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Rubio IT, Wyld L, Marotti L, Athanasiou A, Regitnig P, Catanuto G, Schoones JW, Zambon M, Camps J, Santini D, Dietz J, Sardanelli F, Varga Z, Smidt M, Sharma N, Shaaban AM, Gilbert F. Corrigendum to "European guidelines for the diagnosis, treatment and follow-up of breast lesions with uncertain malignant potential (B3 lesions) developed jointly by EUSOMA, EUSOBI, ESP (BWG) and ESSO" [Eur J Surg Oncol 50 (1) (January 2024) 107292]. Eur J Surg Oncol 2024; 50:107943. [PMID: 38246851 DOI: 10.1016/j.ejso.2023.107943] [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: 01/23/2024]
Affiliation(s)
- Isabel T Rubio
- Breast Surgical Oncology, Clinica Universidad de Navarra, Madrid, Spain; European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy; European Society of Surgical Oncology (ESSO), Brussels, Belgium.
| | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK; Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Lorenza Marotti
- European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy
| | | | - Peter Regitnig
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Giuseppe Catanuto
- Humanitas-Istituto Clinico Catanese Misterbianco, Italy; Fondazione G.Re.T.A., ETS, Napoli, Italy
| | - Jan W Schoones
- Research Policy & Graduate School Advisor, Leiden University Medical Center Leiden, the Netherlands
| | - Marzia Zambon
- Europa Donna - The European Breast Cancer Coalition, Milan, Italy
| | - Julia Camps
- Breast Health Units in Ribera Salud Hospitals.Valencia, Spain
| | - Donatella Santini
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Jill Dietz
- The American Society of Breast Surgeons, Columbia, MD, USA
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy; Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Marjolein Smidt
- GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nisha Sharma
- Breast Unit, Level 1 Chancellor Wing, St James Hospital, Beckett Street Leeds, West Yorkshire, LS9 7TF, UK
| | - Abeer M Shaaban
- Cellular Pathology, Queen Elizabeth Hospital Birmingham, Birmingham, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Fiona Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, UK
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Rubio IT, Wyld L, Marotti L, Athanasiou A, Regitnig P, Catanuto G, Schoones JW, Zambon M, Camps J, Santini D, Dietz J, Sardanelli F, Varga Z, Smidt M, Sharma N, Shaaban AM, Gilbert F. European guidelines for the diagnosis, treatment and follow-up of breast lesions with uncertain malignant potential (B3 lesions) developed jointly by EUSOMA, EUSOBI, ESP (BWG) and ESSO. Eur J Surg Oncol 2024; 50:107292. [PMID: 38061151 DOI: 10.1016/j.ejso.2023.107292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Breast lesions of uncertain malignant potential (B3) include atypical ductal and lobular hyperplasias, lobular carcinoma in situ, flat epithelial atypia, papillary lesions, radial scars and fibroepithelial lesions as well as other rare miscellaneous lesions. They are challenging to categorise histologically, requiring specialist training and multidisciplinary input. They may coexist with in situ or invasive breast cancer (BC) and increase the risk of subsequent BC development. Management should focus on adequate classification and management whilst avoiding overtreatment. The aim of these guidelines is to provide updated information regarding the diagnosis and management of B3 lesions, according to updated literature review evidence. METHODS These guidelines provide practical recommendations which can be applied in clinical practice which include recommendation grade and level of evidence. All sections were written according to an updated literature review and discussed at a consensus meeting. Critical appraisal by the expert writing committee adhered to the 23 items in the international Appraisal of Guidelines, Research and Evaluation (AGREE) tool. RESULTS Recommendations for further management after core-needle biopsy (CNB) or vacuum-assisted biopsy (VAB) diagnosis of a B3 lesion reported in this guideline, vary depending on the presence of atypia, size of lesion, sampling size, and patient preferences. After CNB or VAB, the option of vacuum-assisted excision or surgical excision should be evaluated by a multidisciplinary team and shared decision-making with the patient is crucial for personalizing further treatment. De-escalation of surgical intervention for B3 breast lesions is ongoing, and the inclusion of vacuum-assisted excision (VAE) will decrease the need for surgical intervention in further approaches. Communication with patients may be different according to histological diagnosis, presence or absence of atypia, or risk of upgrade due to discordant imaging. Written information resources to help patients understand these issues alongside with verbal communication is recommended. Lifestyle interventions have a significant impact on BC incidence so lifestyle interventions need to be suggested to women at increased BC risk as a result of a diagnosis of a B3 lesion. CONCLUSIONS These guidelines provide a state-of-the-art overview of the diagnosis, management and prognosis of B3 lesions in modern multidisciplinary breast practice.
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Affiliation(s)
- Isabel T Rubio
- Breast Surgical Oncology, Clinica Universidad de Navarra, Madrid, Spain; European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy; European Society of Surgical Oncology (ESSO), Brussels, Belgium.
| | - Lynda Wyld
- Department of Oncology and Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK; Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, Doncaster, UK
| | - Lorenza Marotti
- European Society of Breast Cancer Specialists (EUSOMA), Florence, Italy
| | | | - Peter Regitnig
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Giuseppe Catanuto
- Humanitas-Istituto Clinico Catanese Misterbianco, Italy; Fondazione G.Re.T.A., ETS, Napoli, Italy
| | - Jan W Schoones
- Research Policy & Graduate School Advisor, Leiden University Medical Center Leiden, the Netherlands
| | - Marzia Zambon
- Europa Donna - The European Breast Cancer Coalition, Milan, Italy
| | - Julia Camps
- Breast Health Units in Ribera Salud Hospitals.Valencia, Spain
| | - Donatella Santini
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Jill Dietz
- The American Society of Breast Surgeons, Columbia, MD, USA
| | - Francesco Sardanelli
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy; Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Marjolein Smidt
- GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nisha Sharma
- Breast Unit, Level 1 Chancellor Wing, St James Hospital, Beckett Street Leeds, West Yorkshire, LS9 7TF, UK
| | - Abeer M Shaaban
- Cellular Pathology, Queen Elizabeth Hospital Birmingham, Birmingham, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Fiona Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, UK.
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Gilbert F. Balancing human and AI roles in clinical imaging. Nat Med 2023; 29:1609-1610. [PMID: 37460755 DOI: 10.1038/s41591-023-02441-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Affiliation(s)
- Fiona Gilbert
- Department of Radiology, Clinical School of Medicine, University of Cambridge, Cambridge, UK.
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Fauquembergue L, Le Guen V, Badreau M, Gilbert F, Descatha A. Matrices secteurs-inaptitudes et handicap à la Réunion : de la description, la prédiction par Machine Learning à la prévention de la désinsertion professionnelle. ARCH MAL PROF ENVIRO 2023. [DOI: 10.1016/j.admp.2022.101705] [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: 02/19/2023]
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Rubion E, Fouquet N, Gilbert F, Roquelaure Y. Fractions de risque attribuable aux douleurs chroniques ou intenses de l’épaule en France à partir de la cohorte Constances. ARCH MAL PROF ENVIRO 2022. [DOI: 10.1016/j.admp.2022.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Sevin F, Naidati A, Miganeh Hadi S, Perez C, Maugeais M, Lahrach M, Gilbert F, Pradeau C, Lesaine E. Traitement automatisé des textes médicaux pour le repérage des patients dans un registre. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.036] [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: 10/16/2022] Open
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Le E, Rundo L, Tarkin J, Evans N, Chowdhury M, Coughlin P, Pavey H, Wall C, Zaccagna F, Gallagher F, Huang Y, Sriranjan R, Le A, Weir-McCall J, Roberts M, Gilbert F, Warburton E, Schönlieb CB, Sala E, Rudd J. 146 Ct radiomics in carotid artery atherosclerosis: a systematic evaluation of robustness, reproducibility and predictive performance for culprit lesions. IMAGING 2022. [DOI: 10.1136/heartjnl-2022-bcs.146] [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: 11/03/2022] Open
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Stevens I, Gilbert F. International Regulatory Standards for the Qualitative Measurement of Deep Brain Stimulation in Clinical Research. J Empir Res Hum Res Ethics 2022; 17:228-241. [DOI: 10.1177/15562646221094922] [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: 11/16/2022]
Abstract
Deep brain stimulation (DBS) has progressed to become a promising treatment modality for neurologic and psychiatric disorders like epilepsy and major depressive disorder due to its growing personalization. Despite evidence pointing to the benefits of DBS if tested on these personalized qualitative metrics, rather than randomized-control trial quantitative standards, the evaluation of these novel devices appears to be based on the latter. This study surveyed the presence of this trend in the national regulatory guidelines of the prominent DBS researching countries. It was found that two governing bodies, in the European Union and Australia, acknowledged the option for qualitative measures. These findings support further development of national regulatory guidelines, so the neuroscientific community developing these neurotechnologies can better understand the impact their treatments have on patients.
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Affiliation(s)
- I. Stevens
- School of Humanities, University of Tasmania, Hobart, Tasmania, Australia
| | - F. Gilbert
- School of Humanities, University of Tasmania, Hobart, Tasmania, Australia
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Delaloge S, Rossi PG, Guindy M, Gilbert F, Burrion JB, Balleyguier C, Exposito MR, Giordano L, De Koning H, de Montgolfier S, Ragusa S, Drubay D, Rouge-Bugat ME, Evans GD, Keatley D, Blanche H, Boland A, Gauthier E, Dubois d'Aische A, Vissac-Sabatier C, Couch D, Baron C, Deleuze JF, Pharoah P, Michiels S. Abstract OT2-10-02: Mypebs: An international randomized study comparing personalized, risk-stratified to standard breast cancer screening in women aged 40-70. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-ot2-10-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background Currently, mammographic-based breast cancer screening (BCS) using age as the single criterion for population selection, apart from rare high-risk indications, is being questioned for its imperfect sensitivity (interval cancers) and specificity (false positive recalls), as well as the risk of over-diagnoses. BC risk scores incorporating personal and family history, breast mammographic density and genetic information based on a polygenic score (PRS) give a promisingly accurate likelihood of a woman developing invasive BC in the next 5 years. MyPeBS, a European Commission H2020-funded randomized clinical trial (NCT03672331) conducted in 6 countries (Belgium, France, Israel, Italy, Spain and UK) aims to demonstrate the usefulness of a risk-based screening approach to improve BCS in the general population. Methods MyPeBS’s primary objective is to show non-inferiority of the risk-stratified BCS arm in terms of incidence rate of breast cancer of stage 2 and higher, compared to the standard BCS arm. The key secondary objective, if non-inferiority is shown, is to demonstrate superiority of the risk-based screening arm. MyPeBS also assesses whether this strategy allows reduces morbidity (less false positives); is equally or more cost-effective, and impacts women’s understanding, awareness and emotional responses as compared to standard of care. Women aged 40 to 70 are eligible if they did not have prior BC or high risk-condition, and live in a participating country and area. Participants are randomized 1:1 between standard BCS according to country’s/region’s ongoing policy, or risk-stratified BCS, where screening frequency and method depend on their individual 5 year predicted risk of invasive BC (Table 1). Stratification factors include age, prior mammogram and country. Risk assessment uses a centralized genotyping on a saliva sample to assess PRS 313 (Mavaddat et al, Am J Hum Genet 2019), which is embedded in either a BCSC-derived score for women with at most one first-degree relative with BC; or Tyrer-Cuzick score for women with > 1 family member with breast cancer. Women participate for 4 years. Planned accrual is 85000. On June 30th, 2021, 13882 women have been randomized.
Table 1.BC Screening schedule in MyPeBS’ Risk-based armRisk levelLow riskAverage riskHigh riskVery high riskNumerical definition (invasive breast cancer risk at 5 years)<1%1-1.66%≥ 1.66% and < 6%≥ 6%Mammogram1 at end of study (4 years)Every 2 yearsYearlyYearlyAdditionalYearly breast cancer awareness reminderHigh density: US or ABUS every 2 yearsHigh density: US or ABUS every 2 yearsAnnual MRI until age 60
Citation Format: Suzette Delaloge, Paolo Giorgi Rossi, Michal Guindy, Fiona Gilbert, Jean-Benoit Burrion, Corinne Balleyguier, Marta Roman Exposito, Livia Giordano, Harry De Koning, Sandrine de Montgolfier, Stephane Ragusa, Damien Drubay, Marie-Eve Rouge-Bugat, Gareth D Evans, Debbie Keatley, Helene Blanche, Anne Boland, Emilien Gauthier, Aloys Dubois d'Aische, Cécile Vissac-Sabatier, Daniel Couch, Camille Baron, Jean-François Deleuze, Paul Pharoah, Stefan Michiels. Mypebs: An international randomized study comparing personalized, risk-stratified to standard breast cancer screening in women aged 40-70 [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr OT2-10-02.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Paul Pharoah
- University of Cambridge, Cambridge, United Kingdom
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Monaghan O, O’Dwyer N, Dunne M, Nugent J, Coughlan N, Nolan A, Gilbert F, Glynn A, Duane F, Parkes C, Brennan S. PO-0967 Factors associated with feeding tube requirement in Oropharyngeal Cancer treated with IMRT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07418-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Thevenet V, Maugeais M, Lesaine E, Miganeh Hadi S, Gilbert F, Rouanet F, Sibon I, Saillour-Glénisson F. Prise en charge hospitalière des infarctus cérébraux : lien entre caractéristiques structurelles des établissements de santé et délais intrahospitaliers. Rev Epidemiol Sante Publique 2021. [DOI: 10.1016/j.respe.2021.04.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Baxter GC, Patterson AJ, Woitek R, Allajbeu I, Graves MJ, Gilbert F. Improving the image quality of DWI in breast cancer: comparison of multi-shot DWI using multiplexed sensitivity encoding to conventional single-shot echo-planar imaging DWI. Br J Radiol 2021; 94:20200427. [PMID: 32903028 PMCID: PMC8011253 DOI: 10.1259/bjr.20200427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective: To compare diffusion-weighted images (DWI) acquired using single-shot echo-planar imaging (ss-EPI) and multiplexed sensitivity encoding (MUSE) in breast cancer. Methods 20 females with pathologically confirmed breast cancer (age 51 ± 12 years) were imaged with ss-EPI-DWI and MUSE-DWI. ADC, normalised ADC (nADC), blur and distortion metrics and qualitative image quality scores were compared. The Crété-Roffet and Mattes mutual information metrics were used to evaluate blurring and distortion, respectively. In a breast phantom, six permutations of MUSE-DWI with varying parallel acceleration factor and number of shots were compared. Differences in ADC and nADC were compared using the coefficient of variation in the phantom and a paired t-test in patients. Differences in blur, distortion and qualitative metrics were analysed using a Wilcoxon signed-rank test. Results: There was a low coefficient of variation (<2%) in ADC between ss-EPI-DWI and all MUSE-DWI permutations acquired using the phantom. 22 malignant and three benign lesions were identified in 20 patients. ADC values measured using MUSE were significantly lower compared to ss-EPI for malignant but not benign lesions (p < 0.001, p = 0.21). nADC values were not significantly different (p = 0.62, p = 0.28). Blurring and distortion improved with number of shots and acceleration factor, and significantly improved with MUSE in patients (p < 0.001, p = 0.002). Qualitatively, image quality improved using MUSE. Conclusion: MUSE improves the image quality of breast DWI compared to ss-EPI. Advances in knowledge: MUSE-DWI has superior image quality and reduced blurring and distortion compared to ss-EPI-DWI in breast cancer.
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Affiliation(s)
- Gabrielle C Baxter
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Andrew J Patterson
- Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Ramona Woitek
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Iris Allajbeu
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
| | - Martin J Graves
- Department of Radiology, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Fiona Gilbert
- Department of Radiology, University of Cambridge, Cambridge, United Kingdom
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Bartram A, Gilbert F, Thompson A, Mann GB, Agrawal A. Breast MRI in DCIS size estimation, breast-conserving surgery and oncoplastic breast surgery. Cancer Treat Rev 2021; 94:102158. [PMID: 33610127 DOI: 10.1016/j.ctrv.2021.102158] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/18/2022]
Abstract
The impact of MRI on improving surgical outcomes in DCIS is debated. Here, we explore the utility of MRI in the investigation and management of DCIS in three key areas. Firstly, we highlight that MRI is likely to be a more accurate predictor of actual tumour size than conventional imaging. Secondly, we examine mastectomy rates and reoperation rates across the literature and suggest that surgical outcomes do not differ between pre-operative MRI and conventional imaging groups, despite improved size estimation on MRI. Finally, we examine the rapidly developing field of oncoplastic breast surgery and highlight a paucity of data in determining the usefulness of pre-operative MRI in this field, despite this being an oncologically safe alternative with improved patient outcomes and satisfaction.
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Affiliation(s)
- Alexander Bartram
- University of Cambridge, School of Clinical Medicine, Cambridge, CB2 0SP, UK
| | - Fiona Gilbert
- University of Cambridge, Department of Radiology, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Alastair Thompson
- Baylor College of Medicine, Division of Surgical Oncology, 7200 Cambridge Street, Houston, TX 77030, USA
| | - G Bruce Mann
- University of Melbourne, Department of Surgery, The Royal Melbourne Hospital, Parkville, 3050, Australia
| | - Amit Agrawal
- Cambridge University Hospitals, Department of Breast Surgery, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
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Flores M, Dayan I, Roth H, Zhong A, Harouni A, Gentili A, Abidin A, Liu A, Costa A, Wood B, Tsai CS, Wang CH, Hsu CN, Lee CK, Ruan C, Xu D, Wu D, Huang E, Kitamura F, Lacey G, César de Antônio Corradi G, Shin HH, Obinata H, Ren H, Crane J, Tetreault J, Guan J, Garrett J, Park JG, Dreyer K, Juluru K, Kersten K, Bezerra Cavalcanti Rockenbach MA, Linguraru M, Haider M, AbdelMaseeh M, Rieke N, Damasceno P, Cruz E Silva PM, Wang P, Xu S, Kawano S, Sriswasdi S, Park SY, Grist T, Buch V, Jantarabenjakul W, Wang W, Tak WY, Li X, Lin X, Kwon F, Gilbert F, Kaggie J, Li Q, Quraini A, Feng A, Priest A, Turkbey B, Glicksberg B, Bizzo B, Kim BS, Tor-Diez C, Lee CC, Hsu CJ, Lin C, Lai CL, Hess C, Compas C, Bhatia D, Oermann E, Leibovitz E, Sasaki H, Mori H, Yang I, Sohn JH, Keshava Murthy KN, Fu LC, Furtado de Mendonça MR, Fralick M, Kang MK, Adil M, Gangai N, Vateekul P, Elnajjar P, Hickman S, Majumdar S, McLeod S, Reed S, Graf S, Harmon S, Kodama T, Puthanakit T, Mazzulli T, de Lima Lavor V, Rakvongthai Y, Lee YR, Wen Y. Federated Learning used for predicting outcomes in SARS-COV-2 patients. Res Sq 2021:rs.3.rs-126892. [PMID: 33442676 PMCID: PMC7805458 DOI: 10.21203/rs.3.rs-126892/v1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
'Federated Learning' (FL) is a method to train Artificial Intelligence (AI) models with data from multiple sources while maintaining anonymity of the data thus removing many barriers to data sharing. During the SARS-COV-2 pandemic, 20 institutes collaborated on a healthcare FL study to predict future oxygen requirements of infected patients using inputs of vital signs, laboratory data, and chest x-rays, constituting the "EXAM" (EMR CXR AI Model) model. EXAM achieved an average Area Under the Curve (AUC) of over 0.92, an average improvement of 16%, and a 38% increase in generalisability over local models. The FL paradigm was successfully applied to facilitate a rapid data science collaboration without data exchange, resulting in a model that generalised across heterogeneous, unharmonized datasets. This provided the broader healthcare community with a validated model to respond to COVID-19 challenges, as well as set the stage for broader use of FL in healthcare.
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Affiliation(s)
| | | | | | - Aoxiao Zhong
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | | | | | | | | | - Bradford Wood
- Radiology & Imaging Sciences / Clinical Center, National Institutes of Health
| | - Chien-Sung Tsai
- Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chih-Hung Wang
- Tri-Service General Hospital, National Defense Medical Center
| | - Chun-Nan Hsu
- Center for Research in Biological Systems, University of California, San Diego
| | | | | | | | - Dufan Wu
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | | | | | | | | | | | - Hui Ren
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jason Crane
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | | | | | - John Garrett
- The University of Wisconsin-Madison School of Medicine and Public Health
| | | | - Keith Dreyer
- Center for Clinical Data Science, Massachusetts General Brigham, Boston, MA
| | | | | | | | - Marius Linguraru
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital and School of Medicine and Health Sciences, George Washington University, Washington, DC
| | - Masoom Haider
- Joint Dept. of Medical Imaging, Sinai Health System, University of Toronto, Toronto, Canada and Lunenfeld-Tanenbaum Research Institute, Toronto, Canada
| | | | | | - Pablo Damasceno
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | | | - Pochuan Wang
- MeDA Lab and Institute of Applied Mathematical Sciences, National Taiwan University, Taipei, Taiwan
| | - Sheng Xu
- Center for Interventional Oncology, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Soo Young Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | | | - Varun Buch
- Center for Clinical Data Science, Massachusetts General Brigham, Boston, MA
| | - Watsamon Jantarabenjakul
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand and Thai Red Cross Emerging Infectious Diseases Clinical Center, King Chulalongkorn Memorial Hospital, Bang
| | | | - Won Young Tak
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Xiang Li
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Xihong Lin
- Harvard T.H. Chan School of Public Health
| | | | | | - Josh Kaggie
- Department of Radiology, NIHR Cambridge Biomedical Resource Centre, University of Cambridge
| | - Quanzheng Li
- Center for Advanced Medical Computing and Analysis, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | | | - Andrew Priest
- Department of Radiology, NIHR Cambridge Biomedical Resource Centre, Cambridge University Hospital
| | | | | | - Bernardo Bizzo
- Center for Clinical Data Science, Massachusetts General Brigham, Boston, MA
| | - Byung Seok Kim
- Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea
| | - Carlos Tor-Diez
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Hospital, Washington, DC
| | - Chia-Cheng Lee
- Planning and Management Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C. and Division of Colorectal Surgery, Department of Surgery, Tri-Service General H
| | - Chia-Jung Hsu
- Planning and Management Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chin Lin
- School of Medicine, National Defense Medical Center, Taipei, Taiwan, R.O.C. and School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C. and Graduate Institute of Life Scienc
| | - Chiu-Ling Lai
- Medical Review and Pharmaceutical Benefits Division, National Health Insurance Administration, Taipei. Taiwan
| | | | | | | | | | - Evan Leibovitz
- The Center for Clinical Data Science, Mass General Brigham
| | | | | | | | - Jae Ho Sohn
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | | | - Li-Chen Fu
- MOST/NTU All Vista Healthcare Center, Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, Taiwan
| | | | - Mike Fralick
- Division of General Internal Medicine and Geriatrics (Fralick), Sinai Health System, Toronto, Canada
| | - Min Kyu Kang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, South Korea
| | | | | | - Peerapon Vateekul
- Department of Computer Engineering, Faculty of Engineering, Chulalongkorn University
| | | | - Sarah Hickman
- Department of Radiology, NIHR Cambridge Biomedical Resource Centre, University of Cambridge
| | - Sharmila Majumdar
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Shelley McLeod
- Schwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, ON, Canada and Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Sheridan Reed
- Center for Interventional Oncology, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | - Thanyawee Puthanakit
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Center of Excellence in Pediatric Infectious Diseases and Vaccine, Chulalongkorn University
| | - Tony Mazzulli
- Department of Microbiology, Sinai Health/University Health Network, Toronto, Canada and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto. Canada Public Health Ontar
| | | | - Yothin Rakvongthai
- Chulalongkorn University Biomedical Imaging Group and Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Yu Rim Lee
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
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Sevin F, Gilbert F, Domecq S, Jouson D, Lesaine E, Saillour-Glenisson F. Mise en place du système d’information régional de l’Observatoire des accidents vasculaires cérébraux en Nouvelle-Aquitaine (ObA2-NA). Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.03.037] [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: 10/23/2022] Open
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16
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Domecq S, Saillour-Glénisson F, Lesaine E, Gilbert F, Maugeais M, Rouanet F. Description des délais de prise en charge des patients victimes d’un accident vasculaire cérébral entre l’apparition des symptômes et le traitement dans 11 établissements de santé entre 2012 et 2019 en ex-Aquitaine. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.03.072] [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: 10/23/2022] Open
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17
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Kaggie JD, Markides H, Graves MJ, MacKay J, Houston G, El Haj A, Gilbert F, Henson F. Author Correction: Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model. Sci Rep 2020; 10:11171. [PMID: 32612189 PMCID: PMC7330032 DOI: 10.1038/s41598-020-68531-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Joshua D Kaggie
- Department of Radiology, University of Cambridge, Box 218, Cambridge, UK. .,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK.
| | - Hareklea Markides
- Institute of Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, UK.,Department of Chemical Engineering, Healthcare Technologies Institute, Birmingham University, Birmingham, B15 2TT, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Box 218, Cambridge, UK.,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - James MacKay
- Department of Radiology, University of Cambridge, Box 218, Cambridge, UK.,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | | | - Alicia El Haj
- Institute of Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, UK.,Department of Chemical Engineering, Healthcare Technologies Institute, Birmingham University, Birmingham, B15 2TT, UK
| | - Fiona Gilbert
- Department of Radiology, University of Cambridge, Box 218, Cambridge, UK.,Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - Frances Henson
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Cambridge, UK.,Comparative Musculoskeletal Biology Group, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
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18
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Kaggie JD, Markides H, Graves MJ, MacKay J, Houston G, El Haj A, Gilbert F, Henson F. Ultra Short Echo Time MRI of Iron-Labelled Mesenchymal Stem Cells in an Ovine Osteochondral Defect Model. Sci Rep 2020; 10:8451. [PMID: 32439838 PMCID: PMC7242461 DOI: 10.1038/s41598-020-64423-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 03/13/2020] [Indexed: 01/22/2023] Open
Abstract
Multipotent Mesenchymal Stem/Stromal Cells (MSCs) are widely used in cellular therapy for joint repair. However, the use of MSC therapies is complicated by a lack of understanding of the behaviour of cells and repair within the joint. Current methods of MSC tracking include labelling the cells with Super Paramagnetic Iron Oxide nanoparticles (SPIOs). However, standard acquisition sequences (T2 and T2*) give poor anatomical definition in the presence of SPIOs. To avoid anatomical compromise in the presence of SPIOs, we have investigated the use of Ultra-short Echo Time (UTE) MRI, using a 3D cones acquisition trajectory. This method was used to track SPIO labelled MSC injected into joints containing osteochondral defects in experimental sheep. This study demonstrates that multiple echo times from UTE with 3 T MRI can provide excellent anatomical detail of osteochondral defects and demonstrate similar features to histology. This work also monitors the location of SPIO-labelled cells for regenerative medicine of the knee with MRI, histology, and Prussian blue staining. With these methods, we show that the SPIOs do not hone to the site of defect but instead aggregate in the location of injection, which suggests that any repair mechanism with this disease model must trigger a secondary process.
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Affiliation(s)
- Joshua D Kaggie
- Department of Radiology, Box 218, University of Cambridge, Cambridge, United Kingdom.
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom.
| | - Hareklea Markides
- Institute of Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, UK
- Department of Chemical Engineering, Healthcare Technologies Institute, Birmingham University, B15 2TT, Birmingham, UK
| | - Martin J Graves
- Department of Radiology, Box 218, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - James MacKay
- Department of Radiology, Box 218, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | | | - Alicia El Haj
- Institute of Science and Technology in Medicine, Guy Hilton Research Centre, Keele University, Thornburrow Drive, Stoke-on-Trent, ST4 7QB, UK
- Department of Chemical Engineering, Healthcare Technologies Institute, Birmingham University, B15 2TT, Birmingham, UK
| | - Fiona Gilbert
- Department of Radiology, Box 218, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Frances Henson
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Cambridge, United Kingdom
- Comparative Musculoskeletal Biology Group, Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
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19
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Schmalzl J, Plumhoff P, Gilbert F, Gohlke F, Konrads C, Brunner U, Jakob F, Ebert R, Steinert AF. The inflamed biceps tendon as a pain generator in the shoulder: A histological and biomolecular analysis. J Orthop Surg (Hong Kong) 2020; 27:2309499018820349. [PMID: 30739571 DOI: 10.1177/2309499018820349] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 11/15/2022] Open
Abstract
INTRODUCTION The long head of the biceps (LHB) is often resected in shoulder surgery. However, its contribution to inflammatory processes in the shoulder remains unclear. In the present study, inflamed and noninflamed human LHBs were comparatively characterized for features of inflammation. MATERIALS AND METHODS Twenty-two resected LHB tendons were classified into inflamed ( n = 11) and noninflamed ( n = 11) samples. For histological examination, samples were stained with hematoxylin eosin, Azan, van Gieson, and Masson Goldner trichrome. Neuronal tissue was immunohistochemically visualized. In addition, specific inflammatory marker gene expression of primary LHB-derived cell cultures were analyzed. RESULTS Features of tendinopathy, such as collagen disorganization, infiltration by inflammatory cells, neovascularization, and extensive neuronal innervation were found in the tendinitis group. Compared to noninflamed samples, inflamed LHBs showed a significantly increased inflammatory marker gene expression. CONCLUSION Structural and biomolecular differences of both groups suggest that the LHB tendon acts as an important pain generator in the shoulder joint. These findings can, on the one hand, contribute to the understanding of the biomolecular genesis of LHB tendinitis and, on the other hand, provide possibilities for new therapeutic approaches.
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Affiliation(s)
- J Schmalzl
- 1 Department of Orthopaedic Surgery, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany.,2 Department of Traumatology and Hand Surgery, St. Vincentius Clinic, Suedendstraße Karlsruhe, Germany
| | - P Plumhoff
- 1 Department of Orthopaedic Surgery, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany
| | - F Gilbert
- 1 Department of Orthopaedic Surgery, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany.,3 Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - F Gohlke
- 1 Department of Orthopaedic Surgery, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany.,4 Clinic for Shoulder Surgery, Rhoen Klinikum AG, Bad Neustadt/Saale, Germany
| | - C Konrads
- 1 Department of Orthopaedic Surgery, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany
| | - U Brunner
- 5 Department of Orthopaedic and Trauma Surgery, Norbert-Kerkel-Platz, Krankenhaus Agatharied GmbH, Hausham, Germany
| | - F Jakob
- 1 Department of Orthopaedic Surgery, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany
| | - R Ebert
- 1 Department of Orthopaedic Surgery, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany
| | - A F Steinert
- 1 Department of Orthopaedic Surgery, Julius Maximilians University of Wuerzburg, Wuerzburg, Germany.,5 Department of Orthopaedic and Trauma Surgery, Norbert-Kerkel-Platz, Krankenhaus Agatharied GmbH, Hausham, Germany
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20
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Domecq S, Saillour-Glenisson F, Lesaine E, Gilbert F, Maugeais M, Rouanet F. Description des délais de prise en charge des patients victimes d’un accident vasculaire cérébral entre l’apparition des symptômes et le traitement dans six établissements de santé aquitains entre 2012 et 2017. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2020.01.022] [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: 11/24/2022] Open
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21
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Weissenberger M, Weissenberger MH, Gilbert F, Groll J, Evans CH, Steinert AF. Reduced hypertrophy in vitro after chondrogenic differentiation of adult human mesenchymal stem cells following adenoviral SOX9 gene delivery. BMC Musculoskelet Disord 2020; 21:109. [PMID: 32066427 PMCID: PMC7026978 DOI: 10.1186/s12891-020-3137-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/12/2020] [Indexed: 01/03/2023] Open
Abstract
Background Mesenchymal stem cell (MSC) based-treatments of cartilage injury are promising but impaired by high levels of hypertrophy after chondrogenic induction with several bone morphogenetic protein superfamily members (BMPs). As an alternative, this study investigates the chondrogenic induction of MSCs via adenoviral gene-delivery of the transcription factor SOX9 alone or in combination with other inducers, and comparatively explores the levels of hypertrophy and end stage differentiation in a pellet culture system in vitro. Methods First generation adenoviral vectors encoding SOX9, TGFB1 or IGF1 were used alone or in combination to transduce human bone marrow-derived MSCs at 5 × 102 infectious particles/cell. Thereafter cells were placed in aggregates and maintained for three weeks in chondrogenic medium. Transgene expression was determined at the protein level (ELISA/Western blot), and aggregates were analysed histologically, immunohistochemically, biochemically and by RT-PCR for chondrogenesis and hypertrophy. Results SOX9 cDNA was superior to that encoding TGFB1, the typical gold standard, as an inducer of chondrogenesis in primary MSCs as evidenced by improved lacuna formation, proteoglycan and collagen type II staining, increased levels of GAG synthesis, and expression of mRNAs associated with chondrogenesis. Moreover, SOX9 modified aggregates showed a markedly lower tendency to progress towards hypertrophy, as judged by expression of the hypertrophy markers alkaline phosphatase, and collagen type X at the mRNA and protein levels. Conclusion Adenoviral SOX9 gene transfer induces chondrogenic differentiation of human primary MSCs in pellet culture more effectively than TGFB1 gene transfer with lower levels of chondrocyte hypertrophy after 3 weeks of in vitro culture. Such technology might enable the formation of more stable hyaline cartilage repair tissues in vivo.
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Affiliation(s)
- M Weissenberger
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Center for Musculoskeletal Research, Julius-Maximilians-University, Brettreichstrasse 11, D-97074, Würzburg, Germany.
| | - M H Weissenberger
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Center for Musculoskeletal Research, Julius-Maximilians-University, Brettreichstrasse 11, D-97074, Würzburg, Germany.,Department of Pathology, Caritas-Hospital, Bad Mergentheim, Germany
| | - F Gilbert
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Center for Musculoskeletal Research, Julius-Maximilians-University, Brettreichstrasse 11, D-97074, Würzburg, Germany.,Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Würzburg, Germany
| | - J Groll
- Department of Functional Materials in Medicine and Dentistry, Julius-Maximilians-University, Würzburg, Germany
| | - C H Evans
- Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, USA
| | - A F Steinert
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Center for Musculoskeletal Research, Julius-Maximilians-University, Brettreichstrasse 11, D-97074, Würzburg, Germany.,Present address: Department of Orthopaedic, Trauma, Shoulder and Arthroplasty Surgery, Rhön-Klinikum Campus Bad Neustadt, Bad Neustadt a.d. Saale, Germany
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Affiliation(s)
- F Gilbert
- Centre for Neurotechnology, University of Washington, Seattle, USA
- School of Humanities, CALE, University of Tasmania, Hobart, Australia
| | - C Pham
- Centre for Neurotechnology, University of Washington, Seattle, USA
| | - Jnm Viaña
- School of Humanities, CALE, University of Tasmania, Hobart, Australia
| | - W. Gillam
- Centre for Neurotechnology, University of Washington, Seattle, USA
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23
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Gilbert F, Cook M, O’Brien T, Illes J. Embodiment and Estrangement: Results from a First-in-Human "Intelligent BCI" Trial. Sci Eng Ethics 2019; 25:83-96. [PMID: 29129011 PMCID: PMC6418065 DOI: 10.1007/s11948-017-0001-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 10/31/2017] [Indexed: 05/21/2023]
Abstract
While new generations of implantable brain computer interface (BCI) devices are being developed, evidence in the literature about their impact on the patient experience is lagging. In this article, we address this knowledge gap by analysing data from the first-in-human clinical trial to study patients with implanted BCI advisory devices. We explored perceptions of self-change across six patients who volunteered to be implanted with artificially intelligent BCI devices. We used qualitative methodological tools grounded in phenomenology to conduct in-depth, semi-structured interviews. Results show that, on the one hand, BCIs can positively increase a sense of the self and control; on the other hand, they can induce radical distress, feelings of loss of control, and a rupture of patient identity. We conclude by offering suggestions for the proactive creation of preparedness protocols specific to intelligent-predictive and advisory-BCI technologies essential to prevent potential iatrogenic harms.
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Affiliation(s)
- F. Gilbert
- Centre for Sensorimotor Neural Engineering, Department of Philosophy, University of Washington, Seattle, WA USA
- National Core for Neuroethics, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC USA
- Australian Research Council DECRA Fellow, University of Tasmania, Hobart, Australia
| | - M. Cook
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
- Department of Neurology, St. Vincent’s Hospital, Melbourne, Australia
| | - T. O’Brien
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - J. Illes
- National Core for Neuroethics, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC USA
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24
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Gilbert F, Schneemann C, Scholz CJ, Kickuth R, Meffert RH, Wildenauer R, Lorenz U, Kellersmann R, Busch A. Clinical implications of fracture-associated vascular damage in extremity and pelvic trauma. BMC Musculoskelet Disord 2018; 19:404. [PMID: 30458745 PMCID: PMC6247697 DOI: 10.1186/s12891-018-2333-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 10/31/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Vascular damage in polytrauma patients is associated with high mortality and morbidity. Therefore, specific clinical implications of vascular damage with fractures in major trauma patients are reassessed. METHODS This comprehensive nine-year retrospective single center cohort study analyzed demography, laboratory, treatment and outcome data from 3689 patients, 64 patients with fracture-associated vascular injuries were identified and were compared to a control group. RESULTS Vascular damage occurred in 7% of patients with upper and lower limb and pelvic fractures admitted to the trauma room. Overall survival was 80% in pelvic fracture and 97% in extremity fracture patients and comparable to non-vascular trauma patients. Additional arterial damage required substantial fluid administration and was visible as significantly anemia and disturbed coagulation tests upon admission. Open procedures were done in over 80% of peripheral extremity vascular damage. Endovascular procedures were predominant (87%) in pelvic injury. CONCLUSION Vascular damage is associated with high mortality rates especially in combination with pelvic fractures. Initial anemia, disturbed coagulation tests and the need for extensive pre-clinical fluid substitution were observed in the cohort with vascular damage. Therefore, fast diagnosis and early interventional and surgical procedures are necessary to optimize patient-specific outcome.
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Affiliation(s)
- F. Gilbert
- Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Würzburg, Germany
- Department of Trauma Hand Plastic and Reconstructive Surgery, University Munich Germany, Julius-Maximilians-University of Würzburg Oberdürrbacherstr, 6 D-, 97080 Würzburg, Germany
| | - C. Schneemann
- Department for General Visceral, Vascular & Paediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - C. J. Scholz
- Core Unit Systems Medicine IZKF, University Hospital Würzburg, Würzburg, Germany
| | - R. Kickuth
- Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany
| | - R. H. Meffert
- Department of Orthopaedic Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Würzburg, Würzburg, Germany
| | - R. Wildenauer
- Department for General Visceral, Vascular & Paediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - U. Lorenz
- Department for General Visceral, Vascular & Paediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - R. Kellersmann
- Department of Vascular Surgery, Klinikum Fulda, Fulda, Germany
| | - A. Busch
- Department for General Visceral, Vascular & Paediatric Surgery, University Hospital Würzburg, Würzburg, Germany
- Department for Vascular and Endovascular Surgery Klinikum rechts der Isar, Technical University Munich, Munich, Germany
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25
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Sturla Lompré J, Nievas M, Franco M, Grossi V, Ferrando A, Militon C, Gilbert F, Cuny P, Stora G, Sepúlveda M, Esteves J, Commendatore M. Fate of petroleum hydrocarbons in bioturbated pristine sediments from Caleta Valdés (Patagonia Argentina): An ex situ bioassay. Ecotoxicol Environ Saf 2018; 162:673-682. [PMID: 30025591 DOI: 10.1016/j.ecoenv.2018.06.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 06/12/2018] [Accepted: 06/22/2018] [Indexed: 06/08/2023]
Abstract
Petroleum can pollute pristine shorelines as a consequence of accidental spills or chronic leaks. In this study, the fate of petroleum hydrocarbons in soft pristine sediment of Caleta Valdés (Argentina) subject to ex situ simulated oil pollution was assessed. Sedimentary columns were exposed to medium and high concentrations of Escalante Crude Oil (ECO) and incubated in the laboratory during 30 days. Levels of aliphatic hydrocarbons at different depths of the sedimentary column were determined by gas chromatography. Oil penetration was limited to the first three centimetres in both treatments, and under this depth, hydrocarbons were clearly biogenic (terrestrial plants) as in the whole sedimentary column of the control assay. Bioturbation by macrobenthic infauna was strongly impacted by oil pollution which resulted in reduced sediment oxygenation and low burial of petroleum hydrocarbons. This may partly explain the limited hydrocarbon biodegradation observed, as indicated by the relatively high values of the ratios nC17/pristane, nC18/phytane, and total resolved aliphatic hydrocarbons/unresolved complex mixture. Correspondingly, at the end of the experiment the most probable number of hydrocarbon-degrading bacteria reached ~ 103 MPN g-1 dry weight. These values were lower than those found in chronically polluted coastal sediments, reflecting a low activity level of the oil-degrading community. The results highlight the low attenuation capacities of Caleta Valdés pristine sediments to recover its original characteristics in a short time period if an oil spill occurs. In this work, we present a novel and integrative tool to evaluate the fate of petroleum hydrocarbons and their potential damage on pristine sediments.
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Affiliation(s)
- J Sturla Lompré
- Centro para el Estudio de Sistema Marinos, CONICET, Bvd. Brown 2915, Puerto Madryn 9120, Argentina.
| | - M Nievas
- Centro para el Estudio de Sistema Marinos, CONICET, Bvd. Brown 2915, Puerto Madryn 9120, Argentina; Universidad Tecnológica Nacional, Facultad Regional Chubut, Av. del Trabajo 1536, Puerto Madryn 9120, Argentina
| | - M Franco
- Universidad Tecnológica Nacional, Facultad Regional Chubut, Av. del Trabajo 1536, Puerto Madryn 9120, Argentina; Centro Nacional Patagónico, CONICET, Bvd. Brown 2915, Puerto Madryn 9120, Argentina
| | - V Grossi
- Laboratoire de Géologie de Lyon, Université Claude Bernard, Lyon 1, Campus Scientifique de la Doua, 69622 Villeurbanne, France
| | - A Ferrando
- Centro para el Estudio de Sistema Marinos, CONICET, Bvd. Brown 2915, Puerto Madryn 9120, Argentina; Universidad Tecnológica Nacional, Facultad Regional Chubut, Av. del Trabajo 1536, Puerto Madryn 9120, Argentina
| | - C Militon
- Aix-Marseille Université, CNRS, Université de Toulon, IRD, MIO UM 110, 13288 Marseille, France
| | - F Gilbert
- Laboratoire Ecologie Fonctionnelle et Environnement, Université de Toulouse, INP, UPS, 118 Route de Narbonne, 31062 Toulouse, France; CNRS, EcoLab, 31062 Toulouse, France
| | - P Cuny
- Aix-Marseille Université, CNRS, Université de Toulon, IRD, MIO UM 110, 13288 Marseille, France
| | - G Stora
- Aix-Marseille Université, CNRS, Université de Toulon, IRD, MIO UM 110, 13288 Marseille, France
| | - M Sepúlveda
- Centro para el Estudio de Sistema Marinos, CONICET, Bvd. Brown 2915, Puerto Madryn 9120, Argentina
| | - J Esteves
- Centro para el Estudio de Sistema Marinos, CONICET, Bvd. Brown 2915, Puerto Madryn 9120, Argentina
| | - M Commendatore
- Centro para el Estudio de Sistema Marinos, CONICET, Bvd. Brown 2915, Puerto Madryn 9120, Argentina
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26
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Paluch-Shimon S, Cardoso F, Sessa C, Balmana J, Cardoso MJ, Gilbert F, Senkus E. Prevention and screening in BRCA mutation carriers and other breast/ovarian hereditary cancer syndromes: ESMO Clinical Practice Guidelines for cancer prevention and screening. Ann Oncol 2018; 27:v103-v110. [PMID: 27664246 DOI: 10.1093/annonc/mdw327] [Citation(s) in RCA: 244] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- S Paluch-Shimon
- Division of Oncology and the Dr Pinchas Borenstein Talpiot Medical Leadership Program, Sheba Medical Center, Ramat Gan, Israel
| | - F Cardoso
- Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal
| | - C Sessa
- Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
| | - J Balmana
- Vall d`Hebron University Hospital Institut d'Oncologia, Barcelona, Spain
| | - M J Cardoso
- Breast Unit, Champalimaud Clinical Center, Lisbon, Portugal
| | - F Gilbert
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - E Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
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Papalouka V, Kilburn-Toppin F, Gaskarth M, Gilbert F. MRI-guided breast biopsy: a review of technique, indications, and radiological-pathological correlations. Clin Radiol 2018; 73:908.e17-908.e25. [PMID: 30041954 DOI: 10.1016/j.crad.2018.05.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 05/24/2018] [Indexed: 10/28/2022]
Abstract
Breast magnetic resonance imaging (MRI) is the technique of choice in detection, local staging, and monitoring of breast cancer; however, breast MRI results in the detection of more indeterminate/suspicious lesions that need to be histopathologically proven to guide patient management than any other breast imaging method. If such abnormalities are not detectable in any of the conventional imaging tools (mammography (MMG) or ultrasound) then an MRI-guided biopsy needs to be performed to obtain a diagnosis. Breast MRI-guided biopsy is a time-consuming and complex procedure that requires specific equipment and experienced, well-trained staff. This review article explores and illustrates the indications, the currently available technologies, and the technique of breast MRI-guided biopsy, and explains the importance of careful imaging review and selection of cases. We correlate the radiological-pathological findings and highlight the impact on patient management in a multidisciplinary setting.
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Affiliation(s)
- V Papalouka
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
| | - F Kilburn-Toppin
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
| | - M Gaskarth
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
| | - F Gilbert
- Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK
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Gilbert F, Meffert RH, Schmalzl J, Weng AM, Köstler H, Eden L. Grade of retraction and tendon thickness correlates with MR-spectroscopically measured amount of fatty degeneration in full thickness supraspinatus tears. BMC Musculoskelet Disord 2018; 19:197. [PMID: 30037322 PMCID: PMC6055352 DOI: 10.1186/s12891-018-2096-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/16/2018] [Indexed: 12/11/2022] Open
Abstract
Background The amount of fatty degeneration (FD) has major impact on the clinical result and cuff integrity after rotator cuff repair. A quantitative analysis with magnet resonance imaging (MRI) spectroscopy was employed to analyze possible correlation of FD with tendon retraction, tendon thickness and patients’ characteristics in full thickness supraspinatus tears. Methods Forty-two patients with full-thickness supraspinatus tears underwent shoulder MRI including an experimental spectroscopic sequence allowing quantification of the fat fraction in the supraspinatus muscle belly. The amount of fatty degeneration was correlated with tendon retraction, tendon thickness, patients’ age, gender, smoker status, symptom duration and body mass index (BMI). Patients were divided in to three groups of retraction (A) 0-10 mm (n=), (B) 11-20 mm (n=) and (C) < 21 mm (n=) and the means of FD for each group were calculated. Results Tendon retraction (R = 0.6) and symptom duration (R = 0.6) correlated positively, whereas tendon thickness correlated negatively (R = − 0.6) with the amount of FD. The fat fraction increased significantly with tendon retraction: Group (A) showed a mean fat mount of 3.7% (±4%), group (B) of 16.7% (±8.2%) and group (C) of 37.5% (±19%). BMI, age and smoker-status only showed weak to moderate correlation with the amount of FD in this cohort. Conclusion MRI spectroscopy revealed significantly higher amount of fat with increasing grade of retraction, symptom duration and decreased tendon thickness. Thus, these parameters may indirectly be associated with the severity of tendon disease.
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Affiliation(s)
- F Gilbert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany.
| | - R H Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - J Schmalzl
- Department of Traumatology and Hand Surgery, St. Vincentius Klinik, ViDia Kliniken, Suedendstraße 32, D-76137, Karlsruhe, Germany
| | - A M Weng
- Department of Radiology, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - H Köstler
- Department of Radiology, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - L Eden
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
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Chan K, Gilbert F, Hilborne S, Benson J. The impact of selective pre-operative MRI on outcomes of breast conserving surgery in early breast cancer. Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.02.070] [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: 10/16/2022] Open
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Zavidovique L, Gilbert F, Vercambre-Jacquot MN. Bien-être au travail et qualité de vie des enseignants : quelles différences selon l’ancienneté ? ARCH MAL PROF ENVIRO 2018. [DOI: 10.1016/j.admp.2017.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gilbert F, Eden L, Meffert R, Konietschke F, Lotz J, Bauer L, Staab W. Intra- and interobserver reliability of glenoid fracture classifications by Ideberg, Euler and AO. BMC Musculoskelet Disord 2018; 19:89. [PMID: 29580228 PMCID: PMC5870213 DOI: 10.1186/s12891-018-2016-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/21/2018] [Indexed: 01/24/2023] Open
Abstract
Background Representing 3%–5% of shoulder girdle injuries scapula fractures are rare. Furthermore, approximately 1% of scapula fractures are intraarticularfractures of the glenoid fossa. Because of uncertain fracture morphology and limited experience, the treatment of glenoid fossa fractures is difficult. The glenoid fracture classification by Ideberg (1984) and Euler (1996) is still commonly used in literature. In 2013 a new glenoid fracture classification was introduced by the AO. The purpose of this study was to examine the new AO classification in clinical practice in comparison with the classifications by Ideberg and Euler. Methods In total CT images of 84 patients with glenoid fossa fractures from 2005 to 2018 were included. Parasagittal, paracoronary and axial reconstructions were examined according to the classifications of Ideberg, Euler and the AO by 3 investigators (orthopedic surgeon, radiologist, student of medicine) at three individual time settings. Inter- and intraobserver reliability of the three classification systems were ascertained by computing Inter- and Intraclass (ICCs) correlation coefficients using Spearman’s rank correlation coefficient, 95%-confidence intervals as well as F-tests for correlation coefficients. Results Inter- and intraobserver reliability for the AO classification showed a perspicuous coherence (R = 0.74 and R = 0.79). Low to moderate intraobserver reliability for Ideberg (R = 0.46) and Euler classification (R = 0.41) was found. Furthermore, data show a low Interobserver reliability for both Ideberg and Euler classification (R < 0.2). Both the Inter- and Intraclass reliability using AO is significantly higher than those using Ideberg and Euler (p < 0.05). Using the new AO classification, it was possible to find a proper class for every glenoid fossa fracture. On average, according to Euler classification 10 of 84 fractures were not classifiable whereas to Ideberg classification 21 of 84 fractures were not classifiable. Conclusion The new AO classification system introduced 2013 facilitates reliable grading of glenoid fossa fractures with high inter- and intraobserver reliability in 84 patients using CT images. It should possibly be applied in order to enable a valid, reliable and consistent academic description of glenoid fossa fractures. The established classifications by Euler and Ideberg are not capable of providing a similar reliability.
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Affiliation(s)
- F Gilbert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Würzburg, Germany.
| | - L Eden
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Würzburg, Germany
| | - R Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Würzburg, Germany
| | - F Konietschke
- Department of Mathematical Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - J Lotz
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - L Bauer
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - W Staab
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
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Gilbert F, Heintel TM, Jakubietz MG, Köstler H, Sebald C, Meffert RH, Weng AM. Quantitative MRI comparison of multifidus muscle degeneration in thoracolumbar fractures treated with open and minimally invasive approach. BMC Musculoskelet Disord 2018. [PMID: 29514622 PMCID: PMC5842610 DOI: 10.1186/s12891-018-2001-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Minimally invasive pedicle screw fixation has less approach-related morbidity than open screw placement and is allegedly less traumatizing on paravertebral muscles, as there is no requirement to mobilize and retract the adjacent muscle portion. The approach-related long-term effects to the morphology of the paravertebral muscles are unknown. The purpose of this study was to compare the long-term amount of fatty degeneration of the multifidus muscle in patients treated with a classical open or a minimally invasive approach. Methods Fourteen Patients meeting inclusion criteria were selected. In all patients a singular fracture of the thoracolumbar spine with a two-level posterior instrumentation was treated, either using an open approach or a minimally invasive approach. All patients underwent quantitative MRI spectroscopy for quantification of the fatty degeneration in the multifidus muscle as a long-term proof for muscle loss after minimum 4-year follow-up. Clinical outcome was assessed using Oswestry Low Back Pain Disability Questionnaire, SF-36 and VA-scale for pain. Results The minimally invasive approach group failed to show less muscle degeneration in comparison to the open group. Total amount of fatty degeneration was 14.22% in the MIS group and 12.60% in the open group (p = 0.64). In accordance to MRI quantitative results there was no difference in the clinical outcome after a mean follow up of 5.9 years (±1.8). Conclusion As short-term advantages of minimal invasive screw placement have been widely demonstrated, no advantage of the MIS, displaying a significant difference in the amount of fatty degeneration and resulting in a better clinical outcome could be found. Besides the well-known short-term advantage of minimally invasive pedicle screw placement, a long-term advantage, such as less muscle degeneration and thus superior clinical results, compared to the open approach could not be shown.
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Affiliation(s)
- F Gilbert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany.
| | - T M Heintel
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - M G Jakubietz
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - H Köstler
- Department of Radiology Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - C Sebald
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - R H Meffert
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
| | - A M Weng
- Department of Radiology Julius-Maximilians-University of Würzburg, Oberdürrbacherstr. 6, D-97080, Würzburg, Germany
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Vercambre-Jacquot MN, Gilbert F, Billaudeau N. [Teacher sick leave: Prevalence, duration, reasons and covariates]. Rev Epidemiol Sante Publique 2017; 66:19-31. [PMID: 29290454 DOI: 10.1016/j.respe.2017.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/30/2016] [Revised: 08/03/2017] [Accepted: 10/20/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Absences from work have considerable social and economic impact. In the education sector, the phenomenon is particularly worrying since teacher sick leave has an impact on the overall performance of the education system. Yet, available data are scarce. METHODS In April-June 2013, 2653 teachers responded to a population-based postal survey on their quality of life (enquête Qualité de vie des enseignants, MGEN Foundation/Ministry of education, response rate 53 %). Besides questions on work environment and health, teachers were asked to describe their eventual sick leave(s) since the beginning of the school year: duration, type and medical reasons. Self-reported information was reinforced by administrative data from ministerial databases and weighted to be extrapolated to all French teachers. Tobit models adjusted for individual factors of a private nature were used to investigate different occupational risk factors of teacher sick leave, taking into account both the estimated effect on the probability of sick leave and the length of it. RESULTS More than one in three teachers (36 %) reported having had at least one day of sick leave since the beginning of the school year. Respiratory/ENT diseases were the leading reason for sick leave (37 %). However, and because sick leave duration depended on the underlying health problem, such diseases came in third place among justifications of sick leave days (14 %), far behind musculoskeletal problems (27 %) and neurological and psychological disorders (25 %). Tobit models suggested that some occupational factors significantly associated with the risk of sick leave may represent promising preventive targets, including high psychological demand, workplace violence and unfavorable socio-environmental context. CONCLUSION Our study provides objective evidence about the issue of sick leave among French teachers, highlighting the usefulness of implementing actions to minimize its weight. To this end, the study findings point-out the importance of considering not only the probability of sick leave, but also its duration.
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Affiliation(s)
- M-N Vercambre-Jacquot
- Fondation d'entreprise MGEN pour la santé publique, 3, square Max-Hymans, 75748 Paris cedex 15, France.
| | - F Gilbert
- Fondation d'entreprise MGEN pour la santé publique, 3, square Max-Hymans, 75748 Paris cedex 15, France
| | - N Billaudeau
- Fondation d'entreprise MGEN pour la santé publique, 3, square Max-Hymans, 75748 Paris cedex 15, France
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Baird RD, Ramenatte N, Watts C, Jonson A, Jones L, Biggs H, Harrison E, Oberg I, Bullen G, Williams M, Qian W, Gilbert F, Jodrell D, Caldas C, Karabatsou K, Dunn L, Jena R, Whitfield G, Chalmers A, Jefferies S, Price S. Abstract OT1-04-01: Cambridge brain mets trial 1 (CamBMT1): A proof-of-principle phase 1b / randomised phase 2 study of afatinib penetration into brain metastases for patients undergoing neurosurgical resection, both with and without prior low-dose, targeted radiotherapy. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-ot1-04-01] [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: 11/16/2022]
Abstract
Abstract
Background
Failure of drugs to cross the blood brain barrier (BBB) can be a major reason for treatment failure for patients with brain tumors. For most patients who don't respond to treatment, it is not known whether this is due to inadequate drug concentrations in the tumor, or due to drug resistance. Preliminary data suggest that low-dose radiotherapy may disrupt the BBB, and could facilitate increased drug delivery into brain tumors. Afatinib is a potent, irreversible inhibitor of EGFR / HER2 / HER4 and takes approximately 8 days to achieve steady-state concentrations in cancer patients.
Aims
CamBMT1 has been designed to investigate the delivery of afatinib into brain metastases and whether this might be enhanced by low dose-radiotherapy.
Patient Population
Key eligibility criteria
Patients with operable brain metastases from breast or lung primaries for whom neurosurgical resection would be standard of care, as determined by the local multi-disciplinary team. ECOG PS 0, 1 or 2.
Trial design
After a phase 1b safety run- in, the phase 2 part of the trial randomises patients (n=60) into 3 pre-operative arms:
Arm 1afatinib alone for 11 days, then neurosurgery on day 12Arm 2afatinib for 11 days plus a single 2 Gy fraction on day 10, then neurosurgery on day 12Arm 3afatinib for 11 days plus a single 4 Gy fraction on day 10, then neurosurgery on day 12
Primary endpoint: to compare steady-state afatinib concentration in resected brain metastases, following afatinib administered alone, or in combination with radiotherapy (2 Gy or 4 Gy). Afatinib concentrations are measured in the resected brain metastases and in plasma.
Secondary endpoints: safety of afatinib administration in combination with radiotherapy; and multi-sequence MRI (optional) to detect changes in perfusion, vascular density, blood-brain-barrier permeability and interstitial pressure.
Exploratory endpoints: molecular profiling of resected brain metastases, for comparison with paired primary lung and breast cancers; the establishment and study of patient-derived xenografts.
Statistical methods
With 20 patients randomised in each of 3 arms in the phase 2 part of CamBMT1, the trial has a power of 84% at a significance level of 20% (one-sided) to detect an increase in afatinib concentrations with targeted radiotherapy, measured as a Cohen's D (standardised mean difference) ≥0.5.
Accrual
By the end of q2 2016, phase 1b had nearly completed enrolment. The randomised phase 2 part of CamBMT1 is due to open by q4 2016 at additional Experimental Cancer Medicine Centres.
Acknowledgments
CamBMT1 is funded by Cancer Research UK, the Brain Tumour Charity and Boehringer-Ingelheim.
Citation Format: Baird RD, Ramenatte N, Watts C, Jonson A, Jones L, Biggs H, Harrison E, Oberg I, Bullen G, Williams M, Qian W, Gilbert F, Jodrell D, Caldas C, Karabatsou K, Dunn L, Jena R, Whitfield G, Chalmers A, Jefferies S, Price S. Cambridge brain mets trial 1 (CamBMT1): A proof-of-principle phase 1b / randomised phase 2 study of afatinib penetration into brain metastases for patients undergoing neurosurgical resection, both with and without prior low-dose, targeted radiotherapy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-04-01.
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Affiliation(s)
- RD Baird
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - N Ramenatte
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - C Watts
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - A Jonson
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - L Jones
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - H Biggs
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - E Harrison
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - I Oberg
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - G Bullen
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - M Williams
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - W Qian
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - F Gilbert
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - D Jodrell
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - C Caldas
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - K Karabatsou
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - L Dunn
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - R Jena
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - G Whitfield
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - A Chalmers
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - S Jefferies
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
| | - S Price
- Cambridge Cancer Centre - Breast Cancer Research Unit, Cambridge, Cambridgeshire, United Kingdom; Cambridge Clinical Trials Unit – Cancer Theme, Cambridge, Cambridgeshire, United Kingdom; Cambridge Cancer Centre - Early Phase Clinical Trials Team, Cambridge, Cambridgeshire, United Kingdom; University of Cambridge, Cambridge, Cambridgeshire, United Kingdom; Neuro-Oncology, Addenbrooke's Hospital, Cambridge, Cambridgeshire, United Kingdom; Cancer Research UK Cambridge Institute - PK-PD Core Facility, Cambridge, Cambridgeshire, United Kingdom; University of Glasgow - Neuro-Oncology, Glasgow, United Kingdom; University of Manchester, Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, United Kingdom; University of Cambridge - Cambridge Cancer Centre, United Kingdom
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Caetano G, Gilbert F, Loie C, Lapie-Legouis P, Garsi JP. Trouble vocal chez les enseignants : vers une prévention collective ? ARCH MAL PROF ENVIRO 2016. [DOI: 10.1016/j.admp.2016.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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de Clercq D, Sacko M, Behnke J, Gilbert F, Vercruysse J. The relationship between Schistosoma haematobium infection and school performance and attendance in Bamako, Mali. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.1998.11813350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Donnelly Y, Brennan S, Gilbert F, Gorham A, Parks C, Glynn A. MON-P088: Establishing a Reactive Homeng Service Using Cortrak Enteral Access System (EAS) for Head and Neck Cancer Patients Undergoing Radiotherapy and/or Chemotherapy. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30722-1] [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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Vercambre-Jacquot MN, Gilbert F. Bien-être professionnel et qualité de vie des enseignants : quelles évolutions sur 15ans ? Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.06.285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Smith R, Bryan M, Campbell K, Cooney L, Gilbert F, Hamill T, Scott A, Williams K. The challenges of an autologous cell therapy product in clinical trials. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61480-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mohamed NE, Gilbert F, Lee CT, Sfakianos J, Knauer C, Mehrazin R, Badr H, Wittmann D, Downs T, Berry D, Given B, Wiklund P, Steineck G. Pursuing Quality in the Application of Bladder Cancer Quality of Life Research. Bladder Cancer 2016; 2:139-149. [PMID: 27376136 PMCID: PMC4927895 DOI: 10.3233/blc-160051] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Patient-reported outcomes (PRO), including health-related quality of life (HRQOL) measures, represent important means for evaluating patients' health outcomes and for guiding health care decisions made by patients, practitioners, investigators, and policy makers. In spite of the large number of studies examining HRQOL in patients with bladder cancer, very few review articles investigated this topic. Because these review studies report mixed results, incorporating bladder cancer HRQOL measures into standard urological practice is not a viable option. In this non-systematic review of the literature and commentary we note some general concerns regarding PRO research, but our primary focus is on the HRQOL methodology within the context of two types of bladder cancer: muscle invasive and non-muscle invasive bladder cancer. Considering bladder cancer HRQOL as the interaction of four areas of the assessment process (i.e., what model of HRQOL to choose, what instruments are available to fit the choice, how interpretation of the resulting data fits the model, and how to derive some utility from the chosen model) and the two types of disease (i.e., muscle invasive and non-muscle invasive) may move us toward a better understanding of bladder cancer HRQOL. Establishing a useful model of perceived general health or specific symptoms is the first and most important step in developing the responsive bladder cancer HRQOL measures necessitated by clinical settings.
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Affiliation(s)
- N E Mohamed
- Department of Urology, Icahn School of Medicine at Mount Sinai , New York, NY, USA
| | | | - C T Lee
- Department of Urology, University of Michigan , Ann Arbor, MI, USA
| | - J Sfakianos
- Department of Urology, Icahn School of Medicine at Mount Sinai , New York, NY, USA
| | - C Knauer
- Department of Urology, Icahn School of Medicine at Mount Sinai , New York, NY, USA
| | - R Mehrazin
- Department of Urology, Icahn School of Medicine at Mount Sinai , New York, NY, USA
| | - H Badr
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai , New York, NY, USA
| | | | - T Downs
- Department of Urology, University of Wisconsin , Madison, WI, USA
| | - D Berry
- Dana-Farber Cancer Institute , Boston, MA, USA
| | - B Given
- Department of Medicine, Harvard Medical School, Dana-Farber Cancer Institute , Boston, MA, USA
| | - P Wiklund
- Department of Urology, Icahn School of Medicine at Mount Sinai , New York, NY, USA
| | - G Steineck
- Division of Clinical Cancer Epidemiology, Sahlgrenska universitetssjukhuset , Göteborg, Sweden
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Ramasundara S, Tucker L, Wallis M, Britton P, Moyle P, Taylor K, Sinnatamby R, Freeman A, Gaskarth M, Gilbert F. Diagnostic implications of digital breast tomosynthesis in symptomatic patients. Breast Cancer Res 2015. [PMCID: PMC4670148 DOI: 10.1186/bcr3782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Billaudeau N, Gilbert F, Lapie-Legouis P, Vercambre-Jacquot M. Enquête « Qualité de vie des enseignants » : état des lieux. ARCH MAL PROF ENVIRO 2015. [DOI: 10.1016/j.admp.2015.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sieker JT, Kunz M, Weißenberger M, Gilbert F, Frey S, Rudert M, Steinert AF. Direct bone morphogenetic protein 2 and Indian hedgehog gene transfer for articular cartilage repair using bone marrow coagulates. Osteoarthritis Cartilage 2015; 23:433-42. [PMID: 25463442 DOI: 10.1016/j.joca.2014.11.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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: 05/20/2014] [Revised: 11/01/2014] [Accepted: 11/05/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Bone morphogenetic protein 2 (BMP-2, encoded by BMP2) and Indian hedgehog protein (IHH, encoded by IHH) are well known regulators of chondrogenesis and chondrogenic hypertrophy. Despite being a potent chondrogenic factor BMP-2 was observed to induce chondrocyte hypertrophy in osteoarthritis (OA), growth plate cartilage and adult mesenchymal stem cells (MSCs). IHH might induce chondrogenic differentiation through different intracellular signalling pathways without inducing subsequent chondrocyte hypertrophy. The primary objective of this study is to test the efficacy of direct BMP2 and IHH gene delivery via bone marrow coagulates to influence histological repair cartilage quality in vivo. METHOD Vector-laden autologous bone marrow coagulates with 10(11) adenoviral vector particles encoding BMP2, IHH or the Green fluorescent protein (GFP) were delivered to 3.2 mm osteochondral defects in the trochlea of rabbit knees. After 13 weeks the histological repair cartilage quality was assessed using the ICRS II scoring system and the type II collagen positive area. RESULTS IHH treatment resulted in superior histological repair cartilage quality than GFP controls in all of the assessed parameters (with P < 0.05 in five of 14 assessed parameters). Results of BMP2 treatment varied substantially, including severe intralesional bone formation in two of six joints after 13 weeks. CONCLUSION IHH gene transfer is effective to improve repair cartilage quality in vivo, whereas BMP2 treatment, carried the risk intralesional bone formation. Therefore IHH protein can be considered as an attractive alternative candidate growth factor for further preclinical research and development towards improved treatments for articular cartilage defects.
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Affiliation(s)
- J T Sieker
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University of Würzburg, Germany.
| | - M Kunz
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University of Würzburg, Germany.
| | - M Weißenberger
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University of Würzburg, Germany.
| | - F Gilbert
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University of Würzburg, Germany; Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Germany.
| | - S Frey
- Department of Trauma, Hand, Plastic and Reconstructive Surgery, Julius-Maximilians-University of Würzburg, Germany.
| | - M Rudert
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University of Würzburg, Germany.
| | - A F Steinert
- Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University of Würzburg, Germany.
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Lejeune F, Parmentier F, Gilbert F, Neri C. B02 Systems Modelling And Network-based Approaches For Basic And Translational Research In Huntington's Disease. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gendreau J, Gilbert F, Lapie-Legouis P, Sevilla-Dedieu C. Recours au médecin endocrinologue dans une population diabétique (France). Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.06.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Gendreau J, Gilbert F, Lapie-Legouis P, Sevilla-Dedieu C. Qualité du suivi médical des diabétiques de la Mutuelle générale de l’éducation nationale (France). Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.06.022] [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: 10/24/2022] Open
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Sadeghi H, Rotheray G, Laska P, Gilbert F. Host preferences of aphidophagous hoverflies from field distribution of their larvae. ACTA ACUST UNITED AC 2014. [DOI: 10.4314/ejb.v16i1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Green PR, Gentle L, Peake TM, Scudamore RE, McGregor PK, Gilbert F, Dittrich WH. Conditioning pigeons to discriminate naturally lit insect specimens. Behav Processes 2014; 46:97-102. [PMID: 24925502 DOI: 10.1016/s0376-6357(99)00022-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/1998] [Revised: 02/09/1999] [Accepted: 02/12/1999] [Indexed: 10/17/2022]
Abstract
Pigeons (Columba livia) were trained on a visual discrimination task using a novel apparatus which enabled pinned specimens of insects, illuminated by natural daylight, to be presented under a pecking key transparent to ultraviolet light. Three birds showed evidence of learning to discriminate between sets of wasp and fly specimens. This response transferred to specimens of four hoverfly species, the strength of the response varying between the different hoverfly species. This conditioning technique offers a promising means of analysing mechanisms of visual processing in birds that are relevant to theories of the evolution of camouflage and mimicry.
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Affiliation(s)
- P R Green
- Department of Psychology, University of Nottingham, Nottingham NG7 2RD, UK.
| | - L Gentle
- Department of Life Science, University of Nottingham, Nottingham NG7 2RD, UK
| | - T M Peake
- Department of Life Science, University of Nottingham, Nottingham NG7 2RD, UK
| | - R E Scudamore
- Department of Life Science, University of Nottingham, Nottingham NG7 2RD, UK
| | - P K McGregor
- Department of Life Science, University of Nottingham, Nottingham NG7 2RD, UK
| | - F Gilbert
- Department of Life Science, University of Nottingham, Nottingham NG7 2RD, UK
| | - W H Dittrich
- Department of Psychology, University of Exeter, Exeter EX4 4QG, UK
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Tromans C, Highnam R, Morrish O, Black R, Tucker L, Gilbert F, Brady M. TU-F-18C-06: Which Women Based On Clinical Benefits and Dose Should Be Considered For Breast Screening with Tomosynthesis? Med Phys 2014. [DOI: 10.1118/1.4889351] [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: 11/07/2022] Open
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Wilson A, Cameron D, Evans G, Broeders M, Lerda D, Knox S, Gilbert F, Skaane P, Evans A, Mann R, Bick U, Ramirez A, Michell M. E03. Update on breast cancer screening. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70055-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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