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Lam S, Lee CH, Fong CHY, Wong Y, Shiu SWM, Mak LY, Yuen MF, Lam KSL, Tan KCB. Serum Tsukushi Level Is Associated With the Severity of Liver Fibrosis Independent of Type 2 Diabetes. J Clin Endocrinol Metab 2024; 109:e1048-e1054. [PMID: 37933700 DOI: 10.1210/clinem/dgad650] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/19/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND AND AIMS Tsukushi (TSK) is a recently identified hepatokine, and we aimed to investigate the association between systemic TSK and the severity of nonalcoholic fatty liver disease (NAFLD) in subjects with and without type 2 diabetes mellitus (DM). METHODS Three hundred ninety-three DM and 289 without DM individuals were recruited for transient elastography assessment to determine liver steatosis and fibrosis. Serum TSK was measured by ELISA. The presence of NAFLD was defined as controlled attenuation parameter ≥ 248 dB/m. RESULTS NAFLD was present in 276 (70.2%) and 129 (44.6%) subjects with and without DM respectively, and they had higher serum TSK levels than those without NAFLD [DM group: 91.0 ng/mL (61.7-133.8) vs 82.5 (60.9-118.5), P < .01 respectively; without DM group: 97.1 ng/mL (69.3-148.6) vs 80.8 (53.4-111.6) respectively, P < .01]. Univariate analysis showed that serum TSK significantly correlated with the degree of steatosis and fibrosis both in subjects with and without DM. On multivariable regression analysis, only liver stiffness and estimated glomerular filtration rate were significant determinants of TSK level, and the relationship was independent of diabetes and serum adiponectin. Out of 405 subjects with NAFLD, 49 had either advanced fibrosis or cirrhosis. The area under receiver operating characteristic curve of serum TSK to indicate advanced fibrosis or cirrhosis was 0.70 (95% CI .62-.77), which was significantly better than that of fibrosis-4 index, 0.64 (95% CI .55-.72), P < .05. CONCLUSION Serum TSK levels were increased in subjects with NAFLD and reflected the severity of liver fibrosis.
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Affiliation(s)
- Sum Lam
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Chi-Ho Lee
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Carol H Y Fong
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Ying Wong
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Sammy W M Shiu
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Lung-Yi Mak
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Man-Fung Yuen
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Karen S L Lam
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
| | - Kathryn C B Tan
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China
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Kim M, Lam S, Thirunavaya Kalathil MA, Paterson A, Bowden DJ, Liau SS. A new variant of gallbladder duplication mimicking a choledochal cyst: stepwise management of an unexpected surgical finding. Ann R Coll Surg Engl 2024. [PMID: 38362748 DOI: 10.1308/rcsann.2022.0131] [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: 02/17/2024] Open
Abstract
We present a case of previously unclassified duplicated gallbladder which posed a surgical challenge intraoperatively by mimicking a choledochal cyst. An intraoperative cholangiogram was performed followed by a simple cholecystectomy. No further dissection was performed to avoid bile duct injury and complication from the unconventional anatomy. Postoperative imaging and histology, followed by the second operation confirmed findings consistent with the duplicated gallbladder. Through this case, we have demonstrated the principles of safe cholecystectomy and the importance of a staged approach in an unanticipated encounter of anatomical uncertainty, as well as the description of a new variant of duplicated gallbladder.
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Affiliation(s)
- M Kim
- Addenbrooke's Hospital, UK
| | - S Lam
- Addenbrooke's Hospital, UK
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Lam YL, Lam S, Cheung ALY, Ho WY, Kong FM, Cai J, Ren G. Exploration of AI-Assisted On-Board Perfusion Imaging Technique on Patients Undergoing Thoraxradiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e33. [PMID: 37785165 DOI: 10.1016/j.ijrobp.2023.06.719] [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) Pulmonary function of lung cancer patients can significantly change along the radiation therapy (RT) course. Scholars have synthesized lung function maps from computed tomography (CT) images. Still, there is lack of study exploring the feasibility of generating lung perfusion information from cone-beam CT (CBCT). Our study aims to fill up this gap in the body of literatures. MATERIALS/METHODS One-hundred-and-six pairs of planning CT and CBCT images of thoracic cancer patients from XX hospital were collected retrospectively. All CT images were registered to CBCT with a deformable algorithm, and referred as deformed planning CT (dCT). A 2D convolutional neural network (CNN) model built with cycle generative adversarial network (cycle-GAN) was trained to correct CBCT image artifacts and HU value discrepancies. The corrected CBCT was named enhanced CBCT (eCBCT) in this study. All CBCT, eCBCT and dCT images were then input to a pre-trained CT-to-perfusion deep learning (DL) model to synthesize perfusion images (PI), namely PICBCT, PIeCBCT and PIdCT respectively. For model training, 80 image pairs were assigned to the training set while others to the testing set. dCT and PIdCT were respectively regarded as the ground truth in two consecutive models. One extra validation case acquired with SPECT perfusion scan was collected for model performance test. Quantitative evaluation was done between the ground truth and the synthesized images. Peak signal-to-noise ratio (PSNR) and mean absolute error (MAE) were computed to assess efficacy of CBCT enhancement. Correlation (R) and Dice similarity coefficient (DSC) were used to evaluate voxel-wise and function-wise concurrence in CBCT-derived perfusion mapping. RESULTS In CBCT enhancement, [eCBCT-dCT] pairs demonstrated higher agreement than [CBCT-dCT] pairs. Quantitatively, PSNR and MAE were improved from 21.10±1.60 to 24.08±1.76, and 68.99±13.51 to 47.06±11.31 (p<0.01), respectively. For perfusion translation, higher correlation was demonstrated in both voxel-wise and function-wise evaluation within [PIeCBCT-PIdCT] than [PICBCT-PIdCT]. R correlation increased from 0.84±0.09 to 0.89±0.06 (p<0.01), whereas DSC in high-functional regions increased from 0.77±0.06 to 0.82±0.05 (p<0.01). In the validation case, strong correlation was observed between SPECT perfusion scan and PIeCBCT, with R increasing from 0.57 to 0.65 when compared to PICBCT. CONCLUSION We proposed a novel DL framework that synthesized perfusion images from fractionally acquired CBCT. Our framework met the clinical needs in providing real-time lung perfusion maps. It can be used to track the continuously changing pulmonary function status throughout the RT course using routinely scanned CBCT, without additional imaging modalities. The framework can facilitate functionally guided adaptive radiation therapy by providing immediate pulmonary function information.
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Affiliation(s)
- Y L Lam
- Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - S Lam
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - A L Y Cheung
- University of Hong Kong, Hong Kong, Hong Kong; St Paul Hospital, Hong Kong, Hong Kong, Hong Kong
| | - W Y Ho
- Department of Nuclear Medicine, Queen Mary Hospital, Hong Kong, China, Hong Kong, Hong Kong
| | - F M Kong
- The University of Hong Kong, Hong Kong, China
| | - J Cai
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - G Ren
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China
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Fonseca PAS, Lam S, Chen Y, Waters SM, Guan LL, Cánovas A. Multi-breed host rumen epithelium transcriptome and microbiome associations and their relationship with beef cattle feed efficiency. Sci Rep 2023; 13:16209. [PMID: 37758745 PMCID: PMC10533831 DOI: 10.1038/s41598-023-43097-8] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Understanding host-microbial interactions in the rumen and its influence on desirable production traits may lead to potential microbiota manipulation or genetic selection for improved cattle feed efficiency. This study investigated the host transcriptome and its correlation with the rumen archaea and bacteria differential abundance of two pure beef cattle breeds (Angus and Charolais) and one composite beef hybrid (Kinsella) divergent for residual feed intake (RFI; low-RFI vs. high-RFI). Using RNA-Sequencing of rumen tissue and 16S rRNA gene amplicon sequencing, differentially expressed genes (FDR ≤ 0.05, |log2(Fold-change) >|2) and differentially abundant (p-value < 0.05) archaea and bacteria amplicon sequence variants (ASV) were determined. Significant correlations between gene expression and ASVs (p-value < 0.05) were determine using Spearman correlation. Interesting associations with muscle contraction and the modulation of the immune system were observed for the genes correlated with bacterial ASVs. Potential functional candidate genes for feed efficiency status were identified for Angus (CCL17, CCR3, and CXCL10), Charolais (KCNK9, GGT1 and IL6), and Kinsella breed (ESR2). The results obtained here provide more insights regarding the applicability of target host and rumen microbial traits for the selection and breeding of more feed efficient beef cattle.
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Grants
- Beef Farmers of Ontario, Genome Canada and the Sustainable Beef and Forage Science Cluster funded by the Canadian Beef Cattle Check-Off, Beef Cattle Research Council (BCRC), Alberta Beef Producers, Alberta Cattle Feeders’ Association, Beef Farmers of Ontario, La Fédération des Productuers de bovins du Québec, and Agriculture and Agri-Food Canada’s Canadian Agricultural Partnership
- Ontario Ministry of Agriculture, Food, and Rural Affairs (OMAFRA), Ontario Ministry of Research and Innovation, and the Ontario Agri-Food Innovation Alliance
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Affiliation(s)
- P A S Fonseca
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - S Lam
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Y Chen
- Livestock Gentec, Department of Agriculture, Food & Nutritional Science, University of Alberta, Edmonton, AB, T6H 2P5, Canada
| | - S M Waters
- Teagasc, Animal and Bioscience Research Department, Animal and Grassland Research and Innovation Centre, Grange, Dunsany, C15 PW93, Co. Meath, Ireland
| | - L L Guan
- Livestock Gentec, Department of Agriculture, Food & Nutritional Science, University of Alberta, Edmonton, AB, T6H 2P5, Canada
| | - A Cánovas
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, N1G 2W1, Canada.
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Lam S, Lui DTW, Shiu SWM, Wong Y, Tan KCB. Effect of type 2 diabetes on the inducible degrader of LDL receptor. J Lipid Res 2023; 64:100380. [PMID: 37094639 PMCID: PMC10230263 DOI: 10.1016/j.jlr.2023.100380] [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: 06/07/2022] [Revised: 04/12/2023] [Accepted: 04/15/2023] [Indexed: 04/26/2023] Open
Abstract
The inducible degrader of LDL receptor (IDOL) acts as a post-transcriptional degrader of the LDL receptor (LDLR). IDOL is functionally active in the liver and in peripheral tissues. We have evaluated IDOL expression in circulating monocytes in subjects with and without type 2 diabetes and determined whether changes in IDOL expression could affect macrophage function like cytokine production in vitro. One hundred forty individuals with type 2 diabetes and 110 healthy control subjects were recruited. Cellular expression of IDOL and LDLR in peripheral blood CD14+ monocytes was measured by flow cytometry. The expression of intracellular IDOL was lower in individuals with diabetes than control (21.3 ± 4.6 mean fluorescence intensity × 1,000 vs. 23.8 ± 6.2, P < 0.01), and this was accompanied by an increase in cell surface LDLR (5.2 ± 3.0 mean fluorescence intensity × 1,000 vs. 4.3 ± 1.5, P < 0.01), LDL binding, and intracellular lipid (P < 0.01). IDOL expression correlated with HbA1c (r = -0.38, P < 0.01) and serum fibroblast growth factor-21 (FGF21) (r = -0.34, P < 0.01). Multivariable regression analysis, including age, sex, BMI, smoking, HbA1c, and log(FGF21), showed that HbA1c and FGF21 were significant independent determinants of IDOL expression. IDOL knockdown human monocyte-derived macrophages produced higher concentrations of interleukin 1 beta, interleukin 6, and TNFα than control macrophages upon stimulation with lipopolysaccharide (all P < 0.01). In conclusion, the expression of IDOL in CD14+ monocytes was decreased in type 2 diabetes and was associated with glycemia and serum FGF21 concentration.
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Affiliation(s)
- Sum Lam
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - David Tak Wai Lui
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Ying Wong
- Department of Medicine, The University of Hong Kong, Hong Kong, China
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Arkle T, Lam S, Toogood G, Kumar B. How should we secure the cystic duct during laparoscopic cholecystectomy? A UK-wide survey of clinical practice and systematic review of the literature with meta-analysis. Ann R Coll Surg Engl 2022; 104:650-654. [PMID: 35196149 PMCID: PMC9685994 DOI: 10.1308/rcsann.2021.0264] [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] [Accepted: 07/30/2021] [Indexed: 11/03/2023] Open
Abstract
INTRODUCTION It is currently unknown which method of cystic duct closure is most effective at reducing the risk of bile leak after laparoscopic cholecystectomy. The aims of this work were to determine the most common closure methods used in the UK and review available evidence on which method has the lowest risk of bile leak. METHODS We conducted an online survey through the Association of Upper Gastrointestinal Surgeons (AUGIS). We also undertook a systematic review using PubMed, EMBASE, MEDLINE and the Cochrane Library for studies that compared different methods for cystic duct occlusion and reported postoperative bile leak. FINDINGS There was significant variation in practice between consultant surgeons. For routine laparoscopic cholecystectomy metal clips were used most (64%) followed by locking polymer clips (33%) and suture ties (3%). In cases of a dilated cystic duct, preferences were locking polymer clips (60%), suture ties (30%) and metal clips (5%). We included six studies in our review with a total of 8,011 patients. Metal clips were associated with an increased odds of bile leak compared with locking polymer clips (OR 5.66, 95% CI 1.13-28.41, p=0.04) or suture ties (OR 4.17, 95% CI 0.72-24.31, p=0.12). Most studies were retrospective, unlikely to be adequately powered, and vulnerable to selection bias. CONCLUSIONS Limited available evidence suggests that metal clips have the highest risk of bile leak, but results are not strong enough to recommend a change in current clinical practice. A trial is now required to determine the best method of cystic duct closure.
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Affiliation(s)
| | | | - G Toogood
- Leeds Teaching Hospital NHS Trust, UK
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Mak J, Gangi A, Chan N, Vittay O, Ashok A, Rogers P, Jehanli L, Dhas K, Wong J, Lam S, Hall-Craggs M. How can the Radiology Academic Network for Trainees (RADIANT) reshape the future of radiology research? A follow-up survey at the RADIANT Annual Meeting 2022. Clin Radiol 2022; 77:e835-e838. [DOI: 10.1016/j.crad.2022.09.116] [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: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 11/03/2022]
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8
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Cavic M, Kerpel-Fronius A, Viola L, Ventura L, Jiang L, Sales dos Santos R, Yang D, Koegelenberg C, Zulueta J, Henschke C, Kazerooni E, Tammemägi M, Field J, Wynes M, Balata H, Yankelevitz D, Sozzi G, Lam S, Huber R. P1.02-02 Current Status, Challenges and Perspectives of Lung Cancer Screening in Low- and Middle-Income Countries. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.163] [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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Yuan R, Silver A, Ye M, Ho C, Zhang J, Wang Y, Wu L, Martin M, Lam S, MacAulay C, Melosky B. EP08.01-075 Combination of Baseline Disease and Smoking Pack-Years Can Guide The 1st-line Treatment Decision in Advanced NSCLC with High PD-L1 Expression. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.647] [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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Avila R, Krishnan K, Wynes M, Connolly C, McWilliams A, Logan J, Henschke C, Yankelevitz D, Pastorino U, Santos R, Hochhegger B, Ashizawa K, Kobayashi T, Rzyman W, Jelitto-Gorska M, Field J, Mulshine J, Lam S. EP01.04-005 Quantitative Characteristics in Global CT Lung Cancer Screening Populations Using the ELIC Distributed Database and Computation Environment. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.300] [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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Avila R, Krishnan K, Wynes M, Connolly C, McWilliams A, Logan J, Henschke C, Yankelevitz D, Pastorino U, Santos R, Hochhegger B, Ashizawa K, Kobayashi T, Rzyman W, Jelitto-Gorska M, Field J, Mulshine J, Lam S. MA11.07 The ELIC Distributed Database and Computation Environment for Analyses of Lung Cancer Screening LDCTs Across the World. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.140] [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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Yuan R, Mayo J, Myers R, Atkar-Khattra S, Yee J, English J, Chen D, Lam S. MA11.08 Value of Computer Aided Diagnosis on Radiologists’ Workflow and Recommendation for Reporting Lung Cancer Screening LDCT. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.141] [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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Yuan R, Jazen I, Ho C, Melosky B, Li J, Lam S, MacAulay C. P2.09-03 A Radiomics Approach Using Baseline CT Can Predict Response to 1st-Line Pembrolizumab in Advanced NSCLC with High PD-L1. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Meyers R, Wilson D, Yee J, McGuire A, Atkar-Khattra S, Ye Q, Mayo J, Rosell A, Lisbona RL, Lam S. EP01.07-004 FDG-PET-CT for Staging Screen Detected Lung Cancer. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.325] [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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Gopaul S, Lam S. 680 An Incidental Finding of Pneumatosis of the Colon in a Patient with Mesothelioma Being Treated with Nivolumab. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.148] [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: 11/07/2022]
Abstract
Abstract
A 75-year-old woman attended a large academic teaching hospital for a computed tomography (CT) of the chest for a T3 N0 M0 epithelioid mesothelioma of the right pleura (to assess treatment response). The malignancy was diagnosed one year previously, and the patient was being treated with second line immunotherapy, Nivolumab (a human immunoglobulin G4 monoclonal antibody) with palliative intent. To date, the patient was showing a partial response to this treatment.
The CT chest incidentally showed locules of gas under the right diaphragm and therefore an urgent CT of the abdomen and pelvis was performed. This scan re-demonstrated a small pneumoperitoneum, but also an incidental finding of pneumatosis involving the hepatic flexure. Prior to Nivolumab treatment, there were no abnormalities noted on the most recent abdominal CT scan.
The patient was admitted to hospital as an emergency under the care of oncology. The patient was entirely asymptomatic with a soft, non-tender abdomen, with both a normal diet and bowel function. Observations including heart rate, temperature, blood pressure and respiratory rate were within normal limits. Blood testing showed a C-reactive protein of 86 mg/L and white cell count of 4.8 10^9. Based on the radiological findings, intravenous fluids and antibiotics were commenced and the patient was restricted to nil intake orally. A surgical review was also requested. Based on surgical advice, the patient was treated conservatively, and was discharged home without complication and no surgical follow up.
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Affiliation(s)
- S Gopaul
- Norfolk and Norwich University Hospitals NHS Foundation Trust , Norwich , United Kingdom
| | - S Lam
- Norfolk and Norwich University Hospitals NHS Foundation Trust , Norwich , United Kingdom
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Lam S, Kumar B, Dhatariya K. Screening for diabetes peri-operatively: a reply. Anaesthesia 2022; 77:1180. [PMID: 35864723 DOI: 10.1111/anae.15805] [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] [Accepted: 06/25/2022] [Indexed: 11/01/2022]
Affiliation(s)
- S Lam
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - B Kumar
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Dhatariya
- Norwich Medical School, University of East Anglia, Norwich, UK
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Lam S. Comorbidities as mediator or confounder for the association between glycated haemoglobin and postoperative complications: a reply. Anaesthesia 2022; 77:1178. [PMID: 35737467 DOI: 10.1111/anae.15791] [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] [Accepted: 06/07/2022] [Indexed: 11/29/2022]
Affiliation(s)
- S Lam
- University of East Anglia Norwich Medical School, Norwich, UK
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Chou W, Lam S, Kumar B. 'Clinical frailty is a risk factor of adverse outcomes in patients with esophageal cancer undergoing esophagectomy: analysis of 2011-2017 US hospitals'. Dis Esophagus 2022; 35:6547571. [PMID: 35279719 DOI: 10.1093/dote/doac013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 02/22/2022] [Indexed: 12/11/2022]
Affiliation(s)
- W Chou
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - S Lam
- Norwich Medical School, University of East Anglia, Norwich, UK
- Department of Oesophagogastric Surgery, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
| | - B Kumar
- Norwich Medical School, University of East Anglia, Norwich, UK
- Department of Oesophagogastric Surgery, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK
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Lam S, Shiu SW, Wong Y, Tan KC. Effect of type 2 diabetes on A disintegrin and metalloprotease 10. J Diabetes 2022; 14:394-400. [PMID: 35705192 PMCID: PMC9366558 DOI: 10.1111/1753-0407.13287] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/29/2022] [Accepted: 05/18/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND As a type 1 transmembrane protein, a disintegrin and metalloprotease 10 (ADAM10) is responsible for the cleavage of a variety of cell surface molecules and has been implicated in the pathogenesis of Alzheimer disease, atherosclerosis, and inflammatory and neoplastic disorders. It has been suggested that systemic ADAM10 concentration may potentially be used as a prognostic biomarker. Since high glucose can upregulate ADAM10 expression in vitro, we investigated whether serum levels of ADAM10 and its substrate, the lectin-like oxidized low-density lipoprotein receptor 1 (LOX-1), can be influenced by type 2 diabetes. METHODS A total of 1091 individuals with type 2 diabetes and 358 age-matched healthy control subjects were recruited. Serum concentrations of ADAM10 and the soluble form of LOX-1 (sLOX-1) released by cleavage of LOX-1 by ADAM were measured by enzyme-linked immunosorbent assay kits (ELISA). RESULTS Serum ADAM10 was increased in subjects with diabetes compared with control (40.5 ng/mL [22.3-65.7] vs 10.3 ng/mL [7.0-17.9], respectively; P < .01); the highest levels were seen in insulin-treated subjects. On multiple linear regression analysis, glycosylated hemoglobin, age, body mass index, and insulin use were independent determinants of ADAM10 level. The increase in serum ADAM10 levels in diabetes was accompanied by changes in serum sLOX-1. Subjects with diabetes had higher serum sLOX-1 than the control (110 pg/mL [89-153] vs 104 pg/mL [85-138], respectively; P < .01), and there was a significant correlation between serum ADAM10 and sLOX-1 (r = 0.26, P < .01). CONCLUSIONS Serum concentration of ADAM10 is increased in type 2 diabetes and is associated with glycemia and insulin therapy, which may potentially affect the specificity of systemic ADAM10 level as a biomarker.
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Affiliation(s)
- Sum Lam
- Department of MedicineUniversity of Hong KongHong Kong SARChina
| | | | - Ying Wong
- Department of MedicineUniversity of Hong KongHong Kong SARChina
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Lam S, Kumar B, Loke YK, Orme SE, Dhatariya K. Glycated haemoglobin and the risk of postoperative complications in people without diabetes: a prospective population-based study in UK Biobank. Anaesthesia 2022; 77:659-667. [PMID: 35238399 PMCID: PMC9314702 DOI: 10.1111/anae.15684] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 12/13/2022]
Abstract
Summary The aim of our study was to clarify the association between glycated haemoglobin (HbA1c) and postoperative outcomes in people without an existing diagnosis of diabetes. Half a million adults were recruited into the UK Biobank prospective cohort study between March 2006 and October 2010. We divided participants into three groups: no diagnosis of diabetes and HbA1c < 42 mmol.mol−1; no diagnosis of diabetes and elevated HbA1c (≥ 42 mmol.mol−1 with no upper limit); and prevalent diabetes (regardless of HbA1c concentration) at recruitment. We followed up participants by linkage with routinely collected hospital data to determine any surgical procedures undertaken after recruitment and the associated postoperative outcomes. Our main outcome measure was a composite primary outcome of 30‐day major postoperative complications and 90‐day all‐cause mortality. We used logistic regression to estimate the odds of the primary outcome by group. We limited analyses to those who underwent surgery within one year of recruitment (n = 26,653). In a combined effects logistic regression model, participants not known to have diabetes with HbA1c ≥ 42 mmol.mol−1 had increased odds of the primary outcome (OR [95% CI] 1.43 [1.02–2.02]; p = 0.04), when compared with those without diabetes and HbA1c < 42 mmol.mol−1. This effect was attenuated and no longer statistically significant in a direct effects model with adjustment for hyperglycaemia‐related comorbidity (OR [95% CI] 1.37 [0.97–1.93]; p = 0.07). Elevated pre‐operative HbA1c in people without diabetes may be associated with an increased risk of complications, but the association is likely confounded by end‐organ comorbidity. In contrast to previous evidence, our findings suggest that to prevent adverse postoperative outcomes, optimisation of pre‐existing morbidity should take precedence over reducing HbA1c in people without diabetes.
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Affiliation(s)
- S Lam
- Norwich Medical School, University of East Anglia, Norwich, UK.,Department of General Surgery, Norfolk and Norwich University Hospital NHS Trust, UK
| | - B Kumar
- Norwich Medical School, University of East Anglia, Norwich, UK.,Department of Upper Gastrointestinal Surgery, Norfolk and Norwich University Hospital NHS Trust, UK
| | - Y K Loke
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - S E Orme
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Dhatariya
- Norwich Medical School, University of East Anglia, Norwich, UK.,Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospital NHS Trust, UK
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Lam S, Poon-King A, Hill S, Tilsley O. Improving Palliative Radiotherapy Training: A Multi-professional, Combined Clinical and Training Improvement Project. Clin Oncol (R Coll Radiol) 2022. [DOI: 10.1016/j.clon.2022.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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22
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Tammemagi M, Myers R, Ruparel M, Tremblay A, Atkar-Khattra S, Marshall H, Brims F, Mcwilliams A, Fogarty P, Stone E, Manser R, Canfell K, Lim K, Rosell A, Weber M, Yee J, Mayo J, Berg C, Lam D, Janes S, Fong K, Lam S. OA19.01 Prospective Study of Lung Cancer Screening Criteria: USPSTF2013 vs PLCOm2012 – International Lung Screening Trial (ILST) Results. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.097] [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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Janzen I, Abraham R, Seyyedi S, Ho C, Melosky B, Martin M, Lam S, Yuan R, Macaulay C. P57.04 Predicting Treatment Response to 1st- line Pembrolizumab in Advanced Non-Small Cell Lung Cancer (NSCLC) Patients with High PDL1 Expression. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.576] [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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Myers R, Mayo J, Atkar-Khattra S, Yuan R, Yee J, English J, Mcguire A, Grant K, Dewar L, Tammemagi M, Lam S. MA10.01 Prospective Evaluation of the International Lung Screening Trial (ILST) Protocol for Management of First Screening LDCT. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.158] [Citation(s) in RCA: 1] [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: 10/20/2022]
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Xu Y, Mandal I, Lam S, Troumpoukis N, Uberoi R, Sabharwal T, Makris GC. Impact of the COVID-19 pandemic on interventional radiology services across the world. Clin Radiol 2021; 76:621-625. [PMID: 34090708 PMCID: PMC8133525 DOI: 10.1016/j.crad.2021.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/05/2021] [Indexed: 12/14/2022]
Abstract
AIM To review data on the impact of the COVID-19 pandemic on interventional radiology (IR) services. MATERIALS AND METHODS A systematic review of the available studies was performed according to the PRISMA guidelines. RESULTS A total of 14 studies met the inclusion criteria. IR caseload reduced between 16.8-80%, with elective activity affected more than emergency work. Trainees also experienced a 11-51.9% reduction in case volumes and many were redeployed to critical care. IR departments re-organised operations and personnel, and many continued to offer 24/7 services and support critical care areas through redeployment of staff. The majority of studies report no significant issues with the availability of personal protective equipment and that local or national governing body or radiology society guidelines were followed. CONCLUSION The COVID-19 pandemic reduced case volumes and training opportunities. IR departments showed flexibility in service delivery. The lessons learned offer novel insights into how services and training can be reorganised to ensure that IR continues to thrive.
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Affiliation(s)
- Y Xu
- Department of Radiology, Imperial College Healthcare NHS Trust, Paddington, London, W2 1NY, UK
| | - I Mandal
- Department of Radiology, Royal Berkshire Hospital, Reading, RG1 5AN, UK; UK National Interventional Radiology Trainee Research (UNITE) Collaborative, St Thomas Hospital, SE1 7EH, UK
| | - S Lam
- UK National Interventional Radiology Trainee Research (UNITE) Collaborative, St Thomas Hospital, SE1 7EH, UK; Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AD, UK
| | - N Troumpoukis
- Alfa Institute of Biomedical Sciences, Neapoleos 9, Marousi, Athens, Greece; Radiology Department, University Hospital of Lewisham, London, SE13 6LH, UK
| | - R Uberoi
- Department of Interventional Radiology, Oxford University Hospitals, NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - T Sabharwal
- Department of Interventional Radiology, Guys & St Thomas NHS Foundation Trust, London, SE1 9RS, UK
| | - G C Makris
- UK National Interventional Radiology Trainee Research (UNITE) Collaborative, St Thomas Hospital, SE1 7EH, UK; Alfa Institute of Biomedical Sciences, Neapoleos 9, Marousi, Athens, Greece; Radiology Department, University Hospital of Lewisham, London, SE13 6LH, UK; Department of Interventional Radiology, Guys & St Thomas NHS Foundation Trust, London, SE1 9RS, UK.
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Pinkhasov AM, Collantes CMC, Chen M, Fazzari MJ, Coriolan S, Lam S. Effect of Low Dose Haloperidol and Quetiapine on QTc Interval in Hospitalized Elderly Patients With Delirium. J Pharm Pract 2021; 34:675-677. [PMID: 34159827 DOI: 10.1177/08971900211025148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Aaron M Pinkhasov
- Department of Behavioral Health, 12297NYU Langone Hospital, Long Island-NYU Long Island School of Medicine, Mineola, NY, USA
| | - Cyril Manuel C Collantes
- Department of Pharmacy, Outpatient Mental Health, Newington 19913VA Clinic-VA Connecticut Healthcare System, Newington, CT, USA
| | - Mandy Chen
- Pharmacy Practice, 44254Arnold and Marie Schwartz College of Pharmacy, Brooklyn, NY, USA
| | - Melissa J Fazzari
- Division of Biostatistics, Department of Epidemiology and Population Health, 2006Albert Einstein College of Medicine, Bronx, NY, USA
| | - Shanice Coriolan
- Department of Pharmacy, 12297NYU Langone Hospital,Long Island, Mineola, NY, USA
| | - Sum Lam
- Department of Clinical Health Professions, 4131St. John's University, Queens, NY, USA
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Lam S, Soladoye O, Prieto N, Uttaro B, Aalhus J, Larsen I, Shand P, Gariépy C, Juárez M. Performance of near-infrared spectroscopy in pork shoulder as a predictor for pork belly softness. Can J Anim Sci 2021. [DOI: 10.1139/cjas-2020-0049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pork belly quality indicators are economically relevant in the pork industry. Near-infrared (NIR) spectroscopy of the pork shoulder outer subcutaneous fat layer, belly flop angle, and subjective softness scores of the pork belly were measured (N = 144) to determine the accuracy of pork shoulder NIR spectroscopy as a predictor of pork belly softness. The NIR spectra hot carcass estimates explained over 80.0% variability in pork belly softness (80.5%–90.8%), with low prediction error, suggesting that NIR spectroscopy measured in the pork shoulder is an efficient and accurate indicator of pork belly softness to classify pork bellies for specific market demands.
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Affiliation(s)
- S. Lam
- Agriculture and Agri-Food Canada, Lacombe, AB T4L 1W1, Canada
| | - O.P. Soladoye
- Alberta Ministry of Agriculture and Forestry, Leduc, AB T9E 7C5, Canada
| | - N. Prieto
- Agriculture and Agri-Food Canada, Lacombe, AB T4L 1W1, Canada
| | - B. Uttaro
- Agriculture and Agri-Food Canada, Lacombe, AB T4L 1W1, Canada
| | - J.L. Aalhus
- Agriculture and Agri-Food Canada, Lacombe, AB T4L 1W1, Canada
| | - I. Larsen
- Agriculture and Agri-Food Canada, Lacombe, AB T4L 1W1, Canada
| | - P. Shand
- University of Saskatchewan, Saskatoon, SK S7N 5A8, Canada
| | - C. Gariépy
- Agriculture and Agri-Food Canada, Saint-Hyacinthe, QC J2S 8E3, Canada
| | - M. Juárez
- Agriculture and Agri-Food Canada, Lacombe, AB T4L 1W1, Canada
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Resasco A, MacLellan A, Ayala MA, Kitchenham L, Edwards AM, Lam S, Dejardin S, Mason G. Cancer blues? A promising judgment bias task indicates pessimism in nude mice with tumors. Physiol Behav 2021; 238:113465. [PMID: 34029586 DOI: 10.1016/j.physbeh.2021.113465] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 02/06/2023]
Abstract
In humans, affective states can bias responses to ambiguous information: a phenomenon termed judgment bias (JB). Judgment biases have great potential for assessing affective states in animals, in both animal welfare and biomedical research. New animal JB tasks require construct validation, but for laboratory mice (Mus musculus), the most common research vertebrate, a valid JB task has proved elusive. Here (Experiment 1), we demonstrate construct validity for a novel mouse JB test: an olfactory Go/Go task in which subjects dig for high- or low-value food rewards. In C57BL/6 and Balb/c mice faced with ambiguous cues, latencies to dig were sensitive to high/low welfare housing: environmentally-enriched animals responded with relative 'optimism' through shorter latencies. Illustrating the versatility of this validated JB task across different fields of research, it further allowed us to test hypotheses about the mood-altering effects of cancer in male and female nude mice (Experiment 2). Males, although not females, treated ambiguous cues as intermediate; and males bearing subcutaneous lung adenocarcinomas also responded more pessimistically to these than did healthy controls. To our knowledge, this is the first evidence of a valid mouse JB task, and the first demonstration of pessimism in tumor-bearing animals. This task still needs to be refined to improve its sensitivity. However, it has great potential for investigating mouse welfare, the links between affective state and disease, depression-like states in animals, and hypotheses regarding the neurobiological mechanisms that underlie affect-mediated biases in judgment.
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Affiliation(s)
- A Resasco
- Institute of Cell Biology and Neurosciences, National Scientific and Technical Research Council-University of Buenos Aires, Autonomous City of Buenos Aires, Argentina; Laboratory of Experimental Animals, Faculty of Veterinary Sciences, National University of La Plata, La Plata, Argentina
| | - A MacLellan
- Department of Integrative Biology, University of Guelph, Guelph, Canada
| | - M A Ayala
- Laboratory of Experimental Animals, Faculty of Veterinary Sciences, National University of La Plata, La Plata, Argentina
| | - L Kitchenham
- Department of Integrative Biology, University of Guelph, Guelph, Canada
| | - A M Edwards
- Ontario Agricultural College, University of Guelph, Guelph, Canada
| | - S Lam
- Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - S Dejardin
- Formerly Department of Animal Biosciences, University of Guelph, Guelph, Canada
| | - G Mason
- Department of Integrative Biology, University of Guelph, Guelph, Canada.
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Cressman S, Tammemagi M, Myers R, Yee J, English J, Mayo J, Atkar-Khattra S, Yuan R, Fernandes A, Lam S. FP09.01 Economic Impact of Screening Selection with the PLCOm2012 Risk Model Versus USPSTF-Guidelines in the International Lung Screening Trial (ILST). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.118] [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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Li J, Zhang J, Ho C, Myers R, Mar C, Martin M, Melosky B, Lam S, Yuan R. P06.03 Regression of the Ground Glass Component in Patients with Multifocal Primary Lung Cancers Receiving Pembrolizumab. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.410] [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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Abstract
Diabetes mellitus (DM) is a complex and chronic condition that requires continuous medical care. Uncontrolled hyperglycemia can lead to serious microvascular and macrovascular complications, such as coronary artery disease, peripheral arterial disease, and stroke. Type 2 DM occurs when the pancreas is unable to produce adequate insulin to regulate glucose levels and when there is a decrease in sensitivity to insulin in the body. Insufficient glucagon-like peptide (GLP-1), a normal body hormone, plays an important role in the pathophysiology of DM. The introduction of the GLP-1 receptor agonists expanded therapeutic options in achieving glycemic control in adult patients. In 2005, the US Food and Drug Administration approved exenatide as the first injectable formulation, which led to the advancement of other injectable formulations within the class of GLP-1 receptor agonists. In 2019, semaglutide was approved as the first oral GLP-1 receptor agonist addressing the unmet needs in patients who benefit from therapy with this therapeutic class yet are unwilling to use an injectable drug. This article will provide an overview of the GLP-1 receptor agonists, including the pharmacology of semaglutide, its clinical evidence and role in therapy in type 2 DM.
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Affiliation(s)
- Mabel Chan
- From the Department of Pharmacy, NYU Winthrop Hospital, Mineola, NY
| | - Alexis Dimitriou
- From the Department of Pharmacy, NYU Winthrop Hospital, Mineola, NY
| | - Sum Lam
- Department of Clinical Health Professions, College of Pharmacy and Health Sciences, St John's University, Queens, NY; and
- Divisions of Geriatric Medicine & Pharmacy, NYU Winthrop Hospital, Mineola, NY
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Nazir MS, Yazdani M, Draper JANE, Franks R, Lam S, Plein S, Kapetanakis S, Young A, Chiribiri A. The strain-7 study: multimodal, multivendor, multifield strength, scan:rescan comparison of global longitudinal and circumferential strain in healthy volunteers. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.359] [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] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): National Insitute for Health Research
Background
There is clinical and prognostic evidence for global longitudinal strain (GLS) and circumferential strain (GCS). A range of techniques exist: 2-dimensional echocardiography (2Decho), 3-dimensional echocardiography (3Decho) and Cardiovascular Magnetic Resonance (CMR).
Purpose
To investigate inter-study repeatability and inter-method comparison of GLS and GCS techniques.
Methods
Volunteers underwent same day scan
rescan 2Decho, 3Decho, 1.5T Siemens CMR (Cine imaging and Displacement encoding with stimulated echoes [DENSE]), 3T Siemens CMR (Cine Imaging and DENSE) and 3T Philips CMR (Tagging and Fast strain-encoding [fSENC]) imaging. Strain was quantified for 2Decho (EchoPAC), 3Decho (TomTec), Feature tracking (FT) for cine imaging (CircleCVI), CIM (University of Auckland) for DENSE and Tag, and Myostrain (Myocardial solutions) for fSENC.
Results
20(6F) volunteers, mean age 33 ± 7 years, mean LVEF 62 ± 4%. All GLS and GCS methods had excellent inter-study agreement (ICC > 0.75) with coefficient of variation (CoV) between 4-8% (Table 1). Median and IQR are presented in Figure 1.
Friedman’s test revealed statistically significant inter-method differences for GLS (χ2 = 66.4,p < 0.0001) and GCS (χ2 = 50.9,p < 0.0001). Post hoc analysis using Dunn’s test with Bonferroni correction demonstrated significant differences:
-GLS: 2Decho vs DENSE 1.5T (p = 0.001) and Myostrain 3T (p = 0.0116); 3Decho vs FT 3T (p = 0.049) and DENSE 1.5T (p < 0.0001); FT 1.5T vs DENSE 1.5T (p = 0.001) and Myostrain 3T (p = 0.01); FT 3T vs Myostrain 3T (p < 0.0001); DENSE 1.5T vs Tag 3T (p = 0.0008) and Myostrain 3T (p < 0.0001); Tag 3T vs Myostrain (p = 0.02).
-GCS: 3Decho vs DENSE 1.5T (P = 0.0005), FT 1.5T (p < 0.001), FT 3T (P < 0.001) and Myostrain (p = 0.003); FT 1.5T vs Tag 3T (p = 0.001), FT 3T vs Myostrain 3T (p = 0.04).
Conclusion
There is excellent interstudy agreement for GLS and GCS methods. However, there are important inter-method differences in absolute values, that need to be considered for clinical application as a surveillance method and longitudinal studies.
Table 1 Acquisiton Post processing GLS CoV(%) GLS ICC GCS CoV(%) GCS ICC 2DEcho EchoPAC 4.88 0.80 - - 3DEcho TomTec 4.77 0.86 3.97 0.85 Siemens 1.5T cine FT CircleCVI 8.30 0.79 6.00 0.85 Siemens 3T cine FT CircleCVI 6.21 0.89 4.76 0.94 Philips 3T Tag CIM 6.15 0.89 5.86 0.88 Siemens 1.5T DENSE CIM 4.36 0.90 4.65 0.89 Philips 3T fSENC Myostrain 8.45 0.81 4.06 0.90 Interstudy agreement for the different GLS and GCS methods. Abstract Figure 1
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Affiliation(s)
- MS Nazir
- King"s College London, London, United Kingdom of Great Britain & Northern Ireland
| | - M Yazdani
- King"s College London, London, United Kingdom of Great Britain & Northern Ireland
| | - JANE Draper
- Guys and St Thomas Hospital, Department of Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - R Franks
- Kings College London, Biomedical Engineering and Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
| | - S Lam
- Kings College London, Biomedical Engineering and Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
| | - S Plein
- Kings College London, Biomedical Engineering and Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
| | - S Kapetanakis
- Guys and St Thomas Hospital, Department of Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - A Young
- Kings College London, Biomedical Engineering and Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
| | - A Chiribiri
- Kings College London, Biomedical Engineering and Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
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Lam S, Nazir MS, Campbell B, Yazdani M, Carr-White G, Plein S, Rinaldi A, Chiribiri A. Left ventricular ejection fraction as an imaging biomarker to guide cardiac resynchronisation therapy in heart failure patients: a multimodal comparison of 2D and 3D echocardiography and CMR. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.358] [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] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): The authors acknowledge financial support from the Department of Health through the National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre award to Guy’s & St Thomas’ NHS Foundation Trust in partnership with King’s College London and King’s College Hospital NHS Foundation Trust and by the NIHR MedTech Co-operative for Cardiovascular Disease at Guy’s and St Thomas’ NHS Foundation Trust. This work was supported by the Wellcome/EPSRC Centre for Medical Engineering [WT 203148/Z/16/Z]. MSN was funded by a clinical lectureship awarded by the NIHR. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, the DoH, EPSRC, MRC or the Wellcome Trust.
Introduction – Imaging derived left ventricular ejection fraction (LVEF) has an important role to guide initiation of medical therapy and device insertion in patients with heart failure and reduced ejection fraction (HFrEF). Previous studies have reported the correlation and agreement of LVEF in various patient populations, but sparse evidence exists on patients with heart failure referred for Cardiac Resynchronisation Therapy (CRT) using 2D and 3D echocardiography (2DE & 3DE) and cardiovascular magnetic resonance (CMR).
Objectives – To determine the correlation and agreement of LVEF as determined by 2DE, 3DE and CMR in a cohort of HF patients referred for assessment of CRT.
Methods – Patients with suspected HFrEF referred for assessment for CRT therapy were included in this single centre study. Patients underwent 2DE, 3DE and CMR to derive LVEF, LVESV and LVEDV. Correlation was determined with Pearson’s correlation, agreement with Bland-Altman analysis and Cohen’s kappa analysis for agreement using a dichotomous cut off of LVEF ≤35% as a threshold for CRT insertion (Ponikowski, 2016).
Results - 55 patients (mean age 71 ± 9.2, 76% male) were included. The mean LVEF for 2DE, 3DE, CMR and were 32.4 ± 8.6, 32.1 ± 9.6 and 30.3 ± 9.5 respectively. CMR had a significantly lower LVEF compared to 2DE (p = 0.03).
There was good correlation between 3DE & CMR and 2DE & CMR, and excellent correlation between 3DE and 2DE for LVEF (Table 1). There was for trend for CMR to underestimate LVEF compared to 2DE and 3DE, with small biases although wide limits of agreement (Figure 1). There was excellent correlation of LVEDV and LVESV across all 3 techniques. CMR underestimated volumes compared to 2DE and 3DE with large biases and wide LOA.
The kappa coefficient agreement at threshold level for CRT insertion (LVEF ≤35%) was fair for 3DE and CMR (0.379, p = 0.004) and 2DE and CMR (0.462, p = 0.001), and moderate for 3DE and 2DE (0.575, p ≤ 0.001).
Conclusion – Whilst LVEF is not the only indicator to guide CRT insertion, it remains an important imaging parameter for clinical decision making. We observed large biases in left ventricular volumes between 2D, 3D and CMR. However, whilst the overall bias in LVEF is small, the wide limits of agreement (LOA) observed may represent an area of clinical uncertainty, which may impact on the dichotomous imaging threshold for CRT insertion.
Comparison of indices between modalities LVEF Correlation (r) LVEF Bias & LOA (%±SD) EDV Correlation (r) EDV Bias & LOA (mL ± SD) ESV Correlation (r) ESV Bias & LOA (mL ± SD) 3DE vs CMR 0.676 (p < 0.001) +1.75 ± 15.4 0.896 (p < 0.001) -82.16 ± 42.8 0.937 (p < 0.001) -61.3 ± 34.9 3DE vs 2DE 0.872 (p < 0.001) +0.48 ± 4.5 0.909 (p < 0.001) -10.31 ± 28.3 0.936 (p < 0.001) -8.42 ± 20.5 2DE vs CMR 0.675 (p < 0.001) +2.35 ± 14.6 0.876 (p < 0.001) -67.35 ± 36.3 0.898 (p < 0.001) -51.42 ± 30.1 Abstract Figure. Bland-Altman Plot LVEF by 3DE & CMR
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Affiliation(s)
- S Lam
- King"s College London, School of Biomedical Engineering & Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
| | - MS Nazir
- King"s College London, School of Biomedical Engineering & Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
| | - B Campbell
- Guy"s & St Thomas" NHS Foundation Trust, Department of Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - M Yazdani
- King"s College London, School of Biomedical Engineering & Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
| | - G Carr-White
- Guy"s & St Thomas" NHS Foundation Trust, Department of Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - S Plein
- King"s College London, School of Biomedical Engineering & Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
| | - A Rinaldi
- Guy"s & St Thomas" NHS Foundation Trust, Department of Cardiology, London, United Kingdom of Great Britain & Northern Ireland
| | - A Chiribiri
- King"s College London, School of Biomedical Engineering & Imaging Sciences, London, United Kingdom of Great Britain & Northern Ireland
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Cozart JS, Strober L, Ruppen S, Bradish T, Belcher C, Louthan T, Lam S, Thelen J, Bruce JM. A quick assessment of reliable change in fatigue: Reliable change indices of the modified fatigue impact scale - 5 item (MFIS-5). Mult Scler Relat Disord 2021; 49:102743. [PMID: 33486399 DOI: 10.1016/j.msard.2021.102743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/11/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Reliably monitoring changes in fatigue is an ongoing concern. OBJECTIVE Evaluate reliable change using the Modified Fatigue Impact Scale 5-item version (MFIS-5) in people with MS (PwMS). METHODS The MFIS-5 was administered at three time points in 157 PwMS. Test-retest reliability and reliable change scores were calculated at the 0.70, 0.80, 0.90, and 0.95 confidence intervals. RESULTS Difference scores of 3, 4, 5, and 6 represent statistically meaningful change at the 0.70, 0.80, 0.90, and 0.95 confidence intervals, respectively. CONCLUSION Cut points derived from this study and prior work can help reliably assess changes in fatigue over time.
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Affiliation(s)
- J S Cozart
- University of Missouri-Kansas City, Department of Psychology, Kansas City, MO, USA; University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA
| | - L Strober
- Kessler Foundation, West Orange, NJ, USA; Rutgers, the State University of New Jersey, New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, NJ, USA
| | - S Ruppen
- University of Missouri-Kansas City, Department of Psychology, Kansas City, MO, USA; University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA
| | - T Bradish
- University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA
| | - C Belcher
- University of Missouri-Kansas City, Department of Psychology, Kansas City, MO, USA
| | - T Louthan
- University of Missouri-Kansas City, Department of Psychology, Kansas City, MO, USA
| | - S Lam
- University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA
| | - J Thelen
- University of Missouri-Kansas City, Department of Psychology, Kansas City, MO, USA; University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA
| | - J M Bruce
- University of Missouri-Kansas City, School of Medicine, Department of Biomedical and Health Informatics, Kansas City, MO, USA.
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Koh Y, Vogrin S, Noaman S, Lam S, Pham R, Clark A, Biffin L, Hanson L, Bloom J, Stub D, Brennan A, Reid C, Dinh D, Lefkovits J, Cox N, Chan W. Effect of Different Anthropometric Body Indices on Radiation Exposure in Patients Undergoing Cardiac Catheterisation and Percutaneous Coronary Intervention. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.470] [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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Lewis S, APP F, Lam S, Scanlon C, Ferracane J, Pfeifer C. Effects of systematically varied thiourethane-functionalized filler concentration on polymerization behavior and relevant clinical properties of dental composites. Mater Des 2021; 197:109249. [PMID: 33162633 PMCID: PMC7641517 DOI: 10.1016/j.matdes.2020.109249] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Introduction of thiourethane (TU) oligomer to resin-based dental restorative materials reduces stress and improves fracture toughness without compromising conversion. Localization of TU at the resin-filler interface via silanization procedures may lead to more substantial stress reduction and clinical property enhancements. The objective of this study was to evaluate composite properties as a function of TU-functionalized filler concentration. TU oligomers were synthesized using click-chemistry techniques and subsequently silanized to barium glass filler. Resin-based composites were formulated using varying ratios of TU-functionalized filler and conventional methacrylate-silanized barium filler. Material property testing included thermogravimetric analysis, real-time polymerization kinetics and depth of cure, polymerization stress, stress relaxation and fracture toughness. Clinical property testing included water sorption/solubility, composite paste viscosity, and gloss and surface roughness measured before and after subjecting the samples to 6 h of continuous tooth brushing in a custom-built apparatus using a toothpaste/water mixture. Increasing TU-filler in the composite resulted in as much as a 78% reduction in stress, coupled with an increase in fracture toughness. Conversion was similar for all groups. After simulated tooth brushing, gloss reduction was lower for TU-containing composites and surface roughness was less than or equal to the control.
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Affiliation(s)
- S.H. Lewis
- Oregon Health & Science University, Department of Restorative Dentistry, Biomaterials and Biomechanics, United States of America
| | - Fugolin APP
- Oregon Health & Science University, Department of Restorative Dentistry, Biomaterials and Biomechanics, United States of America
| | - S. Lam
- Apprenticeships in Science and Engineering (ASE, Saturday Academy), United States of America
| | - C. Scanlon
- Oregon Health & Science University, Department of Restorative Dentistry, Biomaterials and Biomechanics, United States of America
| | - J.L. Ferracane
- Oregon Health & Science University, Department of Restorative Dentistry, Biomaterials and Biomechanics, United States of America
| | - C.S. Pfeifer
- Oregon Health & Science University, Department of Restorative Dentistry, Biomaterials and Biomechanics, United States of America
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Thomale UW, Auer C, Spennato P, Schaumann A, Behrens P, Gorelyshev S, Bogoslovskaia E, Shulaev A, Kabanian A, Seliverstov A, Alexeev A, Ozgural O, Kahilogullari G, Schuhmann M, Jimenez-Guerra R, Wittayanakorn N, Sukharev A, Marquez-Rivas J, Linsler S, Damaty AE, Vacek P, Lovha M, Guzman R, Stricker S, Beez T, Wiegand C, Azab M, Buis D, Sáez M, Fleck S, Dziugan C, Ferreira A, Radovnicky T, Bührer C, Lam S, Sgouros S, Roth J, Constantini S, Cavalheiro S, Cinalli G, Kulkarni AV, Bock HC. TROPHY registry - status report. Childs Nerv Syst 2021; 37:3549-3554. [PMID: 34184098 PMCID: PMC8578079 DOI: 10.1007/s00381-021-05258-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The TROPHY registry has been established to conduct an international multicenter prospective data collection on the surgical management of neonatal intraventricular hemorrhage (IVH)-related hydrocephalus to possibly contribute to future guidelines. The registry allows comparing the techniques established to treat hydrocephalus, such as external ventricular drainage (EVD), ventricular access device (VAD), ventricular subgaleal shunt (VSGS), and neuroendoscopic lavage (NEL). This first status report of the registry presents the results of the standard of care survey of participating centers assessed upon online registration. METHODS On the standard of treatment forms, each center indicated the institutional protocol of interventions performed for neonatal post-hemorrhagic hydrocephalus (nPHH) for a time period of 2 years (Y1 and Y2) before starting the active participation in the registry. In addition, the amount of patients enrolled so far and allocated to a treatment approach are reported. RESULTS According to the standard of treatment forms completed by 56 registered centers, fewer EVDs (Y1 55% Y2 46%) were used while more centers have implemented NEL (Y1 39%; Y2 52%) to treat nPHH. VAD (Y1 66%; Y2 66%) and VSGS (Y1 42%; Y2 41%) were used at a consistent rate during the 2 years. The majority of the centers used at least two different techniques to treat nPHH (43%), while 27% used only one technique, 21% used three, and 7% used even four different techniques. Patient data of 110 infants treated surgically between 9/2018 and 2/2021 (13% EVD, 15% VAD, 30% VSGS, and 43% NEL) were contributed by 29 centers. CONCLUSIONS Our results emphasize the varying strategies used for the treatment of nPHH. The international TROPHY registry has entered into a phase of growing patient recruitment. Further evaluation will be performed and published according to the registry protocol.
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Affiliation(s)
- U. W. Thomale
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - C. Auer
- Division of Pediatric Neurosurgery, Kepler Universitätsklinikum, Linz, Austria
| | - P. Spennato
- Pediatric Neurosurgery, AORN Santobono Pausilipon, Naples, Italy
| | - A. Schaumann
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - P. Behrens
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - S. Gorelyshev
- Pediatric Neurosurgery, Moscow Bashlyaeva Pediatric Hospital, Moscow, Russia
| | - E. Bogoslovskaia
- Pediatric Neurosurgery, Surgut Clinical Perinatal Center, Surgut, Russia
| | - A. Shulaev
- Pediatric Neurosurgery, Children’s Republic Clinical Hospital, Kazan, Russia
| | - A. Kabanian
- Pediatric Neurosurgery, Children’s Regional Hospital, Krasnodar, Russia
| | - A. Seliverstov
- Pediatric Neurosurgery, Kemerovo Regional Pediatric Hospital, Kemerovo, Russia
| | - A. Alexeev
- Pediatric Neurosurgery, Chelyabinsk Regional Children’s Clinical Hospital, Chelyabinsk, Russia
| | - O. Ozgural
- Neurosurgery, Ankara University, Ankara, Turkey
| | | | - M. Schuhmann
- Pediatric Neurosurgery, University Hospital of Tübingen, Tubingen, Germany
| | - R. Jimenez-Guerra
- Neonatal Neurosurgery, National Institute of Perinatology, Mexico City, Mexico
| | - N. Wittayanakorn
- Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
| | - A. Sukharev
- Pediatric Neurosurgery, Regional Children Hospital, Yekaterinburg, Russia
| | | | - S. Linsler
- Neurosurgery, Saarland University Hospital, Homburg, Saarland Germany
| | - A. El Damaty
- Pediatric Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany
| | - P. Vacek
- Neurosurgery, University Hospital and Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - M. Lovha
- Neurosurgery, Volyn Regional Pediatric Hospital, Lutsk, Ukraine
| | - R. Guzman
- Neurosurgery, Universitätskinderspital Beider Basel, Basel, Switzerland
| | - S. Stricker
- Neurosurgery, Universitätskinderspital Beider Basel, Basel, Switzerland
| | - T. Beez
- Neurosurgery, Heinrich-Heine-University, Duesseldorf, Germany
| | - C. Wiegand
- Neurosurgery, Marienhospital, Osnabrück, Germany
| | - M. Azab
- Neurosurgery, Damietta Specialized Hospital, Damietta, Egypt
| | - D. Buis
- Neurosurgery, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | - M. Sáez
- Neurosurgery, Hospital La Paz, Madrid, Spain
| | - S. Fleck
- Neurosurgery, University Medicine Greifswald, Greifswald, Germany
| | - C. Dziugan
- Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA
| | - A. Ferreira
- Neurosurgery, Centro Hospitalar Universitário São João, Porto, Portugal
| | - T. Radovnicky
- Neurosurgery, Masaryk Hospital, Usti Nad Labem, Czech Republic
| | - C. Bührer
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin, Berlin Augustenburger Platz 1, 13353 Berlin, Germany
| | - S. Lam
- Pediatric Neurosurgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA
| | - S. Sgouros
- Pediatric Neurosurgery, Iaso Childrens Hospital, Athens, Greece
| | - J. Roth
- Pediatric Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel
| | - S. Constantini
- Pediatric Neurosurgery, Tel Aviv Medical Center, Tel Aviv, Israel
| | - S. Cavalheiro
- Pediatric Neurosurgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - G. Cinalli
- Pediatric Neurosurgery, AORN Santobono Pausilipon, Naples, Italy
| | - A. V. Kulkarni
- Pediatric Neurosurgery, Sick Children Hospital, University of Toronto, Toronto, Canada
| | - H. C. Bock
- Pediatric Neurosurgery, University Medical Center Göttingen, Gottingen, Germany
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Lam S, Miglior F, Fonseca PAS, Gómez-Redondo I, Zeidan J, Suárez-Vega A, Schenkel F, Guan LL, Waters S, Stothard P, Cánovas A. Identification of functional candidate variants and genes for feed efficiency in Holstein and Jersey cattle breeds using RNA-sequencing. J Dairy Sci 2020; 104:1928-1950. [PMID: 33358171 DOI: 10.3168/jds.2020-18241] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 08/29/2020] [Indexed: 12/15/2022]
Abstract
The identification of functional genetic variants and associated candidate genes linked to feed efficiency may help improve selection for feed efficiency in dairy cattle, providing economic and environmental benefits for the dairy industry. This study used RNA-sequencing data obtained from liver tissue from 9 Holstein cows [n = 5 low residual feed intake (RFI), n = 4 high RFI] and 10 Jersey cows (n = 5 low RFI, n = 5 high RFI), which were selected from a single population of 200 animals. Using RNA-sequencing, 3 analyses were performed to identify: (1) variants within low or high RFI Holstein cattle; (2) variants within low or high RFI Jersey cattle; and (3) variants within low or high RFI groups, which are common across both Holstein and Jersey cattle breeds. From each analysis, all variants were filtered for moderate, modifier, or high functional effect, and co-localized quantitative trait loci (QTL) classes, enriched biological processes, and co-localized genes related to these variants, were identified. The overlapping of the resulting genes co-localized with functional SNP from each analysis in both breeds for low or high RFI groups were compared. For the first two analyses, the total number of candidate genes associated with moderate, modifier, or high functional effect variants fixed within low or high RFI groups were 2,810 and 3,390 for Holstein and Jersey breeds, respectively. The major QTL classes co-localized with these variants included milk and reproduction QTL for the Holstein breed, and milk, production, and reproduction QTL for the Jersey breed. For the third analysis, the common variants across both Holstein and Jersey breeds, uniquely fixed within low or high RFI groups were identified, revealing a total of 86,209 and 111,126 functional variants in low and high RFI groups, respectively. Across all 3 analyses for low and high RFI cattle, 12 and 31 co-localized genes were overlapping, respectively. Among the overlapping genes across breeds, 9 were commonly detected in both the low and high RFI groups (INSRR, CSK, DYNC1H1, GAB1, KAT2B, RXRA, SHC1, TRRAP, PIK3CB), which are known to play a key role in the regulation of biological processes that have high metabolic demand and are related to cell growth and regeneration, metabolism, and immune function. The genes identified and their associated functional variants may serve as candidate genetic markers and can be implemented into breeding programs to help improve the selection for feed efficiency in dairy cattle.
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Affiliation(s)
- S Lam
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - F Miglior
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - P A S Fonseca
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - I Gómez-Redondo
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - J Zeidan
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - A Suárez-Vega
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - F Schenkel
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - L L Guan
- Department of Agriculture, Food & Nutritional Science, University of Alberta, Edmonton, Canada T6H 2P5
| | - S Waters
- Teagasc, Animal & Grassland Research and Innovation Centre, Grange, Dunsany, Ireland C15 PW93
| | - P Stothard
- Department of Agriculture, Food & Nutritional Science, University of Alberta, Edmonton, Canada T6H 2P5
| | - A Cánovas
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, Guelph, ON, Canada N1G 2W1.
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Lam S, Zeidan J, Miglior F, Suárez-Vega A, Gómez-Redondo I, Fonseca PAS, Guan LL, Waters S, Cánovas A. Development and comparison of RNA-sequencing pipelines for more accurate SNP identification: practical example of functional SNP detection associated with feed efficiency in Nellore beef cattle. BMC Genomics 2020; 21:703. [PMID: 33032519 PMCID: PMC7545862 DOI: 10.1186/s12864-020-07107-7] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 09/28/2020] [Indexed: 12/14/2022] Open
Abstract
Background Optimization of an RNA-Sequencing (RNA-Seq) pipeline is critical to maximize power and accuracy to identify genetic variants, including SNPs, which may serve as genetic markers to select for feed efficiency, leading to economic benefits for beef production. This study used RNA-Seq data (GEO Accession ID: PRJEB7696 and PRJEB15314) from muscle and liver tissue, respectively, from 12 Nellore beef steers selected from 585 steers with residual feed intake measures (RFI; n = 6 low-RFI, n = 6 high-RFI). Three RNA-Seq pipelines were compared including multi-sample calling from i) non-merged samples; ii) merged samples by RFI group, iii) merged samples by RFI and tissue group. The RNA-Seq reads were aligned against the UMD3.1 bovine reference genome (release 94) assembly using STAR aligner. Variants were called using BCFtools and variant effect prediction (VeP) and functional annotation (ToppGene) analyses were performed. Results On average, total reads detected for Approach i) non-merged samples for liver and muscle, were 18,362,086.3 and 35,645,898.7, respectively. For Approach ii), merging samples by RFI group, total reads detected for each merged group was 162,030,705, and for Approach iii), merging samples by RFI group and tissues, was 324,061,410, revealing the highest read depth for Approach iii). Additionally, Approach iii) merging samples by RFI group and tissues, revealed the highest read depth per variant coverage (572.59 ± 3993.11) and encompassed the majority of localized positional genes detected by each approach. This suggests Approach iii) had optimized detection power, read depth, and accuracy of SNP calling, therefore increasing confidence of variant detection and reducing false positive detection. Approach iii) was then used to detect unique SNPs fixed within low- (12,145) and high-RFI (14,663) groups. Functional annotation of SNPs revealed positional candidate genes, for each RFI group (2886 for low-RFI, 3075 for high-RFI), which were significantly (P < 0.05) associated with immune and metabolic pathways. Conclusion The most optimized RNA-Seq pipeline allowed for more accurate identification of SNPs, associated positional candidate genes, and significantly associated metabolic pathways in muscle and liver tissues, providing insight on the underlying genetic architecture of feed efficiency in beef cattle.
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Affiliation(s)
- S Lam
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G2W1, Canada
| | - J Zeidan
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G2W1, Canada
| | - F Miglior
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G2W1, Canada
| | - A Suárez-Vega
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G2W1, Canada
| | - I Gómez-Redondo
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G2W1, Canada.,Spanish National Institute for Agriculture and Food Research and Technology, Carretera de La Coruña, 28040, Madrid, Spain
| | - P A S Fonseca
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G2W1, Canada
| | - L L Guan
- Department of Agriculture, Food & Nutritional Science, University of Alberta, Edmonton, Alberta, T6H 2P5, Canada
| | - S Waters
- Teagasc, Animal & Grassland Research and Innovation Centre, Grange, Dunsany, Co. Meath, C15 PW93, Ireland
| | - A Cánovas
- Centre for Genetic Improvement of Livestock, Department of Animal Biosciences, University of Guelph, 50 Stone Road E, Guelph, Ontario, N1G2W1, Canada.
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Liu S, Horn L, Mok T, Mansfield A, De Boer R, Losonczy G, Sugawara S, Dziadziuszko R, Krzakowski M, Smolin A, Hochmair M, Garassino M, Lam S, McCleland M, Cardona A, Morris S, Reck M. 1781MO IMpower133: Characterisation of long-term survivors treated first-line with chemotherapy ± atezolizumab in extensive-stage small cell lung cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Caceres A, Shlobin NA, Lam S, Zamora J, Segura JL. Correction to: Stingray spear injury to the pediatric spinal cord: case report and review of the literature. Childs Nerv Syst 2020; 36:1817. [PMID: 32583149 DOI: 10.1007/s00381-020-04739-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The original version of this article unfortunately contained an error in the spelling of the last name of one of the co-authors. The corresponding author did not notice that the last name of one of the co-authors, Nathan Shlobin, was misspelled as "Schlobin". The correct spelling of his last name is "Shlobin". Given in this article is the corrected author name.
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Affiliation(s)
- A Caceres
- Servicio de Neurocirugía, Hospital Nacional de Niños, "Dr. Carlos Sáenz Herrera", San José, Costa Rica.
| | - N A Shlobin
- Division of Pediatric Neurosurgery and Department of Neurosurgery, Ann and Robert H Lurie Children's Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - S Lam
- Division of Pediatric Neurosurgery and Department of Neurosurgery, Ann and Robert H Lurie Children's Hospital and Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - J Zamora
- Servicio de Neurocirugía, Hospital Nacional de Niños, "Dr. Carlos Sáenz Herrera", San José, Costa Rica
| | - J L Segura
- Servicio de Neurocirugía, Hospital Nacional de Niños, "Dr. Carlos Sáenz Herrera", San José, Costa Rica
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Caceres A, Shlobin NA, Lam S, Zamora J, Segura JL. Stingray spear injury to the pediatric spinal cord: case report and review of the literature. Childs Nerv Syst 2020; 36:1811-1816. [PMID: 32361931 DOI: 10.1007/s00381-020-04629-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/16/2020] [Indexed: 01/22/2023]
Abstract
Stingray injuries are rare, mostly causing injuries to the lower extremities but occasionally fatal if there is direct puncture of the thorax, abdomen, or neck. Direct combined stingray injury to the central nervous system has not been reported in the literature. Herein we present the case of a 12-year-old boy who, while wading at the seashore of the Costa Rica's Pacific Ocean, sustained a combined oblique penetrating injury to the C6 vertebra caused by a Stingray. He initially presented to the hospital with a complete asymmetric right C6/left T1 ASIA A examination, priapism, and loss of anal sphincter tone. Imaging revealed fracture of the posterior elements of C6 with an oblique trajectory into the left radicular foramen. T2W images did not reveal anatomical section but rather edema and minor bleeding in the epidural space. The patient underwent medical management and serial imaging. During the next 3 months, there was recovery of sensation on the right hemi body, bilateral paresthesias and asymmetric progressive improvement in strength on both legs. Acute care management and midterm term follow up are provided, along with a review of the literature for salient management considerations when evaluating and treating combined penetrating and envenomation injuries caused by stingrays. To our knowledge, this is the first report of such injury to the spine.
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Affiliation(s)
- A Caceres
- Servicio de Neurocirugía, Hospital Nacional de Niños, "Dr. Carlos Sáenz Herrera", San José, Costa Rica.
| | - N A Shlobin
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Pediatric Neurosurgery, Lurie Children's Hospital, Chicago, IL, USA
| | - S Lam
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Pediatric Neurosurgery, Lurie Children's Hospital, Chicago, IL, USA
| | - J Zamora
- Servicio de Neurocirugía, Hospital Nacional de Niños, "Dr. Carlos Sáenz Herrera", San José, Costa Rica
| | - J L Segura
- Servicio de Neurocirugía, Hospital Nacional de Niños, "Dr. Carlos Sáenz Herrera", San José, Costa Rica
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Marshall E, Vucic E, Filho F, Leung J, Lam S, Lam W. A03 Lung Adenocarcinoma Resident Microbiome May Contribute to Cancer Hypomethylation Status. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.032] [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: 10/25/2022]
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Marshall E, Filho F, Sin D, Lam S, Leung J, Lam W. A04 Lung-Resident Microbial Signature Precedes Signs of Lung Malignancy. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.033] [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: 10/25/2022]
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Huot S, Ho H, Ko A, Lam S, Tactay P, MacLachlan J, Raanaas RK. Identifying barriers to healthcare delivery and access in the Circumpolar North: important insights for health professionals. Int J Circumpolar Health 2020; 78:1571385. [PMID: 30696379 PMCID: PMC6352934 DOI: 10.1080/22423982.2019.1571385] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Lack of access to healthcare services for people living in the Circumpolar North may have important consequences for their health and well-being, both in terms of the actual treatment and other possible health-related consequences intertwined with their life situation. The aim of the present study was to identify the specific challenges to healthcare service delivery and access for populations in the Circumpolar North that are addressed in contemporary literature. A scoping review of literature published between 2005 and 2016 was conducted and 43 articles were selected for inclusion into the review. The review findings address 4 main themes identified in the literature: (1) the influence of physical geography, (2) healthcare provider-related barriers, (3) the importance of culture and language and (4) the impact of systemic factors. The review of the literature enabled us to identify existing gaps in both health service access and issues discussed in the available literature, particularly for informing healthcare services in the Circumpolar North, as well as point towards opportunities for future research. The thematic findings drawn from interdisciplinary and international literature inform understandings of the impact of health system barriers on healthcare services and the opportunities for Northern residents to support their own health.
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Affiliation(s)
- S Huot
- a Department of Occupational Science and Occupational Therapy , University of British Columbia , Vancouver , Canada
| | - H Ho
- b School of Occupational Therapy , University of Western Ontario , London , Canada
| | - A Ko
- b School of Occupational Therapy , University of Western Ontario , London , Canada
| | - S Lam
- b School of Occupational Therapy , University of Western Ontario , London , Canada
| | - P Tactay
- b School of Occupational Therapy , University of Western Ontario , London , Canada
| | - J MacLachlan
- c Dalla Lana School of Public Health , University of Toronto , Toronto , Canada
| | - R K Raanaas
- d Department of Public Health Science , Norwegian University of Life Sciences , Ås , Norway
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Mansfield AS, Każarnowicz A, Karaseva N, Sánchez A, De Boer R, Andric Z, Reck M, Atagi S, Lee JS, Garassino M, Liu SV, Horn L, Wen X, Quach C, Yu W, Kabbinavar F, Lam S, Morris S, Califano R. Safety and patient-reported outcomes of atezolizumab, carboplatin, and etoposide in extensive-stage small-cell lung cancer (IMpower133): a randomized phase I/III trial. Ann Oncol 2019; 31:310-317. [PMID: 31959349 DOI: 10.1016/j.annonc.2019.10.021] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [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: 07/01/2019] [Revised: 09/27/2019] [Accepted: 10/20/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The addition of atezolizumab to carboplatin and etoposide (CP/ET) significantly improved progression-free and overall survival for patients with extensive-stage small-cell lung cancer (ES-SCLC) in the IMpower133 study (NCT02763579). We have evaluated adverse events (AEs) and patient-reported outcomes in IMpower133 to assess the benefit-risk profile of this regimen. PATIENTS AND METHODS Patients received four 21-day cycles of CP/ET plus intravenous atezolizumab 1200 mg or placebo (induction phase), followed by atezolizumab or placebo (maintenance phase) until progression or loss of benefit. AEs were assessed and patient-reported outcomes were evaluated every 3 weeks during treatment using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 (QLQ-C30) and QLQ-LC13. RESULTS Overall, 394 patients were assessable for safety in the induction phase and 318 in the maintenance phase. The frequency of AEs, grade 3-4 AEs, and serious AEs was similar between arms in both phases. Immune-related AEs were more frequent in the atezolizumab arm during both induction (28% versus 17%; leading to atezolizumab/placebo interruption 9% versus 5%, leading to withdrawal 4% versus 0%) and maintenance (26% versus 15%; leading to atezolizumab/placebo interruption, 3% versus 2%, leading to withdrawal 1% versus 1%), most commonly rash (induction 11% versus 9%, maintenance 14% versus 4%), and hypothyroidism (induction 4.0% versus 0%, maintenance 10% versus 1%). Changes in patient-reported treatment-related symptoms commonly associated with quality of life impairment were generally similar during induction and most of the maintenance phase. Patient-reported function and health-related quality of life (HRQoL) improved in both arms after initiating treatment, with more pronounced and persistent HRQoL improvements in the atezolizumab arm. CONCLUSIONS In patients with ES-SCLC, atezolizumab plus CP/ET has a comparable safety profile to placebo plus CP/ET, and the addition of atezolizumab did not adversely impact patient-reported HRQoL. These data demonstrate the positive benefit-risk profile of first-line atezolizumab plus CP/ET in ES-SCLC and further support this regimen as a new standard of care in this setting. CLINICAL TRIALS NUMBER NCT02763579.
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Affiliation(s)
- A S Mansfield
- Division of Medical Oncology, Mayo Clinic, Rochester, USA.
| | - A Każarnowicz
- Department of Oncology, Tuberculosis and Lung Disease Hospital, Olsztyn, Poland
| | - N Karaseva
- City Clinical Oncology Dispensary, St Petersburg, Russia
| | - A Sánchez
- Department of Medical Oncology, Hospital Universitario "Virgen del Rocio", Seville, Spain
| | - R De Boer
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Z Andric
- Department of Medical Oncology, University Hospital Medical Center Bezanijska Kosa, Belgrade, Serbia
| | - M Reck
- Department of Thoracic Oncology, German Center for Lung Research (DZL), Großhansdorf, Germany
| | - S Atagi
- Department of Thoracic Oncology, Kinki-Chuo Chest Medical Center, Osaka, Japan
| | - J-S Lee
- Division of Hematology-Oncology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - M Garassino
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S V Liu
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington DC, USA
| | - L Horn
- Thoracic Oncology Program, Vanderbilt University Medical Center, Nashville, USA
| | - X Wen
- Product Development Oncology, Genentech, Inc., South San Francisco, USA
| | - C Quach
- Product Development Oncology, Genentech, Inc., South San Francisco, USA
| | - W Yu
- Biometrics, Genentech, Inc., South San Francisco, USA
| | - F Kabbinavar
- Product Development Oncology, Genentech, Inc., South San Francisco, USA
| | - S Lam
- Product Development Oncology, Genentech, Inc., South San Francisco, USA
| | - S Morris
- Global PD Medical Affairs (Oncology), F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - R Califano
- Department of Medical Oncology, The Christie NHS Foundation Trust, and Division of Cancer Sciences, University of Manchester, Manchester, UK
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Myers R, Atkar-Khattra S, Pillainayagam S, Ladhar S, Cho K, Janicker M, Callaghan J, Yee J, Lam S. OA09.01 Opt-Out Smoking Cessation Program in Lung Cancer Screening Provides Excellent Quit Rates. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vucic E, Marshall E, Ng R, Lam S, Lam W. P2.03-24 Concurrent Aberrations in G2/M-Phase Transcriptional Programs and Genomic Gatekeepers Highlight Lung Cancer Predisposition in COPD Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1471] [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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Myers R, Mayo J, Tammemägi M, Atkar-Khattra S, Yuan R, Yee J, English J, Grant K, Lee A, Mcguire A, Mcwilliams A, Brims F, Mo L, Lam S. MA10.09 Evaluation of the Clinical Utility of the PanCan, EU-NELSON and Lung-RADS Protocols for Management of Screen Detected Lung Nodules at Baseline. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Reck M, Liu S, Mansfield A, Mok T, Scherpereel A, Reinmuth N, Garassino M, De Carpeno JC, Califano R, Nishio M, Orlandi F, Alexander JAA, Leal T, Cheng Y, Lee JS, Lam S, McCleland M, Deng Y, Phan S, Horn L. IMpower133: Updated overall survival (OS) analysis of first-line (1L) atezolizumab (atezo) + carboplatin + etoposide in extensive-stage SCLC (ES-SCLC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz264] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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