significant inhibition of chronic rejection post-transplantation, as compared to UW augmented with free rapamycin at a ten-fold higher dose. Here, for the first time, we present a novel method of organ pretreatment using a nanotherapeutic-based cellular targeted delivery system that enables donor administration of rapamycin, at a ten-fold decreased dose during cold storage. Clinically, these pretreatment strategies may positively impact post-transplant outcomes and can be readily translated to clinical scenarios.
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Affiliation(s)
- Peng Zhu
- Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, USA. .,Department of Microbiology and Immunology, Lee Patterson Allen Transplant Immunobiology Laboratory, Medical University of South Carolina, USA.,Institute of Organ Transplantation, Department of Surgery, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Carl Atkinson
- Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, USA. .,Department of Microbiology and Immunology, Lee Patterson Allen Transplant Immunobiology Laboratory, Medical University of South Carolina, USA
| | - Suraj Dixit
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, USA.
| | - Qi Cheng
- Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, USA. .,Department of Microbiology and Immunology, Lee Patterson Allen Transplant Immunobiology Laboratory, Medical University of South Carolina, USA.,Institute of Organ Transplantation, Department of Surgery, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Danh Tran
- Department of Microbiology and Immunology, Lee Patterson Allen Transplant Immunobiology Laboratory, Medical University of South Carolina, USA
| | - Kunal Patel
- Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, USA. .,Department of Microbiology and Immunology, Lee Patterson Allen Transplant Immunobiology Laboratory, Medical University of South Carolina, USA
| | - Yu-Lin Jiang
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, USA.
| | - Scott Esckilsen
- Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, USA. .,Department of Microbiology and Immunology, Lee Patterson Allen Transplant Immunobiology Laboratory, Medical University of South Carolina, USA
| | - Kayla Miller
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, USA.
| | - Grace Bazzle
- Department of Microbiology and Immunology, Lee Patterson Allen Transplant Immunobiology Laboratory, Medical University of South Carolina, USA
| | - Patterson Allen
- Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, USA. .,Department of Microbiology and Immunology, Lee Patterson Allen Transplant Immunobiology Laboratory, Medical University of South Carolina, USA
| | - Alfred Moore
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, USA.
| | - Ann-Marie Broome
- Department of Cell and Molecular Pharmacology & Experimental Therapeutics, Medical University of South Carolina, USA. .,Department of Bioengineering, Clemson University, USA
| | - Satish N Nadig
- Department of Surgery, Division of Transplant Surgery, Medical University of South Carolina, USA. .,Department of Microbiology and Immunology, Lee Patterson Allen Transplant Immunobiology Laboratory, Medical University of South Carolina, USA
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Tran D, Michelet F, Lelong C, Hans D. TBS Association with Biomechanical Properties of Human Vertebrae, Ex-Vivo. J Clin Densitom 2018. [DOI: 10.1016/j.jocd.2017.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tang S, Koh E, Delaney G, George A, Tran D, Otton J, Thomas L, Holloway L, Liney G. Quantification of Cardiac Subvolume Dosimetry in Breast Cancer Patients Receiving Tangential Beam Radiation Therapy. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tran D, Welsh R, Ohinmaa A, Nguyen T, Kaul P. RELATIVE BURDEN OF HOSPITALIZATION, OUTPATIENT, PHYSICIAN, AND DRUG COSTS IN THE SHORT- AND LONG-TERM AFTER ACUTE MYOCARDIAL INFARCTION. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Sheldon R, Tran D, Sandhu R, Kaul P. ASSOCIATION OF HOSPITALIZATION WITH FATAL OUTCOMES IN PATIENTS WITH SYNCOPE: A PROPENSITY ANALYSIS. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Libman E, Bailes S, Fichten C, Rizzo D, Creti L, Bailes M, Grad R, Tran D, Conrod K, Amsel R. 0817 ADHERENCE TO CPAP TREATMENT IN WOMEN WITH OBSTRUCTIVE SLEEP APNEA. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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