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Qiao J, Kang H, Ran Q, Tong H, Ma Q, Wang S, Zhang W, Wu H. Metabolic habitat imaging with hemodynamic heterogeneity predicts individual progression-free survival in high-grade glioma. Clin Radiol 2024; 79:e842-e853. [PMID: 38582632 DOI: 10.1016/j.crad.2024.02.011] [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: 01/30/2023] [Revised: 12/07/2023] [Accepted: 02/10/2024] [Indexed: 04/08/2024]
Abstract
AIM We design a feasibility study to obtain a set of metabolic-hemodynamic habitats for tackling tumor spatial metabolic patterns with hemodynamic information. MATERIALS AND METHODS Preoperative data from 69 high-grade gliomas (HGG) patients with subsequent histologic confirmation of HGG were prospectively collected (January 2016 to March 2020) after concurrent chemoradiotherapy (CCRT). Four vascular habitats were automatically segmented by multiparametric magnetic resonance imaging (MRI). The metabolic information, either at enhancing or edema tumor regions, was obtained by two neuroradiologists. The relative habitat volumes were used for weight estimation procedures for computing the coefficients of a linear regression model using weighted least squares (WLS) for metabolite semiquantifications (i.e. the Cho/NAA ratio and the Cho/Cr ratio) at vascular habitats. Multivariate Cox proportional hazard regression analyses are used to obtain the odds ratio (OR) and develop a nomogram using weighted estimators corresponding to each covariate derived from Cox regression coefficients. RESULTS There was a strongly correlation between perfusion indexes and the Cho/Cr ratio (rCBV, r=0.71) or Cho/NAA ratio (rCBV, r=0.66) at high-angiogenic enhancing tumor habitats (HAT) habitat. Compared isocitrate dehydrogenase (IDH) mutation to their wild type, the IDH wild type had significantly decreased Cho/Cr ratio (IDH mutation: Cho/Cr ratio = 2.44 ± 0.33, IDH wildtype: Cho/Cr ratio = 2.66 ± 0.36, p=0.02) and Cho/NAA ratio (IDH mutation: Cho/Cr ratio = 4.59 ± 0.61, IDH wildtype: Cho/Cr ratio = 4.99 ± 0.66, p=0.022) at the HAT. The C-index for the median progression-free survival (PFS) prediction was 0.769 for the Cho/NAA nomogram and 0.747 for the Cho/Cr nomogram through 1000 bootstrapping validation. CONCLUSIONS Our findings suggest that spatial metabolism combined with hemodynamic heterogeneity is associated with individual PFS to HGG patients post-CCRT.
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Affiliation(s)
- J Qiao
- Department of Radiology, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Chongqing, 400024, China; Chongqing Clinical Research Centre of Imaging and Nuclear Medicine, Chongqing, 400042, China
| | - H Kang
- Department of Radiology, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Chongqing, 400024, China; Chongqing Clinical Research Centre of Imaging and Nuclear Medicine, Chongqing, 400042, China
| | - Q Ran
- Department of Radiology, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Chongqing, 400024, China; Chongqing Clinical Research Centre of Imaging and Nuclear Medicine, Chongqing, 400042, China
| | - H Tong
- Department of Radiology, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Chongqing, 400024, China; Chongqing Clinical Research Centre of Imaging and Nuclear Medicine, Chongqing, 400042, China
| | - Q Ma
- Department of Pathology, Army Medical Center, PLA, Chongqing, 400042, China
| | - S Wang
- Department of Radiology, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Chongqing, 400024, China; Chongqing Clinical Research Centre of Imaging and Nuclear Medicine, Chongqing, 400042, China.
| | - W Zhang
- Department of Radiology, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Chongqing, 400024, China; Chongqing Clinical Research Centre of Imaging and Nuclear Medicine, Chongqing, 400042, China.
| | - H Wu
- Department of Radiology, Daping Hospital, Army Medical University, 10# Changjiangzhilu, Chongqing, 400024, China; Chongqing Clinical Research Centre of Imaging and Nuclear Medicine, Chongqing, 400042, China.
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Keegan G, Zhu M, Paz M, Kang H, Patel A, Baig AA. Neighborhood-level factors associated with COVID-19 vaccination rates: a case study in Chicago. BMC Public Health 2024; 24:889. [PMID: 38528490 DOI: 10.1186/s12889-024-18352-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Chicago's deeply-rooted racial and socioeconomic residential segregation is a pattern mirrored in other major cities, making it a prototype for studying the uptake of public health interventions across the US. Residential segregation is related to availability of primary care, sense of community, and trust in the healthcare system, components which are essential in the response to crises like Covid-19 in which vaccine rollout was primarily community-based. We aimed to evaluate the association between rates of access to primary care and community-belonging with Covid-19 vaccination within Chicago's neighborhoods. METHODS Data from Chicago Department of Public Health (12/2020-6/2022) on Covid-19 vaccination rates, race/ethnicity (% Black and % Hispanic/Latinx residents), age (% >65), gender (% female), socioeconomic status (% below the federal poverty line), access to needed care rate, and rate of self-reported sense of community-belonging on the neighborhood level were analyzed. Linear mixed models (LMMs) were used to study the impact of variables on vaccination; each neighborhood was added as a random effect to account for with-community association. RESULTS The average Covid-19 vaccination rates across Chicago's neighborhoods was 79%, ranging from 37 to 100%, with median 81%. We found that Covid-19 vaccination rates were positively correlated with access to needed care (p < 0.001) and community-belonging (p < 0.001). Community areas that had lower vaccination rates had greater percentage of Black residents (p < 0.0001) and greater poverty rates (p < 0.0001). After adjusting for poverty, race, gender and age in the models, the association between vaccination rates and access to care or community-belonging were no longer significant, but % Black residents and poverty remained significant. CONCLUSIONS Though access to needed primary care and community-belonging are correlated with vaccination rates, this association was not significant when controlling for demographic factors. The association between poverty, race and vaccination status remained significant, indicating that socioeconomic and racial disparities across Chicago drive Covid-19 vaccine recommendation adherence regardless of care access. Understanding how poverty, and its intersectional relation to race and primary care access, affects vaccination should be a priority for public health efforts broadly.
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Affiliation(s)
- Grace Keegan
- Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Ave. MC 2007, 60637, Chicago, IL, USA.
| | - Mengqi Zhu
- Department of Medicine, Section of General Internal Medicine, University of Chicago, Chicago, USA
| | - Maria Paz
- Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Ave. MC 2007, 60637, Chicago, IL, USA
| | - Hyojung Kang
- Department of Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Ajanta Patel
- Chicago Department of Public Health, Chicago, IL, USA
| | - Arshiya A Baig
- Department of Medicine, Section of General Internal Medicine, University of Chicago, Chicago, USA
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Hu WJ, Wang ZH, Wu G, Guo XN, Dong CX, Kang H, Liu QY, Yuan JJ, Yang X. [Analysis of ultrasound images features and diagnostic model establishment of alveolar soft part sarcoma and intramuscular capillary-type hemangiomas]. Zhonghua Yi Xue Za Zhi 2024; 104:608-613. [PMID: 38389238 DOI: 10.3760/cma.j.cn112137-20230728-00112] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Objective: The ultrasonography features of alveolar soft part sarcoma (ASPS) and intramuscular capillary-type hemangiomas (ICTH) were analyzed, and the diagnostic model of ASPS was established. Methods: A cross-sectional study was carried out. The clinical data of 52 patients [28 males and 24 females, aged (20.7±15.1) years] with pathologically confirmed ASPS and ICTH admitted to People's Hospital of Henan Province from January 2005 to February 2023 were included in the study. According to pathological types, the patients were divided into ASPS group and ICTH group. Clinical data of patients were retrospectively collected, and meaningful indicators in the univariate analysis were included in the regression analysis for screening. After comprehensive consideration of clinical significance and statistical significance, eligible indicators were selected for inclusion in the regression analysis. Binary logistic regression analysis was used to screen the factors that distinguished the pathological types of ASPS and ICTH, and the diagnostic model was established. The area under receiver operating characteristic (ROC) curve (AUC) was used to evaluate the diagnostic effectiveness of the diagnostic model in distinguishing ASPS from ICTH. Results: There were 20 patients in ASPS group, 10 males and 10 females, aged (26.9±13.5) years, and 32 patients in ICTH group, 18 males and 14 females, aged (16.8±15.0) years. The age difference between the ASPS group and the ICTH group was statistically significant (P<0.05), and there were statistically significant differences in the ultrasound imaging features of "clear boundary" "peripheral lobe" "thin blood vessels inside the lesion are straight and out of shape" "intra-lesion liquification" "peripheral thick blood vessels" and "peripheral muscle fiber disruption" between the two groups (all P<0.001).Variables with clinical and statistical significance were selected as independent variables. Binary logistic regression analysis showed that peripheral muscle fiber interruption (OR=97.358, 95%CI:6.833-1 387.249) and internal thin blood vessels were flat and out of shape (OR=0.052, 95%CI:0.003-0.921) was the correlation factor to distinguish the pathological types of ASPS and ICTH. Two ultrasonic image features of "peripheral muscle fiber interruption" and "internal thin blood vessels are straight and out of shape" were used to establish the diagnostic model. The sensitivity of "peripheral muscle fiber interruption" diagnostic model was 81.3%, and the specificity was 95.0%. The AUC was 0.811(95%CI: 0.761-0.954). The sensitivity, specificity and AUC of the diagnosis model of "internal thin vessels with flat misshape" were 90.0%, 96.9% and 0.934(95%CI: 0.830-0.984). The sensitivity, specificity and AUC of the combined diagnosis model of "peripheral muscle fiber interruption" and "internal thin blood vessel straight out of shape" were 96.9%, 90.0% and 0.974(95%CI:0.877-0.999). Conclusion: Ultrasonography can be used to distinguish ASPS from ICTH, and the combined diagnostic model based on the two ultrasonic imaging features of "peripheral muscle fiber interruption" and "internal thin blood vessel straight out of shape" can further improve the diagnostic efficiency.
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Affiliation(s)
- W J Hu
- Department of Ultrasound, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital,Zhengzhou 450003,China
| | - Z H Wang
- Department of Ultrasound, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital,Zhengzhou 450003,China
| | - G Wu
- Department of Ultrasound, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital,Zhengzhou 450003,China
| | - X N Guo
- Department of Hemangioma,Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou 450003,China
| | - C X Dong
- Department of Hemangioma,Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou 450003,China
| | - H Kang
- Department of Pathology,Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital,Zhengzhou 450003,China
| | - Q Y Liu
- Department of Pathology,Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital,Zhengzhou 450003,China
| | - J J Yuan
- Department of Ultrasound, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital,Zhengzhou 450003,China
| | - X Yang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China
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Park SS, Kang H, Kim YH, Kim JH. Different tumor growth pattern of clinically nonfunctioning pituitary neuroendocrine tumor according to sex and age: a longitudinal study. J Endocrinol Invest 2024:10.1007/s40618-024-02303-8. [PMID: 38310625 DOI: 10.1007/s40618-024-02303-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/02/2024] [Indexed: 02/06/2024]
Abstract
PURPOSE Asymptomatic patients with clinically non-functional pituitary neuroendocrine tumors (CNF-PitNETs) are usually followed up. However, the natural course of CNF-PitNETs according to sex and age remains unclear. Therefore, this study assessed growth patterns of CNF-PitNETs according to sex and age. METHODS In this longitudinal study, we enrolled 431 consecutive patients with CNF-PitNETs who were treated at Seoul National University Hospital from 1997 to 2021. The patients underwent hormone function testing and visual field testing, and were subsequently followed up with imaging over a median duration of 66 months. RESULTS The median age of the patients was 53.0 years, and 37.1% (n = 160) were men. Men were older and harbored more macroadenomas than women. The annual tumor volume change was higher in men than in women (0.21 vs. 0.04 cm3/year, P < 0.001). The estimated cutoff value of age for significant tumor growth was 51 years. In men, the annual tumor volume change was similar across all age groups. In women, those aged ≤ 50 years showed significantly lower annual tumor volume change than those aged > 50 years (0.01, 0.11, and 0.17 cm3/year, P = 0.001). When comparing sexes within the same age group, the annual tumor volume changes was significantly lower for women than for men, only in patients aged ≤ 50 years (0.01 vs. 0.15 cm3/year, P < 0.001). CONCLUSIONS Among patients with CNF-PitNET, tumor growth was slower in women aged ≤ 50 years than in men and women aged > 50. These findings may guide the customization of surveillance strategies for CNF-PitNETs according to sex and age.
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Affiliation(s)
- S S Park
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Dae-hak ro, Seoul, 03080, Korea
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Pituitary Center, Seoul National University Hospital, Seoul, Korea
| | - H Kang
- Pituitary Center, Seoul National University Hospital, Seoul, Korea
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Dae-hak ro, Seoul, 03080, Korea
| | - Y H Kim
- Pituitary Center, Seoul National University Hospital, Seoul, Korea.
- Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 101 Dae-hak ro, Seoul, 03080, Korea.
| | - J H Kim
- Department of Internal Medicine, Seoul National University College of Medicine, 101 Dae-hak ro, Seoul, 03080, Korea.
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
- Pituitary Center, Seoul National University Hospital, Seoul, Korea.
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McMurry TL, Lobo JM, Kim S, Kang H, Sohn MW. A sampling strategy for longitudinal and cross-sectional analyses using a large national claims database. Front Public Health 2024; 12:1257163. [PMID: 38362210 PMCID: PMC10867963 DOI: 10.3389/fpubh.2024.1257163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/08/2024] [Indexed: 02/17/2024] Open
Abstract
Importance The United States (US) Medicare claims files are valuable sources of national healthcare utilization data with over 45 million beneficiaries each year. Due to their massive sizes and costs involved in obtaining the data, a method of randomly drawing a representative sample for retrospective cohort studies with multi-year follow-up is not well-documented. Objective To present a method to construct longitudinal patient samples from Medicare claims files that are representative of Medicare populations each year. Design Retrospective cohort and cross-sectional designs. Participants US Medicare beneficiaries with diabetes over a 10-year period. Methods Medicare Master Beneficiary Summary Files were used to identify eligible patients for each year in over a 10-year period. We targeted a sample of ~900,000 patients per year. The first year's sample is stratified by county and race/ethnicity (white vs. minority), and targeted at least 250 patients in each stratum with the remaining sample allocated proportional to county population size with oversampling of minorities. Patients who were alive, did not move between counties, and stayed enrolled in Medicare fee-for-service (FFS) were retained in the sample for subsequent years. Non-retained patients (those who died or were dropped from Medicare) were replaced with a sample of patients in their first year of Medicare FFS eligibility or patients who moved into a sampled county during the previous year. Results The resulting sample contains an average of 899,266 ± 408 patients each year over the 10-year study period and closely matches population demographics and chronic conditions. For all years in the sample, the weighted average sample age and the population average age differ by <0.01 years; the proportion white is within 0.01%; and the proportion female is within 0.08%. Rates of 21 comorbidities estimated from the samples for all 10 years were within 0.12% of the population rates. Longitudinal cohorts based on samples also closely resembled the cohorts based on populations remaining after 5- and 10-year follow-up. Conclusions and relevance This sampling strategy can be easily adapted to other projects that require random samples of Medicare beneficiaries or other national claims files for longitudinal follow-up with possible oversampling of sub-populations.
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Affiliation(s)
- Timothy L. McMurry
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Jennifer M. Lobo
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
| | - Soyoun Kim
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States
- Department of Social Welfare, Ewha Womans University, Seoul, Republic of Korea
| | - Hyojung Kang
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL, United States
| | - Min-Woong Sohn
- Department of Health Management and Policy, University of Kentucky, Lexington, KY, United States
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Liu J, Cong C, Zhang J, Qiao J, Guo H, Wu H, Sang Z, Kang H, Fang J, Zhang W. Multimodel habitats constructed by perfusion and/or diffusion MRI predict isocitrate dehydrogenase mutation status and prognosis in high-grade gliomas. Clin Radiol 2024; 79:e127-e136. [PMID: 37923627 DOI: 10.1016/j.crad.2023.09.025] [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: 03/21/2023] [Revised: 08/15/2023] [Accepted: 09/22/2023] [Indexed: 11/07/2023]
Abstract
AIM To determine whether tumour vascular and cellular heterogeneity of high-grade glioma (HGG) is predictive of isocitrate dehydrogenase (IDH) mutation status and overall survival (OS) by using tumour habitat-based analysis constructed by perfusion and/or diffusion magnetic resonance imaging (MRI). MATERIALS AND METHODS Seventy-eight HGG patients that met the 2021 World Health Organization WHO Classification of Tumors of the Central Nervous System, 5th edition (WHO CNS5), were enrolled to predict IDH mutation status, of which 32 grade 4 patients with unmethylated O6-methylguanine-DNA methyltransferase (MGMT) promoter were enrolled for prognostic analysis. The deep-learning-based model nnU-Net and K-means clustering algorithm were applied to construct the Traditional Habitat, Vascular Habitat (VH), Cellular Density Habitat (DH), and their Combined Habitat (CH). Quantitative parameters were extracted and compared between IDH-mutant and IDH-wild-type patients, respectively, and the prediction potential was evaluated by receiver operating characteristic (ROC) curve analysis. OS was analysed using Kaplan-Meier survival analysis and the log-rank test. RESULTS Compared with IDH-mutants, median relative cerebral blood volume (rCBVmedian) values in the whole enhancing tumour (WET), VH1, VH3, CH1-4 habitats were significantly increased in IDH-wild-type HGGs (all p<0.05). Additionally, the accuracy of rCBVmedian values in CH1 outperformed other habitats in identifying IDH mutation status (p<0.001) at a cut-off value of 4.83 with AUC of 0.815. Kaplan-Meier survival analysis highlighted significant differences in OS between the populations dichotomised by the median of rCBVmedian in WET, VH1, CH1-3 habitats (all p<0.05). CONCLUSIONS The habitat imaging technique may improve the accuracy of predicting IDH mutation status and prognosis, and even provide a new direction for subsequent personalised precision treatment.
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Affiliation(s)
- J Liu
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China; Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, 400042, China
| | - C Cong
- Department of Nuclear Medicine, Daping Hospital, Army Medical University, Chongqing, 400042, China; School of Electrical and Electronic Engineering, Chongqing University of Technology, Chongqing, 400054, China
| | - J Zhang
- Department of Radiology, General Hospital of Western Theater Command of PLA, Chengdu, 600083, China
| | - J Qiao
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China; Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, 400042, China
| | - H Guo
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China; Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, 400042, China
| | - H Wu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400042, China
| | - Z Sang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China; Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, 400042, China
| | - H Kang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China; Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, 400042, China
| | - J Fang
- Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, 400042, China; Department of Ultrasound, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - W Zhang
- Department of Radiology, Daping Hospital, Army Medical University, Chongqing, 400042, China; Chongqing Clinical Research Center for Imaging and Nuclear Medicine, Chongqing, 400042, China.
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Hasnain L, Kang H, Vaince F, Ganesh K, Gomez K, Gahtan V, Small W, Refaat T. Incidence, Radiologic and Dosimetric Parameters Associated with Radiation Induced Breast Lymphedema. Int J Radiat Oncol Biol Phys 2023; 117:e178. [PMID: 37784796 DOI: 10.1016/j.ijrobp.2023.06.1027] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation induced breast lymphedema (BL) is an underreported but common finding. This study aimed to report the incidence of clinical BL and investigate the radiologic and dosimetric parameters associated with higher risk of BL. MATERIALS/METHODS This IRB approved study included women with breast cancer who underwent breast conservative surgery followed by adjuvant radiation therapy between 2019 and 2021 at our institution. We reviewed the eligible patients' charts for incidence of clinical BL resulting in symptoms and requiring physical therapy referral. Thickness of the skin at defined center and bottom points of the breast was measured for patient' baseline and follow up mammograms. Dosimetric parameters were imported from patients' radiation plans including mean, maximum doses, and volumes receiving 20, 30, 40, & 50 Gy (V20, V30, V40, & V50), of the whole breast (WB), breast_eval (BE), and breast skin (BS) (defined as the superficial 5 mm of the skin). A chi-square test was used to test the association between clinical BL and radiation treatment regimens and beam energies and the association of skin thicknesses between those who had clinical BL and those who did not. A Wilcoxon rank sum test was used to test the association of the dosimetric parameters with clinical BL. RESULTS We identified 268 patients who were eligible for the study. After chart and radiologic review, 119 patients had complete records available and were included in this study. Twenty-nine patients (24.4%) of the patients presented with symptomatic BL. Most patients (68%) received hypofractionated (42.56 Gy with or without 10 Gy boost), while 25% received conventional and 7% received ultra-hypofractionated radiotherapy. There was no association between the fractionation and incidence of BL (p = 0.4). There was no association between breast size and BL (mean 1065 cc vs 1232 cc, p = 0.35). There was significant association between BL and BS V30 (142cc vs 162 cc, p = 0.02), and BS V40 (82 cc vs 102 cc, p = 0.02), and a trend towards significant association with BS V20 (172cc vs. 193cc, p = 0.08), BS V50 (8 cc vs. 16 cc, p = 0.06). There was no significant association between BL and BS mean dose (36.9 Gy vs 39 Gy p = 0.11), or BS max dose (53.9 Gy vs 54.1 Gy, p = 0.21). None of the dosimetric parameters of WB and BE had significant association with clinical BL. Utilizing ROC analysis, there was significant association between clinical BL and the change of baseline mammogram breast skin thickness and skin thickness at 6 months follow up mammograms (+13 mm center point p = 0.04, +9 mm bottom point p<0.5), and at 12 months mammograms (+15 mm center point p<0.5, +11 mm bottom point p<0.5). CONCLUSION Almost 1 in 4 women experienced radiation induced BL in our cohort. BS V30 & V40 are significantly associated with higher risk of BL. There was significant association between increased skin thickening in 6- and 12-months follow up mammograms and BL. Further analysis will follow to assess the association between surgical and clinical characteristics and BL.
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Affiliation(s)
- L Hasnain
- Loyola University Stritch School of Medicine, Maywood, IL
| | - H Kang
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernadin Cancer Center, Loyola University Chicago, Maywood, IL
| | - F Vaince
- Loyola University Stritch School of Medicine, Maywood, IL
| | - K Ganesh
- Loyola University Stritch School of Medicine, Maywood, IL
| | - K Gomez
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - V Gahtan
- Loyola University Stritch School of Medicine, Maywood, IL
| | - W Small
- Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL
| | - T Refaat
- Loyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, IL
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Lee KN, Chen YH, Kang H, Doyle P, Pomerantz M, Ravi P, Choudhury AD, Kozono DE, Balboni TA, Spektor A, Huynh MA. Clinical Outcomes with Stereotactic Body Radiation Therapy for Oligometastatic Prostate Cancer: Results from a Prospective Registry Trial. Int J Radiat Oncol Biol Phys 2023; 117:e126-e127. [PMID: 37784680 DOI: 10.1016/j.ijrobp.2023.06.921] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Metastasis-directed radiation therapy using stereotactic body radiation therapy (SBRT) in oligometastatic prostate cancer (Oligo PCa) has a demonstrated benefit for local control and biochemical recurrence free survival for men with oligorecurrent PCa; however, the impact of SBRT within other oligometastatic states and in the context of systemic therapy remains poorly characterized. In this study, we investigate prognostic factors for clinical outcomes in a prospective cohort of Oligo PCa patients treated with metastasis-directed SBRT. MATERIALS/METHODS Using a single-institution registry trial, we analyzed a prospective cohort of 86 patients with Oligo PCa (≤5 metastatic lesions) and treated with metastasis-directed SBRT between 2017- 2022. Patients were classified as synchronous, metachronous, or induced oligometastatic disease as per the ESTRO guidelines. We evaluated the time to radiographic progression (TTRP), defined as the time from SBRT start date to radiographic progression, as well as time to initiation of new treatment (TTNT), defined as the time from SBRT end date to initiation of new therapy (systemic or radiation therapy). Time to event (TTE) was defined as the time from SBRT start date to radiographic progression or initiation of new therapy, whichever occurred first. Patients without documented events were censored at the date of last disease assessment. Comparative analyses were performed using Kaplan-Meier and Cox proportional hazards regression methods. RESULTS Eighty-six men with Oligo PCa treated with SBRT were followed for a median of 16.4 months with M0 (73%), Oligo PCa (21%) or polymetastatic PCa (6%) GS > = 8 (63%) at initial diagnosis. At the time of treatment with initial SBRT, 21% had synchronous oligometastatic disease, 63% had metachronous or repeat oligorecurrence or oligoprogression, and 16% had induced oligometastatic disease. Most patients were treated to 1-3 sites (94%), which predominantly included bone (86%), and the median dose was 35 Gy/5F. Concurrent systemic therapy during SBRT was seen in 85% of patients, including (60.5% with new generation androgen receptor signaling inhibitors). Overall survival at 1-year and 2-years was 96.9% [95% CI, 88.2-99.2%] and 94.4% [95% CI, 83.2-98.2%]. Using univariable analysis, those who did not receive systemic treatment during SBRT had significantly shorter TTRP (HR 3.67, [95% CI, 1.62-8.32], p = 0.002), TTNT (HR 3.24, 95% CI [1.49-7.06], p = 0.003), and TTE (HR 3.05, [95% CI, 1.44-6.45], p = 0.004). Additionally, patients treated with SBRT for metachronous (HR 2.89, [95% CI 0.68-12.30]) and induced metastatic disease (HR 8.96, [95% CI 1.85-43.37]) had significantly shorter TTE compared to synchronous oligometastatic disease (p = 0.006). CONCLUSION Using a prospective registry cohort of men with Oligo PCa treated with SBRT, we identify an association of oligometastatic state and the use of concurrent systemic therapy with improved TTRP and TTNT. Further prospective studies are warranted.
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Affiliation(s)
- K N Lee
- Harvard Radiation Oncology Program, Boston, MA
| | - Y H Chen
- Dana-Farber Cancer Institute, Boston, MA
| | - H Kang
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA
| | - P Doyle
- Brigham and Women's Hospital/Dana-Farber, Boston, MA, United States
| | | | - P Ravi
- Dana Farber Cancer Institute, Boston, MA
| | - A D Choudhury
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - D E Kozono
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
| | - T A Balboni
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - A Spektor
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA
| | - M A Huynh
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA
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9
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Jeong W, Kang H, Patel A, Singh M, Prachand N, Stewart WP. Financial, Social, and Health Impacts from the COVID-19 Pandemic: Findings from the Healthy Chicago Survey. Int J Behav Med 2023:10.1007/s12529-023-10220-y. [PMID: 37700149 DOI: 10.1007/s12529-023-10220-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND This study examines self-reported impacts of the COVID-19 pandemic among Chicago residents and disparities of these impacts across demographic characteristics. Six logistic regression models were developed to identify demographic and socioeconomic factors associated with each COVID-19 impact. METHOD The study used de-identified and weighted data from the 2020 Healthy Chicago Survey (HCS). HCS is an annual survey using an address-based random sampling method administered by the Chicago Department of Public Health (CDPH) across the city of Chicago on adults aged 18 or older living between July 17 and November 11, 2020, and received 4517 responses. RESULTS Chicago residents with lower socioeconomic status had a higher likelihood of food and housing insecurity. Non-Hispanic (NH) Black residents were more likely to report being unable to obtain food (OR: 2.996; 95% CI: 2.268-2.324); being unable to pay for rent, mortgage, or bills (OR: 2.352; 95% CI: 2.325-2.380); and grief from a loss of someone to COVID-19 (OR: 2.037; 95% CI: 2.013-2.061) compared to NH White residents. NH White residents were more likely than other racial/ethnic groups to report loss of social connections, worsened mental health, and canceling or postponing medical care. CONCLUSIONS The analysis showed higher odds of social contact loss and worsened mental health from COVID-19 in NH White and higher education populations. By implementing strategies to address specific challenges faced by different racial groups, Chicago may effectively mitigate pandemic's adverse effects. These strategies can promote a more inclusive approach to distributing COVID investments for programs and policies.
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Affiliation(s)
- Wonjin Jeong
- Department of Recreation, Sport and Tourism, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
| | - Hyojung Kang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Ajanta Patel
- Chronic Disease Prevention and Health Promotion, Chicago Department of Public Health, Chicago, IL, USA
| | - Meha Singh
- Healthy Chicago Survey, Chicago Department of Public Health, Chicago, IL, USA
| | - Nikhil Prachand
- Epidemiology, Chicago Department of Public Health, Chicago, IL, USA
| | - William P Stewart
- Department of Recreation, Sport and Tourism, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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10
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Kim E, Kang H, Noh TS, Oh SH, Suh MW. Auditory cortex hyperconnectivity before rTMS is correlated with tinnitus improvement. Neurologia 2023; 38:475-485. [PMID: 37659838 DOI: 10.1016/j.nrleng.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 01/06/2021] [Indexed: 09/04/2023] Open
Abstract
INTRODUCTION Repetitive transcranial magnetic stimulation (rTMS) has been used as a potential treatment for tinnitus; however, its effectiveness is variable and unpredictable. We hypothesized that resting-state functional connectivity before rTMS may be correlated with rTMS treatment effectiveness. METHODS We applied 1-Hz rTMS to the left primary auditory (A1) and dorsolateral prefrontal cortices (DLPFC) of 10 individuals with tinnitus and 10 age-matched controls. Resting-state functional magnetic resonance imaging (fMRI) studies were performed approximately one week before rTMS. Seed-based connectivity analyses were conducted for each individual, with seed regions as rTMS target areas. RESULTS Compared to controls, the left superior temporal areas showed significantly increased positive connectivity with the left A1 and negative connectivity with the left DLPFC in the tinnitus group. The left frontoparietal and right cerebellar areas showed significantly increased negative connectivity with the left A1 and positive connectivity with the left DLPFC. Seed-based hyperconnectivity was correlated with tinnitus improvement (pre-rTMS vs. 2-week post-rTMS Tinnitus Handicap Inventory scores). Tinnitus improvement was significantly correlated with left A1 hyperconnectivity; however, no correlation was observed with left DLPFC connectivity. Positive rTMS outcomes were associated with significantly increased positive connectivity in bilateral superior temporal areas and significantly increased negative connectivity in bilateral frontal areas. CONCLUSIONS Our results suggest that oversynchronisation of left A1 connectivity before rTMS of the left A1 and DLPFC is associated with treatment effectiveness.
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Affiliation(s)
- E Kim
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - H Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
| | - T-S Noh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - S-H Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - M-W Suh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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11
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Lee HH, Kang H, Cho H. Role of Interleukin(IL)-6 in NK Activity to Hypoxic-Induced Highly Invasive Hepatocellular Carcinoma(HCC) Cells. J Microbiol Biotechnol 2023; 33:864-874. [PMID: 37501379 PMCID: PMC10394337 DOI: 10.4014/jmb.2304.04023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/24/2023] [Accepted: 06/01/2023] [Indexed: 07/29/2023]
Abstract
Natural killer (NK) cell dysfunctions against hepatocellular carcinoma (HCC) in a hypoxic environment. Many solid tumors are present in a hypoxic condition, which changes the effector function of various immune cells. The transcription of hypoxic-inducible factors (HIFs) in cancer cells make it possible to adapt to their hypoxic environment and to escape the immune surveillance of NK cells. Recently, the correlation between the transcription of HIF-1α and pro-inflammatory cytokines has been reported. Interleukin (IL)-6 is higher in cancers with a highly invasive ability, and is closely related to the metastasis of cancers. This study showed that the expression of HIF-1α in HCC cells was associated with the presence of IL-6 in the environment of HCC-NK cells. Blocking of IL-6 by antibody in the HCC-NK interaction changed the production of several cytokines including TGF-β, IL-1, IL-18 and IL-21. Interestingly, in a co-culture of HIF-1α-expressed HCC cells and NK cells, blocking of IL-6 increased the production of IL-21 in their supernatants. In addition, the absence of IL-6 significantly enhanced the cytotoxic ability and the expression of the activating receptors (NKG2D, NKp44, and NKG2C) in NK cells to HIF-1α-expressed HCC cells. These effects might be made by the decreased expression of HIF-1α in HCC cells through the inhibited phosphorylation of STAT3. In conclusion, the absence of IL-6 in the interaction of HIF-1α-expressed HCC cells and NK cells could enhance the antitumor activity of NK cells to HCC cells.
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Affiliation(s)
- Hwan Hee Lee
- Department of Pharmacy, Duksung Women's University, Seoul 01369, Republic of Korea
- Duksung Innovative Drug Center, Duksung Women's University, Seoul 01369, Republic of Korea
| | - Hyojung Kang
- Vessel-Organ Interaction Research Center, VOICE (MRC), Cancer Research Institute, College of Pharmacy, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Hyosun Cho
- Department of Pharmacy, Duksung Women's University, Seoul 01369, Republic of Korea
- Duksung Innovative Drug Center, Duksung Women's University, Seoul 01369, Republic of Korea
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12
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Bobitt J, Kang H, Arora K, Bhagianadh D, Milavetz G, Kaskie B. Offering an Alternative to Persons with Chronic Pain: How Access to Cannabis May Provide an Off-Ramp from Undesired Prescription Opioid Use. Cannabis 2023; 6:113-122. [PMID: 37484046 PMCID: PMC10361805 DOI: 10.26828/cannabis/2023/000125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Background Chronic pain (CP) is experienced by as many as 50 million Americans and can negatively impact physical and mental health. Prescribing opioids is the most common approach to address moderate to severe CP though these potent analgesics are associated with a significant number of side effects. One alternative some Americans are turning to for CP management is cannabis. In addition to serving as an alternative, many individuals with CP use cannabis in addition to using prescription opioids. This study examined individuals with CP who enrolled in the state of Illinois' opioid diversion program, the Opioid Alternative Pilot Program (OAPP), which offers individuals aged 21 and older a separate pathway to access medical cannabis if they have or could receive a prescription for opioids as certified by a licensed physician. Methods Cross-sectional survey data were collected from 450 participants. We described participants and compared those who use only cannabis with those who use cannabis and opioids. Results While 16% of the respondents were cannabis-only users, 84% of the respondents were co-users of opioids and cannabis. Both groups considered opioid use risky (100% cannabis-only, 89% co-users,). The majority (73%) of respondents sought to completely stop or never start using opioids for CP. Cannabis-only users reported lower levels of pain compared to co-users. Co-users (85%) were more likely to have their routine provider as a cannabis certifying physician than cannabis-only users (69%). Conclusion With increasing clinical evidence, legalization and acceptance, researchers should continue to examine how cannabis may be a viable alternative to reduce the risk of prescription opioid side effects, misuse, or dependence. Our findings also inform health care providers and state policymakers who increasingly are being asked to consider how cannabis may reduce the potential for harmful outcomes among persons with CP who use prescription opioids.
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Affiliation(s)
- Julie Bobitt
- University of Illinois Chicago, Department of Medicine, Center for Dissemination and Implementation Science
| | - Hyojung Kang
- University of Illinois Urbana Champaign, College of Applied Health Sciences, Department of Kinesiology and Community Health
| | - Kanika Arora
- The University of Iowa, College of Public Health, Department of Health, Management and Policy
| | | | | | - Brian Kaskie
- The University of Iowa, College of Public Health, Department of Health, Management and Policy
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13
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Cai LY, Tanase C, Anderson AW, Patel NJ, Lee CA, Jones RS, LeStourgeon LM, Mahon A, Taki I, Juvera J, Pruthi S, Gwal K, Ozturk A, Kang H, Rewers A, Rewers MJ, Alonso GT, Glaser N, Ghetti S, Jaser SS, Landman BA, Jordan LC. Exploratory Multisite MR Spectroscopic Imaging Shows White Matter Neuroaxonal Loss Associated with Complications of Type 1 Diabetes in Children. AJNR Am J Neuroradiol 2023; 44:820-827. [PMID: 37263786 PMCID: PMC10337627 DOI: 10.3174/ajnr.a7895] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/03/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND PURPOSE Type 1 diabetes affects over 200,000 children in the United States and is associated with an increased risk of cognitive dysfunction. Prior single-site, single-voxel MRS case reports and studies have identified associations between reduced NAA/Cr, a marker of neuroaxonal loss, and type 1 diabetes. However, NAA/Cr differences among children with various disease complications or across different brain tissues remain unclear. To better understand this phenomenon and the role of MRS in characterizing it, we conducted a multisite pilot study. MATERIALS AND METHODS In 25 children, 6-14 years of age, with type 1 diabetes across 3 sites, we acquired T1WI and axial 2D MRSI along with phantom studies to calibrate scanner effects. We quantified tissue-weighted NAA/Cr in WM and deep GM and modeled them against study covariates. RESULTS We found that MRSI differentiated WM and deep GM by NAA/Cr on the individual level. On the population level, we found significant negative associations of WM NAA/Cr with chronic hyperglycemia quantified by hemoglobin A1c (P < .005) and a history of diabetic ketoacidosis at disease onset (P < .05). We found a statistical interaction (P < .05) between A1c and ketoacidosis, suggesting that neuroaxonal loss from ketoacidosis may outweigh that from poor glucose control. These associations were not present in deep GM. CONCLUSIONS Our pilot study suggests that MRSI differentiates GM and WM by NAA/Cr in this population, disease complications may lead to neuroaxonal loss in WM in children, and deeper investigation is warranted to further untangle how diabetic ketoacidosis and chronic hyperglycemia affect brain health and cognition in type 1 diabetes.
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Affiliation(s)
- L Y Cai
- From the Department of Biomedical Engineering (L.Y.C., A.W.A., B.A.L.)
| | - C Tanase
- Departments of Psychiatry and Behavioral Sciences (C.T.)
| | - A W Anderson
- From the Department of Biomedical Engineering (L.Y.C., A.W.A., B.A.L.)
- Vanderbilt University Institute of Imaging Science (A.W.A., B.A.L.)
- Departments of Radiology and Radiological Sciences (A.W.A., S.P., B.A.L.)
| | - N J Patel
- Pediatrics (N.J.P., R.S.J., S.S.J., L.C.J.)
| | | | - R S Jones
- Pediatrics (N.J.P., R.S.J., S.S.J., L.C.J.)
| | | | - A Mahon
- Psychology (A.M., S.G.), University of California, Davis, Davis, California
| | - I Taki
- Department of Pediatrics (I.T., A.R., M.J.R.)
| | - J Juvera
- Department of Psychiatry (J.J.), University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - S Pruthi
- Departments of Radiology and Radiological Sciences (A.W.A., S.P., B.A.L.)
| | - K Gwal
- Departments of Radiology (K.G., A.O.)
| | - A Ozturk
- Departments of Radiology (K.G., A.O.)
| | - H Kang
- Biostatistics (H.K.), Vanderbilt University Medical Center, Nashville, Tennessee
| | - A Rewers
- Department of Pediatrics (I.T., A.R., M.J.R.)
| | - M J Rewers
- Department of Pediatrics (I.T., A.R., M.J.R.)
| | | | - N Glaser
- Pediatrics (N.G.), University of California Davis Health, University of California Davis School of Medicine, Sacramento, California
| | - S Ghetti
- Psychology (A.M., S.G.), University of California, Davis, Davis, California
| | - S S Jaser
- Pediatrics (N.J.P., R.S.J., S.S.J., L.C.J.)
| | - B A Landman
- From the Department of Biomedical Engineering (L.Y.C., A.W.A., B.A.L.)
- Vanderbilt University Institute of Imaging Science (A.W.A., B.A.L.)
- Department of Electrical and Computer Engineering (B.A.L.), Vanderbilt University, Nashville, Tennessee
- Departments of Radiology and Radiological Sciences (A.W.A., S.P., B.A.L.)
| | - L C Jordan
- Pediatrics (N.J.P., R.S.J., S.S.J., L.C.J.)
- Neurology (C.A.L., L.C.J.)
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14
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Zhu X, Zhang P, Kang H, Marla L, Robles Granda MI, Ebert-Allen RA, Stewart de Ramirez S, Oderwald T, McGee M, Handler JA. Derivation of a Unique, Algorithm-Based Approach to Cancer Patient Navigator Workload Management. JCO Clin Cancer Inform 2023; 7:e2200170. [PMID: 37207310 PMCID: PMC10569769 DOI: 10.1200/cci.22.00170] [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: 11/11/2022] [Revised: 02/05/2023] [Accepted: 03/15/2023] [Indexed: 05/21/2023] Open
Abstract
PURPOSE Cancer patient navigators (CPNs) can decrease the time from diagnosis to treatment, but workloads vary widely, which may lead to burnout and less optimal navigation. Current practice for patient distribution among CPNs at our institution approximates random distribution. A literature search did not uncover previous reports of an automated algorithm to distribute patients to CPNs. We sought to develop an automated algorithm to fairly distribute new patients among CPNs specializing in the same cancer type(s) and assess its performance through simulation on a retrospective data set. METHODS Using a 3-year data set, a proxy for CPN work was identified and multiple models were developed to predict the upcoming week's workload for each patient. An XGBoost-based predictor was retained on the basis of its superior performance. A distribution model was developed to fairly distribute new patients among CPNs within a specialty on the basis of predicted work needed. The predicted work included the week's predicted workload from a CPN's existing patients plus that of newly distributed patients to the CPN. Resulting workload unfairness was compared between predictor-informed and random distribution. RESULTS Predictor-informed distribution significantly outperformed random distribution for equalizing weekly workloads across CPNs within a specialty. CONCLUSION This derivation work demonstrates the feasibility of an automated model to distribute new patients more fairly than random assignment (with unfairness assessed using a workload proxy). Improved workload management may help reduce CPN burnout and improve navigation assistance for patients with cancer.
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Affiliation(s)
- Xiyitao Zhu
- University of Illinois at Urbana-Champaign, Champaign, IL
| | - Peng Zhang
- University of Illinois at Urbana-Champaign, Champaign, IL
| | - Hyojung Kang
- University of Illinois at Urbana-Champaign, Champaign, IL
| | - Lavanya Marla
- University of Illinois at Urbana-Champaign, Champaign, IL
| | | | | | - Sarah Stewart de Ramirez
- OSF HealthCare System, Peoria, IL
- University of Illinois College of Medicine at Peoria, Peoria, IL
| | | | | | - Jonathan A. Handler
- OSF HealthCare System, Peoria, IL
- Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
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15
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Narasimha K, Albert SK, Kim J, Kang H, Kang S, Park J, Park J, Park SJ. Charge-Transfer-Induced Self-Assembly of Doped Conjugated Block Copolymer Nanofibers. ACS Macro Lett 2023; 12:382-388. [PMID: 36866815 DOI: 10.1021/acsmacrolett.2c00752] [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: 03/04/2023]
Abstract
Here, we report charge-transfer-driven self-assembly of conjugated block copolymers (BCP) into highly doped conjugated polymer nanofibers. The ground-state integer charge transfer (ICT) between a BCP composed of poly(3-hexylthiophene) and poly(ethylene oxide) (P3HT-b-PEO) and electron-deficient 2,3,5,6-tetrafluoro-7,7,8,8-tetracyanoquinodimethane (F4TCNQ) induced spontaneous self-assembly of the donor and the acceptor into well-defined one-dimensional nanofibers. The presence of the PEO block plays an important role for the self-assembly by providing a polar environment that can stabilize nanoscale charge transfer (CT) assemblies. The doped nanofibers were responsive to various external stimuli such as heat, chemical, and light and exhibited efficient photothermal properties in the near-IR region. The CT-driven BCP self-assembly reported here provides a new platform for the fabrication of highly doped semiconductor nanostructures.
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Affiliation(s)
- Karnati Narasimha
- Department of Chemistry and Nanoscience, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Shine K Albert
- Department of Chemistry and Nanoscience, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Jongwook Kim
- Department of Chemistry and Nanoscience, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Hyojung Kang
- Department of Chemistry and Nanoscience, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Sungsu Kang
- School of Chemical and Biological Engineering, Institute of Chemical Process, Seoul National University, Seoul 08826, Republic of Korea
- Center for Nanoparticle Research, Institute for Basic Science (IBS), Seoul 08826, South Korea
| | - Jungwon Park
- School of Chemical and Biological Engineering, Institute of Chemical Process, Seoul National University, Seoul 08826, Republic of Korea
- Center for Nanoparticle Research, Institute for Basic Science (IBS), Seoul 08826, South Korea
| | - JaeHong Park
- Department of Chemistry and Nanoscience, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - So-Jung Park
- Department of Chemistry and Nanoscience, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
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16
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Kang H, Clary K, Zhao Z, Quintero Silva L, Bobitt J. Characteristics of Cannabis and Opioid Users Among Older U.S. Veterans and Their Health Outcomes: A Longitudinal Perspective. J Psychoactive Drugs 2023:1-11. [PMID: 36919533 DOI: 10.1080/02791072.2023.2186286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Medical cannabis use among U.S. Veterans has continued to rise. However, data on cannabis use by older Veterans is generally less available. This study aims to understand the characteristics of older Veterans who enrolled in the Medical Cannabis Patient Program in Illinois and analyze their health outcomes and co-use of cannabis and opioids using longitudinal survey data. Overall, participants reported positive outcomes for pain, sleep, and emotional problems because of cannabis use in two survey periods. Approximately, 62% and 85% respondents reported no change in memory and falls, respectively, with only 3% and 1% reporting a negative outcome for the conditions in both surveys. About 20.4% of those who indicated cannabis use only in the initial survey started to co-use opioids in the follow-up survey, while 44.1% of those who indicated the use of both substances in the initial survey reported no longer using opioids in the follow-up survey. However, these changes were not statistically significant (α=0.05). The logistic regression showed that both clinical and contextual factors affected co-use. In conclusion, older U.S. Veterans may be using cannabis to alleviate their pain and other chronic conditions. More research is needed to understand the effect of cannabis use on reducing or substituting opioids.
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Affiliation(s)
- Hyojung Kang
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Kelly Clary
- School of Social Work, Texas State University, San Marcos, TX, USA
| | - Ziang Zhao
- Department of Statistics, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Laura Quintero Silva
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Julie Bobitt
- College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
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17
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Kang H, Lee EB, Lee S, Go TH, Lee JY, Lee SH, Song SA, Lim HK, Hong SP. Dipeptidyl peptidase-4 inhibitors increase the risk of bullous pemphigoid in older patients with diabetes: A retrospective analysis using the Korean National Health Insurance Database. J Eur Acad Dermatol Venereol 2023. [PMID: 36799763 DOI: 10.1111/jdv.18975] [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] [Received: 11/01/2022] [Accepted: 02/15/2023] [Indexed: 02/18/2023]
Affiliation(s)
- H Kang
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - E B Lee
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - S Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - T-H Go
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - J Y Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - S-H Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - S A Song
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - H K Lim
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - S-P Hong
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea.,Research Institute of Metabolism and Inflammation, Yonsei University Wonju College of Medicine, Wonju, Korea
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Chung C, Shin JE, Jeon D, Kang H, Yim JJ, Jo KW, Shim TS. Treatment outcomes and safety of bedaquiline, delamanid, and linezolid in multidrug-resistant TB. Int J Tuberc Lung Dis 2023; 27:151-153. [PMID: 36853109 DOI: 10.5588/ijtld.22.0466] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- C Chung
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J E Shin
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - D Jeon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - H Kang
- Department of Chest Medicine, Masan National Tuberculosis Hospital, Masan, Republic of Korea
| | - J-J Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - K-W Jo
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - T S Shim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Koo K, Wong V, Halawani A, Lee S, Baek S, Kang H, Chew B. Machine learning-based decision support system to distinguish uric acid stones in patients with kidney stones of grey zone Hounsfield units: International multicenter development and external validation study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00401-3] [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: 02/12/2023]
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20
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Bobitt J, Clary K, Krawitz M, Silva LQ, Kang H. Prevention, Practice, and Policy: Older US Veterans' Perspectives on Cannabis Use. Drugs Aging 2023; 40:59-70. [PMID: 36648751 DOI: 10.1007/s40266-022-00995-2] [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] [Accepted: 12/01/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Veterans often struggle with disabling physical and mental health conditions that tend to worsen as they age. Current medications used to treat these conditions include opioids and benzodiazepines though they can have negative side effects. Looking for alternatives to these medications, many older Veterans use cannabis for medical purposes. We aimed to develop a deeper understanding of older Veterans' cannabis use. METHODS We used maximum variation sampling to select 32 Veterans who had completed baseline and follow-up surveys to participate in semi-structured interviews. RESULTS After applying a thematic analysis, results show older Veterans are using medical cannabis as a means of harm reduction as an adjunct or substitute for other medications and substances with limited guidance from their healthcare providers. Veterans also reported that there exists an inconsistency across the Veterans Health Administration system regarding the interpretation and application of cannabis policies. CONCLUSIONS Drawing from these findings, we explore medical cannabis as a harm reduction technique and discuss how a lack of physician engagement and current Veterans Health Administration policies discourage older Veterans from discussing and potentially benefiting from the use of medical cannabis.
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Affiliation(s)
- Julie Bobitt
- Department of Medicine, Center for Dissemination and Implementation Science, University of Illinois at Chicago, 818 S. Wolcott Ave, SRH-629, Chicago, IL, 60612, USA.
| | - Kelly Clary
- School of Social Work, Texas State, San Marcos, TX, USA
| | | | - Laura Quintero Silva
- Department of Kinesiology and Community Health, University of Illinois at Urbana, Champaign, IL, USA
| | - Hyojung Kang
- Department of Kinesiology and Community Health, University of Illinois at Urbana, Champaign, IL, USA
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21
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Kwon YS, Shin JE, Kang H, Jeon D, Yim JJ, Shim TS. Treatment outcomes of multidrug-resistant TB with selective use of new drugs. Int J Tuberc Lung Dis 2023; 27:55-60. [PMID: 36853130 DOI: 10.5588/ijtld.22.0343] [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: 01/14/2023] Open
Abstract
SETTING: This was a nationwide cohort study.OBJECTIVE: To assess the treatment outcomes in patients with multidrug-resistant TB (MDR-TB) who underwent treatment guided by a national TB expert review committee in South Korea.DESIGN: We enrolled all patients with MDR-TB submitted for approval for the use of new TB drugs, including bedaquiline and delamanid, from 2016 to 2019. Patients were classified into two groups: those on new TB drugs and those not on new TB drugs. We compared the final treatment outcomes between the groups and analysed the prognostic factors.RESULTS: Of a total of 785 patients, respectively 754 (96.1%) and 31 (3.9%) were classified into the "new TB drugs" group and "no new TB drugs" group. The new TB drugs group had a higher acid-fast bacilli smear positivity rate and higher resistance rate to second-line injectable drugs or fluoroquinolones. Of all the patients, 97.8% achieved culture conversion (97.7% vs. 100%), and 80.4% achieved treatment success (80.2% vs. 86.7%); there was no difference between the two groups.CONCLUSIONS: New drugs are currently recommended for use in all MDR-TB treatment regimens, and the use of new drugs, as determined by an expert committee, in mainly quinolone-susceptible MDR-TB, did not compromise the treatment success rate.
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Affiliation(s)
- Y-S Kwon
- Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, South Korea
| | - J E Shin
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - H Kang
- Department of Chest Medicine, Masan National Tuberculosis Hospital, Masan, South Korea
| | - D Jeon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - J-J Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - T S Shim
- Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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22
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Kim T, Park T, Kweon Y, Baek D, Lee J, Kang H. 530 Age-dependent sequential increase of senescent cells in the skin. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.545] [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: 11/21/2022]
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23
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Kang H, Venkatesulu B, Podgorsak A, Abuhamad M, Harkenrider M, Solanki A, Roeske J. Accuracy of Prostate Segmentation on Synthetic MR Images Generated from CT Scans Using a Novel Generative Adversarial Network for High-Dose-Rate Prostate Brachytherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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24
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Ritter T, Chao H, Chang M, Katsoulakis E, Padilla L, Xiao Y, Kang H, Al-Hallaq H, Moghanaki D, Palta J, Nickols N, Salama J, Solanki A. Enhancing Radiation Therapy Plan Quality in a Multi-Site Randomized Clinical Trial with a Benchmark Credentialing Exercise: The VA STARPORT Experience. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.514] [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: 10/31/2022]
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25
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Kaur M, Luce J, Mostafavi H, Lehmann M, Morf D, Zhu L, Kang H, Walczak M, Harkenrider M, Roeske J. Evaluation of Markerless Tumor Tracking Using Synthetic Dual Energy Images Produced Using a Convolutional Neural Network. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.2201] [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: 10/31/2022]
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26
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Yang D, Papke D, Kang H, Aizer A, Lamba N, Kozono D, Wee J, Enzinger P, Mamon H. Clinical and Genomic Characterization of Esophageal Cancer Brain Metastases. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.817] [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: 10/31/2022]
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Tian Y, Li MW, Liu QK, Kang H. [Clinical features and prognosis of cutaneous melanoma]. Zhonghua Zhong Liu Za Zhi 2022; 44:1146-1154. [PMID: 36319462 DOI: 10.3760/cma.j.cn112152-20200818-00751] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To analyze the clinical features and prognosis of patients with cutaneous melanoma. Methods: The clinical data and follow-up data of 125 patients with cutaneous malignant melanoma (CMM) treated in the Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology between February 2008 and August 2019 were collected. Kaplan-Meier method and Log rank test were used for survival analysis, and Cox proportional risk regression model was used for impact factor analysis. Results: Among the 125 patients, 12 were stage Ⅰ, 62 were stage Ⅱ, 30 were stage Ⅲ, and 21 were stage Ⅳ; 76 were acral and 49 were non-acral. The median survival time was 44 months, and the 1-, 2-, and 5-year survival rates were 85.4%, 63.2% and 38.7%, respectively. Kaplan-Meier univariate survival analysis showed that Karnofsky performance status score, tumor stage, primary site, vascular infiltration, Ki-67, BRAF, lactate dehydrogenase (LDH), and surgical treatment were related to the prognosis of patients (P<0.05). The median overall survival (OS) time of patients receiving interferon treatment was 53 months, which was better than 40 months of patients not receiving interferon treatment, but the difference was not statistically significant (P=0.448). Among stage Ⅲ patients, the median OS time of patients receiving interferon therapy was 40 months, which was better than 17 months of patients not receiving interferon therapy (P=0.012). Among stage Ⅱ patients, the 1-, 2-, and 5-year survival rates of acral patients were 97.1%, 84.7%, and 65.8%, and the 1-, 2-, and 5-year survival rates of non-acral patients were 93.3%, 70.0% and 17.0%. The prognosis of patients with stage Ⅱ acral type was better than that of non-acral type (P=0.043). The median survival time of stage Ⅲ patients with acral type was 32 months, better than 17 months of non-acral type, but the difference was not statistical significance (P=0.164). The median survival time of acral type and non-acral type was 8 months and 11 months respectively (P=0.458). Cox multivariate analysis showed that tumor stage and preoperative LDH level were independent prognostic risk factors for cutaneous melanoma. Conclusions: Interferon treatment can improve the prognosis of patients with stage Ⅲ, and stage Ⅱ acral type patients have better prognosis than that of non-acral type patients. Tumor stage and preoperative LDH level were independent prognostic risk factors for cutaneous melanoma.
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Affiliation(s)
- Y Tian
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - M W Li
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Q K Liu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - H Kang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Maurer L, Kang H, Smyers M, Klei L, Cheng J, Trotta M, Hu D, Ekambaram P, Murai M, Nikolovska-Coleska Z, Chen B, Lucas P, McAllister-Lucas L. BLOCKING THE BCL10-MALT1 INTERACTION IN DIFFUSE LARGE B-CELL LYMPHOMA. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00224-7] [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]
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29
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Kang H, Jiang S, Song Q, Zhang Y. [Activation of cannabinoid receptor 2 alleviates acute lung injury in rats with lipopolysaccharide-induced sepsis]. Nan Fang Yi Ke Da Xue Xue Bao 2022; 42:1374-1380. [PMID: 36210711 DOI: 10.12122/j.issn.1673-4254.2022.09.14] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the protective effect of cannabinoid receptor 2 (CB2) activation against acute lung injury in rats with lipopolysaccharide (LPS)-induced sepsis and explore the underlying mechanism. METHODS Forty-eight SD rats were randomly assigned into control group, model group, CB2 agonist group and P38 MAPK inhibitor group (n=12). In the latter 3 groups, the rats received intraperitoneal injection of LPS to induce sepsis, and the control rats were given saline injection. In CB2 agonist group, JWH133 (3 mg/kg) was injected intraperitoneally 30 min before LPS injection; in P38 MAPK inhibitor group, the rats received intraperitoneal injection of SB203580 (5 mg/kg) 30 min prior to JWH133 injection. The changes in lung histopathology, water content, fluid clearance rate, inflammatory factors, pulmonary expressions of CB2 and tight junctionrelated genes, and phosphorylation of P38 MAPK in the lung tissues were examined. RESULTS The rat models of sepsis showed severe damage of alveolar structures with significantly decreased fluid clearance rate, lowered pulmonary expressions of CB2, occludin and ZO-1 mRNA and proteins, increased water content in the lung tissue, and increased phosphorylation level of P38 MAPK and TNF-α and IL-1β levels in lung lavage fluid (all P < 0.05). Treatment with JWH133 improved alveolar pathology in the septic rats, but there was still inflammatory infiltration; lung tissue water content, phosphorylation of P38 MAPK, and TNF-α and IL-1β levels in lung lavage fluid were all significantly decreased, and the fluid clearance rate, pulmonary expressions of CB2, occludin and ZO-1 were significantly increased (all P < 0.05). Additional treatment with SB203580 resulted in further improvements of alveolar pathologies, lowered phosphorylation levels of P38 MAPK in the lung tissue and TNF-α and IL-1β levels in lung lavage fluid, and increased the protein expressions of occludin and ZO-1 (P < 0.05) without causing significant changes in mRNA and protein expression of CB2 (P > 0.05). CONCLUSION In rats with LPS-induced sepsis, activation of CB2 can inhibit the p38 MAPK signaling pathway, reduce the release of inflammatory factors in the lung tissues, promote tight junction protein expressions, and thus offer protection against acute lung injury.
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Affiliation(s)
- H Kang
- School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - S Jiang
- School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Q Song
- School of Public Health, North China University of Science and Technology, Tangshan 063210, China
| | - Y Zhang
- Health Management Center, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 325000, China
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Kim S, Chowdhury T, Yu H, Choi S, Kim K, Kang H, Lee J, Lee S, Won J, Kim K, Kim K, Kim M, Lee J, Kim J, Kim Y, Kim T, Choi S, Phi J, Shin Y, Ku J, Lee S, Yun H, Lee H, Kim D, Kim K, Hur JK, Park S, Kim S, Park C. P02.01.B The telomere maintenance mechanism spectrum and its dynamics in gliomas. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.094] [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: 11/12/2022] Open
Abstract
Abstract
The activation of the telomere maintenance mechanism (TMM) is one of the critical drivers of cancer cell immortality. In gliomas, TERT expression and TERT promoter mutation are considered to reliably indicate telomerase activation, while ATRX mutation indicates alternative lengthening of telomeres (ALT). However, these relationships have not been extensively validated in tumor tissues. Here, we show through the direct measurement of telomerase activity and ALT in a large set of glioma samples that the TMM in glioma cannot be defined in the dichotomy of telomerase activity and ALT, regardless of TERT expression, TERT promoter mutation and ATRX mutation. Moreover, we observed that a considerable proportion of gliomas lack both telomerase activity and ALT (Neither group). And this Neither group exhibited evidence of slow growth potential. From a set of longitudinal samples from a separate cohort of glioma patients, we discovered that the TMM is not fixed but changes with glioma progression. Collectively, these results suggest that the TMM is a dynamic entity and that reflects the plasticity of the oncogenic biological status of tumor cells and that the TMM should be defined by the direct measurement of telomerase enzyme activity and evidence of ALT.
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Affiliation(s)
- S Kim
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - T Chowdhury
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - H Yu
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - S Choi
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - K Kim
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - H Kang
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - J Lee
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - S Lee
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - J Won
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - K Kim
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - K Kim
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - M Kim
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - J Lee
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - J Kim
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - Y Kim
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - T Kim
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - S Choi
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - J Phi
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - Y Shin
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - J Ku
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - S Lee
- Seoul National University Hospital , Seoul , Korea, Republic of
| | - H Yun
- Seoul National University Hospital , Seoul , Korea, Republic of
| | - H Lee
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - D Kim
- Kyung Hee University , Seoul , Korea, Republic of
| | - K Kim
- Korea University , Seoul , Korea, Republic of
| | - J K Hur
- Hanyang University , Seoul , Korea, Republic of
| | - S Park
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - S Kim
- Seoul National University College of Medicine , Seoul , Korea, Republic of
| | - C Park
- Seoul National University College of Medicine , Seoul , Korea, Republic of
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Xu YD, Lin M, Xu ZY, Kang H, Li ZT, Luo ZZ, Lin SY. Holter electrocardiogram research trends and hotspots: bibliometrics and visual analysis. Eur Rev Med Pharmacol Sci 2022; 26:6027-6039. [PMID: 36111902 DOI: 10.26355/eurrev_202209_29617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE With the help of metrology, we can identify research hotspots and development trends in dynamic electrocardiography, and thereby provide corresponding reference material to aid further theoretical research. MATERIALS AND METHODS All research data derived from the core collection of Web of Science, and all searches were completed on the same day (February 6, 2022). The obtained data were stored in plain text format and imported into CiteSpace for subsequent analysis. Citation analysis and visualization technology were used to draw a visual map of the research elements, using factors such as annual literature volume, country, journal, author, abstract, keywords, and citation. RESULTS After screening, 2,937 papers were obtained. Research on ambulatory electrocardiography is increasing worldwide every year. Using research hotspots, keyword-clustering time-zone maps, and high-frequency emerging words, the research in this field was roughly divided into two stages, with 2017 as the divider. The first stage primarily focuses on areas such as atrial fibrillation, stroke, autonomic nerve function, catheter ablation, and T-wave alternation. The second stage saw the focus shift to wearable devices, sudden cardiac death, obstructive sleep apnea, feature extraction, cryptogenic stroke, and similar topics. CONCLUSIONS With the development of various wearable technologies, the daily monitoring of healthy people engaged in sporting activities and the development of innovative analysis algorithms providing more accurate data may represent the hotspots and direction of future research.
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Affiliation(s)
- Y-D Xu
- Department of Electrocardiogram, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, China.
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Acharya M, Lee D, Maharjan A, Yang S, Seo S, Kang H, Sin J, Lee G, Yu Y, Park J, Lee G, Kim C, Kim H, Heo Y. P10-04 Development of alternative test method for immunotoxicity prediction on chemical substances through profiling of cytokines production from THP-1 cell line. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.435] [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]
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Kang H, Sole-Guitart A, Mellor VA, Gaughan JB, Zsoldos RR. The use of percutaneous thermal sensing microchips for non-invasive measurement of body temperature in foals during summer seasons in a subtropical region. Animal 2022; 16:100620. [PMID: 35994970 DOI: 10.1016/j.animal.2022.100620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/17/2022] [Accepted: 07/22/2022] [Indexed: 11/28/2022] Open
Abstract
Continuous accurate attainment of the body temperature of foals is important to detect early stages of severe heat stress or fever due to a systemic illness. Among a number of methods to measure body temperature, measuring rectal temperature with a digital thermometer is most frequently used due to being relatively fast and simple method. It is also comparatively accurate and correlates well with the core body temperature. However, this method requires restraining the foal for a few seconds to obtain the temperature, and it can be dangerous for the handling person. Percutaneous thermal sensing microchips (PTSMs) are a means of monitoring the body temperature of horses, which offers a non-invasive, hygienic, quick, and accurate way to measure body temperature and provide an identification number for each individual, once it is implanted. This study tested the hypothesis that PTSM has a strong relationship with a conventional body temperature measurement, i.e., measuring rectal temperature with a digital thermometer of foals during summer seasons. Thirty-two foals in three consecutive foaling seasons (2018, 2019, and 2020 season) were implanted a PTSM into the right pectoral muscle, the right splenius muscle, the right gluteal muscle, and the nuchal ligament as early as two weeks after birth. The four PTSM temperatures, rectal temperature, and climate conditions (air temperature, relative humidity, and wet-bulb globe temperature) were obtained simultaneously during the three summer seasons and paired for comparison analysis. Among the PTSM temperatures, the pectoral muscle had the highest correlation and the least differences with rectal temperature. Using PTSM was safe, easy, and reliable for attaining body temperature in foals.
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Affiliation(s)
- H Kang
- School of Agriculture and Food Sciences, The University of Queensland, Gatton 4343, Australia.
| | - A Sole-Guitart
- School of Veterinary Science, The University of Queensland, Gatton 4343, Australia
| | - V A Mellor
- School of Agriculture and Food Sciences, The University of Queensland, Gatton 4343, Australia
| | - J B Gaughan
- School of Agriculture and Food Sciences, The University of Queensland, Gatton 4343, Australia
| | - R R Zsoldos
- School of Agriculture and Food Sciences, The University of Queensland, Gatton 4343, Australia
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Kang H, Wan A, Desai B, Beveridge M, Rohr B, Barlev D, Wong C, Scott J. LB956 Dermatology on reddit: Analysis of content and quality on major dermatologic conditions. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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McMurry TL, Lobo JM, Kang H, Kim S, Balkrishnan R, Anderson R, McCall A, Sohn MW. Annual wellness visits are associated with increased use of preventive services in patients with diabetes living in the Diabetes Belt. Diabetes Epidemiology and Management 2022; 7. [PMID: 35991000 PMCID: PMC9387346 DOI: 10.1016/j.deman.2022.100094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: To examine whether Annual Wellness Visits (AWVs) were associated with increased use of preventive services in Medicare patients with diabetes living in the Diabetes Belt. Methods: We used a case-control design where outcomes were utilization of preventive services recommended for patients with diabetes (foot exam, eye exam, A1c test, and microalbuminuria test) and the exposure was AWVs using data for Medicare patients with diabetes in 2014 − 2015 residing in the Diabetes Belt (N = 412,009). Results: Only 13.4% of patients in 2014 and 17.4% in 2015 used AWVs. Eye exams (61% vs 53%), foot exams (93% vs 79%), A1c tests (81% vs 71%), and microalbuminuria tests (45% vs 28%) were more common among patients who had an AWV in the preceding year compared with those who did not. These differences remained significant after adjusting for patient demographics, comorbidities, county level medical resources, and geographic factors. Conclusions: AWVs were significantly associated with increased preventive care use among patients with diabetes living in the Diabetes Belt. Low AWV utilization by patients with diabetes in and around the Diabetes Belt is concerning.
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An R, Kang H, Cao L, Xiang X. Engagement in outdoor physical activity under ambient fine particulate matter pollution: A risk-benefit analysis. J Sport Health Sci 2022; 11:537-544. [PMID: 33035708 PMCID: PMC7537654 DOI: 10.1016/j.jshs.2020.09.008] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/16/2020] [Accepted: 08/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Outdoor physical activity (PA) brings important health benefits, but exposure to polluted air increases health risks. This study aimed to quantify the tradeoff of PA under fine particulate matter (PM2.5) air pollution by estimating the optimal PA duration under various pollution levels. METHODS A risk-benefit analysis was performed to estimate the optimal outdoor moderate-intensity PA (MPA) duration under varying PM2.5 concentrations. RESULTS An inverse nonlinear relationship was identified between optimal MPA duration and background PM2.5 concentration levels. When background PM2.5 concentration increased to 186 µg/m3, the optimal outdoor MPA duration decreased to 2.5 h/week, the minimum level recommended by current PA guidelines. When background PM2.5 concentration further increased to 235 µg/m3, the optimal outdoor MPA duration decreased to 1 h/week. The relationship between optimal MPA duration and background PM2.5 concentration levels was stronger when exercising at a location closer to a source of air pollution. Compared to the general adult population, adults aged 60 years and older had substantially steeper curves-the optimal outdoor MPA duration decreased to 2.5 h/week when background PM2.5 concentration reached 45 µg/m3. CONCLUSION The health benefit of outdoor MPA by far outweighs the health risk of PM2.5 pollution for the global average urban background concentration (22 μg/m3). This modeling study examined a single type of air pollutant and suffered from measurement errors and estimation uncertainties. Future research should examine other air pollutants and indoor PA, incorporate short- and mid-term health effects of MPA and air pollution into the risk-benefit analysis, and provide estimates specific for high-risk subgroups.
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Affiliation(s)
- Ruopeng An
- Brown School, Washington University, St. Louis, MO 63130, USA
| | - Hyojung Kang
- Department of Kinesiology and Community Health, University of Illinois, Champaign, IL 61820, USA
| | - Lianzhong Cao
- School of Management and Journalism, Shenyang Sport University, Shenyang 110102, China.
| | - Xiaoling Xiang
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA
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Choi JI, Lee J, Yeh AB, Lan Q, Kang H. Spatial clustering of heroin-related overdose incidents: a case study in Cincinnati, Ohio. BMC Public Health 2022; 22:1253. [PMID: 35752791 PMCID: PMC9233379 DOI: 10.1186/s12889-022-13557-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/24/2022] [Indexed: 12/03/2022] Open
Abstract
Background Drug overdose is one of the top leading causes of accidental death in the U.S., largely due to the opioid epidemic. Although the opioid epidemic is a nationwide issue, it has not affected the nation uniformly. Methods We combined multiple data sources, including emergency medical service response, American Community Survey data, and health facilities datasets to analyze distributions of heroin-related overdose incidents in Cincinnati, Ohio at the census block group level. The Ripley’s K function and the local Moran’s I statistics were performed to examine geographic variation patterns in heroin-related overdose incidents within the study area. Then, conditional cluster maps were plotted to examine a relationship between heroin-related incident rates and sociodemographic characteristics of areas as well as the resources for opioid use disorder treatment. Results The global spatial analysis indicated that there was a clustered pattern of heroin-related overdose incident rates at every distance across the study area. The univariate local spatial analysis identified 7 hot spot clusters, 27 cold spot clusters, and 1 outlier cluster. Conditional cluster maps showed characteristics of neighborhoods with high heroin overdose rates, such as a higher crime rate, a high percentage of the male, a high poverty level, a lower education level, and a lower income level. The hot spots in the Southwest areas of Cincinnati had longer distances to opioid treatment programs and buprenorphine prescribing physicians than the median, while the hot spots in the South-Central areas of the city had shorter distances to those health resources. Conclusions Our study showed that the opioid epidemic disproportionately affected Cincinnati. Multi-phased spatial clustering models based on various data sources can be useful to identify areas that require more policy attention and targeted interventions to alleviate high heroin-related overdose rates. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13557-3.
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Affiliation(s)
- Jung Im Choi
- Data Science, Bowling Green State University, 221 Hayes Hall, Bowling Green, OH, 43403, USA
| | - Jinha Lee
- Faculty of Public and Allied Health, Bowling Green State University, 111 Health and Human Services Building, Bowling Green, OH, 43403, USA.
| | - Arthur B Yeh
- Faculty of Applied Statistics and Operations Research, Bowling Green State University, 1001 E Wooster Street, Maurer Center 241J, Bowling Green, OH, 43403, USA
| | - Qizhen Lan
- Data Science, Bowling Green State University, 221 Hayes Hall, Bowling Green, OH, 43403, USA
| | - Hyojung Kang
- Faculty of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 1206 Fourth Street, IL, 61820, Champaign, USA.
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Clary KL, Kang H, Quintero Silva L, Bobitt J. Weeding Out the Stigma: Older Veterans in Illinois Share Their Experiences Using Medical Cannabis. J Psychoactive Drugs 2022:1-8. [PMID: 35640046 DOI: 10.1080/02791072.2022.2082901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Many U.S. Veterans are using cannabis for medical purposes. Modern research findings continue to point to medical cannabis as a potentially effective alternative to prescription medications for treating a range of medical conditions. While research exists on the use levels of cannabis, limited research can be found on the perceived stigma of using cannabis, especially among older Veterans. We surveyed 121 older U.S. Veterans who were enrolled in the Illinois Medical Cannabis Patient Program during Fall 2020. We then used maximum variation sampling to select a subset of 32 Veterans to partake in a phone interview. Two researchers conducted and qualitatively coded 30-minute audiotaped semi-structured interviews. Interview topics included (1) the use of cannabis, opioids, and benzodiazepines; (2) interactions with medical providers; (3) stigma regarding cannabis use; and (4) educational materials. We share findings from stigma. We identified three themes: (1) stereotypes regarding people who use cannabis, (2) media portrayal of cannabis users, and (3) hesitation in disclosing cannabis use. Stigma creates situations in which older Veterans may be hesitant to disclose their use of cannabis with physicians and friends/family, which can be dangerous and socially isolating. Additional research is needed to expand upon our findings with more generalizable methods.
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Affiliation(s)
- Kelly Lynn Clary
- School of Social Work, Texas State University, San Marcos, TX, USA
| | - Hyojung Kang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Laura Quintero Silva
- Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Julie Bobitt
- Center for Dissemination and Implementation Science, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
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Kang H, Tillmann T, Morrison J. Gender bias in the primary prevention of cardiovascular disease. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.284] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background/introduction
Women receive less aggressive treatment for cardiovascular disease (CVD), partly due to a delayed or incorrect diagnosis. However, there is little research into whether this gender bias extends to primary prevention of CVD (i.e. prevention of CVD in those individuals with no prior CVD events), and the reasons behind this bias.
Purpose
This study analysed gender differences in the primary prevention of CVD in the USA, using data from the National Health and Nutrition Examination Survey (NHANES) for the years 2015-2018. It also explored the drivers behind these differences. The hypothesis was that the known gender bias in CVD treatment also extends to primary prevention.
Methods
The risk of developing CVD over the next ten years was calculated using the Pooled Cohort Equations (PCEs) for 9,623 healthy men and women aged 40 to 79 years. 3,035 participants were found to be at higher CVD risk (ASCVD score above 7.5%) and potentially eligible for statins. Individuals with prior diagnosis of CVD were excluded from this study. Multivariable logistic regression was used to calculate adjusted odds ratios (AOR) in the usage of preventive treatment between genders.
Results
The results showed that men were 21% more likely to be prescribed statins than women whilst women were 20-37% more likely to be told to make behaviour modifications than men (Table 1). An interdisciplinary literature review showed that lower CVD risk perception in women is a likely driver of this gender difference.
Conclusion
The well-known gender bias in the treatment of CVD also appears to take place in the primary prevention of CVD with statin therapy. These findings have highlighted the gender bias in primary prevention of CVD, supporting the scarce existing literature on this topic and providing more recent evidence in line with the updated CVD prevention guidance. This has implications in developing interventions based in the health system and community context to improve the treatment and survival outcomes for women with CVD.
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Affiliation(s)
- H Kang
- University of Southampton, Southampton, United Kingdom of Great Britain & Northern Ireland
| | - T Tillmann
- University College London, London, United Kingdom of Great Britain & Northern Ireland
| | - J Morrison
- University College London, London, United Kingdom of Great Britain & Northern Ireland
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Li DJ, Kang H, Zhang L, Xu ZG, Wang XY, Wang LF, Song XX, Kong LF. [Clinicopathological features of mature T/NK cell lymphoma with aberrant CD20 or CD79α expression]. Zhonghua Bing Li Xue Za Zhi 2022; 51:413-418. [PMID: 35511636 DOI: 10.3760/cma.j.cn112151-20211219-00913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To investigate the clinicopathological characteristics and prognosis of mature T/NK cell lymphomas with aberrant CD20 or CD79α expression. Methods: A retrospective analysis of 641 cases of mature T/NK cell lymphoma diagnosed from January 2014 to December 2020 was performed, and 14 cases of CD20-positive and one case of CD79α-positive mature T/NK-cell lymphoma were identified. Histological examination, immunohistochemical characterization, in situ hybridization for Epstein-Barr virus encoded early RNA (EBER), and PCR testing for immunoglobulin and T cell receptor (TCR) gene rearrangements were performed. Clinicopathological characteristics of these lymphomas were analyzed. Results: There were 13 males and 2 females, with a median age of 56 years. There were 8 cases of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), 3 cases of extranodal NK/T-cell lymphoma, nasal type (ENKTCL), 2 cases of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) and 2 cases of angioimmunoblastic T-cell lymphoma (AITL). Twelve cases were stage Ⅲ or Ⅳ lymphomas. The prognosis was overall poor. The histology, immunophenotype and TCR gene rearrangement were not significantly different from the corresponding types of lymphoma. Ki-67 proliferation index was over 70% in all cases. The expression of CD20 or CD79α was weak and heterogeneous. All 15 case of Ig gene rearrangement were polyclonal. Conclusions: Mature T/NK cell lymphoma with abnormal expression of CD20 or CD79α is rare, commonly found in advanced stage, and associated with poor prognosis. The expression of CD20 or CD79α in these cases is weaker than the corresponding mature T/NK cell lymphomas, while its proliferation index is higher. Histomorphology, extensive immunoprofiling and molecular detection are required for accurate diagnosis.
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MESH Headings
- Antigens, CD20
- Epstein-Barr Virus Infections/complications
- Female
- Herpesvirus 4, Human/genetics
- Humans
- Killer Cells, Natural/metabolism
- Killer Cells, Natural/pathology
- Lymphoma, T-Cell, Peripheral/genetics
- Lymphoma, T-Cell, Peripheral/pathology
- Male
- Middle Aged
- Receptors, Antigen, T-Cell
- Retrospective Studies
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Affiliation(s)
- D J Li
- Department of Pathology, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - H Kang
- Department of Pathology, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - L Zhang
- Department of Pathology, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - Z G Xu
- Department of Pathology, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - X Y Wang
- Department of Pathology, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - L F Wang
- Department of Pathology, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - X X Song
- Department of Pathology, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou 450003, China
| | - L F Kong
- Department of Pathology, Henan Provincial People's Hospital/People's Hospital of Zhengzhou University, Zhengzhou 450003, China
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Lee H, Kang H, Chie E. PO-1307 High-dose stereotactic ablative body radiotherapy for locally advanced pancreatic cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03271-6] [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: 11/30/2022]
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42
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Song J, Chie E, Kim Y, Ryu J, Lee S, Paik W, Cho I, Kim H, Jang J, Kang H. PO-1309 Safety and efficacy of neoadjuvant stereotactic ablative radiotherapy (SABR) in pancreatic cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03273-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kang H, Guan MY, Chen FG. [Pollution characteristics, source analysis, and risk assessment of metal and metalloid in PM 2.5 of Shijiazhuang city]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:507-511. [PMID: 35488551 DOI: 10.3760/cma.j.cn112150-20220128-00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In 2020, the mass concentration of PM2.5 in Shijiazhuang urban area was(80.30±71.43)μg/m3. The Spearman correlation analysis between metals and metalloids showed that Sb with Cd, Pb, Ni, Se, Cd with Pb, Ni, Se, Pb with Ni, Se, Ni with Se, and Se with Tl were positively correlated, with a coefficient greater than 0.5. The main sources of metals and metalloids of PM2.5 were traffic emissions, fuel combustion, metal smelting and dust. The HQ values of Pb, Hg and Mn for each population were less than 1, with lower non-carcinogenic risk. The R values of carcinogenic risk of Ni and Cd in each population were less than 1×10-6, which could be acceptable risk level for the population. The R values of carcinogenic risk of As and Cr in different populations were between 1×10-6 and 1×10-4, with potential carcinogenic risk, particularly higher in adult males.
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Affiliation(s)
- H Kang
- Department of Public Health Monitoring and Evaluation, ShiJiazhuang Center for Disease Control and Prevention, Shijiazhuang 050011, China
| | - M Y Guan
- Department of Public Health Monitoring and Evaluation, ShiJiazhuang Center for Disease Control and Prevention, Shijiazhuang 050011, China
| | - F G Chen
- Department of Public Health Monitoring and Evaluation, ShiJiazhuang Center for Disease Control and Prevention, Shijiazhuang 050011, China
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Kang H, Zhang P, Lee S, Shen S, Dunham E. Racial disparities in opioid administration and prescribing in the emergency department for pain. Am J Emerg Med 2022; 55:167-173. [DOI: 10.1016/j.ajem.2022.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 10/19/2022] Open
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Kang H. Negative Clusters Associated With Cannabis Use: Tangled Up in Blues. Innov Aging 2021. [PMCID: PMC8970299 DOI: 10.1093/geroni/igab046.1969] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Previous studies concerning older adults have focused on whether cannabis use leads to positive or negative outcomes. In this study, we identified clusters of negative health outcomes associated with medical cannabis use. In total, we examined eight health outcomes: pain, sleep, falls, memory, digestive issues, mental health conditions, exercise, and general productivity reported by 2,968 persons over 60 who participated in the Illinois Medical Cannabis Program. We used association analysis to simultaneously identify groups of negative outcomes reported by participants. The distribution of non-positive outcomes shows a bell-shaped curve: 1.4% of participants responded that cannabis use improved all outcomes, while 4.1% of participants answered that cannabis use did not. When looking at negative outcomes, 86% of participants reported none worsened, and 11% reported one of the outcomes was affected. Only a small fraction of the participants (3%) claimed more than one negative outcomes after cannabis use.
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Affiliation(s)
- Hyojung Kang
- University of Illinois, University of Illinois, Illinois, United States
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Roeske J, Mostafavi H, Lehmann M, Morf D, Cortesi L, Zhu L, Wagstaff P, Kaur M, Kang H, Harkenrider M. Initial Clinical Evaluation of Fast-kV Dual Energy Imaging for Markerless Tumor Tracking of Lung Tumors in Stereotactic Body Radiation Therapy (SBRT). Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.128] [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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Kang H, Liang J, Zhang Y, Li Z, Yang X, Sui B. Imaging Features of Symptomatic MCA Stenosis in Patients of Different Ages: A Vessel Wall MR Imaging Study. AJNR Am J Neuroradiol 2021; 42:1934-1941. [PMID: 34475196 DOI: 10.3174/ajnr.a7268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/11/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE The prevalence of intracranial artery stenosis is high in Asian people. This study aimed to investigate whether there are differences in the imaging features of symptomatic MCA stenosis in patients of different ages using vessel wall MR imaging. MATERIALS AND METHODS We retrospectively reviewed the data of consecutive patients with unilateral MCA stenosis based on a prospectively established vessel wall MR imaging data base between January 2017 and December 2018. According to age, the patients were divided into the young group (18-45 years of age) and the middle-aged and elderly group (older than 45 years of age). RESULTS Overall, 131 patients with unilateral MCA stenosis were included (45.8% in the young group and 54.2% in the middle-aged and elderly group). Middle-aged and elderly patients had a higher prevalence of hypertension (P = .01) and diabetes (P = .05). The lesion length (P < .0001), proportion of circular involvement (P = .006), and proportion of circular enhancement (P = .03) were higher in the young group than in the middle-aged and elderly group. The analysis of the atherosclerotic subgroup showed that compared with middle-aged and elderly patients, young patients had longer lesions (P = .002). The atherosclerotic-versus-nonatherosclerotic subgroup analysis showed that the maximal wall thickness in the patients with atherosclerosis was larger than that of patients without it (P = .002). CONCLUSIONS Compared with the middle-aged and elderly group, young patients with MCA stenosis tended to have longer lesions and more circular wall involvement and circular enhancement, which may indicate the differences in underlying vascular pathophysiologic and developmental mechanisms in symptomatic MCA stenosis.
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Affiliation(s)
- H Kang
- From the Beijing Neurosurgical Institute (H.K., Y.Z., X.Y.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - J Liang
- Shijingshan Teaching Hospital of Capital Medical University (J.L.), Beijing Shijingshan Hospital, Beijing, China
| | - Y Zhang
- From the Beijing Neurosurgical Institute (H.K., Y.Z., X.Y.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Z Li
- Tiantan Neuroimaging Center for Excellence (Z.L., B.S.), China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - X Yang
- From the Beijing Neurosurgical Institute (H.K., Y.Z., X.Y.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - B Sui
- Tiantan Neuroimaging Center for Excellence (Z.L., B.S.), China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Suh JW, Kang H, Kim J, Cho HW, Lee W, Yoon CH, Youn TJ, Chae IH. Prediction of endogenous thrombolytic activity in patients with coronary artery disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1284] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Endogenous thrombolytic activity (ETA) has been suggested as an essential factor related to the acute coronary syndrome. However, there have been little data regarding clinical characteristics of ETA in East Asians.
Method
As an interim study of the entire cohort (n=2,000), we analyzed a total of 278 patients who underwent percutaneous coronary intervention (PCI) due to coronary artery disease (CAD). Informed consent was obtained from all research subjects. Blood samples of patients were brought before the procedure. The Global Thrombosis Test (GTT, Thromboquest, UK), a novel test for examining ETA, was used. Lysis time (LT), which means the time interval between blood flow occlusion and restart, was used as an indicator for ETA. Clinical, laboratory and angiographic characteristics were obtained. LT=3000 seconds was used as a cut-off value to divide patients into two groups. P value<0.05 was regarded as significant.
Results
LT of Korean CAD patients showed bimodal distribution. Median value was 1695 [IQR: 1099, 5932] and it was higher than previous data from Europeans (Figure 1). Patients with impaired ETA (LT>3000) were older and more diabetic. They showed higher creatinine, aPTT, fibrinogen, D-dimer, c-reactive protein, and proBNP values. Moreover, they had lower hemoglobin and platelet levels. Intracoronary thrombus was more frequently observed in LT>3000 group. In the multivariable regression analysis, hemoglobin (per g/dL, odds ratio 0.766, 95% confidence interval (CI) 0.632–0.928) and fibrinogen level(per 10mg/L, odds ratio 1.054, 95% CI 1.015–1.095) could significantly predict impaired ETA.
Conclusion
East Asian patients showed a right-shifted distribution of ETA compared to that of Europeans. Patients with impaired ETA had different clinical, laboratory and angiographic characteristics from those with intact ETA. Hemoglobin and fibrinogen level were significantly associated with impaired ETA. Further studies are warranted to confirm causal relationship among these factors.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Research Foundation, Republic of Korea
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Affiliation(s)
- J W Suh
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - H Kang
- Seoul National University College of Medicine, Seoul, Korea (Republic of)
| | - J Kim
- Seoul National University College of Medicine, Seoul, Korea (Republic of)
| | - H W Cho
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - W Lee
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - C H Yoon
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - T J Youn
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
| | - I H Chae
- Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)
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Shin JE, Jo KW, O YJ, Jeon D, Kang H, Yim JJ, Kwon YS, Shim TS. Impact of revised definitions for extensively drug-resistant TB on disease classification. Int J Tuberc Lung Dis 2021; 25:766-768. [PMID: 34802501 DOI: 10.5588/ijtld.21.0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- J E Shin
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - K-W Jo
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, Republic of Korea, Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Seoul
| | - Y J O
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - D Jeon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - H Kang
- Department of Chest Medicine, Masan National Tuberculosis Hospital, Masan, Republic of Korea
| | - J-J Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Y-S Kwon
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - T S Shim
- Division of Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, Republic of Korea, Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Seoul
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50
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Yang W, Wu J, Yu J, Zheng X, Kang H, Wang Z, Zhang S, Zhou L, Liu J. A genome-wide association study reveals additive and dominance effects on growth and fatness traits in large white pigs. Anim Genet 2021; 52:749-753. [PMID: 34403536 DOI: 10.1111/age.13131] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 01/13/2023]
Abstract
The dominance effect is a kind of non-additive effect due to the interaction between alleles at the same locus. Quantitative traits such as growth traits in farm animals have been found to be influenced by dominance effects. However, dominance effects are usually ignored in the genome-wide association study (GWAS) of complex traits for farm animals. In this study, we performed GWAS and genetic parameters estimation for the two traits age at 100 kg (AGE) and backfat thickness at 100 kg (BF) of 3572 Large White pigs. The pigs were from three breeding farms of China and were genotyped by an in-house designed 50k SNP chip. Our results showed significant non-zero variance for the dominance effect of AGE, while the dominance effect of BF was not significant. Using a GWAS model accounting for both additive and dominance effects, we identified three additive and two dominance significant SNPs for the trait AGE. For the trait BF, three genome-wide significant additive SNPs were detected, but no significant SNP was found for the dominance effect. In total, six important functional genes (NPAS3, USP16, PARN, ARL15, GPC3, ABHD4) near significant SNPs were identified as candidate genes associated with AGE or BF. Notably, ARL15 and PARN were associated with AGE near the dominance association signals. Overall, the newly detected SNPs and newly identified candidate genes in our study added new information about the genetic architectures of growth and fatness traits in pigs, and have the potential to be applied to the pig breeding program in the future.
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Affiliation(s)
- W Yang
- College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - J Wu
- Beijing Zhongyu Pig Breeding Co., Ltd, Beijing, 100194, China
| | - J Yu
- College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - X Zheng
- College of Animal Science and Technology, Anhui Agricultural University, Hefei, 230036, China
| | - H Kang
- School of Life Science and Engineering, Foshan University, Foshan, Guangdong, 528231, China
| | - Z Wang
- Beijing Zhongyu Pig Breeding Co., Ltd, Beijing, 100194, China
| | - S Zhang
- College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - L Zhou
- College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - J Liu
- College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
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