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Madir A, Barisic Jaman M, Milosevic M, Dinjar Kujundžić P, Grgurevic I. Improved Applicability and Diagnostic Accuracy of the Novel Spleen-Dedicated Transient Elastography Device for High-Risk Esophageal Varices. Diagnostics (Basel) 2024; 14:743. [PMID: 38611656 PMCID: PMC11011917 DOI: 10.3390/diagnostics14070743] [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: 03/09/2024] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Spleen stiffness measurement (SSM) by transient elastography (TE) has been repeatedly demonstrated as the reliable way to rule out the presence of high-risk esophageal varices (HRV). We aimed to evaluate and compare novel vs. standard TE-SSM module performance in diagnosing HRV in patients with compensated advanced chronic liver disease (cACLD). This retrospective study included patients with cACLD; blood data, upper digestive endoscopy performed within 3 months of TE, SSM@50Hz and SSM@100Hz were collected. Overall, 112 patients with cACLD were analyzed (75.9% males, average age of 66, 43.7% alcohol-related chronic liver disease, 22.3% metabolic-associated steatotic liver disease, 6.2% viral hepatitis). Reliable SSM was possible in 80.3% and 93.8% of patients by using SSM@50Hz and SSM@100Hz probe, respectively. At the cut-off 41.8 kPa and 40.9 kPa (Youden), SSM@50Hz and SSM@100Hz had AUROCs of 0.746 and 0.752, respectively, for diagnosing HRV (p = 0.71). At the respective cut-offs, sensitivities for HRV were 92.9% and 100%, resulting in misclassification rates of 7.1% and 0% by using SSM@50Hz and SSM@100Hz. SSM reliably excludes HRV in cACLD patients, with measurements below 41 kPa potentially avoiding EGD in around 50% of cases, with minimal risk of HRV omission. SSM@100Hz demonstrated less measurement failures and no HRV misclassification.
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Affiliation(s)
- Anita Madir
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (A.M.); (M.B.J.); (P.D.K.)
| | - Mislav Barisic Jaman
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (A.M.); (M.B.J.); (P.D.K.)
| | - Marko Milosevic
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (A.M.); (M.B.J.); (P.D.K.)
| | - Petra Dinjar Kujundžić
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (A.M.); (M.B.J.); (P.D.K.)
| | - Ivica Grgurevic
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (A.M.); (M.B.J.); (P.D.K.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
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Barisic-Jaman M, Milosevic M, Skurla V, Dohoczky D, Stojic J, Dinjar Kujundzic P, Cigrovski Berkovic M, Majic-Tengg A, Matijaca A, Lucijanic T, Kardum-Pejic M, Pandzic Jaksic V, Marusic S, Grgurevic I. Compensated Advanced Chronic Liver Disease and Steatosis in Patients with Type 2 Diabetes as Assessed through Shear Wave Measurements and Attenuation Measurements. Biomedicines 2024; 12:323. [PMID: 38397925 PMCID: PMC10886655 DOI: 10.3390/biomedicines12020323] [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: 12/30/2023] [Revised: 01/17/2024] [Accepted: 01/28/2024] [Indexed: 02/25/2024] Open
Abstract
Patients with type 2 diabetes (T2D) are at risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD). We investigated the prevalence of compensated advanced chronic liver disease (cACLD) and steatosis in patients with T2D using the new non-invasive diagnostic methods of shear wave measurements (SWMs) and attenuation (ATT) measurements in comparison with those of vibration-controlled transient elastography (VCTE) and the controlled attenuation parameter (CAP), which served as the reference methods. Among 214 T2D patients, steatosis at any grade and cACLD were revealed in 134 (62.6%) and 19 (8.9%) patients, respectively. SWMs showed a high correlation with VCTE (Spearman's ρ = 0.641), whereas SWMs produced lower (mean of -0.7 kPa) liver stiffness measurements (LSMs) overall. At a LSM of >11.0 kPa (Youden), SWMs had an AUROC of 0.951 that was used to diagnose cACLD (defined as a LSM of >15 kPa through VCTE) with 84.2% sensitivity and 96.4% specificity. The performance of ATT measurements in diagnosing liver steatosis at any grade (defined as the CAP of ≥274 dB/m) was suboptimal (AUROC of 0.744 at the ATT measurement cut-off of >0.63 dB/cm/MHz (Youden) with 59% sensitivity and 81.2% specificity). In conclusion, the prevalence of liver steatosis and previously unrecognized cACLD in patients with T2D is high and SWMs appear to be a reliable diagnostic method for this purpose, whereas further investigation is needed to optimize the diagnostic performance of ATT measurements.
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Affiliation(s)
- Mislav Barisic-Jaman
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.B.-J.); (V.S.); (D.D.); (J.S.); (P.D.K.); (I.G.)
| | - Marko Milosevic
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.B.-J.); (V.S.); (D.D.); (J.S.); (P.D.K.); (I.G.)
| | - Viktoria Skurla
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.B.-J.); (V.S.); (D.D.); (J.S.); (P.D.K.); (I.G.)
| | - David Dohoczky
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.B.-J.); (V.S.); (D.D.); (J.S.); (P.D.K.); (I.G.)
| | - Josip Stojic
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.B.-J.); (V.S.); (D.D.); (J.S.); (P.D.K.); (I.G.)
| | - Petra Dinjar Kujundzic
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.B.-J.); (V.S.); (D.D.); (J.S.); (P.D.K.); (I.G.)
| | - Maja Cigrovski Berkovic
- Department of Endocrinology, Diabetes, Diseases of Metabolism and Clinical Pharmacology, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.C.B.); (A.M.-T.); (A.M.); (T.L.); (M.K.-P.); (S.M.)
- Department of Sport and Exercise Medicine, Faculty of Kinesiology, University of Zagreb, 10000 Zagreb, Croatia
| | - Ana Majic-Tengg
- Department of Endocrinology, Diabetes, Diseases of Metabolism and Clinical Pharmacology, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.C.B.); (A.M.-T.); (A.M.); (T.L.); (M.K.-P.); (S.M.)
| | - Ana Matijaca
- Department of Endocrinology, Diabetes, Diseases of Metabolism and Clinical Pharmacology, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.C.B.); (A.M.-T.); (A.M.); (T.L.); (M.K.-P.); (S.M.)
| | - Tomo Lucijanic
- Department of Endocrinology, Diabetes, Diseases of Metabolism and Clinical Pharmacology, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.C.B.); (A.M.-T.); (A.M.); (T.L.); (M.K.-P.); (S.M.)
| | - Mirjana Kardum-Pejic
- Department of Endocrinology, Diabetes, Diseases of Metabolism and Clinical Pharmacology, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.C.B.); (A.M.-T.); (A.M.); (T.L.); (M.K.-P.); (S.M.)
| | - Vlatka Pandzic Jaksic
- Department of Endocrinology, Diabetes, Diseases of Metabolism and Clinical Pharmacology, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.C.B.); (A.M.-T.); (A.M.); (T.L.); (M.K.-P.); (S.M.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Srecko Marusic
- Department of Endocrinology, Diabetes, Diseases of Metabolism and Clinical Pharmacology, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.C.B.); (A.M.-T.); (A.M.); (T.L.); (M.K.-P.); (S.M.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Ivica Grgurevic
- Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, Croatia; (M.B.-J.); (V.S.); (D.D.); (J.S.); (P.D.K.); (I.G.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
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Milosevic M, Jin Q, Singh A, Amal S. Applications of AI in multi-modal imaging for cardiovascular disease. Front Radiol 2024; 3:1294068. [PMID: 38283302 PMCID: PMC10811170 DOI: 10.3389/fradi.2023.1294068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/22/2023] [Indexed: 01/30/2024]
Abstract
Data for healthcare is diverse and includes many different modalities. Traditional approaches to Artificial Intelligence for cardiovascular disease were typically limited to single modalities. With the proliferation of diverse datasets and new methods in AI, we are now able to integrate different modalities, such as magnetic resonance scans, computerized tomography scans, echocardiography, x-rays, and electronic health records. In this paper, we review research from the last 5 years in applications of AI to multi-modal imaging. There have been many promising results in registration, segmentation, and fusion of different magnetic resonance imaging modalities with each other and computer tomography scans, but there are still many challenges that need to be addressed. Only a few papers have addressed modalities such as x-ray, echocardiography, or non-imaging modalities. As for prediction or classification tasks, there have only been a couple of papers that use multiple modalities in the cardiovascular domain. Furthermore, no models have been implemented or tested in real world cardiovascular clinical settings.
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Affiliation(s)
- Marko Milosevic
- Roux Institute, Northeastern University, Portland, ME, United States
| | - Qingchu Jin
- Roux Institute, Northeastern University, Portland, ME, United States
| | - Akarsh Singh
- College of Engineering, Northeastern University, Boston, MA, United States
| | - Saeed Amal
- Roux Institute, Northeastern University, Portland, ME, United States
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Han K, Zou J, Zhao Z, Baskurt Z, Zheng Y, Barnes T, Croke JM, Fyles A, Gladwish AP, Lecavalier-Barsoum M, Lukovic J, Marchand EL, Milosevic M, Taggar A, Bratman SV, Leung EW. Clinical Validation of HPV ctDNA for Early Detection of Residual Disease Following Chemoradiation in Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:S7-S8. [PMID: 37784556 DOI: 10.1016/j.ijrobp.2023.06.216] [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) Despite chemoradiation (CRT), 30-40% of patients with locally advanced cervical cancer relapse. Most cases are caused by human papilloma virus (HPV), and HPV circulating tumor DNA (ctDNA) may identify patients at highest risk of relapse. Our previous pilot study showed that detectable HPV ctDNA at the end of CRT is associated with inferior progression-free survival (PFS) using digital polymerase chain reaction (dPCR), and that a next generation sequencing approach (HPV-seq) may outperform dPCR. We hypothesized that HPV ctDNA may identify cervical cancer patients at increased risk of relapse following CRT and aimed to prospectively validate HPV ctDNA as a tool for early detection of residual disease. MATERIALS/METHODS This prospective, multicenter validation study accrued 70 patients with HPV+ stage IB-IVA cervical cancer treated with definitive CRT from 2017-2022. Patients underwent phlebotomy at baseline, end of, 4-6 weeks and 3 months post CRT for HPV ctDNA levels. HPV genotyping was performed on the baseline plasma sample using HPV-seq. HPV genotype-specific DNA levels in plasma were quantified using both dPCR and HPV-seq. PFS was estimated using the Kaplan-Meier method and compared using the log rank test. Multivariable Cox regression analyses incorporating stage and HPV ctDNA detectability assessed independent prognostic factors associated with PFS. RESULTS At the time of abstract, results for 67 patients were available. The majority had squamous histology (84%) and stage IIB (36%) or IIIC1 (25%) disease. HPV genotyping using HPV-seq revealed 54% (36/67) of cases harboring HPV-16, and 46% harboring other HPV types: 15 HPV-18; 5 HPV-59; 2 HPV-31; 2 HPV-33; 2 HPV-52; 1 each HPV-39, HPV-45, HPV-53, HPV-58, and HPV-82. With a median follow up of 2.2 (range 0.4 - 5.2) years, there were 21 PFS events. Most recurrences (14/21) were distant and/or paraaortic; 4 local and nodal/distant; 2 pelvic nodal; and 1 local. Patients with detectable HPV ctDNA on dPCR at the end of, 4-6 weeks and 3 months post CRT had significantly worse 2-year PFS compared to those with undetectable HPV ctDNA (78 vs 52%, p = 0.04; 82 vs 26%, p < 0.001; and 80 vs 23%, p = < 0.001, respectively). HPV-seq showed similar results (87 vs 55%, p = 0.02; 81 vs 45%, p = 0.003; and 84 vs 31%, p = < 0.001, respectively). On multivariable analyses, detectable HPV ctDNA on dPCR and HPV-seq remained independently associated with inferior PFS (see table). CONCLUSION HPV-seq enables HPV genotyping directly from plasma in locally advanced cervical cancer. Persistent HPV ctDNA following CRT is independently associated with inferior PFS in this prospective validation study. HPV ctDNA testing can be used to identify, as early as at the end of CRT, patients at high risk of recurrence in future treatment intensification trials.
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Affiliation(s)
- K Han
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - J Zou
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Z Zhao
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Z Baskurt
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Y Zheng
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - T Barnes
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - J M Croke
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - A Fyles
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - A P Gladwish
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Royal Victoria Hospital, Barrie, ON, Canada
| | | | - J Lukovic
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - E L Marchand
- Hopital Maisonneuve-Rosemont, Montreal, QC, Canada
| | - M Milosevic
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - A Taggar
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - S V Bratman
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - E W Leung
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Lucijanic M, Krecak I, Cicic D, Milosevic M, Vukoja D, Kovacevic I, Marasovic I, Sedinic Lacko M, Bakovic J, Jonjic Z, Vasilj T, Stojic J, Atic A. Hypoosmolar and hyperosmolar COVID-19 patients are predisposed to dismal clinical outcomes. Scand J Clin Lab Invest 2023; 83:397-402. [PMID: 37529905 DOI: 10.1080/00365513.2023.2241368] [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: 04/16/2023] [Revised: 07/09/2023] [Accepted: 07/24/2023] [Indexed: 08/03/2023]
Abstract
We aimed to investigate the associations of hypo- and hyperosmolarity at hospital admission with clinical characteristics and outcomes in 5645 consecutive hospitalized COVID-19 patients treated at a tertiary-level institution. Serum osmolarity was calculated as 2x Na (mmol/L) + urea (mmol/L) + glucose (mmol/L), with normal range from 275 to 295 mOsm/L. Median serum osmolarity was 292.9 mOsm/L with 51.8% normoosmolar, 5.3% hypoosmolar and 42.9% hyperosmolar patients present at the time of hospital admission. Hypoosmolarity was driven by hyponatremia, and was associated with the presence of chronic liver disease, liver cirrhosis, active malignancy and epilepsy. Hyperosmolarity was driven by an increase in urea and glucose and was associated with the presence of chronic metabolic and cardiovascular comorbidities. Both hypo- and hyperosmolar patients presented with more severe COVID-19 symptoms, higher inflammatory status, and experienced higher mortality in comparison to normoosmolar patients. In multivariate analysis, hypoosmolarity (adjusted odds ratio (aOR)=1.39, p = 0.024) and hyperosmolarity (aOR = 1.9, p < 0.001) remained significantly associated with higher mortality independently of older age, male sex, higher Charlson Comorbidity Index and more severe COVID-19. Disruptions in serum osmolarity are frequent in COVID-19 patients, may be easy to detect and target therapeutically, and thus potentially moderate associateds poor prognosis.
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Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivan Krecak
- Internal Medicine Department, General Hospital Sibenik-Knin County, Sibenik, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - David Cicic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Marko Milosevic
- Gastroenterology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Damir Vukoja
- Pulmonology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Ivona Kovacevic
- Pulmonology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Ivan Marasovic
- Pulmonology Department, University Hospital Dubrava, Zagreb, Croatia
| | | | - Josip Bakovic
- Abdominal Surgery Department, University Hospital Dubrava, Zagreb, Croatia
| | - Zeljko Jonjic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Tamara Vasilj
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Josip Stojic
- Gastroenterology Department, University Hospital Dubrava, Zagreb, Croatia
| | - Armin Atic
- Nephrology Department, University Hospital Center Zagreb, Zagreb, Croatia
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Tomulic Brusich K, Juricic K, Bobinac M, Milosevic M, Protic A, Boban A. Administration of tocilizumab in septic patients with pancytopenia and hyper-inflammatory syndrome. Ann Hematol 2023; 102:2633-2634. [PMID: 37365299 DOI: 10.1007/s00277-023-05335-x] [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] [Received: 05/22/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Affiliation(s)
- Katarina Tomulic Brusich
- Department of Anesthesiology, Intensive Care and Pain Medicine, Clinical Hospital Centre Rijeka, 51000, Rijeka, Croatia.
| | - Kazimir Juricic
- Department of Anesthesiology, Intensive Care and Pain Medicine, Clinical Hospital Centre Rijeka, 51000, Rijeka, Croatia
| | - Mirna Bobinac
- Department of Anesthesiology, Intensive Care and Pain Medicine, Clinical Hospital Centre Rijeka, 51000, Rijeka, Croatia
- Department of Anesthesiology, Resuscitation, Emergency and Intensive Care Medicine, Faculty of Medicine, University of Rijeka, 51000, Rijeka, Croatia
| | - Marko Milosevic
- Department of Anesthesiology, Intensive Care and Pain Medicine, Clinical Hospital Centre Rijeka, 51000, Rijeka, Croatia
- Department of Anesthesiology, Resuscitation, Emergency and Intensive Care Medicine, Faculty of Medicine, University of Rijeka, 51000, Rijeka, Croatia
| | - Alen Protic
- Department of Anesthesiology, Intensive Care and Pain Medicine, Clinical Hospital Centre Rijeka, 51000, Rijeka, Croatia
- Department of Anesthesiology, Resuscitation, Emergency and Intensive Care Medicine, Faculty of Medicine, University of Rijeka, 51000, Rijeka, Croatia
| | - Ana Boban
- Division of Hematology, Department of Internal Medicine, University Hospital Centre Zagreb, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000, Zagreb, Croatia
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Scott A, Weersink M, Liu Z, Milosevic M, Croke J, Fyles A, Lukovic J, Rink A, Beiki-Ardakani A, Borg J, Xie J, Chan K, Ballantyne H, Skliarenko J, Conway J, Gladwish A, Weersink R, Han K. Comparing Dosimetry of Locally Advanced Cervix Cancer Patients Treated with 3 vs. 4 Fractions of MRI-Guided Brachytherapy. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.601] [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: 11/16/2022]
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Mitera G, Tsang D, Wright P, Sussman J, Craig T, Thompson R, Tyldesley S, Foxcroft S, Goddard K, Greenland J, Koul R, McCurdy B, Milosevic M, Morneau M, Morrison A, Pan L, Pantarotto J, Rutledge R, Warde P, Patel S. First Pan-Canadian Consensus Recommendations for Proton Beam Therapy Access in Canada. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1439] [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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Santiago PHR, Milosevic M, Ju X, Cheung W, Haag D, Jamieson L. A network psychometric validation of the Children Oral Health-Related Quality of Life (COHQoL) questionnaire among Aboriginal and/or Torres Strait Islander children. PLoS One 2022; 17:e0273373. [PMID: 35980996 PMCID: PMC9387801 DOI: 10.1371/journal.pone.0273373] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 08/07/2022] [Indexed: 11/29/2022] Open
Abstract
In Australia, research evidence has shown that Aboriginal and/or Torres Strait Islander children experience a higher burden of oral health diseases compared to other non-Indigenous children. The impact of oral health diseases on children’s functional and psychosocial outcomes led to the development of several instruments to evaluate child oral health-related quality of life (COHQoL), such as the Parental-Caregiver Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS). However, the psychometric properties of these instruments have been evaluated only in Western cultures and have not been investigated for Aboriginal children in Australia. The current study aimed to examine the psychometric properties of the short-forms P-CPQ and FIS for Aboriginal and/or Torres Strait Islander children aged 2–3 years. Data were collected from the South Australian Aboriginal Birth Cohort (SAABC), including 270 Aboriginal children aged 2–3 years. Network psychometric models were used to investigate dimensionality, item redundancy, structural consistency and item stability, model fit, internal consistency reliability and criterion validity. We propose an instrument named Aboriginal Children’s Oral Health-Related Quality of Life Questionnaire (A-COHQoL). Our findings indicated that, after the exclusion of four problematic items, the A-COHQoL showed a three-dimensional structure (“Parent/Family Activities”, “COHQoL” and “Family Conflict”) with good model fit and reliability. The A-COHQoL is a psychometrically robust and sensitive instrument that is readily available for Aboriginal and/or Torres Strait Islander children aged 2–3 years in Australia and can be adapted in the future for Indigenous child groups in other countries.
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Affiliation(s)
- Pedro Henrique Ribeiro Santiago
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
- School of Public Health, The University of Adelaide, Adelaide, Australia
- * E-mail:
| | - Marko Milosevic
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Wendy Cheung
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Dandara Haag
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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Grgurevic I, Lucijanić M, Pastrovic F, Barisic Jaman M, Tjesic Drinkovic I, Zelenika M, Milosevic M, Medic B, Kardum D, Bokun T, Luksic I, Piskac Zivkovic N, Keres T, Grabovac V, Persec J, Barsic B. The short-term outcomes of patients with chronic liver disease hospitalized with COVID-19. Intern Med J 2022; 52:1891-1899. [PMID: 35555962 PMCID: PMC9348237 DOI: 10.1111/imj.15817] [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] [Received: 10/19/2021] [Revised: 04/19/2022] [Accepted: 05/02/2022] [Indexed: 11/28/2022]
Abstract
Background and aims Patients with chronic liver disease (CLD) might have aggravated course upon acquisition of coronavirus disease 2019 (COVID‐19). We aimed to analyse the outcomes of patients with CLD who were hospitalized due to COVID‐19. Methods Medical records of 4014 patients hospitalized due to COVID‐19 in a regional referral hospital over a 12‐month period were analysed. Patients with CLD were identified based on discharge diagnoses according to ICD‐10 classification. Patients were followed for 30 days from admission, and their outcomes (intensive care unit (ICU) admission, mechanical ventilation (MV) or death) were analysed. Results Of the 4014 patients, 110 (2.7%) had CLD and 49 (1.2%) had cirrhosis. Median age of CLD patients was 67.5 years, 79 (71.8%) were males, 224 (23.5%) obese, 56 (50.9%) reported alcohol abuse, 24 (21.8%) had non‐alcoholic fatty liver disease, 11 (10%) viral hepatitis and 98 (89.1%) had pneumonia. Median length of hospitalization was 12 days, 32 (29.1%) patients required ICU admission and 23 (20.9%) MV, while 43 (39.1%) died. In univariate analysis, patients with cirrhosis (45% vs 73%, HR=2.95; P<0.001), but not those with non‐cirrhotic CLD (74% vs 73%, P>0.05), experienced worse 30‐days survival when compared to age, sex and COVID‐19 duration matched cohorts. In a logistic regression analysis conducted on the overall and matched cohorts, liver cirrhosis, but not CLD, predicted inferior survival independently of age, comorbidities and severity of COVID‐19, with a fourfold higher adjusted risk of 30‐day mortality. Conclusion Cirrhosis is independently associated with higher 30‐day mortality of hospitalized patients with COVID‐19. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ivica Grgurevic
- Department of gastroenterology, hepatology and clinical nutrition, University hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of medicine, Zagreb, Croatia.,University of Zagreb Faculty of pharmacy and biochemistry
| | - Marko Lucijanić
- University of Zagreb School of medicine, Zagreb, Croatia.,Department of hematology, University hospital Dubrava, Zagreb, Croatia
| | - Frane Pastrovic
- Department of gastroenterology, hepatology and clinical nutrition, University hospital Dubrava, Zagreb, Croatia
| | - Mislav Barisic Jaman
- Department of gastroenterology, hepatology and clinical nutrition, University hospital Dubrava, Zagreb, Croatia
| | - Ida Tjesic Drinkovic
- Department of gastroenterology, hepatology and clinical nutrition, University hospital Dubrava, Zagreb, Croatia
| | - Marko Zelenika
- Department of gastroenterology, hepatology and clinical nutrition, University hospital Dubrava, Zagreb, Croatia
| | - Marko Milosevic
- Department of gastroenterology, hepatology and clinical nutrition, University hospital Dubrava, Zagreb, Croatia
| | - Barbara Medic
- Department of gastroenterology, hepatology and clinical nutrition, University hospital Dubrava, Zagreb, Croatia
| | - Dusko Kardum
- Department of gastroenterology, hepatology and clinical nutrition, University hospital Dubrava, Zagreb, Croatia
| | - Tomislav Bokun
- Department of gastroenterology, hepatology and clinical nutrition, University hospital Dubrava, Zagreb, Croatia.,University of Zagreb Faculty of pharmacy and biochemistry
| | - Ivica Luksic
- University of Zagreb School of medicine, Zagreb, Croatia.,Department of maxillofacial surgery, University hospital Dubrava, Zagreb, Croatia
| | | | - Tatjana Keres
- Intensive care unit, Department of internal medicine, University hospital Dubrava, Zagreb, Croatia
| | - Vlatko Grabovac
- Intensive care unit, Department of internal medicine, University hospital Dubrava, Zagreb, Croatia.,Department of emergency medicine, University hospital Dubrava, Zagreb, Croatia
| | - Jasminka Persec
- Intensive care unit, Department of anestesiology, renimatology and intensive care, University hospital Dubrava, Zagreb, Croatia.,University of Zagreb School of Dental medicine
| | - Bruno Barsic
- University of Zagreb School of medicine, Zagreb, Croatia.,Intensive care unit, Department of internal medicine, University hospital Dubrava, Zagreb, Croatia
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11
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Stevanovic N, Markovic V, Milosevic M, Djurdjevic A, Stajic J, Milenkovic B, Nikezic D. Correlations between track parameters in a solid-state nuclear track detector and its diffraction pattern. Radiat Phys Chem Oxf Engl 1993 2022. [DOI: 10.1016/j.radphyschem.2022.109986] [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: 11/25/2022]
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12
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Scott A, Polo A, Zubizarreta E, Aidoo C, Milosevic M, Rodin D. Access to Radiotherapy in Ghana: A Geospatial Analysis. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.276] [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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13
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Madariaga Urrutia A, Bonilla L, King I, Garg S, Bowering V, Dhani N, Milosevic M, Han K, Lajkosz K, Karakasis K, Ghiassi P, Siman S, Rouzbahman M, Downs G, Park N, Sheen C, Udagani S, Stockley T, Oza A, Lheureux S. 805P Clinically actionable alterations in adolescents and young adults (AYA) with gynaecological cancers. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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14
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Milosevic M, Rodin D. SP-0049 Using health economics to make the case for brachytherapy – HALYS, QALYS and DALYS. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Abdovic S, Cuk M, Hizar I, Milosevic M, Jerkovic A, Saraga M. Pretreatment morning urine osmolality and oral desmopressin lyophilisate treatment outcome in patients with primary monosymptomatic enuresis. Int Urol Nephrol 2021; 53:1529-1534. [PMID: 33774753 DOI: 10.1007/s11255-021-02843-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/22/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine the association between urine osmolality (Uosm) in patients with primary monosymptomatic enuresis (PMNE) and response to desmopressin (dDAVP) lyophilisate. METHODS This was a prospective cohort study that included 419 children with enuresis seen in outpatient clinic between October 2017 and October 2019. Patient workup included symptom checklist, 48 h frequency/volume chart, kidney and bladder ultrasound, uroflow, urinalysis and culture, spot urine Ca/creatinine, and first-morning Uosm. Patients < 5 years, with secondary enuresis, or loss of follow-up were excluded. Oral dDAVP lyophilisate was recommended to all with PMNE and normal bladder capacity. After 1 month of therapy, initial success was assessed according to ICCS. Significant predictor variables for complete response were identified and analyzed using correlation coefficients and binary logistic regression. RESULTS There were 48 patients with PMNE who received dDAVP and were followed for treatment success. Partial and complete responses were achieved for 14 (29.2%) and 20 cases (41.7%), respectively. Older age and lower Uosm were found to be significantly in favor of complete response to dDAVP lyophilisate, P = 0.007 and 0.033, respectively. ROC analysis determined the Uosm of ≤ 814 mOsm/kg as a cut-off value for complete success (sensitivity 65% and specificity 75%, AUC = 68.2%). The odds ratio for complete success for selected cut-off value was 5.57 (95% CI 1.588-19.551, P = 0.007). CONCLUSION High pretreatment morning Uosm (> 814 mOsm/kg) might be suggestive of an alternative treatment to dDAVP lyophilisate in PMNE because of the higher risk of treatment failure.
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Affiliation(s)
- S Abdovic
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia.
| | - M Cuk
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia
| | - I Hizar
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia
| | - M Milosevic
- Andrija Stampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
| | - A Jerkovic
- Department of Pediatric Nephrology, Children's Hospital Zagreb, Klaiceva 16, 10000, Zagreb, Croatia
| | - M Saraga
- Department of Pediatric Nephrology, University Hospital Center Split, Split, Croatia
- School of Medicine, University of Split, Split, Croatia
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16
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Khoja L, Hurst N, Weiss J, Liu Z, Laframboise S, Clarke B, Han K, Milosevic M, Fyles A, Dhani N, Croke J. Vulvar Carcinoma: Patterns Of Practice And Clinical Outcomes From A Large Academic Cancer Centre. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Milosevic M, Edwards J, Tsang D, Dunning J, Shackcloth M, Batchelor T, Coonar A, Hasan J, Davidson B, Marchbank A, Grumett S, Williams N, Macbeth F, Farewell V, Treasure T. Pulmonary Metastasectomy in Colorectal Cancer: updated analysis of 93 randomized patients - control survival is much better than previously assumed. Colorectal Dis 2020; 22:1314-1324. [PMID: 32388895 PMCID: PMC7611567 DOI: 10.1111/codi.15113] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/24/2020] [Indexed: 12/23/2022]
Abstract
AIM Lung metastases from colorectal cancer are resected in selected patients in the belief that this confers a significant survival advantage. It is generally assumed that the 5-year survival of these patients would be near zero without metastasectomy. We tested the clinical effectiveness of this practice in Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC), a randomized, controlled noninferiority trial. METHOD Multidisciplinary teams in 14 hospitals recruited patients with resectable lung metastases into a two-arm trial. Randomization was remote and stratified according to site, with minimization for age, sex, primary cancer stage, interval since primary resection, prior liver involvement, number of metastases and carcinoembryonic antigen level. The trial management group was blind to patient allocation until after intention-to-treat analysis. RESULTS From 2010 to 2016, 93 participants were randomized. These patients were 35-86 years of age and had between one and six lung metastases at a median of 2.7 years after colorectal cancer resection; 29% had prior liver metastasectomy. The patient groups were well matched and the characteristics of these groups were similar to those of observational studies. The median survival after metastasectomy was 3.5 (95% CI: 3.1-6.6) years compared with 3.8 (95% CI: 3.1-4.6) years for controls. The estimated unadjusted hazard ratio for death within 5 years, comparing the metastasectomy group with the control group, was 0.93 (95% CI: 0.56-1.56). Use of chemotherapy or local ablation was infrequent and similar in each group. CONCLUSION Patients in the control group (who did not undergo lung metastasectomy) have better survival than is assumed. Survival in the metastasectomy group is comparable with the many single-arm follow-up studies. The groups were well matched with features similar to those reported in case series.
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Affiliation(s)
- M. Milosevic
- Institute for Lung Diseases of VojvodinaThoracic Surgery ClinicSremska KamenicaSerbia
| | - J. Edwards
- Sheffield Teaching Hospitals NHS Foundation TrustSheffieldUK
| | - D. Tsang
- Basildon and Thurrock University Hospitals NHS Foundation TrustBasildonUK
| | - J. Dunning
- South Tees Hospitals NHS Foundation TrustThe James Cook University HospitalMiddlesbroughUK
| | - M. Shackcloth
- Liverpool Heart And Chest Hospital NHS Foundation TrustLiverpoolUK
| | - T. Batchelor
- Bristol Royal InfirmaryUniversity Hospitals Bristol NHS Foundation TrustBristolUK
| | - A. Coonar
- Royal Papworth Hospital NHS Foundation TrustCambridgeUK
| | - J. Hasan
- The Christie NHS Foundation TrustManchesterUK
| | - B. Davidson
- Division of SurgeryRoyal Free London NHS Foundation TrustUCLLondonUK
| | - A. Marchbank
- Derriford HospitalUniversity Hospitals Plymouth NHS TrustPlymouthUK
| | - S. Grumett
- The Royal Wolverhampton NHS TrustNew Cross HospitalWolverhamptonUK
| | - N.R. Williams
- Surgical & Interventional Trials Unit (SITU)University College LondonLondonUK
| | - F. Macbeth
- Centre for Trials ResearchCardiff UniversityCardiffUK
| | | | - T. Treasure
- Clinical Operational Research UnitUniversity College LondonLondonUK
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18
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Affatato S, Ruzzi S, Milosevic M, Ruggiero A. Wear characterization and contact surfaces analysis of menisci and femoral retrieved components in bi-condylar knee prostheses. J Mech Behav Biomed Mater 2020; 110:103959. [PMID: 32957250 DOI: 10.1016/j.jmbbm.2020.103959] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/06/2020] [Accepted: 06/28/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Although total knee arthroplasty is a well-practiced surgical procedure, material properties and surface topography can contribute to the wear mechanisms and the implant failure. It has been advised that an increased femoral component's surface roughness of total knee prostheses may be a contributing factor to accelerated wear of the polyethylene menisci and eventually prosthesis failure. The aim of this study is to investigate the wear phenomena occurring on medial and lateral compartments of retrieved total knee arthroplasty in order to correlate the surface roughness vs. BMI, age at revision, and time in situ. METHODS Qualitative visual analyses were performed on all the retrieved knee components to assess the damage due to the wear phenomena. Quantitative analysis includes surface characterization performed using optical apparatus to describe surface roughness and morphology on the retrieved femoral, tibial and polyethylene component. The Mann-Whitney statistical test was performed to correlate the medial vs. lateral condyle surface roughness of all explants with BMI, age at revision, and time in situ. RESULTS Visual and topographical analysis showed damage along the entire zone of the sliding contact area. A statistical difference between medial and lateral condyle roughness was found on four prosthesis. No statistical significance was found between surface roughness measurements and patient BMI, age at revision, and time in situ. On the femoral components various scratches were observed in the anterior/posterior (AP) direction of all the fixed femoral components. A statistically significant difference between medial and lateral condyle was found on two mobile knee design (p = 0.03) and on two fixed design (p = 0.01). The results were discussed in the framework of the usual TKR loading conditions during the gait, and of knowledge on the bio-tribological behavior of the prosthetic joint. CONCLUSIONS The visual and topographical analysis showed consistent damage patterns with respect to the main movements to which the prosthetic components are subjected and no statistical significance was found between surface roughness measurements and patient BMI, age at revision, and time in situ.
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Affiliation(s)
- Saverio Affatato
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Silvia Ruzzi
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Marko Milosevic
- Department of Industrial Engineering, University of Salerno, Salerno, Italy
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Kang J, Tsai CC, Hasegawa H, Morris-Paterson T, Higgins S, Crum W, Gnoni V, Green D, Gunasinghe C, Nesbitt A, Williams S, Milosevic M, Ashkan K, Goadsby P, Leschziner G, Harridge S, Rosenzweig I. The effect of hyper-buoyancy floatation (HBF), a model of simulated microgravity, on sleep and cognitive function in humans. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.1091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Velec M, Tadic T, Xie J, Moseley J, Patel T, Milosevic M, Fyles A, Han K, Croke J. Deformable Dose Accumulation for Hybrid CBCT-MRI Guided Adaptive Radiotherapy for Cervix Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Tadic T, Croke J, Xie J, Stanescu T, Letourneau D, Bissonnette J, Breen S, Simeonov A, Dickie C, Hill C, Li W, Ellis C, Winter J, Velec M, Fyles A, Han K, Jaffray D, Milosevic M. In-Room MRI for Adaptive Radiotherapy for Cervical Cancer Using an Integrated MR-Guided Radiation Therapy System. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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22
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Milosevic M. SP-0150 Using functional imaging as a guidance and decision tool in radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30570-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Kojic M, Milosevic M, Simic V, Geroski V, Ziemys A, Filipovic N, Ferrari M. Smeared multiscale finite element model for electrophysiology and ionic transport in biological tissue. Comput Biol Med 2019; 108:288-304. [PMID: 31015049 DOI: 10.1016/j.compbiomed.2019.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 03/22/2019] [Accepted: 03/23/2019] [Indexed: 10/27/2022]
Abstract
Basic functions of living organisms are governed by the nervous system through bidirectional signals transmitted from the brain to neural networks. These signals are similar to electrical waves. In electrophysiology the goal is to study the electrical properties of biological cells and tissues, and the transmission of signals. From a physics perspective, there exists a field of electrical potential within the living body, the nervous system, extracellular space and cells. Electrophysiological problems can be investigated experimentally and also theoretically by developing appropriate mathematical or computational models. Due to the enormous complexity of biological systems, it would be almost impossible to establish a detailed computational model of the electrical field, even for only a single organ (e.g. heart), including the entirety of cells comprising the neural network. In order to make computational models feasible for practical applications, we here introduce the concept of smeared fields, which represents a generalization of the previously formulated multiscale smeared methodology for mass transport in blood vessels, lymph, and tissue. We demonstrate the accuracy of the smeared finite element computational models for the electric field in numerical examples. The electrical field is further coupled with ionic mass transport within tissue composed of interstitial spaces extracellularly and by cytoplasm and organelles intracellularly. The proposed methodology, which couples electrophysiology and molecular ionic transport, is applicable to a variety of biological systems.
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Affiliation(s)
- M Kojic
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA; Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400, Kragujevac, Serbia; Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000, Belgrade, Serbia.
| | - M Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400, Kragujevac, Serbia; Belgrade Metropolitan University, Tadeuša Košćuška 63, 11000, Belgrade, Serbia
| | - V Simic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400, Kragujevac, Serbia
| | - V Geroski
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400, Kragujevac, Serbia
| | - A Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA
| | - N Filipovic
- University of Kragujevac, Faculty for Engineering Sciences, Sestre Janic 6, 34000, Kragujevac, Serbia
| | - M Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA
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Abdovic S, Cuk M, Cekada N, Milosevic M, Geljic A, Fusic S, Bastic M, Bahtijarevic Z. Predicting posterior urethral obstruction in boys with lower urinary tract symptoms using deep artificial neural network. World J Urol 2018; 37:1973-1979. [DOI: 10.1007/s00345-018-2588-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 11/28/2018] [Indexed: 10/27/2022] Open
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25
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Grabovac I, Milosevic M, Mustajbegovic J. Perceived and Experienced Discrimination and Sexual Identity Disclosure of Lesbian, Gay and Bisexual Patients in Croatia. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.148] [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: 11/15/2022] Open
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26
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Han K, Welch M, Weiss J, Pintilie M, Fyles T, Milosevic M. An MRI-Based Radiomic Signature for Disease-Free Survival in Locally Advanced Cervical Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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27
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Schulman D, Milosevic M, Singh P. TECHNOLOGY-ENABLED SUBJECTIVE WELLNESS OBSERVATIONS BY INFORMAL CAREGIVERS: A QUALITATIVE ANALYSIS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.471] [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: 11/12/2022] Open
Affiliation(s)
| | | | - P Singh
- Philips Research North America
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28
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Ziemys A, Yokoi K, Kai M, Liu YT, Kojic M, Simic V, Milosevic M, Holder A, Ferrari M. Progression-dependent transport heterogeneity of breast cancer liver metastases as a factor in therapeutic resistance. J Control Release 2018; 291:99-105. [PMID: 30332610 DOI: 10.1016/j.jconrel.2018.10.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 12/13/2022]
Abstract
Metastatic disease is a major cause of mortality in cancer patients. While many drug delivery strategies for anticancer therapeutics have been developed in preclinical studies of primary tumors, the drug delivery properties of metastatic tumors have not been sufficiently investigated. Therapeutic efficacy hinges on efficient drug permeation into the tumor microenvironment, which is known to be heterogeneous thus potentially making drug permeation heterogeneous, also. In this study, we have identified that 4 T1 liver metastases, treated with pegylated liposomal doxorubicin, have unfavorable and heterogeneous transport of doxorubicin. Our drug extravasation results differ greatly from analogous studies with 4 T1 tumors growing in the primary site. A probabilistic tumor population model was developed to estimate drug permeation efficiency and drug kinetics of liver metastases by integrating the transport and structural properties of tumors and delivered drugs. The results demonstrate significant heterogeneity in metastases with regard to transport properties of doxorubicin within the same animal model, and even within the same organ. These results also suggest that the degree of heterogeneity depends on the stage of tumor progression and that differences in transport properties can define transport-based tumor phenotypes. These findings may have valuable clinical implications by illustrating that therapeutic agents can permeate and eliminate metastases of "less resistant" transport phenotypes, while sparing tumors with more "resistant" transport properties. We anticipate that these results could challenge the current paradigm of drug delivery into metastases, highlight potential caveats for therapies that may alter tumor perfusion, and deepen our understanding of the emergence of drug transport-based therapeutic resistance.
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Affiliation(s)
- A Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA.
| | - K Yokoi
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA
| | - M Kai
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA
| | - Y T Liu
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA
| | - M Kojic
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA; Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia; Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000 Belgrade, Serbia
| | - V Simic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - M Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - A Holder
- Department of Surgery, Houston Methodist, Houston, TX, USA
| | - M Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, Houston, TX, USA
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Milosevic M, Simic V, Milicevic B, Koay E, Ferrari M, Ziemys A, Kojic M. Correction function for accuracy improvement of the Composite Smeared Finite Element for diffusive transport in biological tissue systems. Comput Methods Appl Mech Eng 2018; 338:97-116. [PMID: 30555187 PMCID: PMC6292687 DOI: 10.1016/j.cma.2018.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Modeling of drug transport within capillaries and tissue remains a challenge, especially in tumors and cancers where the capillary network exhibits extremely irregular geometry. Recently introduced Composite Smeared Finite Element (CSFE) provides a new methodology of modeling complex convective and diffusive transport in the capillary-tissue system. The basic idea in the formulation of CSFE is in dividing the FE into capillary and tissue domain, coupled by 1D connectivity elements at each node. Mass transport in capillaries is smeared into continuous fields of pressure and concentration by introducing the corresponding Darcy and diffusion tensors. Despite theoretically correct foundation, there are still differences in the overall mass transport to (and from) tissue when comparing smeared model and a true 3D model. The differences arise from the fact that the smeared model cannot take into account the detailed non-uniform pressure and concentration distribution in the vicinity of capillaries. We introduced a field of correction function for diffusivity through the capillary walls of smeared models, in order to have the same mass accumulation in tissue as in case of true 3D models. The parameters of the numerically determined correction function are: ratio of thickness and diameter of capillary wall, ratio of diffusion coefficient in capillary wall and surrounding tissue; and volume fraction of capillaries within tissue domain. Partitioning at the capillary wall - blood interface can also be included. It was shown that the correction function is applicable to complex configurations of capillary networks, providing improved accuracy of our robust smeared models in computer simulations of real transport problems, such as in tumors or human organs.
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Affiliation(s)
- M. Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia
- Belgrade Metropolitan University, Tadeusa Koscuska 63, 11000 Belgrade, Serbia
| | - V. Simic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia
| | - B. Milicevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia
| | - E.J. Koay
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - M. Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
| | - A. Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
| | - M. Kojic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 34000 Kragujevac, Serbia
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
- Serbian Academy of Sciences and Arts, Knez Mihailova 35,11000 Belgrade
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Kojic M, Milosevic M, Simic V, Koay EJ, Kojic N, Ziemys A, Ferrari M. Multiscale smeared finite element model for mass transport in biological tissue: From blood vessels to cells and cellular organelles. Comput Biol Med 2018; 99:7-23. [PMID: 29807251 DOI: 10.1016/j.compbiomed.2018.05.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/19/2018] [Accepted: 05/19/2018] [Indexed: 11/16/2022]
Abstract
One of the basic and vital processes in living organisms is mass exchange, which occurs on several levels: it goes from blood vessels to cells and organelles within cells. On that path, molecules, as oxygen, metabolic products, drugs, etc. Traverse different macro and micro environments - blood, extracellular/intracellular space, and interior of organelles; and also biological barriers such as walls of blood vessels and membranes of cells and organelles. Many aspects of this mass transport remain unknown, particularly the biophysical mechanisms governing drug delivery. The main research approach relies on laboratory and clinical investigations. In parallel, considerable efforts have been directed to develop computational tools for additional insight into the intricate process of mass exchange and transport. Along these lines, we have recently formulated a composite smeared finite element (CSFE) which is composed of the smeared continuum pressure and concentration fields of the capillary and lymphatic system, and of these fields within tissue. The element offers an elegant and simple procedure which opens up new lines of inquiry and can be applied to large systems such as organs and tumors models. Here, we extend this concept to a multiscale scheme which concurrently couples domains that span from large blood vessels, capillaries and lymph, to cell cytosol and further to organelles of nanometer size. These spatial physical domains are coupled by the appropriate connectivity elements representing biological barriers. The composite finite element has "degrees of freedom" which include pressures and concentrations of all compartments of the vessels-tissue assemblage. The overall model uses the standard, measurable material properties of the continuum biological environments and biological barriers. It can be considered as a framework into which we can incorporate various additional effects (such as electrical or biochemical) for transport through membranes or within cells. This concept and the developed FE software within our package PAK offers a computational tool that can be applied to whole-organ systems, while also including specific domains such as tumors. The solved examples demonstrate the accuracy of this model and its applicability to large biological systems.
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Affiliation(s)
- M Kojic
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA; Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia; Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000, Belgrade, Serbia.
| | - M Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - V Simic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - E J Koay
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - N Kojic
- Center for Engineering in Medicine and Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - A Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA
| | - M Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX, 77030, USA
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Yap M, Allo G, Cuartero J, Pintilie M, Kamel-Reid S, Murphy J, Mackay H, Clarke B, Fyles A, Milosevic M. Prognostic Significance of Human Papilloma Virus and p16 Expression in Patients with Vulvar Squamous Cell Carcinoma who Received Radiotherapy. Clin Oncol (R Coll Radiol) 2018; 30:254-261. [DOI: 10.1016/j.clon.2018.01.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 11/17/2017] [Accepted: 12/22/2017] [Indexed: 10/18/2022]
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Lukovic J, Han K, Pintilie M, Chaudary N, Hill R, Fyles A, Milosevic M. OC-0149: Intratumoral heterogeneity and hypoxia gene expression signatures in cervix cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30459-6] [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: 11/16/2022]
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Conway J, Felder S, Tang J, Fyles A, Milosevic M, Lukovic J, Han K, Croke J. PO-0811: Patient-reported quality of life in cervical cancer patients treated with definitive chemoradiation. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31121-6] [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: 10/14/2022]
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Lecavalier-Barsoum M, Chaudary N, Thapa P, Larsen M, Pintilie M, Han K, Hill R, Milosevic M. EP-1527: Targeting CXCL12/CXCR4 to enhance the therapeutic ratio during radiochemotherapy for cervix cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31836-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: 11/29/2022]
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Skliarenko J, D'Souza D, Perdrizet J, Ang M, Barbera L, Gutierrez E, Ravi A, Tanderup K, Warde P, Chan K, Isaranuwatchai W, Milosevic M. OC-0076: MR-guided vs CT-guided brachytherapy more effective and less costly in locally advanced cervical cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30386-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Hamilton JL, Foxcroft S, Moyo E, Cooke-Lauder J, Spence T, Zahedi P, Bezjak A, Jaffray D, Lam C, Létourneau D, Milosevic M, Tsang R, Wong R, Liu FF. Strategic planning in an academic radiation medicine program. Curr Oncol 2017; 24:e518-e523. [PMID: 29270061 DOI: 10.3747/co.24.3725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background In this paper, we report on the process of strategic planning in the Radiation Medicine Program (rmp) at the Princess Margaret Cancer Centre. The rmp conducted a strategic planning exercise to ensure that program priorities reflect the current health care environment, enable nimble responses to the increasing burden of cancer, and guide program operations until 2020. Methods Data collection was guided by a project charter that outlined the project goal and the roles and responsibilities of all participants. The process was managed by a multidisciplinary steering committee under the guidance of an external consultant and consisted of reviewing strategic planning documents from close collaborators and institutional partners, conducting interviews with key stakeholders, deploying a program-wide survey, facilitating an anonymous and confidential e-mail feedback box, and collecting information from group deliberations. Results The process of strategic planning took place from December 2014 to December 2015. Mission and vision statements were developed, and core values were defined. A final document, Strategic Roadmap to 2020, was established to guide programmatic pursuits during the ensuing 5 years, and an implementation plan was developed to guide the first year of operations. Conclusions The strategic planning process provided an opportunity to mobilize staff talents and identify environmental opportunities, and helped to enable more effective use of resources in a rapidly changing health care environment. The process was valuable in allowing staff to consider and discuss the future, and in identifying strategic issues of the greatest importance to the program. Academic programs with similar mandates might find our report useful in guiding similar processes in their own organizations.
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Affiliation(s)
- J L Hamilton
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - S Foxcroft
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - E Moyo
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - J Cooke-Lauder
- Health Industry Management Practice, Schulich School of Business, York University, and
| | - T Spence
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - P Zahedi
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - A Bezjak
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network
| | - D Jaffray
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - C Lam
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - D Létourneau
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - M Milosevic
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - R Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - R Wong
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
| | - F F Liu
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network.,Department of Radiation Oncology, University of Toronto, Toronto, ON
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Chan K, Simeonov A, Di Tomasso A, O'Leary G, Filici AL, Rink A, Beiki-Ardakani A, Borg J, Croke J, Fyles T, Han K, Milosevic M. Implementation of Real-Time MR-Guided Interstitial Brachytherapy for Gynecological Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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D'Souza D, Perdrizet J, Skliarenko J, Ang M, Barbera L, Ravi A, Gutierrez E, Tanderup K, Warde P, Chan K, Isaranuwatchai W, Milosevic M. A Cost-Utility Analysis Comparing MR-Guided Brachytherapy to Standard 2D Brachytherapy for Patients With Locally Advanced Cervical Cancer in Ontario, Canada. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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Gerber R, Han K, Xie J, Jiang H, Beiki-Ardakani A, Fyles T, Milosevic M, Croke J. Patient-Reported Sexual Health After Definitive Chemoradiation Therapy and MR-Guided Brachytherapy for Cervical Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.266] [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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Chaudary N, Cheung M, Foltz W, Abdalaty AH, Stewart J, Lindsay P, Siddiqui I, Larsen M, Hill R, Milosevic M, Kim J, Hedley D. Preclinical Development of Targeted Stereotactic Body Radiation Therapy for Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.2464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Pawlicki T, Coffey M, Milosevic M. Incident Learning Systems for Radiation Oncology: Development and Value at the Local, National and International Level. Clin Oncol (R Coll Radiol) 2017; 29:562-567. [DOI: 10.1016/j.clon.2017.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 07/06/2017] [Accepted: 07/07/2017] [Indexed: 10/19/2022]
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Kojic M, Milosevic M, Simic V, Koay E, Fleming J, Nizzero S, Kojic N, Ziemys A, Ferrari M. A composite smeared finite element for mass transport in capillary systems and biological tissue. Comput Methods Appl Mech Eng 2017; 324:413-437. [PMID: 29200531 PMCID: PMC5703437 DOI: 10.1016/j.cma.2017.06.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
One of the key processes in living organisms is mass transport occurring from blood vessels to tissues for supplying tissues with oxygen, nutrients, drugs, immune cells, and - in the reverse direction - transport of waste products of cell metabolism to blood vessels. The mass exchange from blood vessels to tissue and vice versa occurs through blood vessel walls. This vital process has been investigated experimentally over centuries, and also in the last decades by the use of computational methods. Due to geometrical and functional complexity and heterogeneity of capillary systems, it is however not feasible to model in silico individual capillaries (including transport through the walls and coupling to tissue) within whole organ models. Hence, there is a need for simplified and robust computational models that address mass transport in capillary-tissue systems. We here introduce a smeared modeling concept for gradient-driven mass transport and formulate a new composite smeared finite element (CSFE). The transport from capillary system is first smeared to continuous mass sources within tissue, under the assumption of uniform concentration within capillaries. Here, the fundamental relation between capillary surface area and volumetric fraction is derived as the basis for modeling transport through capillary walls. Further, we formulate the CSFE which relies on the transformation of the one-dimensional (1D) constitutive relations (for transport within capillaries) into the continuum form expressed by Darcy's and diffusion tensors. The introduced CSFE is composed of two volumetric parts - capillary and tissue domains, and has four nodal degrees of freedom (DOF): pressure and concentration for each of the two domains. The domains are coupled by connectivity elements at each node. The fictitious connectivity elements take into account the surface area of capillary walls which belongs to each node, as well as the wall material properties (permeability and partitioning). The overall FE model contains geometrical and material characteristics of the entire capillary-tissue system, with physiologically measurable parameters assigned to each FE node within the model. The smeared concept is implemented into our implicit-iterative FE scheme and into FE package PAK. The first three examples illustrate accuracy of the CSFE element, while the liver and pancreas models demonstrate robustness of the introduced methodology and its applicability to real physiological conditions.
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Affiliation(s)
- M. Kojic
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
- Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000 Belgrade, Serbia
- Corresponding author: Milos Kojic, Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030, , phone: 713 441 7355; fax: 713 441 7438
| | - M. Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - V. Simic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - E.J. Koay
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77030
| | - J.B. Fleming
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX 77030
| | - S. Nizzero
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
- Applied Physics Graduate Program, Rice University, Houston, TX 77005
| | - N. Kojic
- Center for Engineering in Medicine and Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | - A. Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
| | - M. Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030
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Grabovac I, Mustajbegovic J, Milosevic M. Are patients ready for lesbian, gay and bisexual family physicians - A Croatian study. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw173.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Tran K, Rahal R, Brundage M, Fung S, Louzado C, Milosevic M, Xu J, Bryant H. Use of low-value radiotherapy practices in Canada: an analysis of provincial cancer registry data. ACTA ACUST UNITED AC 2016; 23:351-355. [PMID: 27803600 DOI: 10.3747/co.23.3359] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND As part of Choosing Wisely Canada (a national campaign to encourage patient-provider conversations about unnecessary medical tests, treatments, and procedures), a list of ten oncology practices that could be low-value in some instances was developed. Of those practices, two were specific to radiation therapy (rt): conventional fractionation as part of breast-conserving therapy (bct) for women with early-stage breast cancer, and multifraction radiation for palliation of uncomplicated painful bone metastases. Here, we report baseline findings for the current utilization rates of those two rt practices in Canada. RESULTS The use of conventional fractionation as part of bct varied substantially from province to province. Of women 50 years of age and older, between 8.8% (Alberta) and 36.5% (Saskatchewan) received radiation in 25 fractions (excluding boost irradiation) as part of bct. The use of hypofractionated rt (that is, 16 fractions excluding boost irradiation)-a preferred approach for many patients-was more common in all 6 reporting provinces, ranging from 43.2% in Saskatchewan to 94.7% in Prince Edward Island. The use of multifraction rt for palliation of bone metastases also varied from province to province, ranging from 40.3% in British Columbia to 69.0% in Saskatchewan. The most common number of fractions delivered to bone metastases was 1, at 50.2%; the second most common numbers were 2-5 fractions, at 41.7%. CONCLUSIONS Understanding variation in the use of potentially low-value rt practices can help to inform future strategies to promote higher-value care, which balances high-quality care with the efficient use of limited system resources. Further work is needed to understand the factors contributing to the interprovincial variation observed and to develop benchmarks for the appropriate rate of use of these rt practices.
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Affiliation(s)
- K Tran
- Canadian Partnership Against Cancer, Toronto, ON
| | - R Rahal
- Canadian Partnership Against Cancer, Toronto, ON
| | - M Brundage
- Departments of Oncology and of Public Health Sciences, Queen's University, Kingston, ON
| | - S Fung
- Canadian Partnership Against Cancer, Toronto, ON
| | - C Louzado
- Canadian Partnership Against Cancer, Toronto, ON
| | - M Milosevic
- Department of Radiation Oncology, University of Toronto, and Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, ON
| | - J Xu
- Canadian Partnership Against Cancer, Toronto, ON
| | - H Bryant
- Canadian Partnership Against Cancer, Toronto, ON;; Departments of Community Health Sciences and of Oncology, University of Calgary, Calgary, AB
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Chan K, Benwell Q, Schneider K, Ang M, D'Souza D, Milosevic M, Barbera L. A Canadian Experience: Current State and Challenges of Magnetic Resonance--Guided Cervical Cancer Brachytherapy in Ontario. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1438] [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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46
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Prati S, Milosevic M, Sciutto G, Bonacini I, Kazarian S, Mazzeo R. Analyses of trace amounts of dyes with a new enhanced sensitivity FTIR spectroscopic technique: MU-ATR (metal underlayer ATR spectroscopy). Anal Chim Acta 2016; 941:67-79. [DOI: 10.1016/j.aca.2016.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 11/27/2022]
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Rodin D, Hanna T, Burger E, Zubizarreta E, Yap M, Barton M, Atun R, Knaul F, Van Dyk J, Lievens Y, Gospodarowicz M, Jaffray D, Milosevic M. Global Access to Radiation Therapy for Cervical Cancer: The Cost of Inaction. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kojic M, Milosevic M, Kojic N, Koay EJ, Fleming JB, Ferrari M, Ziemys A. Mass release curves as the constitutive curves for modeling diffusive transport within biological tissue. Comput Biol Med 2016; 92:156-167. [PMID: 29182964 DOI: 10.1016/j.compbiomed.2016.06.026] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/15/2016] [Accepted: 06/24/2016] [Indexed: 11/17/2022]
Abstract
In diffusion governed by Fick's law, the diffusion coefficient represents the phenomenological material parameter and is, in general, a constant. In certain cases of diffusion through porous media, the diffusion coefficient can be variable (i.e. non-constant) due to the complex process of solute displacements within microstructure, since these displacements depend on porosity, internal microstructural geometry, size of the transported particles, chemical nature, and physical interactions between the diffusing substance and the microstructural surroundings. In order to provide a simple and general approach of determining the diffusion coefficient for diffusion through porous media, we have introduced mass release curves as the constitutive curves of diffusion. The mass release curve for a selected direction represents cumulative mass (per surface area) passed in that direction through a small reference volume, in terms of time. We have developed a methodology, based on numerical Finite Element (FE) and Molecular Dynamics (MD) methods, to determine simple mass release curves of solutes through complex media from which we calculate the diffusion coefficient. The diffusion models take into account interactions between solute particles and microstructural surfaces, as well as hydrophobicity (partitioning). We illustrate the effectiveness of our approach on several examples of complex composite media, including an imaging-based analysis of diffusion through pancreatic cancer tissue. The presented work offers an insight into the role of mass release curves in describing diffusion through porous media in general, and further in case of complex composite media such as biological tissue.
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Affiliation(s)
- M Kojic
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030, United States; Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia; Serbian Academy of Sciences and Arts, Knez Mihailova 35, 11000 Belgrade, Serbia.
| | - M Milosevic
- Bioengineering Research and Development Center BioIRC Kragujevac, Prvoslava Stojanovica 6, 3400 Kragujevac, Serbia
| | - N Kojic
- Center for Engineering in Medicine and Surgical Services, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - E J Koay
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - J B Fleming
- Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX 77030, United States
| | - M Ferrari
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030, United States
| | - A Ziemys
- Houston Methodist Research Institute, The Department of Nanomedicine, 6670 Bertner Ave., R7-117, Houston, TX 77030, United States
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Keller H, Kueng R, Shek T, Driscoll B, Yeung I, Milosevic M, Jaffray D. WE-H-207A-06: Hypoxia Quantification in Static PET Images: The Signal in the Noise. Med Phys 2016. [DOI: 10.1118/1.4958011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Skliarenko J, Carlone M, Han K, Beiki–Ardakani A, Borg J, Croke J, Ujaimi R, Levin W, Rink A, Xie J, Fyles A, Milosevic M. PO-0960: Making MR-guided cervix cancer brachytherapy efficient: Are plan adaptation & daily planning needed? Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32210-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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