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Wenying S, Jing H, Ying L, Hui D. The role of TLR4/MyD88/NF-κB in the protective effect of ulinastatin on the intestinal mucosal barrier in mice with sepsis. BMC Anesthesiol 2023; 23:414. [PMID: 38102579 PMCID: PMC10722746 DOI: 10.1186/s12871-023-02374-9] [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: 04/03/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE To investigate the effect of the TLR4/MyD88/NF-κB (Toll-like receptor 4/myeloid differentiation factor/nuclear factor kappa B) signalling pathway on the protective effect of ulinastatin on the intestinal mucosal barrier in mice with sepsis. METHODS A mouse model of sepsis was established by classical caecal ligation and perforation. Forty-four SPF C57BL/6 mice were randomly divided into the following four groups with 11 mice in each group: the control group (Con group), ulinastatin group (Uti group), Uti + LPS (lipopolysaccharide, LPS) group (Uti + LPS group) and LPS group. Mice in the Con group and Uti group received saline or ulinastatin injected 2 h after modelling; Mice in the Uti + LPS group received LPS injected 0 h after modelling, other procedures were the same as in the Uti group; Mice in the LPS group received LPS only. At 48 h after surgery, the levels of TNF-α (tumour necrosis factor-α, TNF-α), IL-6 (interleukin-6, IL-6) and IL-1β (interleukin-1β, IL-1β) in vein, and the expression of TLR4, MyD88 and NF-κB mRNA in small intestinal mucosa tissues using ELISA and RT‒PCR. RESULTS The pathological specimens showed increased inflammatory injury in the Con and LPS groups, while these injuries and changes improved in the Uti group. The scores of intestinal mucosal injury at 48 h of Uti injection were significantly lower than those of the Con group (P < 0.001), while the scores of intestinal mucosal injury of Uti + LPS were significantly higher than those of the Uti group (P = 0.044). The expression of TNF-α, IL-6 and IL-1β in the Uti decreased significantly at 48 h after surgery than that in the Con group (P = 0.001, P = 0.014, P = 0.004), while the expression of TNF-α, IL-6 and IL-1β in the Uti + LPS group increased significantly after surgery than that in the Uti group (P = 0.026, P = 0.040, P = 0.039). The expression of TLR4, MyD88 and NF-κB mRNA in the Uti group decreased significantly compared with that in the Con group (P = 0.001, P = 0.021, P = 0.007), while the expression of TLR4, MyD88 and NF-κB mRNA in the Uti + LPS group was higher than that in the Uti group (P = 0.023, P = 0.040, P = 0.045). CONCLUSION These findings indicate that the protective effect of ulinastatin on the intestinal mucosal barrier against sepsis may be mediated through the TLR4/MyD88/NF-κB pathway.
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Affiliation(s)
- Song Wenying
- Department of Anesthesiology, Shaanxi Provincial Hospital, The Third Affiliated Hospital of Xi'an JiaoTong University, Xi'an, 710068, Shaanxi Province, People's Republic of China
| | - Huang Jing
- Xi'an Medical University, Xi'an 710068, Shaanxi Province, People's Republic of China
| | - Li Ying
- Xi'an Medical University, Xi'an 710068, Shaanxi Province, People's Republic of China
| | - Ding Hui
- Department of Anesthesiology, Shaanxi Provincial Hospital, The Third Affiliated Hospital of Xi'an JiaoTong University, Xi'an, 710068, Shaanxi Province, People's Republic of China.
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Zhan Z, Shi-Jin L, Yi-Ran Z, Zhi-Long L, Xiao-Xu Z, Hui D, Pan YL, Pan JH. High endothelial venules proportion in tertiary lymphoid structure is a prognostic marker and correlated with anti-tumor immune microenvironment in colorectal cancer. Ann Med 2023; 55:114-126. [PMID: 36503344 PMCID: PMC9754014 DOI: 10.1080/07853890.2022.2153911] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND High endothelial venules (HEV) and tertiary lymphoid structures (TLS) are associated with clinical outcomes of patients with colorectal cancer (CRC). However, because HEV are components of TLS, there have been few studies of the role of the HEV proportion in TLS (HEV/TLS). This study investigated the role of the HEV/TLS and its relationship with the tumor immune microenvironment in CRC. METHODS A retrospective analysis of 203 cases of tissue pathologically diagnosed as CRC after general surgery was performed at the First Affiliated Hospital of Jinan University from January 2014 to July 2017. Paraffin sections were obtained from the paracancerous intestinal mucosal tissues. The area of HEV and TLS and immune cells were detected by immunohistochemistry. We further divided the positive HEV expression group into the high HEV/TLS group and the low HEV/TLS group by the average area of HEV/TLS. After grouping, the data were also analyzed using the chi-square test, Kaplan-Meier method, and univariate and multivariate Cox proportional risk regression analyses. A correlation analysis of the HEV/TLS and immune cells as well as angiogenesis was performed. RESULTS Patients with a high HEV/TLS in CRC tissue were associated with longer OS, DFS and lower TNM stage. Meanwhile, CRC tissue with a high HEV/TLS showed a greater ability to recruit the CD3+ T cells, CD8+ T cells and M1 macrophages and correlated with less angiogenesis. Conclusively, high HEV/TLS links to the favorable prognosis of CRC patients and correlated with anti-tumor immune microenvironment, which can be a potential biomarker for prognosis of CRC patients. CONCLUSION A high HEV/TLS is associated with a favorable prognosis for CRC and is correlated with the anti-tumor immune microenvironment. Therefore, it is a potential biomarker of the CRC prognosis.KEY MESSAGESHigh HEV/TLS is associated with a favorable prognosis for CRC.High HEV/TLS correlated with the anti-tumor immune microenvironment of CRC and can serve as a novel prognostic biomarker.
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Affiliation(s)
- Zhao Zhan
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Liu Shi-Jin
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhang Yi-Ran
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Liu Zhi-Long
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhao Xiao-Xu
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ding Hui
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yun-Long Pan
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jing-Hua Pan
- Department of General Surgery, the First Affiliated Hospital of Jinan University, Guangzhou, China
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Stone P, Buckle P, Dolan R, Feliu J, Hui D, Laird BJA, Maltoni M, Moine S, Morita T, Nabal M, Vickerstaff V, White N, Santini D, Ripamonti CI. Prognostic evaluation in patients with advanced cancer in the last months of life: ESMO Clinical Practice Guideline. ESMO Open 2023; 8:101195. [PMID: 37087198 PMCID: PMC10242351 DOI: 10.1016/j.esmoop.2023.101195] [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: 11/30/2022] [Revised: 02/08/2023] [Accepted: 02/16/2023] [Indexed: 04/24/2023] Open
Abstract
•This ESMO Clinical Practice Guideline provides key recommendations for using prognostic estimates in advanced cancer. •The guideline covers recommendations for patients with cancer and an expected survival of months or less. •An algorithm for use of clinical predictions, prognostic factors and multivariable risk prediction models is presented. •The author group encompasses a multidisciplinary group of experts from different institutions in Europe, USA and Asia. •Recommendations are based on available scientific data and the authors’ collective expert opinion.
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Affiliation(s)
- P Stone
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK; Palliative Care Team, Central and North West London NHS Trust, London, UK
| | | | - R Dolan
- Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK
| | - J Feliu
- Department of Medical Oncology, La Paz University Hospital, IdiPAZ, CIBERONC, Cátedra UAM-AMGEN, Madrid, Spain
| | - D Hui
- Departments of Palliative Care, Rehabilitation and Integrative Medicine, Houston, USA; General Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - B J A Laird
- Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital, Edinburgh, UK; St Columba's Hospice Care, Edinburgh, UK
| | - M Maltoni
- Medical Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Specialised, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy
| | - S Moine
- Health Education and Practices Laboratory (LEPS EA3412), University Paris Sorbonne Paris Cité, Bobigny, Paris, France
| | - T Morita
- Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | - M Nabal
- Palliative Care Supportive Team, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - V Vickerstaff
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - N White
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - D Santini
- UOC Oncologia Medica Territoriale, La Sapienza University of Rome, Polo Pontino, Rome, Italy
| | - C I Ripamonti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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Xing L, Hui-Ying Z, Fu-Min F, He-Dan Y, Hui D, Yin Y, Yi-Ping G, Tong L. [Blue Nevus Hidden within the Nevus of Ota]. Chin Med Sci J 2023; 38:70-72. [PMID: 36727415 DOI: 10.24920/004092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 3-year-old boy presented with bluish patch and scattered blue spots on the left side of his face. After several sessions of laser treatment, the azury patch in the periorbital area became even darker. Histopathology showed many bipolar, pigment-laden dendritic cells scattered in the papillary and upper reticular dermis. Immunohistochemically, these cells were positive for S100, SOX-10, melan-A, P16, and HMB-45. The positive rate of Ki-67 was less than 5%. Finally, the lesion was diagnosed with nevus of Ota concurrent with common blue nevus. Therefore, for cases of the nevus of Ota with poor response to laser treatment, the possible coexisting diseases should be suspected.
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Affiliation(s)
- Liu Xing
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Zheng Hui-Ying
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Fang Fu-Min
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Yang He-Dan
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Ding Hui
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Yang Yin
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Ge Yi-Ping
- Department of Cosmetic Laser Surgery, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
| | - Lin Tong
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Institute of Dermatology, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing 210042, China
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Yanan J, Hui D, Jianwei G, Ronglin L, Lijuan Z, Jing Z. A Comparative Study on Sedation Efficacy Between General and Regional Anesthesia with Dexmedetomidine in Patients Under Maxillofacial Surgery. Curr Drug Metab 2022; 23:920-927. [PMID: 35422208 DOI: 10.2174/1389200223666220413113412] [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: 10/11/2021] [Revised: 02/26/2022] [Accepted: 03/01/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Securing the airway in the surgery of maxillofacial disorders and traumas is fundamental during the operation. The present study aims to investigate the beneficial sedative effects of dexmedetomidine (DEX) in patients who underwent maxillofacial surgery with regional anesthesia compared to general anesthesia. METHODS Fifty patients, aged 20-45 years old were randomly divided into two groups of regional anesthesia (RA) and general anesthesia (GA) (each n=25). The group RA received regional block with sedation (DEX: 1 μg/kg infused over 10 min followed by the maintenance dose of 0.5 μg/kg/h) and the group GA underwent general anesthesia (DEX: 0.1 μg/kg/min over 10 min followed by 0.4-0.7 μg/kg/h). Postoperative pain scores, anesthesia outcomes, hemodynamic parameters, the time of the post-anesthesia care unit (PACU) discharge and intra and postoperative complications were comparatively assessed in both groups. RESULTS The baseline characteristics of the patients (age, gender, BMI, and ASA physical status) showed no differences between the two groups (P>0.05). Although the duration of surgery and recovery time showed no differences between the groups, the duration of anesthesia and extubation time was remarkably lower in the RA group than in the GA group (P<0.01). Administration of nerve blocks demonstrated less pain and longer sleep time in the postoperative phase as compared to the GA group. Heart rate and mean arterial blood pressure were significantly less in the RA group at the end of the loading dose of DEX and incision time (P<0.05). SpO2, respiration rate and Ramsay sedation scale did not exhibit any significant differences between the two groups at all-time points (P>0.05). No significant differences were observed with regard to the adverse events between the two groups (P>0.05). CONCLUSIONS Although our findings revealed that both methods are suitable and safe methods for maxillofacial surgery, the outcomes of anesthesia with regional block and sedation include less pain in the postoperative phase, shorter extubation time and earlier discharge from the PACU demonstrated that this method is more reliable for maxillofacial surgery. Further controlled studies are needed to compare the effectiveness and safety profiles of two RA and GA techniques and also to compare DEX with other anesthetic agents to achieve optimum outcomes in maxillofacial surgeries.
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Affiliation(s)
- Jiang Yanan
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an 710068, China
| | - Ding Hui
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an 710068, China
| | - Guo Jianwei
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an 710068, China
| | - Liu Ronglin
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an 710068, China
| | - Zhu Lijuan
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an 710068, China
| | - Zhao Jing
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an 710068, China
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Preto D, Paiva B, Hui D, Bruera E, Paiva C. 1463P Improvement of the Barretos Prognostic Nomogram (BPN): New prognostic models for advanced cancer outpatients. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.228] [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] Open
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Pan Q, Hui D, Hu C. Associations of CD14 variants with the triglyceride levels and risk of myocardial infarction in an Eastern Chinese Han population. Int Immunopharmacol 2021; 99:108041. [PMID: 34435580 DOI: 10.1016/j.intimp.2021.108041] [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: 03/04/2021] [Revised: 07/14/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND CD14 is crucial in the progression of myocardial infarction (MI). Several studies have explored the association between the risk of MI and the CD14 C-260 T polymorphism, but have reported inconsistent results. METHODS This study analyzed the association of the CD14 C-260 T polymorphism with susceptibility to MI. Totally, 240 MI patients and 298 normal subjects were included. The association between MI risk and the target polymorphism was assessed using 95% confidence intervals and odds ratios obtained through logistic regression. RESULTS The T allele of the CD14 C-260 T polymorphism was linked with an elevated risk of MI in Chinese Han people; subgroup analysis indicated that this effect was associated with smoking, male gender, and hypertension. In addition, the data revealed that different genotype carriers of the CD14 C-260 T polymorphism showed significantly distinct TG levels in MI patients. CONCLUSION Totally, the T allele of the CD14 C-260 T polymorphism is associated with an elevated risk of MI.
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Affiliation(s)
- Quanhua Pan
- Department of Cardiology Surgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu Province 223001, China.
| | - Ding Hui
- Department of Cardiology Surgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu Province 223001, China
| | - Chuangxian Hu
- Department of Cardiology Surgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu Province 223001, China
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Pan Q, Hui D, Hu C. A Variant of IL1B Is Associated with the Risk and Blood Lipid Levels of Myocardial Infarction in Eastern Chinese Individuals. Immunol Invest 2021; 51:1162-1169. [PMID: 33941028 DOI: 10.1080/08820139.2021.1914081] [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] [Indexed: 10/21/2022]
Abstract
In this study, we determined to interpret the effects of the interleukin (IL)1B gene rs1143634 C/T polymorphism on myocardial infarction (MI) risk. This study, conducted in a Chinese Han population, recruited 369 MI patients and 465 controls. The variant of IL1B gene (rs1143634 C/T polymorphism) was genotyped by PCR-RFLP method. In this study, a significant link was shown between the IL1B rs1143634 C/T polymorphism and MI risk. We found that the IL1B rs1143634 C/T polymorphism enhanced the risk of MI in this population. Subgroup analysis detected that the IL1B rs1143634 C/T polymorphism associated with MI susceptibility in males, smokers, and individuals with diabetes mellitus. In addition, the IL1B rs1143634 C/T polymorphism was related with the levels of blood lipids including low-density lipoprotein (LDL), and total cholesterol (TC). This study uncovers that the IL1B rs1143634 C/T polymorphism may associate with the risk and blood lipid levels of MI in an Eastern Chinese Han population.Abbreviations: MI: myocardial infarction; IL-1: Interleukin-1; SNP: single nucleotide polymorphism; BMI: Body Mass Index; HDL: high-density lipoprotein; TC: total cholesterol; TG: triglyceride; LDL: low-density lipoprotein; PCR: polymerase chain reaction; 95% CI: 95% confidence interval; OR: odds ratio.
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Affiliation(s)
- Quanhua Pan
- Department of Cardiology Surgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Ding Hui
- Department of Cardiology Surgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China
| | - Chuangxian Hu
- Department of Cardiology Surgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Huaian, China
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Zhen W, Hui D, Wenying S, Yulong S. MicroRNA-20b-5p regulates propofol-preconditioning-induced inhibition of autophagy in hypoxia-and-reoxygenation-stimulated endothelial cells. J Biosci 2020. [DOI: 10.1007/s12038-020-9998-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Zhen W, Hui D, Wenying S, Yulong S. MicroRNA-20b-5p regulates propofol-preconditioning-induced inhibition of autophagy in hypoxia-and-reoxygenation-stimulated endothelial cells. J Biosci 2020; 45:35. [PMID: 32098914] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Ischemia-reperfusion (IR) injury is a major cause of clinical emergencies during and after surgical procedures. Propofol protects the heart from cardiovascular IR injury by inhibiting autophagy. MicroRNAs (miRNAs) participate in anesthetic-regulated cardiovascular injury. MiR-20b-5p targets unc-51-like autophagy activating kinase 1 (ULK1). Its role in propofol-modulated cardiovascular IR injury remains unclear, however. In this study, we used an in vitro model of hypoxia-reoxygenation (HR)-induced injury to human umbilical vein endothelial cells (HUVECs) to determine the protective effect of miR-20b-5p in cells preconditioned with propofol. We found that miR-20b-5p was significantly higher and ULK1 was lower in propofol-preconditioned HUVECs with HR injury than in HUVECs with HR injury only. Additionally, miR-20b-5p overexpression increased cell viability and repressed autophagy and apoptosis more in propofol-preconditioned HUVECs with HR injury than in HUVECs with HR injury only. A luciferase reporter assay confirmed the target reaction between miR-20b-5p and ULK1. Overexpression of ULK1 restrained the protective effect of miR-20b-5p in propofol-preconditioned HUVECs with HR injury. In conclusion, our results indicate that propofol inhibits autophagic cell death via the miR-20b-5p-ULKI axis and that ULK1 may be a therapeutic target for cardiovascular IR injury.
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Affiliation(s)
- Wang Zhen
- Department of Anesthesiology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi, China
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Yang M, Gao T, Hui D, Chen X, Liu W. Complete mitochondrial genome and the phylogenetic position of the Sphaeroma sp. (Crustacea, Isopod, Sphaeromatidae). Mitochondrial DNA B Resour 2019; 4:3896-3897. [PMID: 33366240 PMCID: PMC7707692 DOI: 10.1080/23802359.2019.1687350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 10/27/2019] [Indexed: 11/27/2022] Open
Abstract
The complete mitogenome of Sphaeroma sp. (Crustacea, Isopod, Sphaeromatidae) was determined in this study. The total length of mitogenome was 15,839 bp, and contained 13 protein-coding genes, 21 tRNA genes, 2 rRNA genes, 1 control region, and 2 unknown fragments which longer than 200 bp. The nucleotide composition was 25.80% A, 16.56% C, 25.94% G and 31.67% T. Six initiation codons (ATA, ATC, ATG, ATT, ACG, GTG) and three termination codons (TAA, TAG, TA-) were used in the protein-coding genes. The length of tRNA genes ranged from 52 to 65 bp, and tRNA-Arg was not identified. The phylogenetic result showed Sphaeroma sp. was closely related to Sphaeroma terebrans with high bootstrap value supported.
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Affiliation(s)
- Mingliu Yang
- Guangxi Academy of Sciences, Guangxi Mangrove Research Center, Guangxi Key Lab of Mangrove Conservation and Utilization, Beihai, PR China
| | - Tingwei Gao
- Guangxi Academy of Sciences, Guangxi Mangrove Research Center, Guangxi Key Lab of Mangrove Conservation and Utilization, Beihai, PR China
| | - Ding Hui
- Guangxi Academy of Sciences, Guangxi Mangrove Research Center, Guangxi Key Lab of Mangrove Conservation and Utilization, Beihai, PR China
| | - Xiao Chen
- College of Marine Sciences, South China Agricultural University, Guangzhou, PR China
| | - Wenai Liu
- Guangxi Academy of Sciences, Guangxi Mangrove Research Center, Guangxi Key Lab of Mangrove Conservation and Utilization, Beihai, PR China
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Hui D, Cherny N, Latino N, Strasser F. The 'critical mass' survey of palliative care programme at ESMO designated centres of integrated oncology and palliative care. Ann Oncol 2018; 28:2057-2066. [PMID: 28911084 DOI: 10.1093/annonc/mdx280] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background The ESMO Designated Centres (ESMO-DCs) of Integrated Oncology and Palliative Care (PC) Incentive Programme has grown steadily. We aimed to characterise the level of PC clinical services, education and research at ESMO-DCs. Methods We sent all 184 ESMO-DCs an electronic survey consisting of 78 questions examining the DC characteristics, palliative care clinical programme (structure, processes, and outcomes), primary PC delivery by oncologists, education, research and attitudes and beliefs towards the ESMO-DC programme. Results The response rate was 83% (152/184). 115 (76%) ESMO-DCs were from Europe, 87 (57%) were tertiary care centres. 136 (90%) had inpatient consultation teams, 135 (89%) had outpatient PC clinics, 107 (71%) had dedicated acute care beds, and 75 (50%) offered community-based PC. An estimated 70% (interquartile range [IQR] 28-80%) of patients with advanced cancer had a PC consultation before death, occurring 90 days before death (median, IQR 40-150 days) for outpatients and 21 days (IQR 14-45 days) for inpatients. 59 (39%) offered PC fellowship programme; 47 (32%) had mandatory PC rotations for oncology fellows. Ninety-nine (65%) had double-boarded palliative oncologists. 118 (78%) of the ESMO-DCs reported that routine symptom screening was offered in the oncology clinic and 30% of patients had documented end-of-life discussions by their oncologists. Most centres (>80%) perceived the ESMO-DC programme to increase their status. Conclusions The ESMO-DCs had a high level of PC infrastructure and provided access to a large proportion of patients with advanced cancer. The survey supports that the 13 criteria required for ESMO designation set a robust framework for integration, stimulated investment of resources into some palliative care programmes prior to accreditation, and raised the interest about palliative care among clinicians, trainees and patients.
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Affiliation(s)
- D Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - N Cherny
- Cancer Pain and Palliative Medicine Service, Department of Medical Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - N Latino
- European Society for Medical Oncology Head Office, Viganello-Lugano
| | - F Strasser
- Oncological Palliative Medicine, Clinic Oncology/Hematology, Cantonal Hospital, St. Gallen, Switzerland
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Dao FY, Yang H, Su ZD, Yang W, Wu Y, Hui D, Chen W, Tang H, Lin H. Recent Advances in Conotoxin Classification by Using Machine Learning Methods. Molecules 2017; 22:molecules22071057. [PMID: 28672838 PMCID: PMC6152242 DOI: 10.3390/molecules22071057] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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: 05/17/2017] [Revised: 06/12/2017] [Accepted: 06/19/2017] [Indexed: 11/16/2022] Open
Abstract
Conotoxins are disulfide-rich small peptides, which are invaluable peptides that target ion channel and neuronal receptors. Conotoxins have been demonstrated as potent pharmaceuticals in the treatment of a series of diseases, such as Alzheimer's disease, Parkinson's disease, and epilepsy. In addition, conotoxins are also ideal molecular templates for the development of new drug lead compounds and play important roles in neurobiological research as well. Thus, the accurate identification of conotoxin types will provide key clues for the biological research and clinical medicine. Generally, conotoxin types are confirmed when their sequence, structure, and function are experimentally validated. However, it is time-consuming and costly to acquire the structure and function information by using biochemical experiments. Therefore, it is important to develop computational tools for efficiently and effectively recognizing conotoxin types based on sequence information. In this work, we reviewed the current progress in computational identification of conotoxins in the following aspects: (i) construction of benchmark dataset; (ii) strategies for extracting sequence features; (iii) feature selection techniques; (iv) machine learning methods for classifying conotoxins; (v) the results obtained by these methods and the published tools; and (vi) future perspectives on conotoxin classification. The paper provides the basis for in-depth study of conotoxins and drug therapy research.
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Affiliation(s)
- Fu-Ying Dao
- Key Laboratory for Neuro-Information of Ministry of Education, School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China.
| | - Hui Yang
- Key Laboratory for Neuro-Information of Ministry of Education, School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China.
| | - Zhen-Dong Su
- Key Laboratory for Neuro-Information of Ministry of Education, School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China.
| | - Wuritu Yang
- Key Laboratory for Neuro-Information of Ministry of Education, School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China.
- Development and Planning Department, Inner Mongolia University, Hohhot 010021, China.
| | - Yun Wu
- College of Computer and Information Engineering, Xiamen University of Technology, Xiamen 361024, China.
| | - Ding Hui
- Key Laboratory for Neuro-Information of Ministry of Education, School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China.
| | - Wei Chen
- Key Laboratory for Neuro-Information of Ministry of Education, School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China.
- Department of Physics, School of Sciences, and Center for Genomics and Computational Biology, North China University of Science and Technology, Tangshan 063000, China.
| | - Hua Tang
- Department of Pathophysiology, Southwest Medical University, Luzhou 646000, China.
| | - Hao Lin
- Key Laboratory for Neuro-Information of Ministry of Education, School of Life Science and Technology, Center for Informational Biology, University of Electronic Science and Technology of China, Chengdu 610054, China.
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Behrends DA, Hui D, Gao C, Awlia A, Al-Saran Y, Li A, Henderson JE, Martineau PA. Defective Bone Repair in C57Bl6 Mice With Acute Systemic Inflammation. Clin Orthop Relat Res 2017; 475:906-916. [PMID: 27844403 PMCID: PMC5289198 DOI: 10.1007/s11999-016-5159-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 11/03/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Bone repair is initiated with a local inflammatory response to injury. The presence of systemic inflammation impairs bone healing and often leads to malunion, although the underlying mechanisms remain poorly defined. Our research objective was to use a mouse model of cortical bone repair to determine the effect of systemic inflammation on cells in the bone healing microenvironment. QUESTION/PURPOSES: (1) Does systemic inflammation, induced by lipopolysaccharide (LPS) administration affect the quantity and quality of regenerating bone in primary bone healing? (2) Does systemic inflammation alter vascularization and the number or activity of inflammatory cells, osteoblasts, and osteoclasts in the bone healing microenvironment? METHODS Cortical defects were drilled in the femoral diaphysis of female and male C57BL/6 mice aged 5 to 9 months that were treated with daily systemic injections of LPS or physiologic saline as control for 7 days. Mice were euthanized at 1 week (Control, n = 7; LPS, n = 8), 2 weeks (Control, n = 7; LPS, n = 8), and 6 weeks (Control, n = 9; LPS, n = 8) after surgery. The quantity (bone volume per tissue volume [BV/TV]) and microarchitecture (trabecular separation and thickness, porosity) of bone in the defect were quantified with time using microCT. The presence or activity of vascular endothelial cells (CD34), macrophages (F4/80), osteoblasts (alkaline phosphatase [ALP]), and osteoclasts (tartrate-resistant acid phosphatase [TRAP]) were evaluated using histochemical analyses. RESULTS Only one of eight defects was bridged completely 6 weeks after surgery in LPS-injected mouse bones compared with seven of nine defects in the control mouse bones (odds ratio [OR], 0.04; 95% CI, 0.003-0.560; p = 0.007). The decrease in cortical bone in LPS-treated mice was reflected in reduced BV/TV (21% ± 4% vs 39% ± 10%; p < 0.01), increased trabecular separation (240 ± 36 μm vs 171 ± 29 μm; p < 0.01), decreased trabecular thickness (81 ± 18 μm vs 110 ± 22 μm; p = 0.02), and porosity (79% ± 4% vs 60% ± 10%; p < 0.01) at 6 weeks postoperative. Defective healing was accompanied by decreased CD34 (1.1 ± 0.6 vs 3.4 ± 0.9; p < 0.01), ALP (1.9 ± 0.9 vs 6.1 ± 3.2; p = 0.03), and TRAP (3.3 ± 4.7 vs 7.2 ± 4.0; p = 0.01) activity, and increased F4/80 (13 ± 2.6 vs 6.8 ± 1.7; p < 0.01) activity at 2 weeks postoperative. CONCLUSION The results indicate that LPS-induced systemic inflammation reduced the amount and impaired the quality of bone regenerated in mouse femurs. The effects were associated with impaired revascularization, decreased bone turnover by osteoblasts and osteoclasts, and by increased catabolic activity by macrophages. CLINICAL RELEVANCE Results from this preclinical study support clinical observations of impaired primary bone healing in patients with systemic inflammation. Based on our data, local administration of VEGF in the callus to stimulate revascularization, or transplantation of stem cells to enhance bone turnover represent potentially feasible approaches to improve outcomes in clinical practice.
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Affiliation(s)
- D. A. Behrends
- grid.63984.300000000090644811Bone Engineering Laboratories, Research Institute-McGill University Health Center, Montreal, QC Canada ,grid.14709.3b0000000419368649Experimental Surgery, Faculty of Medicine, McGill University, Montreal, QC Canada
| | - D. Hui
- grid.63984.300000000090644811Bone Engineering Laboratories, Research Institute-McGill University Health Center, Montreal, QC Canada ,grid.17091.3e0000000122889830Microbiology & Immunology Program, University of British Columbia, Vancouver, BC Canada
| | - C. Gao
- grid.63984.300000000090644811Bone Engineering Laboratories, Research Institute-McGill University Health Center, Montreal, QC Canada ,grid.14709.3b0000000419368649Experimental Medicine, Faculty of Medicine, McGill University, Montreal, QC Canada
| | - A. Awlia
- grid.63984.300000000090644811Bone Engineering Laboratories, Research Institute-McGill University Health Center, Montreal, QC Canada ,grid.14709.3b0000000419368649Experimental Surgery, Faculty of Medicine, McGill University, Montreal, QC Canada
| | - Y. Al-Saran
- grid.63984.300000000090644811Bone Engineering Laboratories, Research Institute-McGill University Health Center, Montreal, QC Canada ,grid.14709.3b0000000419368649Experimental Surgery, Faculty of Medicine, McGill University, Montreal, QC Canada
| | - A. Li
- grid.63984.300000000090644811Bone Engineering Laboratories, Research Institute-McGill University Health Center, Montreal, QC Canada
| | - J. E. Henderson
- grid.63984.300000000090644811Bone Engineering Laboratories, Research Institute-McGill University Health Center, Montreal, QC Canada ,grid.14709.3b0000000419368649Experimental Surgery, Faculty of Medicine, McGill University, Montreal, QC Canada ,grid.14709.3b0000000419368649Experimental Medicine, Faculty of Medicine, McGill University, Montreal, QC Canada ,grid.416099.3000000012218112XBone Engineering Labs, Research Institute-McGill University Health Centre, Surgical Research, C10.148.6, Montreal General Hospital, 1650 Cedar Ave., Montreal, QC H3G 1A4 Canada
| | - P. A. Martineau
- grid.63984.300000000090644811Bone Engineering Laboratories, Research Institute-McGill University Health Center, Montreal, QC Canada ,grid.14709.3b0000000419368649Experimental Surgery, Faculty of Medicine, McGill University, Montreal, QC Canada
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Affiliation(s)
- D Hui
- Department of Dermatology, The Third People's Hospital of Hangzhou, Hangzhou, Zhejiang, China
| | - J Hong-Yan
- Department of Dermatology, The Third People's Hospital of Hangzhou, Hangzhou, Zhejiang, China
| | - X Ai-E
- Department of Dermatology, The Third People's Hospital of Hangzhou, Hangzhou, Zhejiang, China
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Pellizzari M, Hui D, Pinato E, Lisiero M, Serpentini S, Gubian L, Figoli F, Cancian M, De Chirico C, Ferroni E, Avossa F, Saugo M. Impact of intensity and timing of integrated home palliative cancer care on end-of-life hospitalization in Northern Italy. Support Care Cancer 2016; 25:1201-1207. [PMID: 27913873 DOI: 10.1007/s00520-016-3510-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The Veneto Region implemented a novel integrated home-based palliative cancer care (HPCC) program embedded in primary care. We examined the impact of timing and intensity of this program on the quality of end-of-life (EOL) care. METHODS We selected adult cancer patients died in the Veneto Region between March and December 2013, excluding those died from haematological malignancies as well as the very elderly (85+ years). We retrieved the claim-based data on hospitalization and homecare visits, and defined two observation windows: 90 to 16 days before death to examine intensity of HPCC exposure, and the last 15 days of life to examine EOL outcomes, including hospital death, any hospital stay for medical reasons and hospital stay ≥7 days for medical reasons. Multivariate analysis was conducted using a Poisson model. RESULTS Among the 2211 adults who died of solid tumours and received 1+ homecare visits during the exposure period, 1077 (48.7%), 552 (25.0%) and 582 (26.3%) had 0.1-1.9, 2-3.9 and 4+ homecare visits/week, respectively. The median duration between an HPCC home visit and death was 92 days (IQR 42-257 days). Hospital death occurred in 856 (38.7%) patients, while 1087 (49.2%) and 556 (25.1%) had a hospital stay and a hospital stay ≥7 days during the exposure period, respectively. In the multivariate analysis, a greater intensity of integrated HPCC (4+ visits/week) was significantly associated with a lower risk of hospital death (relative risk [RR] = 0.67, 0.59-0.76), any hospital stay (RR = 0.69, 0.62-0.77) and hospital stay ≥7 days for medical reasons (RR = 0.59, 0.49-0.71). A late activation (≤30 days before death) of HPCC was also associated with increased both hospital stay (RR = 1.26, 0.11-1.42) and hospital stay ≥7 days (RR = 1.25, 1.01-1.54). CONCLUSIONS A greater HPCC program intensity reduces the risk of hospital death and hospital stay in the end-of-life. An early activation of this program can contribute to improve these EOL outcomes.
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Affiliation(s)
- M Pellizzari
- Epidemiological Service of the Veneto Region, Passaggio Gaudenzio, 1, 35131, Padua, Padova, Italy
| | - D Hui
- Department of Palliative Care and Rehabilitation Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - E Pinato
- Epidemiological Service of the Veneto Region, Passaggio Gaudenzio, 1, 35131, Padua, Padova, Italy
| | - M Lisiero
- Hospital Direction, Local Health Unit n° 8, Asolo, Italy
| | - S Serpentini
- Palliative Care Unit Local Health Unit n° 3, Bassano del Grappa and Veneto Oncology Institute, Padua, Italy
| | - L Gubian
- Information Technology Service of the Veneto Region, Venezia, Italy
| | - F Figoli
- Palliative Care Unit, Local Health Unit n° 4, Thiene, Italy
| | - M Cancian
- GP, Local Health Unit n° 7, Conegliano, Italy
| | - C De Chirico
- Palliative Care Unit, Local Health Unit n° 7, Pieve di Soligo, Italy
| | - E Ferroni
- Epidemiological Service of the Veneto Region, Passaggio Gaudenzio, 1, 35131, Padua, Padova, Italy.
| | - F Avossa
- Epidemiological Service of the Veneto Region, Passaggio Gaudenzio, 1, 35131, Padua, Padova, Italy
| | - M Saugo
- Epidemiological Service of the Veneto Region, Passaggio Gaudenzio, 1, 35131, Padua, Padova, Italy
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Wu Y, Hui D, Eskin N, Cui S. Water-soluble yellow mustard mucilage: A novel ingredient with potent antioxidant properties. Int J Biol Macromol 2016; 91:710-5. [DOI: 10.1016/j.ijbiomac.2016.05.088] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 04/19/2016] [Accepted: 05/25/2016] [Indexed: 10/21/2022]
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Hui D, Cherny N, Latino N, Strasser F. Characteristics and level of integration of ESMO Designated Centres of integrated oncology and palliative care. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw384.02] [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: 11/13/2022] Open
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Sutherland K, Lee R, Chan T, Ng S, Hui D, Cistulli P. Craniofacial photography for prediction of obstructive sleep apnoea in a Hong Kong sleep clinic population. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hui D, Bansal S, Strasser F, Morita T, Caraceni A, Davis M, Cherny N, Kaasa S, Currow D, Abernethy A, Nekolaichuk C, Bruera E. Reply to the letter to the editor 'Integration between oncology and palliative care: does one size fit all?' by Verna et al. Ann Oncol 2015; 27:549-50. [PMID: 26602776 DOI: 10.1093/annonc/mdv584] [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)
- D Hui
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S Bansal
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - F Strasser
- Oncological Palliative Medicine, Hematology-Oncology, Cantonal Hospital, St Gallen, Switzerland
| | - T Morita
- Department of Palliative and Supportive Care and Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - A Caraceni
- Palliative Care, Pain Therapy and Rehabilitation, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M Davis
- Department of Solid Tumor Oncology, Taussig Cancer Institute, Cleveland, USA
| | - N Cherny
- Cancer Pain and Palliative Medicine Service, Department of Medical Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - S Kaasa
- European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology and The Cancer Clinic, St Olavs Hospital-Trondheim University Hospital, Trondheim, Norway
| | - D Currow
- Palliative and Supportive Services, Flinders University, Adelaide, Australia
| | - A Abernethy
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, USA
| | - C Nekolaichuk
- Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Canada
| | - E Bruera
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
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Hui D, Bansal S, Park M, Reddy A, Cortes J, Fossella F, Bruera E. Differences in attitudes and beliefs toward end-of-life care between hematologic and solid tumor oncology specialists. Ann Oncol 2015; 26:1440-6. [PMID: 26041765 PMCID: PMC4855240 DOI: 10.1093/annonc/mdv028] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [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: 12/09/2014] [Revised: 12/29/2014] [Accepted: 12/30/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with hematologic malignancies often receive aggressive care at the end-of-life. To better understand the end-of-life decision-making process among oncology specialists, we compared the cancer treatment recommendations, and attitudes and beliefs toward palliative care between hematologic and solid tumor specialists. PATIENTS AND METHODS We randomly surveyed 120 hematologic and 120 solid tumor oncology specialists at our institution. Respondents completed a survey examining various aspects of end-of-life care, including palliative systemic therapy using standardized case vignettes and palliative care proficiency. RESULTS Of 240 clinicians, 182 (76%) clinicians responded. Compared with solid tumor specialists, hematologic specialists were more likely to favor prescribing systemic therapy with moderate toxicity and no survival benefit for patients with Eastern Cooperative Oncology Group (ECOG) performance status 4 and an expected survival of 1 month (median preference 4 versus 1, in which 1 = strong against treatment and 7 = strongly recommend treatment, P < 0.0001). This decision was highly polarized. Hematologic specialists felt less comfortable discussing death and dying (72% versus 88%, P = 0.007) and hospice referrals (81% versus 93%, P = 0.02), and were more likely to feel a sense of failure with disease progression (46% versus 31%, P = 0.04). On multivariate analysis, hematologic specialty [odds ratio (OR) 2.77, P = 0.002] and comfort level with prescribing treatment to ECOG 4 patients (OR 3.79, P = 0.02) were associated with the decision to treat in the last month of life. CONCLUSIONS We found significant differences in attitudes and beliefs toward end-of-life care between hematologic and solid tumor specialists, and identified opportunities to standardize end-of-life care.
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Affiliation(s)
- D Hui
- Departments of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S Bansal
- Departments of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - M Park
- Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - A Reddy
- Departments of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - J Cortes
- Leukemia, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - F Fossella
- Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - E Bruera
- Departments of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
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Hui D, Bansal S, Strasser F, Morita T, Caraceni A, Davis M, Cherny N, Kaasa S, Currow D, Abernethy A, Nekolaichuk C, Bruera E. Indicators of integration of oncology and palliative care programs: an international consensus. Ann Oncol 2015; 26:1953-1959. [PMID: 26088196 DOI: 10.1093/annonc/mdv269] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [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: 04/18/2015] [Accepted: 05/29/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recently, the concept of integrating oncology and palliative care has gained wide professional and scientific support; however, a global consensus on what constitutes integration is unavailable. We conducted a Delphi Survey to develop a consensus list of indicators on integration of specialty palliative care and oncology programs for advanced cancer patients in hospitals with ≥100 beds. METHODS International experts on integration rated a list of indicators on integration over three iterative rounds under five categories: clinical structure, processes, outcomes, education, and research. Consensus was defined a priori by an agreement of ≥70%. Major criteria (i.e. most relevant and important indicators) were subsequently identified. RESULTS Among 47 experts surveyed, 46 (98%), 45 (96%), and 45 (96%) responded over the three rounds. Nineteen (40%) were female, 24 (51%) were from North America, and 14 (30%) were from Europe. Sixteen (34%), 7 (15%), and 25 (53%) practiced palliative care, oncology, and both specialties, respectively. After three rounds of deliberation, the panelists reached consensus on 13 major and 30 minor indicators. Major indicators included two related to structure (consensus 95%-98%), four on processes (88%-98%), three on outcomes (88%-91%), and four on education (93%-100%). The major indicators were considered to be clearly stated (9.8/10), objective (9.4/10), amenable to accurate coding (9.5/10), and applicable to their own countries (9.4/10). CONCLUSIONS Our international experts reached broad consensus on a list of indicators of integration, which may be used to identify centers with a high level of integration, and facilitate benchmarking, quality improvement, and research.
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Affiliation(s)
- D Hui
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA.
| | - S Bansal
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - F Strasser
- Oncological Palliative Medicine, Hematology-Oncology, Cantonal Hospital, St. Gallen, Switzerland
| | - T Morita
- Department of Palliative and Supportive Care and Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - A Caraceni
- Palliative Care, Pain Therapy and Rehabilitation, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | - M Davis
- Department of Solid Tumor Oncology, Taussig Cancer Institute, Cleveland, USA
| | - N Cherny
- Cancer Pain and Palliative Medicine Service, Department of Medical Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - S Kaasa
- European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology and The Cancer Clinic, St. Olavs Hospital - Trondheim University Hospital, Trondheim, Norway
| | - D Currow
- Palliative and Supportive Services, Flinders University, Adelaide, South Australia
| | - A Abernethy
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, USA
| | - C Nekolaichuk
- Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Canada
| | - E Bruera
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, USA
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Hui D, Yan X, Wei J, Ruixia M, Guangju G. Significance of mutations in hepatitis B virus X gene for the pathogenesis of HB-associated glomerulonephritis. Acta Virol 2014; 58:278-81. [PMID: 25283864 DOI: 10.4149/av_2014_03_278] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this study, the significance of hepatitis virus (HBV) X gene mutations for the pathogenesis of HBV-associated glomerulonephritis (HBV-GN) was investigated. DNA was extracted from 50 HBV-GN patients and 60 asymptomatic HBV carriers and subjected to PCR amplification and sequencing of HBV X gene. In HBV-GN patients, missense nucleotide mutations of C1653T, A1726C, A1727T, C1730G, T1753C, A1762T, and G1764A were detected in 84% of subjects, all located in the trans-acting regulatory region of the X gene. In control patients, missense nucleotide mutations of A1632C and A1635C were detected in 8% of subjects, both located in the non-functional region of the X gene. We conclude that, in most HBV-GN patients, X gene missense mutations occurred at some key sites playing an important role in the pathogenesis of HBV-GN.
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Hui D, Bowdish M, Cleveland J, Ranjan R, Sinha R, Baker CJ, Cunningham MJ, Starnes VA. 017 * AORTIC VALVE REPLACEMENT THROUGH AN ANTERIOR RIGHT MINI-THORACOTOMY WITH CENTRAL AORTIC CANNULATION IS SAFE. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.17] [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: 11/14/2022] Open
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van de Wiel HJ, Galagan Y, van Lammeren TJ, de Riet JFJ, Gilot J, Nagelkerke MGM, Lelieveld RHCAT, Shanmugam S, Pagudala A, Hui D, Groen WA. Roll-to-roll embedded conductive structures integrated into organic photovoltaic devices. Nanotechnology 2013; 24:484014. [PMID: 24196842 DOI: 10.1088/0957-4484/24/48/484014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Highly conductive screen printed metallic (silver) structures (current collecting grids) combined with poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) are a viable replacement for indium tin oxide (ITO) and inkjet printed silver as transparent electrode materials. To provide successful integration into organic photovoltaic (OPV) devices, screen printed silver current collecting grids should be embedded into a substrate to avoid topology issues. In this study micron-thick conductive structures are embedded and integrated into OPV devices. The embedded structures are produced roll-to-roll with optimized process settings and materials. Topology measurements show that the embedded grids are well suited for integration into OPV devices since the surface is almost without spikes and has low surface roughness. JV measurements of OPV devices with embedded structures on a polyethylene terephthalate/silicon nitride (PET/SiN) substrate show an efficiency of 2.15%, which is significantly higher than identical flexible devices with ITO (1.02%) and inkjet printed silver (1.48%). The use of embedded screen printed silver instead of ITO and inkjet printed silver in OPV devices will allow for higher efficiency devices which can be produced with larger design and process freedom.
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Affiliation(s)
- H J van de Wiel
- TNO, Materials for Integrated Products, De Rondom 1, 5612 AP, Eindhoven, The Netherlands. Holst Centre, PO BOX 8550, 5605 KN Eindhoven, The Netherlands
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Weidong W, Haisheng Z, Hui D. The latest development of low resistance thought imprint psychotherapy sleep-regulating technique of insomnia. Sleep Med 2013. [DOI: 10.1016/j.sleep.2013.11.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hui D, Yan F, Chen RH. The effects of azithromycin on patients with diffuse panbronchiolitis: a retrospective study of 29 cases. J Thorac Dis 2013; 5:613-7. [PMID: 24255774 DOI: 10.3978/j.issn.2072-1439.2013.09.01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 09/02/2013] [Indexed: 11/14/2022]
Abstract
BACKGROUND Diffuse panbronchiolitis (DPB), a chronic inflammatory disease of the airway, is treated with macrolide antibiotics. The ability of azithromycin to improve DPB prognosis, as detected by high-resolution computed tomography (HRCT) scans and lung function tests, has not been studied in a large retrospective of patients. Our study aims to investigate the effects of azithromycin on patients with DPB using lung function tests and radiologic images. METHODS Twenty-nine patients with DPB were studied; their medical records were collected and analyzed retrospectively. Patients studied were hospitalized in the respiratory department of the Yixing Hospital, affiliated with Jiangsu University. Azithromycin was administered for 6-17 months. Changes in lung function and HRCT scans after treatment with azithromycin for six months were compared with pre-treatment values and images respectively. RESULTS Azithromycin therapy for six months resulted in rapid improvements in lung function, demonstrated by forced expiratory volume in one second (FEV1.0%), forced expiratory volume in one second over the forced vital capacity (FEV1.0/FVC), and forced expiratory volume with 75% vital capacity (FEF75%) values. In addition, improvements were seen in small nodular shadows, dilated peripheral bronchi, bronchial wall thickening, and tree-in-bud pattern, as detected by chest HRCT scans. CONCLUSIONS Long-term therapy with azithromycin is effective for patients with DPB.
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Affiliation(s)
- Ding Hui
- Department of Pulmonary Medicine, Affiliated Yixing People's Hospital, Jiangsu University, Yixing 214200, China
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Lee N, Chan PKS, Rainer TH, Hui D, Choi KW, Cockram CS. Influenza virus load in hospitalised patients. Hong Kong Med J 2013; 19 Suppl 4:15-18. [PMID: 23775181] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
1. Hospitalised patients with severe influenza have persistently high viral loads, for whom a different therapeutic approach may be needed. 2. Active screening of influenza infection should be performed in all high-risk patients hospitalised with febrile respiratory illness. Early diagnosis and treatment to suppress the high viral load may maximise clinical benefit. 3. For late presenting high risk patients with severe symptoms, their viral load may remain high, and initiation of antiviral treatment may still be worthwhile. 4. More stringent infection control measures, including strict droplet precautions and preferably isolation for an extended period of time may be necessary owing to prolonged viral shedding. 5. Randomised, controlled trials are indicated to address timing and dosage of treatment for severe influenza infection.
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Affiliation(s)
- N Lee
- Division of Infectious Diseases, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
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Del Fabbro E, Garcia JM, Dev R, Hui D, Williams J, Engineer D, Palmer JL, Schover L, Bruera E. Testosterone replacement for fatigue in hypogonadal ambulatory males with advanced cancer: a preliminary double-blind placebo-controlled trial. Support Care Cancer 2013; 21:2599-607. [DOI: 10.1007/s00520-013-1832-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 04/21/2013] [Indexed: 11/28/2022]
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Kang J, Hui D, Sriram Y, Kwon J, Bruera E. Changes in Symptom Intensities Among Cancer Patients Receiving Outpatient Palliative Care. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33985-5] [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] Open
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Yan L, Tong W, Hui D, Zongzhi W. Research and Application on Risk Assessment DEA Model of Crowd Crushing and Trampling Accidents in Subway Stations. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.proeng.2012.08.085] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hui D, Chen S, Zhuang B. Phylogeny of 12 species of genusGlycine Willd. reconstructed with internal transcribed region in nuclear ribosomal DNA. ACTA ACUST UNITED AC 2011; 40:137-44. [PMID: 18726309 DOI: 10.1007/bf02882041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/1996] [Indexed: 11/26/2022]
Abstract
The ITS-Is of 24 accessions belong to 10 species of subgenusGlycine, and 2 species of subgenusSoja of genusGlycine were amplified, cloned and sequenced. According to the homology of the sequences, the phylogeny of the 24 accessions were reconstructed. The reconstructed dendrogram showed that there were some divergent genomic types found in the previously classified species, such asG. tomentella, G. canescens andG. tabacina, and they might be some cryptic species by morphologic analysis.
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Affiliation(s)
- D Hui
- Plant Biotechnology Laboratory, Institute of Genetics, Chinese Academy of Sciences, 100101, Beijing, China
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33
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Kang JH, Yennurajalingam S, Chisholm G, Kim SH, Rhondali W, Hui D, Bruera E. Frequency and predictors of response to outpatient palliative care in patients with moderate to severe cancer pain. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e19698] [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: 11/20/2022] Open
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34
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Nguyen LMT, De la Cruz M, Hui D, Palmer JL, Parsons HA, Bruera E. Frequency and predictors of patient deviation from prescribed opioids and barriers to opioid pain-management in patients (pts) with advanced cancer. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9081] [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: 11/20/2022] Open
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35
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Rhondali W, Hui D, Kim SH, Kilgore KL, Kang JH, Nguyen LMT, Bruera E. Association between a validated symptom assessment tool and nurse clinical impression in patients with cancer admitted to a palliative care unit. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9112] [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: 11/20/2022] Open
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36
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Dalal S, Hui D, Nguyen LMT, Chacko R, Bruera E. Achievement of personalized pain goal (PPG) in cancer patients referred to a supportive care clinic. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9060] [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: 11/20/2022] Open
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37
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Delgado-Guay MO, Hui D, Parsons HA, De la Cruz M, Govan KB, Arciniega L, Thorney S, Palmer JL, Bruera E. The associations between spirituality (S), religiosity (R), and spiritual pain (SP) in advanced cancer patients (AdCa). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9071] [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: 11/20/2022] Open
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38
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Parsons HA, Hui D, Nguyen L, Palla SL, Liu J, Yennurajalingam S, Kurzrock R, Bruera E. Timing of palliative care referral and symptom burden in phase I cancer patients: A retrospective cohort study. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9062] [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: 11/20/2022] Open
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Chipara M, Skomski R, Ali N, Hui D, Sellmyer DJ. Magnetic properties of barium ferrite dispersed within polystyrene-butadiene-styrene block copolymers. J Nanosci Nanotechnol 2009; 9:3678-3683. [PMID: 19504902 DOI: 10.1166/jnn.2009.ns50] [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: 05/27/2023]
Abstract
Magnetic properties of nanocomposite materials obtained by dispersing barium ferrite nanoparticles within polystyrene-butadiene-styrene block copolymer, in the temperature range, 300 to 500 K are reported. The temperature dependence of the magnetization at saturation, averaged uniaxial magnetocrystalline anisotropy, and coercive field of thick films are analyzed. A "matrix effect" was noticed within the glass transition range of the hard component (polystyrene) of the polymeric matrix. The reported modifications of the magnetic properties were assigned to the competition between the magnetic and mechanical reorientation of nanoparticles within the polymeric matrix. Such modifications were not observed in barium ferrite dispersed in cement.
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Affiliation(s)
- M Chipara
- Department of Physics and Geology, University of Texas-Pan American, Edinburg, TX 78541, USA
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40
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Hui D, Bruera E, Li Z, Palmer JL, de la Cruz M, Elsayem A. Utilization of antineoplastic therapy (ANT) in advanced cancer patients admitted to an acute palliative care unit (APCU) at a comprehensive cancer center. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9590 Background: Cancer patients admitted to a palliative care unit generally have a poor prognosis. The role of ANT (chemotherapy and targeted agents) in these patients is unclear. We examined the frequency, trends, factors and survival associated with ANT use in hospitalized patients who required an APCU stay. Methods: All patients admitted to APCU between September 1, 2003 and August 31, 2008 were included. Demographics, cancer diagnosis and ANTs utilization from day of hospitalization to discharge, and survival information were retrieved retrospectively. Results: 2604 cancer patients had the following characteristics: median age 59 (range 18–101), male 51%, hematologic malignancy 11%, median hospital stay 11 (Q1-Q3 8–17) days, median APCU stay 7 (Q1-Q3 4–10) days and median survival 22 days. During hospitalization, 393 patients (15%) received ANTs, including chemotherapy (N=297, 11%) and targeted therapy (N=155, 6%). No significant change in frequency of ANTs was detected over the 5 year period. Multivariate logistic regression analysis ( Table ) revealed that younger age, cancer primaries and longer admissions were associated with ANT use. Patients with hematologic malignancies received more chemotherapy (38% vs. 8%, p<0.001) and targeted agents (18% vs. 4%, p<0.001) compared to patients with solid tumors. ANT use was associated with longer overall survival in univariate analysis (median 25 days vs. 21 days, p=0.001); however, this was no longer significant in multivariate Cox regression analysis. Conclusions: The use of ANT during hospitalization that included an APCU stay was limited to a highly selected group of patients, and did not increase overtime. ANT use was associated with younger age, specific cancer primaries, longer admissions, and no significant improvement in survival. The APCU at our cancer center facilitates simultaneous care where patients access palliative care while on ANT. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- D. Hui
- M. D. Anderson Cancer Center, Houston, TX
| | - E. Bruera
- M. D. Anderson Cancer Center, Houston, TX
| | - Z. Li
- M. D. Anderson Cancer Center, Houston, TX
| | | | | | - A. Elsayem
- M. D. Anderson Cancer Center, Houston, TX
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Del Fabbro E, Hui D, Nooruddin Z, Dalal S, Freer G, Palmer L, Bruera E. Association between inflammatory markers, symptom burden, hypogonadism, and survival in cancer patients with cachexia. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9594 Background: Cancer cachexia is characterized by muscle wasting, anorexia, and elevated inflammatory markers. Similarly, in patients without cancer, hypogonadism is associated with lower lean body mass, increased symptom burden and decreased survival. Hypogonadism in cancer cachexia could exacerbate symptom distress, facilitate a pro-inflammatory state and decrease survival. Currently, there are no guidelines for testosterone replacement therapy in cancer patients. We evaluated the relationship between hypogonadism, symptom severity, inflammation and survival in patients with cachexia. Methods: A retrospective chart review of 159 consecutive patients (61 females, 98 males) referred to a specialized cachexia clinic at a comprehensive cancer center. 98 patients (62%) had C-reactive protein (CRP) levels measured, and 68(69%) males had serum total testosterone evaluated. Testosterone levels were not evaluated in female patients. Symptoms were assessed by the Edmonton Symptom Assessment Scale (ESAS). Results: All patients reported weight loss of >5% within the preceding 6 months; Median age was 62, CRP 26mg/L and in males median total testosterone186ng/dL (normal level≥240 ng/dL). Spearman correlation revealed higher CRP levels (r=0.57, p<0.01) increased dyspnea (r=0.27, p<0.05) and poorer sleep scores (r=0.29, p<0.05) in males with low testosterone. In 46 males and females who underwent CRP testing within 30 days of their ESAS evaluation, pain (r=0.48, p<0.01), fatigue (r=0.39, p<0.01), poor appetite (r=0.49, p<0.01), insomnia (r=0.42, p<0.01), anxiety (r=0.29, p<0.05), and dyspnea (r=0.31, p<0.05) correlated with an elevated CRP. Survival of male patients with testosterone<186 ng/dL was decreased compared to those with levels ≥ 186ng/dL (13 vs.62 weeks, p=0.004). Patients with CRP>10 mg/L had decreased survival compared to those <10 mg/L (30 vs. 66 weeks, p=0.017). Conclusions: Elevated C-RP levels in cancer cachexia are associated with poorer survival and increased symptom burden. Low testosterone is strongly associated with decreased survival in cachectic male patients and correlates inversely with CRP levels, dyspnea and insomnia. No significant financial relationships to disclose.
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Affiliation(s)
- E. Del Fabbro
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - D. Hui
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - Z. Nooruddin
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - S. Dalal
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - G. Freer
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - L. Palmer
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - E. Bruera
- University of Texas M. D. Anderson Cancer Center, Houston, TX
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Nooruddin Z, Hui D, Dalal S, Bruera E, Del Fabbro E. Clinical findings and interventions in cancer patients referred to a cachexia clinic (CC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20551 Background: The cancer-related anorexia/cachexia syndrome is primarily caused by an aberrant inflammatory response and neurohormonal dysfunction. Secondary causes that contribute to diminished nutrient intake include early satiety, constipation, nausea, vomiting, mood alterations, dysgeusia, and dysphagia. We determined the frequency and management of both secondary cachexia causes and metabolic/endocrine alterations in a new CC at a Comprehensive Cancer Center. Methods: We conducted a retrospective chart review of 159 consecutive patients who underwent structured assessments at the CC. Demographics, weight loss, secondary causes and specific treatments were analyzed. Results: The patients had the following characteristics: median age 59, females 39%, median body mass index 20.3, median weight loss over the preceding 3 months 7%, and hypoalbuminemia 76%. At consultation, 102 (64%) were on chemotherapy/radiation and 13 (8%) were on enteral or parenteral nutrition. Appetite stimulants prior to consult included megestrol (n=36, 22%), corticosteroids (n=21, 13%) and dronabinol (n=10, 6%). The median number of secondary causes was 3 (Q1-Q3 2–4), with a median of 2 (Q1-Q3 1–3) interventions per patient. 22 (14%), 105 (66%) and 32 (20%) patients had 0–1, 2–4 and 5–8 secondary cachexia causes, respectively. The table lists the significant findings and corresponding interventions. 52 (33%) were enrolled onto clinical trials for primary cachexia. Conclusions: A total of 411 treatable secondary cachexia causes and 89 endocrine/metabolic alterations were identified in our cohort. Low cost effective interventions were available for most of the common findings. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
| | - D. Hui
- M. D. Anderson Cancer Center, Houston, TX
| | - S. Dalal
- M. D. Anderson Cancer Center, Houston, TX
| | - E. Bruera
- M. D. Anderson Cancer Center, Houston, TX
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Elsayem AF, Hui D, Li Z, Flores M, Atkinson WA, Bruera E. Acute palliative care unit in a comprehensive cancer center (CCC): Financial and clinical outcomes. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20518 Background: Acute palliative care units (APCU) in CCCs improves symptom control for advanced cancer patients and supports their families. However, these services are not available in the majority of cancer centers. Concerns regarding financial reimbursements represent a major barrier for establishing APCUs. The purpose of this study is to report the clinical outcomes and compare the financial outcomes of our APCU as compared to other services at our CCC. Methods: We reviewed all admissions to the APCU over the last 5 fiscal years for demographic information, length of stay, discharges, survival, hospital billings and collection of charges, and compared these to the rest of the institution. Results: 2,510 unique patients were admitted to the APCU. Median age was 59 years (19–101) and 51% were female. The median length of stay in APCU was 8 days (Q1-Q3 6–10). Median survival of patients discharged home, to health care facilities and hospice were 53, 22, and 13 days, respectively (p<0.001, log rank test), with 6 month survival of 20%, 4%, and 2%, respectively. Professional collections ranged from 42–47% of charges for APCU, vs. 32–38% for rest of the CCC and were stable over the 5 year period. Hospital collections were 47–51% of charges for APCU, vs. 55–57% for the rest of the CCC. The payer mix included commercial 1155 (46%), Medicare 755 (30%), Medicaid 126 (5%), mixed 127 (5%), indigent 198 (8%), and others 149 (6%). Conclusions: The ACPU has reimbursement outcomes consistent with the American acute care model and comparable to the rest of the CCC for last 5 years. The APCU is as viable as any other clinical programs in our institution. Further research is needed to investigate possible reasons for lack of APCU in cancer centers. No significant financial relationships to disclose.
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Affiliation(s)
- A. F. Elsayem
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - D. Hui
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - Z. Li
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - M. Flores
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - W. A. Atkinson
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - E. Bruera
- University of Texas M. D. Anderson Cancer Center, Houston, TX
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de la Cruz M, Hui D, Parsons HA, Lynn P, Parker C, Urbauer D, Bruera E. Placebo and nocebo effects in randomized double-blind clinical trials for fatigue in advanced cancer patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.9640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9640 Background: We have previously reported significant placebo response in randomized controlled treatment trials for cancer related fatigue (CRF). We conducted a retrospective study to determine the frequency and predictors of response to placebo and nocebo effect in patients with CRF. Methods: We reviewed patients that received placebo in two previous randomized clinical trials conducted by our group and determined the proportion of patients who demonstrated clinical response to fatigue using an increase (ΔFACIT-F score) > 7 from baseline to day 8, and those with nocebo response as those who reported side effects. Baseline patient characteristics and symptoms recorded from the Edmonton Symptom Assessment Scale (ESAS) were analyzed to determine their association with placebo and nocebo effects. Results: A total of 105 advanced cancer patients received placebo. 59 (56%) patients responded to placebo (median Δ FACIT-F score of 22). Worse baseline anxiety and well-being subscale score (univariate) and well-being (multivariate, MR) were significantly associated with placebo response. Common side effects reported were insomnia (79%), anorexia (53%), nausea (38%) and restlessness (34%). MR analysis showed that worse baseline (ESAS) sleep, appetite, nausea, and restless are associated with increased reporting of these side effects ( Table ). Conclusions: Nearly half of advanced cancer patients enrolled in the fatigue trials responded to placebo. Worse physical well-being score was associated with placebo response. Patients experiencing specific symptoms at baseline were more likely to report these as side effects of the medication. These findings should be considered in fatigue clinical trial design. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
| | - D. Hui
- M. D. Anderson Cancer Center, Houston, TX
| | | | - P. Lynn
- M. D. Anderson Cancer Center, Houston, TX
| | - C. Parker
- M. D. Anderson Cancer Center, Houston, TX
| | - D. Urbauer
- M. D. Anderson Cancer Center, Houston, TX
| | - E. Bruera
- M. D. Anderson Cancer Center, Houston, TX
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Yennurajalingam S, Urbauer DL, Chacko R, Hui D, Amin YA, Evans AC, Orihuela C, Casper KL, Poulter V, Coldman B, Bruera E. Impact of an outpatient interdisciplinary team (IDT) consultation on symptom clusters in advanced cancer patients seen at a supportive care outpatient clinic (OSC) in a tertiary cancer center. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20542 Background: Advanced cancer patients develop severe physical and psychosocial symptom clusters. There is limited data on the impact of an outpatient interdisciplinary team (IDT) consultation lead by palliative care specialists on symptom clusters. Cluster composition and consistence, response rate and predictors of response are unknown. Methods: 914 consecutive patients with advanced cancer presenting in the OSC from Jan 2003 to Oct 2008 with a complete Edmonton symptom assessment scale at the initial and follow-up visit (median 14 days, range 1–4 wks), and CAGE status (alcohol screening) were reviewed. Wilcoxon ranked sign test was used to determine whether symptoms changed over time. Principal components factor analysis with varimax rotation was used to determine clusters of symptoms at baseline and at follow-up. The number of factors calculated was determined based upon the number of eigen values that were greater than one. Results: Median age was 59 yrs, female were 46%. The most common primary cancer was Lung (19%). Baseline and follow-up visit scores (mean, SD) were: fatigue 5.7 (2.1) and 5.2 (2.2, p<0.0001), pain 4.9 (2.6) and 4.1 (2.6 p<0.0001), nausea 1.8 (2.4) and 1.7 (2.3, p=0.1), depression 2.6 (2.5) and 2.2(2.4,p<0.0001), anxiety 2.9 (2.7) and 2.4 (2.4, p<0.0001), drowsiness 3.2 (2.8) and 3.2 (2.6, p=0.7), dyspnea 2.6 (2.7) and 2.4 (2.6), p=0.0027), appetite 4.2(2.7) and 3.9 (2.7, p<0.0001), sleep 4.2 (2.6) and 3.8 (2.6, p<0.0001) and well being 4.3 (2.5) and 3.9 (2.3, p<0.0001). During the follow- up the symptom clusters varied from a 3 factor to a 2 factor model, reflecting the impact of the IDT on symptom burden. CAGE positive and CAGE negative patients had a significantly different symptom cluster model. Conclusions: Cluster composition differs when patients are assessed and managed by an IDT and among patients who screen positive for alcoholism. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- S. Yennurajalingam
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
| | - D. L. Urbauer
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
| | - R. Chacko
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
| | - D. Hui
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
| | - Y. A. Amin
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
| | - A. C. Evans
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
| | - C. Orihuela
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
| | - K. L. Casper
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
| | - V. Poulter
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
| | - B. Coldman
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
| | - E. Bruera
- UT M. D. Anderson Cancer Center, Houston, TX; M. D. Anderson Cancer Center, Houston, TX
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Abstract
Contrast-enhanced magnetic resonance imaging (MRI) is a novel approach to detect breast tumor, however, multiple 3D image sets need to be analyzed which causes unaffordable inspection tasks to physicians. Computer assistant detection is of great help to this situation and image segmentation is most important process of computer assistant detection. To segment the breast region from 3D MRI set, a multistage image processing procedure was proposed. Considering the morphological features of breast image, the image was divided into two parts to reduce the complexity of the segmentation procedure. For the anterior part of the image, the breast tissue was segmented from background using the region growing method. Meanwhile, the mean intensity of breast tissue was estimated. To segment the posterior part of the image, the estimated mean breast intensity was used to initialize an approximate boundary between breast and chest. The estimated intensity distribution of breast tissue was used to set the propagation term of following level set iterations. Based on this initialization, threshold-based 3D level set algorithm was used to seek the precise boundary between chest and breast. The level set algorithm achieves novel performance for the 3D segmentation of chest boundary. Based on the segmentation of one set of 3D image, the segmentation result was used as the initial boundary of following image sets to achieve automatic 4D segmentation. This multistage procedure greatly accelerates the convergence of the level set algorithm and reduces the chance of running into local minimum. Clinical data demonstrated that this processing procedure was effective for automatic segmentation of 4D breast MRI.
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Affiliation(s)
- Wang Qi
- Department of Biomedical Engineering, Tsinghua University, Beijing, China
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Hui D, Schwarz R. QS324. Visceral Organ Resections Combined With Synchronous Major Hepatectomy: Feasibility and Outcomes. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.631] [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: 10/21/2022]
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48
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Silva P, Guan X, Ho-Shing O, Jones J, Xu J, Hui D, Notter D, Smith E. Mitochondrial DNA-based analysis of genetic variation and relatedness among Sri Lankan indigenous chickens and the Ceylon junglefowl (Gallus lafayetti). Anim Genet 2009; 40:1-9. [PMID: 18945292 PMCID: PMC2633426 DOI: 10.1111/j.1365-2052.2008.01783.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [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] [Indexed: 11/29/2022]
Abstract
Indigenous chickens (IC) in developing countries provide a useful resource to detect novel genes in mitochondrial and nuclear genomes. Here, we investigated the level of genetic diversity in IC from five distinct regions of Sri Lanka using a PCR-based resequencing method. In addition, we investigated the relatedness of IC to different species of junglefowls including Ceylon (CJF; Gallus lafayetti), a subspecies that is endemic to Sri Lanka, green (Gallus varius), grey (Gallus sonneratii) and red (Gallus gallus) junglefowls. A total of 140 birds including eight CJF were used to screen the control region of the mitochondrial DNA sequence for single nucleotide polymorphisms (SNPs) and other variants. We detected and validated 44 SNPs, which formed 42 haplotypes and six haplogroups in IC. The SNPs observed in the CJF were distinct and the D-loop appeared to be missing a 62-bp segment found in IC and the red junglefowl. Among the six haplogroups of IC, only one was region-specific. Estimates of haplotype and nucleotide diversities ranged from 0.901 to 0.965 and from 0.011 to 0.013 respectively, and genetic divergence was generally low. Further, variation among individuals within regions accounted for 92% of the total molecular variation among birds. The Sri Lankan IC were more closely related to red and grey junglefowls than to CJF, indicating multiple origins. The molecular information on genetic diversity revealed in our study may be useful in developing genetic improvement and conservation strategies to better utilize indigenous Sri Lankan chicken resources.
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Affiliation(s)
- P Silva
- Department of Animal and Poultry Sciences, Virginia Tech, Blacksburg, VA 24061, USA
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Woo J, Hui E, Hui D, Lum CM, Or KH, Kwok T. A pilot study to examine the feasibility and acceptability of a community model for exercise prescription for patients with chronic disease. Hong Kong Med J 2009; 15 Suppl 2:12-16. [PMID: 19258627] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
1. A model of community care for chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) that incorporates exercise prescription is lacking, although the benefits of exercise for these diseases are established. 2. Group programmes incorporating exercise, disease education, and social support consisting of weekly sessions for 12 weeks were designed for COPD and CHF patients, in groups of 8 to 10. A home exercise programme was also prescribed. 3. This model was feasible, enjoyed good compliance, improved symptoms and measures of psychosocial outcome for both disease and improved exercise tolerance in the CHF group. 4. This model could be further developed as an integral part of community management for patients with chronic diseases.
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Affiliation(s)
- J Woo
- Department of Community and Family Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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50
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Wei K, Guangzhi W, Hui D. Segmentation of the breast region in mammograms using watershed transformation. Conf Proc IEEE Eng Med Biol Soc 2008; 2005:6500-3. [PMID: 17281758 DOI: 10.1109/iembs.2005.1615988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The author proposes a new approach for the breast region segmentation for the purpose of reduction of subsequent processing calculation and removal of radiopaque artifacts. The proposed algorithm combines the global thresholding method for a coarse estimation of breast region and morphological operations for exact positioning of the breast boundary. 204 mammographic images were randomly selected from the DDSM mammogram database to test the segmenting algorithm and the segmentation results were evaluated by an experienced radiologist. Nearly 95% of the segmentation results were rated as exact segmentation.
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Affiliation(s)
- Kang Wei
- Dept. of Biomedical Engineering, Tsinghua University, Beijing 100084, China
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