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Ye X, Zhang B, Lee K, Storesund R, Song X, Kang Q, Li P, Chen B. A multi-criteria simulation-optimization coupling approach for effective emergency response in marine oil spill accidents. J Hazard Mater 2024; 469:133832. [PMID: 38428295 DOI: 10.1016/j.jhazmat.2024.133832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/15/2024] [Accepted: 02/17/2024] [Indexed: 03/03/2024]
Abstract
Effective marine oil spill responses are vital to reduce environmental, societal, and economic damage. This study developed a Multi-Criteria Emergency Response System (MC-ERS) to comprehensively evaluate response efficiency, operational costs, and environmental losses. The proposed system integrates dynamic multiphase simulation of oil weathering and oil cleanup processes and further provides effective planning for multi-stage resource allocation through system optimization. The developed weight-sum model improved the performance of response operations by reducing the complexity of multi-criteria decision-making. Particle Swarm Optimization (PSO) was chosen as the foundational optimization algorithm due to its efficiency in rapid convergence and suitability for complex problems. From extensive comparisons of PSO variants across benchmark functions and inertia strategies, the C-PSO algorithm was developed, demonstrating enhanced optimization performance for MC-ERS. The developed modelling system performance was demonstrated and evaluated through a representative case study. The optimization plan coordinated resource allocation from onshore warehouses to harbors and spill sites, balancing oil recovery efficiency, costs, and ecological losses. Optimized results indicate an oil recovery of up to 76.50% in five days. Additionally, the system cuts costs by 3.45% and environmental losses by 15.75%. The findings enhance the efficiency of marine oil spill emergency response and provide support for such incidents.
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Affiliation(s)
- Xudong Ye
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Memorial University of Newfoundland, Faculty of Engineering and Applied Science, St. John's, NL A1B 3X5, Canada
| | - Baiyu Zhang
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Memorial University of Newfoundland, Faculty of Engineering and Applied Science, St. John's, NL A1B 3X5, Canada
| | - Kenneth Lee
- Environment and Biodiversity Science Branch, Fisheries and Oceans Canada, Ottawa, ON K1A 0E6, Canada
| | - Rune Storesund
- Center for Catastrophic Risk Management (CCRM), University of California, Berkeley 94720, USA
| | - Xing Song
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Memorial University of Newfoundland, Faculty of Engineering and Applied Science, St. John's, NL A1B 3X5, Canada
| | - Qiao Kang
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Memorial University of Newfoundland, Faculty of Engineering and Applied Science, St. John's, NL A1B 3X5, Canada
| | - Pu Li
- Guangdong Provincial Key Laboratory of Marine Resources and Coastal Engineering, School of Marine Sciences, Sun Yat-sen University, Guangzhou 510275, China
| | - Bing Chen
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Memorial University of Newfoundland, Faculty of Engineering and Applied Science, St. John's, NL A1B 3X5, Canada.
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Kong H, Cao J, Tian J, Yong J, An J, Zhang L, Song X, He Y. Coronary microvascular dysfunction: prevalence and aetiology in patients with suspected myocardial ischaemia. Clin Radiol 2024; 79:386-392. [PMID: 38433042 DOI: 10.1016/j.crad.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/19/2023] [Accepted: 01/09/2024] [Indexed: 03/05/2024]
Abstract
AIM To evaluate the prevalence, aetiology, and corresponding morbidity of coronary microvascular dysfunction (CMD) in patients with suspected myocardial ischaemia. MATERIALS AND METHODS The present study included 115 patients with suspected myocardial ischaemia who underwent stress perfusion cardiac magnetic resonance imaging. CMD was assessed visually based on the myocardial perfusion results. The CMR-derived myocardial perfusion reserve index (MPRI) and left ventricular (LV) strain parameters obtained using the post-processing software CVI42 were employed to evaluate LV myocardial perfusion and deformation. LV strain parameters included global longitudinal, circumferential, and radial strain (GLS, GCS, and GRS), global systolic/diastolic longitudinal, circumferential, and radial strain rates (SLSR, SCSR, SRSR, DLSR, DCSR, and DRSR). RESULTS Of the 115 patients, 12 patients were excluded and 103 patients were finally included in the study. CMD was observed in 79 % (81 patients, aged 53 ± 12 years) of patients. Regarding aetiology, 91 (88 %) patients had non-obstructive coronary artery disease (CAD), eight (8 %) had obstructive CAD, and four (4 %) had hypertrophic cardiomyopathy (HCM). The incidence of CMD was highest (100 %) in patients with HCM, followed by those with non-obstructive CAD (up to 79 %). There were no statistical differences between CMD and non-CMD groups in GCS, GRS, GLS, SRSR, SCSR, SLSR, DCSR, DRSR and DLSR. CONCLUSION The incidence of CMD was higher in patients with signs and symptoms of ischaemia. CMD occurred with non-obstructive CAD, obstructive CAD, and HCM, with the highest prevalence of CMD in HCM.
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Affiliation(s)
- H Kong
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - J Cao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - J Tian
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - J Yong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - J An
- Siemens Shenzhen Magnetic Resonance, MR Collaboration NE Asia, Shenzhen, China
| | - L Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - X Song
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
| | - Y He
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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Xi J, Zhang M, Zhang Y, Zhang C, Zhang Y, Wang R, Shen L, Li J, Song X. [Upregulating KLF11 ameliorates intestinal inflammation in mice with 2, 4, 6-trinitrobenesulfonic acid-induced colitis by inhibiting the JAK2/STAT3 signaling pathway]. Nan Fang Yi Ke Da Xue Xue Bao 2024; 44:765-772. [PMID: 38708511 DOI: 10.12122/j.issn.1673-4254.2024.04.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
OBJECTIVE To investigate the expression level of Kruppel-like transcription factor family member KLF11 in intestinal mucosal tissues of Crohn's disease (CD) and its regulatory effect on intestinal inflammation in CD-like colitis. METHODS We examined KLF11 expression levels in diseased and normal colon mucosal tissues from 12 CD patients and 12 patients with colorectal cancer using immunofluorescence staining. KLF11 expression was also detected in the colon mucosal tissues of a mouse model of 2, 4, 6-trinitrobenesulfonic acid (TNBS)-induced colitis. A recombinant adenoviral vector was used to upregulate KLF11 expression in the mouse models and the changes in intestinal inflammation was observed. A Caco-2 cell model with stable KLF11 overexpression was constructed by lentiviral infection. The effect of KLF11 overexpression on expressions of JAK2/STAT3 signaling pathway proteins was investigated using immunoblotting in both the mouse and cell models. The mouse models were treated with coumermycin A1, a JAK2/STAT3 signaling pathway agonist, and the changes in intestinal inflammatory responses were observed. RESULTS The expression level of KLF11 was significantly lowered in both the clinical specimens of diseased colon mucosal tissues and the colon tissues of mice with TNBS-induced colitis (P < 0.05). Adenovirus-mediated upregulation of KLF11 significantly improved intestinal inflammation and reduced the expression levels of inflammatory factors in the intestinal mucosa of the colitis mouse models (P < 0.05). Overexpression of KLF11 significantly inhibited the expression levels of p-JAK2 and p-STAT3 in intestinal mucosal tissues of the mouse models and in Caco-2 cells (P < 0.05). Treatment with coumermycin A1 obviously inhibited the effect of KLF11 upregulation for improving colitis and significantly increased the expression levels of inflammatory factors in the intestinal mucosa of the mouse models (P < 0.05). CONCLUSION KLF11 is downregulated in the intestinal mucosa in CD, and upregulation of KLF11 can improve intestinal inflammation and reduce the production of inflammatory factors probably by inhibiting the JAK2/STAT3 signaling pathway.
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Affiliation(s)
- J Xi
- Bengbu Medical University, Bengbu 233000, China
| | - M Zhang
- Bengbu Medical University, Bengbu 233000, China
- Clinical Laboratory, First Affiliated Hospital of Bengbu Medical University, Bengbu 233000, China
| | - Y Zhang
- Bengbu Medical University, Bengbu 233000, China
| | - C Zhang
- Bengbu Medical University, Bengbu 233000, China
| | - Y Zhang
- Bengbu Medical University, Bengbu 233000, China
| | - R Wang
- Bengbu Medical University, Bengbu 233000, China
| | - L Shen
- Bengbu Medical University, Bengbu 233000, China
| | - J Li
- Clinical Laboratory, First Affiliated Hospital of Bengbu Medical University, Bengbu 233000, China
- Anhui Province Key Laboratory of Basic and Translational Research of inflammation-related Diseases, First Affiliated Hospital of Bengbu Medical University, Bengbu 233000, China
| | - X Song
- Central Laboratory, First Affiliated Hospital of Bengbu Medical University, Bengbu 233000, China
- Anhui Province Key Laboratory of Basic and Translational Research of inflammation-related Diseases, First Affiliated Hospital of Bengbu Medical University, Bengbu 233000, China
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Zheng XR, Peng JX, Song X, Liu B, Zhong C, Chen XY, Zhang BX, Peng L, Zhu KS, Xie C. [Effect of HBV DNA load on the safety and prognosis of systematic therapy in advanced hepatocellular carcinoma]. Zhonghua Yi Xue Za Zhi 2024; 104:1160-1167. [PMID: 38583047 DOI: 10.3760/cma.j.cn112137-20231110-01055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
Objective: To study the effect of hepatitis B virus (HBV) infection on the occurrence of liver damage, HBV reactivation (HBVr) and the influence of HBVr on the prognosis of patients with advanced hepatocellular carcinoma (HCC) receiving systemic therapy. Methods: The clinical data of 403 patients with HBV-related HCC at the Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University et al, from July 2018 to December 2020 were collected. The incidence of liver damage and HBVr during systematic therapy, and the influence of HBVr on survival prognosis were analyzed. Results: Of the 403 patients, 89.1% were male (n=359), with a median age of 51 years (51.5±12.1). Before propensity score matching (PSM), the proportion of patients with cirrhosis, TNM and advanced BCLC stage was higher in high HBV-DNA (baseline HBV-DNA>1000 U/ml, n=147) group comparing with the low HBV-DNA (baseline HBV DNA≤1000 u/ml, n=256) group (P<0.05). There was no significant difference in baseline indexes between the two groups after PSM. In 290 patients after PSM, there was no significant difference in the incidence of liver damage and HBVr between high HBV-DNA group and low HBV-DNA group (P>0.05). Survival analysis was performed on 169 patients with survival data, the median overall survival (OS) was found to be 11.49 months (95%CI: 7.77-12.89) and 16.65 months (95%CI: 10.54-21.99, P=0.008) in the high and low HBV-DNA groups, respectively. And median progression-free survival (PFS) was 7.41 months (95%CI: 5.06-8.67) and 10.55 months (95%CI: 6.72-13.54, P=0.038), respectively, with a statistically significant difference. There were no differences in overall survival (OS) and progression-free survival (PFS) between patients with and without HBVr and those with or without liver damage (P>0.05). Conclusions: HBV-DNA levels above 1 000 U/ml before systemic therapy do not increase the risk of liver damage or HBVr during systemic therapy in patients with HBV-related hepatocellular carcinoma, and such patients can safely receive systemic therapy.
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Affiliation(s)
- X R Zheng
- Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - J X Peng
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China
| | - X Song
- Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - B Liu
- Department of General Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - C Zhong
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangzhou University of Chinese Medicine,, Guangzhou 510405, China
| | - X Y Chen
- Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - B X Zhang
- Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - L Peng
- Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
| | - K S Zhu
- Laboratory of Interventional Radiology, Department of Minimally Invasive Interventional Radiology and Department of Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - C Xie
- Department of Infectious Diseases, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, China
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Zhang M, Liu SB, Zhang N, Xiao LY, Li WJ, Wang WF, Xu MZ, Hu JG, Li J, Zuo LG, Zhang XF, Geng ZJ, Wang L, Wang YY, Song X. [Application of improved "Swiss roll" method in mouse intestinal tissue section]. Zhonghua Bing Li Xue Za Zhi 2024; 53:393-397. [PMID: 38556826 DOI: 10.3760/cma.j.cn112151-20231016-00270] [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] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Affiliation(s)
- M Zhang
- Department of Central Laboratory, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China School of Laboratory Medicine, Bengbu Medical University, Bengbu 233000, China
| | - S B Liu
- School of Laboratory Medicine, Bengbu Medical University, Bengbu 233000, China
| | - N Zhang
- School of Laboratory Medicine, Bengbu Medical University, Bengbu 233000, China
| | - L Y Xiao
- School of Laboratory Medicine, Bengbu Medical University, Bengbu 233000, China
| | - W J Li
- Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
| | - W F Wang
- Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
| | - M Z Xu
- Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
| | - J G Hu
- Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China Department of Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
| | - J Li
- Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China Department of Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
| | - L G Zuo
- Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China Department of Gastrointestinal Surgery, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
| | - X F Zhang
- Department of Central Laboratory, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
| | - Z J Geng
- Department of Central Laboratory, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
| | - L Wang
- Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China Department of Gastrointestinal Surgery, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
| | - Y Y Wang
- Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China Department of Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
| | - X Song
- Department of Central Laboratory, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-Related Diseases, the First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China
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Zhang W, Chen Y, Yang F, Zhang H, Su T, Wang J, Zhang Y, Song X. Antiviral effect of palmatine against infectious bronchitis virus through regulation of NF-κB/IRF7/JAK-STAT signalling pathway and apoptosis. Br Poult Sci 2024; 65:119-128. [PMID: 38166582 DOI: 10.1080/00071668.2023.2296929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/29/2023] [Indexed: 01/04/2024]
Abstract
1. Infectious bronchitis virus (IBV), a gamma-coronavirus, can infect chickens of all ages and leads to an acute contact respiratory infection. This study evaluated the anti-viral activity of palmatine, a natural non-flavonoid alkaloid, against IBV in chicken embryo kidney (CEK) cells.2. The half toxic concentration (CC50) of palmatine was 672.92 μM, the half inhibitory concentration (IC50) of palmatine against IBV was 7.76 μM and the selection index (SI) was 86.74.3. Mode of action assay showed that palmatine was able to directly inactivate IBV and inhibited the adsorption, penetration and intracellular replication of IBV.4. Palmatine significantly upregulated TRAF6, TAB1 and IKK-β compared with the IBV-infected group, leading to the increased expressions of pro-inflammatory cytokines IL-1β and TNF-α in the downstream NF-κB signalling pathway.5. Palmatine significantly up-regulated the levels of MDA5, MAVS, IRF7, IFN-α and IFN-β in the IRF7 pathway, inducing type I interferon production. It up-regulated the expression of 2'5'-oligoadenylate synthase (OAS) in the JAK-STAT pathway.6. IBV infection induced cell apoptosis and palmatine-treatment delayed the process of apoptosis by regulation of the expression of apoptosis-related genes (BAX, BCL-2, CASPASE-3 and CASPASE-8).7. Palmatine could exert anti-IBV activity through regulation of NF-κB/IRF7/JAK-STAT signalling pathways and apoptosis, providing a theoretical basis for the utilisation of palmatine to treat IBV infection.
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Affiliation(s)
- W Zhang
- Natural Medicine Research Center, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Y Chen
- Natural Medicine Research Center, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - F Yang
- Natural Medicine Research Center, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - H Zhang
- Natural Medicine Research Center, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - T Su
- Natural Medicine Research Center, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - J Wang
- Natural Medicine Research Center, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Y Zhang
- College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, China
| | - X Song
- Natural Medicine Research Center, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
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Fan C, Jiang Z, Teng C, Song X, Li L, Shen W, Jiang Q, Huang D, Lv Y, Du L, Wang G, Hu Y, Man S, Zhang Z, Gao N, Wang F, Shi T, Xin T. Efficacy and safety of intrathecal pemetrexed for TKI-failed leptomeningeal metastases from EGFR+ NSCLC: an expanded, single-arm, phase II clinical trial. ESMO Open 2024; 9:102384. [PMID: 38377785 PMCID: PMC11076967 DOI: 10.1016/j.esmoop.2024.102384] [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: 10/26/2023] [Revised: 01/06/2024] [Accepted: 01/19/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the efficacy and safety of intrathecal pemetrexed (IP) for treating patients with leptomeningeal metastases (LM) from non-small-cell lung cancer (NSCLC) who progressed from epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) treatment in an expanded, prospective, single-arm, phase II clinical study (ChiCTR1800016615). PATIENTS AND METHODS Patients with confirmed NSCLC-LM who progressed from TKI received IP (50 mg, day 1/day 5 for 1 week, then every 3 weeks for four cycles, and then once monthly) until disease progression or intolerance. Objectives were to assess overall survival (OS), response rate, and safety. Measurable lesions were assessed by investigator according to RECIST version 1.1. LM were assessed according to the Response Assessment in Neuro-Oncology (RANO) criteria. RESULTS The study included 132 patients; 68% were female and median age was 52 years (31-74 years). The median OS was 12 months (95% confidence interval 10.4-13.6 months), RANO-assessed response rate was 80.3% (106/132), and the most common adverse event was myelosuppression (n = 42; 31.8%), which reversed after symptomatic treatment. The results of subgroup analysis showed that absence of brain parenchymal metastasis, good Eastern Cooperative Oncology Group score, good response to IP treatment, negative cytology after treatment, and patients without neck/back pain/difficult defecation had longer survival. Gender, age, previous intrathecal methotrexate/cytarabine, and whole-brain radiotherapy had no significant influence on OS. CONCLUSIONS This study further showed that IP is an effective and safe treatment method for the EGFR-TKI-failed NSCLC-LM, and should be recommended for these patients in clinical practice and guidelines.
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Affiliation(s)
- C Fan
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - Z Jiang
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - C Teng
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - X Song
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - L Li
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - W Shen
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - Q Jiang
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - D Huang
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - Y Lv
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - L Du
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - G Wang
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - Y Hu
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - S Man
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - Z Zhang
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin
| | - N Gao
- Department of Oncology, Heilongjiang Sengong General Hospital, Harbin, People's Republic of China
| | - F Wang
- Department of Oncology, Heilongjiang Sengong General Hospital, Harbin, People's Republic of China
| | - T Shi
- Department of Oncology, Heilongjiang Sengong General Hospital, Harbin, People's Republic of China
| | - T Xin
- Department of Oncology, Second Affiliated Hospital of Harbin Medical University, Harbin.
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Wang Z, Song X, Waitman LR, Hyams JS, Denson LA. Fitness-for-use of Retrospective Multicenter Electronic Health Records to Conduct Outcome Analysis for Pediatric Ulcerative Colitis. Medicine (Baltimore) 2024; 103:e37395. [PMID: 38489703 PMCID: PMC10939680 DOI: 10.1097/md.0000000000037395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/11/2023] [Accepted: 02/06/2024] [Indexed: 03/17/2024] Open
Abstract
The use of electronic health records has garnered interest as an approach for conducting innovative outcome research and producing real-world evidence at a reduced cost compared to traditional clinical trials. The study aimed to evaluate the utility of deidentified EHR data from a multicenter research network to identify characteristics associated with treatment escalation (TE) in newly diagnosed pediatric ulcerative colitis patients. EHR data (01/2010-12/2021) from 13 Midwest healthcare systems (Greater Plains Collaborative) were collected for pediatric ulcerative colitis patients. We identified standard treatments, excluded missing initial therapy data, and analyzed the TE and time-to-TE outcomes. The clinical and laboratory characteristics at baseline were extracted. Logistic and Cox models were used, and the missing risk factors were imputed. Machine-learning Bayesian additive regression trees were also utilized to create partial dependence plots for assessing the associations between risk factors and clinical outcomes. A total of 502 eligible pediatric patients (aged 4-17 years) who initiated standard treatment were identified. Among them, 205 out of 502 (41%) experienced TE, with a median (P25, P75) duration of 63 (9, 237) days after the initial treatment. Additionally, 20 out of 509 (4%) patients underwent colectomy (COL) with a median (P25, P75) duration of 80 (3, 205) days. Both multivariable logistic regression and Cox proportional hazards regression demonstrated moderate discriminative power in predicting TE and time-to-TE, respectively. Common positive predictors for both TE and time-to-TE included a high monocyte proportion and elevated platelet counts. Conversely, BMI z-score, albumin, hemoglobin levels, and lymphocyte proportion were negatively associated with both TE and time-to-TE. This study demonstrates that multicenter EHR data can be used to identify a trial-comparable study sample of potentially larger size and to identify clinically meaningful endpoints for conducting outcome analysis and generating real-world evidence.
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Affiliation(s)
- Zhu Wang
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Xing Song
- Biomedical Informatics, Biostatistics and Medical Epidemiology, University of Missouri, Columbia, MO
| | - Lemuel R Waitman
- Biomedical Informatics, Biostatistics and Medical Epidemiology, University of Missouri, Columbia, MO
| | | | - Lee A Denson
- Cincinnati Children's Medical Center, Cincinnati, OH
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Kong H, Cao J, Tian J, Yong J, An J, Song X, He Y. Relationship between coronary microvascular dysfunction (CMD) and left ventricular diastolic function in patients with symptoms of myocardial ischemia with non-obstructive coronary artery disease (INOCA) by cardiovascular magnetic resonance feature-tracking. Clin Radiol 2024:S0009-9260(24)00129-6. [PMID: 38679491 DOI: 10.1016/j.crad.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/18/2024] [Accepted: 02/20/2024] [Indexed: 05/01/2024]
Abstract
AIM To investigate whether there was an association between coronary microvascular dysfunction (CMD) and left ventricular (LV) diastolic function in patients with myocardial ischemia with non-obstructive coronary artery disease (INOCA). MATERIALS AND METHODS Our study included 115 subjects with suspected myocardial ischemia that underwent stress perfusion cardiac magnetic resonance (CMR). They were divided into non-CMD and CMD two groups. CMR-derived volume-time curves and CMR-FT parameters were used to assess LV diastolic function using CVI42 software. The latter included global/regional LV peak longitudinal, circumferential, radial diastolic strain rate (LDSR, CDSR, RDSR). Logistic regression analysis was performed with CMR-FT strain parameters as independent variables and CMD as dependent variables, and the effect value was expressed as an odds ratio (OR). RESULTS Of the 115 patients, we excluded data from 23 patients and 92 patients (56.5% male;52 ± 12 years) were finally included in the study. Of these, 19 patients were included in the non-CMD group (49 ± 11 years) and CMD group included 73patient (52 ± 12 years). The regional CDSR (P=0.019), and regional RDSR (P=0.006) were significantly lower in the CMD group than in non-CMD group. But, regional LDSR in CMD group was higher than non-CMD (P=0.003). In logistic regression analysis, regional LDSR (adjusted β= 0.1, 95%CI 0.077, 0.349, p=0.002) and RDSR (adjusted β= 0.1, 95 % CI 0.066, 0.356, p=0.004) were related to CMD. CONCLUSIONS LV myocardial perfusion parameter MPRI was negatively correlated with LV diastolic function (CDSR) which needs to take into account the degree of diastolic dysfunction.
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Affiliation(s)
- H Kong
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - J Cao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - J Tian
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - J Yong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - J An
- Siemens Shenzhen Magnetic Resonance, MR Collaboration NE Asia, Shenzhen, China
| | - X Song
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
| | - Y He
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
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10
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Wang Z, Nie J, Song X, Denson LA, Hyams JS. A comparison of Bayesian and frequentist approaches to incorporating clinical and biological information for the prediction of response to standardized pediatric colitis therapy. PLoS One 2024; 19:e0295814. [PMID: 38446811 PMCID: PMC10917270 DOI: 10.1371/journal.pone.0295814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/28/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND The prospective cohort study PROTECT is the largest study in pediatric ulcerative colitis (UC) with standardized treatments, providing valuable data for predicting clinical outcomes. PROTECT and previous studies have identified characteristics associated with clinical outcomes. In this study, we aimed to compare predictive modeling between Bayesian analysis including machine learning and frequentist analysis. METHODS The key outcomes for this analysis were week 4, 12 and 52 corticosteroid (CS)-free remission following standardized treatment from diagnosis. We developed predictive modeling with multivariable Bayesian logistic regression (BLR), Bayesian additive regression trees (BART) and frequentist logistic regression (FLR). The effect estimate of each risk factor was estimated and compared between the BLR and FLR models. The predictive performance of the models was assessed including area under curve (AUC) of the receiver operating characteristic (ROC) curve. Ten-fold cross-validation was performed for internal validation of the models. The estimation contained 95% credible (or confidence) interval (CI). RESULTS The statistically significant associations between the risk factors and early or late outcomes were consistent between all BLR and FLR models. The model performance was similar while BLR and BART models had narrower credible intervals of AUCs. To predict week 4 CS-free remission, the BLR model had AUC of 0.69 (95% CI 0.67-0.70), the BART model had AUC of 0.70 (0.67-0.72), and the FLR had AUC of 0.70 (0.65-0.76). To predict week 12 CS-free remission, the BLR model had AUC of 0.78 (0.77-0.79), the BART model had AUC of 0.78 (0.77-0.79), and the FLR model had AUC of 0.79 (0.74-0.83). To predict week 52 CS-free remission, the BLR model had AUC of 0.69 (0.68-0.70), the BART model had AUC of 0.69 (0.67-0.70), and the FLR model had AUC of 0.69 (0.64-0.74). The BART model identified nonlinear associations. CONCLUSIONS BLR and BART models had intuitive interpretation on interval estimation, better precision in estimating the AUC and can be alternatives for predicting clinical outcomes in pediatric patients with UC. BART model can estimate nonlinear nonparametric association.
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Affiliation(s)
- Zhu Wang
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Jia Nie
- Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States of America
| | - Xing Song
- Health Management and Informatics, University of Missouri, Columbia, MO, United States of America
| | - Lee A. Denson
- Cincinnati Children’s Hospital and Medical Center, Cincinnati, OH, United States of America
| | - Jeffrey S. Hyams
- Connecticut Children’s Medical Center, Hartford, CT, United States of America
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11
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Chen W, Yang Z, Liu CH, Jia XY, Zhang YT, Song X, Li S. [The cutoff value of small airway dysfunction in children with bronchial asthma]. Zhonghua Er Ke Za Zhi 2024; 62:245-249. [PMID: 38378286 DOI: 10.3760/cma.j.cn112140-20231012-00278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Objective: To explore the cutoff value for assessing small airway dysfunction in children with asthma. Methods: A total of 364 asthmatic children aged 5 to 14 years, with normal ventilatory function, followed up at the Asthma Clinic of the Children's Hospital of Capital Institute of Pediatrics from January 2017 to January 2018, were selected as the case group. Concurrently, 403 healthy children of the same age range and without any symptoms in the community were chosen as the control group, and pulmonary function tests were conducted. The values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory flow at 50% of FVC (FEF50), forced expiratory flow at 75% of FVC (FEF75) and maximum mid-expiratory flow (MMEF) were compared between case group and control group. Statistical tests such as t-test, χ2 test, or Mann-Whitney U test were used to analyze the differences between the groups. Receiver operating characteristic (ROC) curves were constructed, and the maximum Youden Index was utilized to determine the optimal cutoff values and thresholds for identifying small airway dysfunction in asthmatic children. Results: This study comprised 364 children in the case group (220 boys and 144 girls) and 403 children in the control group (198 boys and 205 girls). The small airway parameters (FEF50%pred, FEF75%pred, MMEF%pred) in the asthmatic group were significantly lower than in the control group (77% (69%, 91%) vs. 95% (83%, 109%), 67% (54%, 82%) vs. 84% (70%, 102%), 76% (66%, 90%) vs. 97% (86%, 113%), Z=12.03, 11.35, 13.66, all P<0.001). The ROC curve area under the curve for FEF50%pred, FEF75%pred, MMEF%pred was 0.75, 0.74, and 0.79, respectively. Using a cutoff value of 80% for FEF50%pred achieved a sensitivity of 56.9% and specificity of 81.4%. A cutoff value of 74% for FEF75%pred resulted in a sensitivity of 67.3% and specificity of 69.2%. Finally, using a cutoff value of 84% for MMEF%pred achieved a sensitivity of 67.9% and specificity of 77.2%. Conclusion: In the presence of normal ventilatory function, utilizing FEF50<80% predicted or MMEF<84% predicted can accurately serve as criteria for identifying small airway dysfunction in children with controlled asthma.
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Affiliation(s)
- W Chen
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - Z Yang
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - C H Liu
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - X Y Jia
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - Y T Zhang
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - X Song
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
| | - S Li
- Department of Allergy, Children's Hospital of Capital Institute of Pediatrics, Beijing 100020, ChinaChen Wei is studying at Graduate School, School of Clinical Medicine of Shandong Second Medical University, Weifang 261000, China
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12
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Gupta A, Chouhdry H, Ellis SD, Young K, Mahnken J, Comfort B, Shanks D, McGreevy S, Rudy C, Zufer T, Mabry S, Woodward J, Wilson A, Anderson H, Loucks J, Chandaka S, Abu-El-Rub N, Mazzotti DR, Song X, Schmitz N, Conroy M, Supiano MA, Waitman LR, Burns JM. Design of a pragmatic randomized implementation effectiveness trial testing a health system wide hypertension program for older adults. Contemp Clin Trials 2024; 138:107466. [PMID: 38331381 DOI: 10.1016/j.cct.2024.107466] [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: 10/30/2023] [Revised: 01/22/2024] [Accepted: 02/05/2024] [Indexed: 02/10/2024]
Abstract
Hypertension control remains poor. Multiple barriers at the level of patients, providers, and health systems interfere with implementation of hypertension guidelines and effective lowering of BP. Some strategies such as self-measured blood pressure (SMBP) and remote management by pharmacists are safe and effectively lower BP but have not been effectively implemented. In this study, we combine such evidence-based strategies to build a remote hypertension program and test its effectiveness and implementation in large health systems. This randomized, controlled, pragmatic type I hybrid implementation effectiveness trial will examine the virtual collaborative care clinic (vCCC), a hypertension program that integrates automated patient identification, SMBP, remote BP monitoring by trained health system pharmacists, and frequent patient-provider communication. We will randomize 1000 patients with uncontrolled hypertension from two large health systems in a 1:1 ratio to either vCCC or control (usual care with education) groups for a 2-year intervention. Outcome measures including BP measurements, cognitive function, and a symptom checklist will be completed during study visits. Other outcome measures of cardiovascular events, mortality, and health care utilization will be assessed using Medicare data. For the primary outcome of proportion achieving BP control (defined as systolic BP < 130 mmHg) in the two groups, we will use a generalized linear mixed model analysis. Implementation outcomes include acceptability and feasibility of the program. This study will guide implementation of a hypertension program within large health systems to effectively lower BP.
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Affiliation(s)
- Aditi Gupta
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States; Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States.
| | - Hira Chouhdry
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Shellie D Ellis
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Kate Young
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jonathan Mahnken
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States
| | - Branden Comfort
- Division of General Internal Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Denton Shanks
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Sheila McGreevy
- Division of General Internal Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Courtney Rudy
- Division of General Internal Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Tahira Zufer
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Sharissa Mabry
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jennifer Woodward
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Amber Wilson
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Heidi Anderson
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jennifer Loucks
- Department of Pharmacy, University of Kansas Health System, Kansas City, KS, United States
| | - Sravani Chandaka
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Noor Abu-El-Rub
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Diego R Mazzotti
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Xing Song
- Department of Biomedical Informatics, Biostatistics, and Medical Epidemiology, University of Missouri, Columbia, MO, United States
| | - Nolan Schmitz
- Department of Pharmacy, University of Kansas Health System, Kansas City, KS, United States
| | - Molly Conroy
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Mark A Supiano
- Geriatrics Division, Department of Internal Medicine, University of Utah Spencer Fox Eccles School of Medicine and Center on Aging, University of Utah, Salt Lake City, UT, United States
| | - Lemuel R Waitman
- Department of Biomedical Informatics, Biostatistics, and Medical Epidemiology, University of Missouri, Columbia, MO, United States
| | - Jeffrey M Burns
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
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Sun R, Xi K, Ji S, Song X, Xi D, Yin W, Shao Y, Gu W, Jiang J. TDP-43 was Involved in Radiation-induced Neuronal Damage and May Not Through the BDNF/TrkB Pathway. Radiat Res 2024; 201:240-251. [PMID: 38235539 DOI: 10.1667/rade-23-00168.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
Cognitive dysfunction is the most common form of radiation-induced brain injury. TDP-43 is known to be associated with hippocampal degeneration and cognitive dysfunction, in this study we wanted to know if it also had an effect on radiation-induced hippocampus damage. At first, we found the expression of TDP-43 and p-TDP-43 was increased in the hippocampus of rats with radiation-induced cognitive dysfunction. Single-cell RNA-seq analysis of the rat hippocampus showed that TDP-43 was expressed in all cell types and was significantly upregulated in neuron cells after irradiation. Enrichment analysis of gene ontology (GO) functions and KEGG pathways showed that the differential expression genes in neuron after irradiation may be involved in synaptic plasticity. In vitro, the expression of TDP-43 was also increased in neuron cells after irradiation, while the expression of brain-derived neurotrophic factor (BDNF), TrkB, typical synaptic signature proteins (SYN, GAP43 and PSD95), β-tubulin and dendritic spines were decreased. In the irradiated neurons, the β-tubulin, dendritic and spines typical synaptic signature proteins had more severe damage in pcDNA3.1-TDP-43 plasmid transfections group, however, the damages were alleviated in the siRNA-TDP-43 plasmid transfections group. BDNF was highly expressed in the irradiated pcDNA3.1-TDP-43 plasmid transfections group, while its expression was decreased in the siRNA-TDP-43 group. The TrkB expression was significantly reduced in neurons after exposure to ionizing radiation, however, there was no significant correlation with TDP-43 expression. These data indicate that TDP-43 is involved in radiation-induced neuronal synaptic plasticity decline and developmental damage, furthermore, the BDNF/TrkB signaling pathway may not be involved in this process.
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Affiliation(s)
- Rui Sun
- Department of Oncology Radiotherapy
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Kedi Xi
- Department of Oncology Radiotherapy
| | - Shengjun Ji
- Department of Radiotherapy and Oncology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | | | - Dan Xi
- Department of Oncology Radiotherapy
| | | | | | | | - Jingting Jiang
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
- Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou, Jiangsu, China
- Institute of Cell Therapy, Soochow University, Changzhou, Jiangsu, China
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14
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Ogundele OB, Song X, Rao P, Greever-Rice T, Boren SA, Edison K, Burgess D, Becevic M. Claims data analysis of provider-to-provider tele-mentoring program impact on opioid prescribing in Missouri. J Opioid Manag 2024; 20:133-147. [PMID: 38700394 DOI: 10.5055/jom.0825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
OBJECTIVE The objective of this study was to assess opioid prescribing patterns of primary care providers (PCPs) participating in a virtual tele-mentoring program for patients with chronic pain as compared to nonparticipants. DESIGN We utilized Missouri Medicaid claims from 2013 to 2021 to compare opioid prescription dosages and daily supply of opioids prescribed by PCPs. Participants and nonparticipants were matched using propensity score matching. SETTING Missouri Medicaid data were received through partnership with the Center for Health Policy's MO HealthNet Data Project, the state's leading provider of Medicaid data. PARTICIPANTS Missouri-based prescribers. INTERVENTION Show-Me Project Extension for Community Healthcare Outcomes (ECHO), an evidence-based provider-to-provider telehealth intervention that connects PCPs with a team of specialists. MAIN OUTCOME MEASURES We compared the rate of prescription opioid >50 morphine milligram equivalents (MMEs), mean MMEs/day, and mean number of daily supply to understand the impact of the ECHO model on providers' opioid prescribing. RESULTS Patients treated by ECHO providers have 33 percent lower odds of being prescribed opioid dose >50 MME/day (p < 0.001) compared to non-ECHO providers. There is also a 14 percent reduction in the average opioid dose prescribed to patients of ECHO providers (p < 0.001). We observed a 3 percent (p < 0.001) reduction in average daily supply of opioids among patients of ECHO providers compared to the comparison group. CONCLUSIONS Pain Management ECHO supports PCPs with needed education and skills to provide specialty care in the management of pain conditions and safe prescribing of opioid medications.
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Affiliation(s)
- Olabode B Ogundele
- Institute for Data Science and Informatics; Missouri Telehealth Network, University of Missouri, Columbia, Missouri
| | - Xing Song
- Institute for Data Science and Informatics; Biomedical Informatics, Biostatistics and Medical Epidemiology (BBME), Columbia, Missouri
| | - Praveen Rao
- Institute for Data Science and Informatics; Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, Missouri
| | | | - Suzanne A Boren
- Institute for Data Science and Informatics; College of Health Sciences, University of Missouri, Columbia, Missouri
| | - Karen Edison
- Missouri Telehealth Network; Center for Health Policy, Department of Dermatology, University of Missouri, Columbia, Missouri
| | - Douglas Burgess
- Department of Psychiatry, University of Missouri-Kansas City (UMKC), Kansas City, Missouri
| | - Mirna Becevic
- Institute for Data Science and Informatics; Missouri Telehealth Network; Department of Dermatology, University of Missouri, Columbia, Missouri. ORCID: https://orcid.org/0000-0001-6520-1581
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15
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Mazzotti DR, Waitman LR, Miller J, Sundar KM, Stewart NH, Gozal D, Song X. Positive Airway Pressure Therapy Predicts Lower Mortality and Major Adverse Cardiovascular Events Incidence in Medicare Beneficiaries with Obstructive Sleep Apnea. medRxiv 2024:2023.07.26.23293156. [PMID: 37546959 PMCID: PMC10402241 DOI: 10.1101/2023.07.26.23293156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Background Obesity is associated with obstructive sleep apnea (OSA) and cardiovascular risk. Positive airway pressure (PAP) is the first line treatment for OSA, but evidence on its beneficial effect on major adverse cardiovascular events (MACE) prevention is limited. Using claims data, the effects of PAP on mortality and incidence of MACE among Medicare beneficiaries with OSA were examined. Methods A cohort of Medicare beneficiaries with ≥2 distinct OSA claims was defined from multi-state, state-wide, multi-year (2011-2020) Medicare fee-for-service claims data. Evidence of PAP initiation and utilization was based on PAP claims after OSA diagnosis. MACE was defined as a composite of myocardial infarction, heart failure, stroke, or coronary revascularization. Doubly robust Cox proportional hazards models with inverse probability of treatment weights estimated treatment effects controlling for sociodemographic and clinical factors. Results Among 888,835 beneficiaries with OSA (median age 73 years; 43.9% women; median follow-up 1,141 days), those with evidence of PAP initiation (32.6%) had significantly lower all-cause mortality (HR [95%CI]: 0.53 [0.52-0.54]) and MACE incidence risk (0.90 [0.89-0.91]). Higher quartiles of annual PAP claims were progressively associated with lower mortality (Q2: 0.84 [0.81-0.87], Q3: 0.76 [0.74-0.79], Q4: 0.74 [0.72-0.77]) and MACE incidence risk (Q2: 0.92 [0.89-0.95], Q3: 0.89 [0.86-0.91], Q4: 0.87 [0.85-0.90]). Conclusion PAP utilization was associated with lower all-cause mortality and MACE incidence among Medicare beneficiaries with OSA. Results might inform trials assessing the importance of OSA therapy towards minimizing cardiovascular risk and mortality in older adults.
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16
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Yamada K, Bixler B, Sakurai Y, Ashton PC, Sugiyama J, Arnold K, Begin J, Corbett L, Day-Weiss S, Galitzki N, Hill CA, Johnson BR, Jost B, Kusaka A, Koopman BJ, Lashner J, Lee AT, Mangu A, Nishino H, Page LA, Randall MJ, Sasaki D, Song X, Spisak J, Tsan T, Wang Y, Williams PA. The Simons Observatory: Cryogenic half wave plate rotation mechanism for the small aperture telescopes. Rev Sci Instrum 2024; 95:024504. [PMID: 38385955 DOI: 10.1063/5.0178066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/01/2024] [Indexed: 02/23/2024]
Abstract
We present the requirements, design, and evaluation of the cryogenic continuously rotating half-wave plate (CHWP) for the Simons Observatory (SO). SO is a cosmic microwave background polarization experiment at Parque Astronómico de Atacama in northern Chile that covers a wide range of angular scales using both small (⌀0.42 m) and large (⌀6 m) aperture telescopes. In particular, the small aperture telescopes (SATs) focus on large angular scales for primordial B-mode polarization. To this end, the SATs employ a CHWP to modulate the polarization of the incident light at 8 Hz, suppressing atmospheric 1/f noise and mitigating systematic uncertainties that would otherwise arise due to the differential response of detectors sensitive to orthogonal polarizations. The CHWP consists of a 505 mm diameter achromatic sapphire HWP and a cryogenic rotation mechanism, both of which are cooled down to ∼50 K to reduce detector thermal loading. Under normal operation, the HWP is suspended by a superconducting magnetic bearing and rotates with a constant 2 Hz frequency, controlled by an electromagnetic synchronous motor. We find that the number of superconductors and the number of magnets that make up the superconducting magnetic bearing are important design parameters, especially for the rotation mechanism's vibration performance. The rotation angle is detected through an angular encoder with a noise level of 0.07 μrad s. During a cooldown process, the rotor is held in place by a grip-and-release mechanism that serves as both an alignment device and a thermal path. In this paper, we provide an overview of the SO SAT CHWP: its requirements, hardware design, and laboratory performance.
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Affiliation(s)
- K Yamada
- Department of Physics, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - B Bixler
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - Y Sakurai
- Graduate School of Natural Science and Technology, Okayama University, Okayama 700-8530, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), UTIAS, The University of Tokyo, Chiba 277-8583, Japan
| | - P C Ashton
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), UTIAS, The University of Tokyo, Chiba 277-8583, Japan
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J Sugiyama
- Department of Physics, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - K Arnold
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - J Begin
- Joseph Henry Laboratories of Physics, Jadwin Hall, Princeton University, Princeton, New Jersey 08544, USA
| | - L Corbett
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - S Day-Weiss
- Joseph Henry Laboratories of Physics, Jadwin Hall, Princeton University, Princeton, New Jersey 08544, USA
| | - N Galitzki
- Department of Physics, University of Texas at Austin, Austin, Texas 78722, USA
- Weinberg Institute for Theoretical Physics, Texas Center for Cosmology and Astroparticle Physics, Austin, Texas 78712, USA
| | - C A Hill
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - B R Johnson
- Department of Astronomy, University of Virginia, Charlottesville, Virginia 22904, USA
| | - B Jost
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), UTIAS, The University of Tokyo, Chiba 277-8583, Japan
| | - A Kusaka
- Department of Physics, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), UTIAS, The University of Tokyo, Chiba 277-8583, Japan
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B J Koopman
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - J Lashner
- Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
| | - A T Lee
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - A Mangu
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - H Nishino
- Research Center for the Early Universe, School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - L A Page
- Joseph Henry Laboratories of Physics, Jadwin Hall, Princeton University, Princeton, New Jersey 08544, USA
| | - M J Randall
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - D Sasaki
- Department of Physics, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan
| | - X Song
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - J Spisak
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - T Tsan
- Department of Physics, University of California, San Diego, La Jolla, California 92093, USA
| | - Y Wang
- Joseph Henry Laboratories of Physics, Jadwin Hall, Princeton University, Princeton, New Jersey 08544, USA
| | - P A Williams
- Physics Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
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Le Y, Wang R, Xing H, Chen H, Song X, He Y. Pericoronary adipose tissue attenuation predicts outcome of percutaneous intervention for chronic total occlusion. Clin Radiol 2024; 79:e232-e238. [PMID: 38087681 DOI: 10.1016/j.crad.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/25/2023] [Accepted: 10/10/2023] [Indexed: 01/02/2024]
Abstract
AIM To investigate the association between pericoronary adipose tissue (PCAT) attenuation (PCATA) and outcomes of chronic total occlusion (CTO) after percutaneous coronary intervention (PCI), and to establish a clinical model that can be easily generalised to predict the outcomes of PCI-CTO. MATERIALS AND METHODS Between September 2015 and September 2019, patients from two centres were enrolled retrospectively. The primary endpoint was a procedural success (defined as achieving residual stenosis of <30% and a grade 3 thrombolysis in myocardial infarction [TIMI] flow). The new predictive model was generated by factors that were determined by multivariate analysis. The PCATA of CTO (PCATA-CTO) score was developed by assigning 1 point for each independent predictor, and then summing all points accrued. In addition, the predictive efficacy and interobserver and intraobserver agreement of PCATA-CTO and other scoring systems based on coronary computed tomography angiography (CCTA) were compared. RESULTS A total of 201 patients (mean age 58.9 ± 10.8 years, 85% male) were enrolled. The PCI success was achieved in 76% of the lesions. PCAT was higher in the PCI success group (-72.44 ± 10.45HU versus -76.76 ± 10.54 HU, p<0.05). Multivariable analysis yielded severe calcification, lesion length ≥15 mm, and perivascular fat attenuation index (FAI) ≤-69.5HU as independent negative predictors for procedural success. The area under the receiver operating characteristic curves for the PCATA-CTO score was 0.72. Comparing the PCATA-CTO score with other predictive scores, the PCATA-CTO score showed the highest interobserver (kappa = 0.74) and intraobserver agreement (kappa = 0.90, all p<0.01). CONCLUSION FAI ≤-69.5HU is an independent negative predictor of procedural success. The PCATA-CTO score improved the reliability of the prediction model. Its potential for clinical implementation requires evaluation.
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Affiliation(s)
- Y Le
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - R Wang
- Department of Radiology, Affiliated Hospital, Chengde Medical University, Hebei 067020, China
| | - H Xing
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - H Chen
- Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - X Song
- Department of Radiology, Affiliated Hospital, Chengde Medical University, Hebei 067020, China.
| | - Y He
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
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Turabieh H, Afshar AS, Statland J, Song X. Towards a Machine Learning Empowered Prognostic Model for Predicting Disease Progression for Amyotrophic Lateral Sclerosis. AMIA Annu Symp Proc 2024; 2023:718-725. [PMID: 38222431 PMCID: PMC10785857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Amyotrophic lateral sclerosis (ALS) is a rare and devastating neurodegenerative disorder that is highly heterogeneous and invariably fatal. Due to the unpredictable nature of its progression, accurate tools and algorithms are needed to predict disease progression and improve patient care. To address this need, we developed and compared an extensive set of screener-learner machine learning models to accurately predict the ALS Function-Rating-Scale (ALSFRS) score reduction between 3 and 12 months, by paring 5 state-of-arts feature selection algorithms with 17 predictive models and 4 ensemble models using the publicly available Pooled Open Access Clinical Trials Database (PRO-ACT). Our experiment showed promising results with the blender-type ensemble model achieving the best prediction accuracy and highest prognostic potential.
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Affiliation(s)
- Hamza Turabieh
- Department of Health Management and Informatics, School of Medicine, University of Missouri-Columbia
| | - Askar S Afshar
- Department of Health Management and Informatics, School of Medicine, University of Missouri-Columbia
| | - Jeffery Statland
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Xing Song
- Department of Health Management and Informatics, School of Medicine, University of Missouri-Columbia
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Gupta S, Song X. Real-World Analysis of Antipsychotic Drugs' Effect on Weight Gain: An EHR Application. AMIA Annu Symp Proc 2024; 2023:961-968. [PMID: 38222412 PMCID: PMC10785896] [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] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Affiliation(s)
- Shraddha Gupta
- School of Medicine at University of Missouri-Columbia, MO
| | - Xing Song
- Department of Health Management and Informatics, University of Missouri Hospital, MO
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Su R, Zhu LM, Huang GH, Li PL, Ge L, Liao MZ, Fu Y, Song X, Li DM. [Analysis on the use of HIV post-exposure prophylaxis and related factors in men who have sex with men in Qingdao]. Zhonghua Liu Xing Bing Xue Za Zhi 2024; 45:134-138. [PMID: 38228536 DOI: 10.3760/cma.j.cn112338-20230530-00339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Objective: To understand the use of post-exposure prophylaxis (PEP) and analyze related factors among men who have sex with men (MSM) in Qingdao, and provide a reference for the AIDS prevention and control in this population. Methods: A cross-sectional survey conducted from April 2022 to February 2023. Relying on MSM social groups in Qingdao, a snowball sampling method was applied to recruit research subjects who met the inclusion criteria of age ≥18 years old, having had homosexual anal or oral sex in the past six months, and HIV-negative or infection status unknown. The sample size was estimated at 566. Data on demographic characteristics, sexual behavior characteristics, PEP use, and others of the research subjects was collected through on-site questionnaires. The logistic regression model was used to analyze the factors associated with using PEP. Results: A total of 811 participants were recruited, mainly aged 25-34 (53.6%, 435/811), unmarried (74.7%, 606/811), with an average monthly income of ≥5 000 yuan (52.2%, 423/811), and having lived in Qingdao for ≥10 years (75.6%, 613/811). The proportion of those who knew the HIV status of their sexual partners in the last six months was 67.1% (544/811), and those with HIV-positive partners were 3.6% (29/811). In the last six months, the proportion of participants who had group sex (86.4%, 701/811), unprotected anal sex (98.2%, 796/811), and use of club drugs (80.3%, 651/811) was high. Moreover, 28.4% (230/811) had used PEP. The multivariate logistic regression analysis showed that the factors related to the use of PEP included divorced or widowed (aOR=5.46,95%CI:1.96-15.17), average monthly income ≥5 000 yuan (aOR=2.04,95%CI:1.44-2.89), same-sex sexual orientation (aOR=0.40,95%CI:0.22-0.71), having HIV-positive sexual partners in the last six months (aOR=2.54,95%CI:1.13-5.71) and having been tested for HIV ≥3 times in the last six months (aOR=1.46,95%CI:1.04-2.06). Conclusions: The prevalence of risk behaviors among MSM in Qingdao was high, and the use of PEP was low. In the future, it is essential to increase HIV/AIDS prevention education among MSM, promote MSM to know the HIV status of their sexual partners, and reduce the prevalence of risk behaviors among this population. Additionally, explore medical insurance reimbursement plans for PEP to reduce utilization costs and promote the use of PEP by MSM after HIV exposure occurs as soon as possible.
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Affiliation(s)
- R Su
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L M Zhu
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - G H Huang
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - P L Li
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L Ge
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - M Z Liao
- Department of AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, Ji'nan 250014, China
| | - Y Fu
- Qingdao Center for Disease Control and Prevention, Qingdao 266033, China
| | - X Song
- Qingdao Center for Disease Control and Prevention, Qingdao 266033, China
| | - D M Li
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Staplin N, Haynes R, Judge PK, Wanner C, Green JB, Emberson J, Preiss D, Mayne KJ, Ng SYA, Sammons E, Zhu D, Hill M, Stevens W, Wallendszus K, Brenner S, Cheung AK, Liu ZH, Li J, Hooi LS, Liu WJ, Kadowaki T, Nangaku M, Levin A, Cherney D, Maggioni AP, Pontremoli R, Deo R, Goto S, Rossello X, Tuttle KR, Steubl D, Petrini M, Seidi S, Landray MJ, Baigent C, Herrington WG, Abat S, Abd Rahman R, Abdul Cader R, Abdul Hafidz MI, Abdul Wahab MZ, Abdullah NK, Abdul-Samad T, Abe M, Abraham N, Acheampong S, Achiri P, Acosta JA, Adeleke A, Adell V, Adewuyi-Dalton R, Adnan N, Africano A, Agharazii M, Aguilar F, Aguilera A, Ahmad M, Ahmad MK, Ahmad NA, Ahmad NH, Ahmad NI, Ahmad Miswan N, Ahmad Rosdi H, Ahmed I, Ahmed S, Ahmed S, Aiello J, Aitken A, AitSadi R, Aker S, Akimoto S, Akinfolarin A, Akram S, Alberici F, Albert C, Aldrich L, Alegata M, Alexander L, Alfaress S, Alhadj Ali M, Ali A, Ali A, Alicic R, Aliu A, Almaraz R, Almasarwah R, Almeida J, Aloisi A, Al-Rabadi L, Alscher D, Alvarez P, Al-Zeer B, Amat M, Ambrose C, Ammar H, An Y, Andriaccio L, Ansu K, Apostolidi A, Arai N, Araki H, Araki S, Arbi A, Arechiga O, Armstrong S, Arnold T, Aronoff S, Arriaga W, Arroyo J, Arteaga D, Asahara S, Asai A, Asai N, Asano S, Asawa M, Asmee MF, Aucella F, Augustin M, Avery A, Awad A, Awang IY, Awazawa M, Axler A, Ayub W, Azhari Z, Baccaro R, Badin C, Bagwell B, Bahlmann-Kroll E, Bahtar AZ, Baigent C, Bains D, Bajaj H, Baker R, Baldini E, Banas B, Banerjee D, Banno S, Bansal S, Barberi S, Barnes S, Barnini C, Barot C, Barrett K, Barrios R, Bartolomei Mecatti B, Barton I, Barton J, Basily W, Bavanandan S, Baxter A, Becker L, Beddhu S, Beige J, Beigh S, Bell S, Benck U, Beneat A, Bennett A, Bennett D, Benyon S, Berdeprado J, Bergler T, Bergner A, Berry M, Bevilacqua M, Bhairoo J, Bhandari S, Bhandary N, Bhatt A, Bhattarai M, Bhavsar M, Bian W, Bianchini F, Bianco S, Bilous R, Bilton J, Bilucaglia D, Bird C, Birudaraju D, Biscoveanu M, Blake C, Bleakley N, Bocchicchia K, Bodine S, Bodington R, Boedecker S, Bolduc M, Bolton S, Bond C, Boreky F, Boren K, Bouchi R, Bough L, Bovan D, Bowler C, Bowman L, Brar N, Braun C, Breach A, Breitenfeldt M, Brenner S, Brettschneider B, Brewer A, Brewer G, Brindle V, Brioni E, Brown C, Brown H, Brown L, Brown R, Brown S, Browne D, Bruce K, Brueckmann M, Brunskill N, Bryant M, Brzoska M, Bu Y, Buckman C, Budoff M, Bullen M, Burke A, Burnette S, Burston C, Busch M, Bushnell J, Butler S, Büttner C, Byrne C, Caamano A, Cadorna J, Cafiero C, Cagle M, Cai J, Calabrese K, Calvi C, Camilleri B, Camp S, Campbell D, Campbell R, Cao H, Capelli I, Caple M, Caplin B, Cardone A, Carle J, Carnall V, Caroppo M, Carr S, Carraro G, Carson M, Casares P, Castillo C, Castro C, Caudill B, Cejka V, Ceseri M, Cham L, Chamberlain A, Chambers J, Chan CBT, Chan JYM, Chan YC, Chang E, Chang E, Chant T, Chavagnon T, Chellamuthu P, Chen F, Chen J, Chen P, Chen TM, Chen Y, Chen Y, Cheng C, Cheng H, Cheng MC, Cherney D, Cheung AK, Ching CH, Chitalia N, Choksi R, Chukwu C, Chung K, Cianciolo G, Cipressa L, Clark S, Clarke H, Clarke R, Clarke S, Cleveland B, Cole E, Coles H, Condurache L, Connor A, Convery K, Cooper A, Cooper N, Cooper Z, Cooperman L, Cosgrove L, Coutts P, Cowley A, Craik R, Cui G, Cummins T, Dahl N, Dai H, Dajani L, D'Amelio A, Damian E, Damianik K, Danel L, Daniels C, Daniels T, Darbeau S, Darius H, Dasgupta T, Davies J, Davies L, Davis A, Davis J, Davis L, Dayanandan R, Dayi S, Dayrell R, De Nicola L, Debnath S, Deeb W, Degenhardt S, DeGoursey K, Delaney M, Deo R, DeRaad R, Derebail V, Dev D, Devaux M, Dhall P, Dhillon G, Dienes J, Dobre M, Doctolero E, Dodds V, Domingo D, Donaldson D, Donaldson P, Donhauser C, Donley V, Dorestin S, Dorey S, Doulton T, Draganova D, Draxlbauer K, Driver F, Du H, Dube F, Duck T, Dugal T, Dugas J, Dukka H, Dumann H, Durham W, Dursch M, Dykas R, Easow R, Eckrich E, Eden G, Edmerson E, Edwards H, Ee LW, Eguchi J, Ehrl Y, Eichstadt K, Eid W, Eilerman B, Ejima Y, Eldon H, Ellam T, Elliott L, Ellison R, Emberson J, Epp R, Er A, Espino-Obrero M, Estcourt S, Estienne L, Evans G, Evans J, Evans S, Fabbri G, Fajardo-Moser M, Falcone C, Fani F, Faria-Shayler P, Farnia F, Farrugia D, Fechter M, Fellowes D, Feng F, Fernandez J, Ferraro P, Field A, Fikry S, Finch J, Finn H, Fioretto P, Fish R, Fleischer A, Fleming-Brown D, Fletcher L, Flora R, Foellinger C, Foligno N, Forest S, Forghani Z, Forsyth K, Fottrell-Gould D, Fox P, Frankel A, Fraser D, Frazier R, Frederick K, Freking N, French H, Froment A, Fuchs B, Fuessl L, Fujii H, Fujimoto A, Fujita A, Fujita K, Fujita Y, Fukagawa M, Fukao Y, Fukasawa A, Fuller T, Funayama T, Fung E, Furukawa M, Furukawa Y, Furusho M, Gabel S, Gaidu J, Gaiser S, Gallo K, Galloway C, Gambaro G, Gan CC, Gangemi C, Gao M, Garcia K, Garcia M, Garofalo C, Garrity M, Garza A, Gasko S, Gavrila M, Gebeyehu B, Geddes A, Gentile G, George A, George J, Gesualdo L, Ghalli F, Ghanem A, Ghate T, Ghavampour S, Ghazi A, Gherman A, Giebeln-Hudnell U, Gill B, Gillham S, Girakossyan I, Girndt M, Giuffrida A, Glenwright M, Glider T, Gloria R, Glowski D, Goh BL, Goh CB, Gohda T, Goldenberg R, Goldfaden R, Goldsmith C, Golson B, Gonce V, Gong Q, Goodenough B, Goodwin N, Goonasekera M, Gordon A, Gordon J, Gore A, Goto H, Goto S, Goto S, Gowen D, Grace A, Graham J, Grandaliano G, Gray M, Green JB, Greene T, Greenwood G, Grewal B, Grifa R, Griffin D, Griffin S, Grimmer P, Grobovaite E, Grotjahn S, Guerini A, Guest C, Gunda S, Guo B, Guo Q, Haack S, Haase M, Haaser K, Habuki K, Hadley A, Hagan S, Hagge S, Haller H, Ham S, Hamal S, Hamamoto Y, Hamano N, Hamm M, Hanburry A, Haneda M, Hanf C, Hanif W, Hansen J, Hanson L, Hantel S, Haraguchi T, Harding E, Harding T, Hardy C, Hartner C, Harun Z, Harvill L, Hasan A, Hase H, Hasegawa F, Hasegawa T, Hashimoto A, Hashimoto C, Hashimoto M, Hashimoto S, Haskett S, Hauske SJ, Hawfield A, Hayami T, Hayashi M, Hayashi S, Haynes R, Hazara A, Healy C, Hecktman J, Heine G, Henderson H, Henschel R, Hepditch A, Herfurth K, Hernandez G, Hernandez Pena A, Hernandez-Cassis C, Herrington WG, Herzog C, Hewins S, Hewitt D, Hichkad L, Higashi S, Higuchi C, Hill C, Hill L, Hill M, Himeno T, Hing A, Hirakawa Y, Hirata K, Hirota Y, Hisatake T, Hitchcock S, Hodakowski A, Hodge W, Hogan R, Hohenstatt U, Hohenstein B, Hooi L, Hope S, Hopley M, Horikawa S, Hosein D, Hosooka T, Hou L, Hou W, Howie L, Howson A, Hozak M, Htet Z, Hu X, Hu Y, Huang J, Huda N, Hudig L, Hudson A, Hugo C, Hull R, Hume L, Hundei W, Hunt N, Hunter A, Hurley S, Hurst A, Hutchinson C, Hyo T, Ibrahim FH, Ibrahim S, Ihana N, Ikeda T, Imai A, Imamine R, Inamori A, Inazawa H, Ingell J, Inomata K, Inukai Y, Ioka M, Irtiza-Ali A, Isakova T, Isari W, Iselt M, Ishiguro A, Ishihara K, Ishikawa T, Ishimoto T, Ishizuka K, Ismail R, Itano S, Ito H, Ito K, Ito M, Ito Y, Iwagaitsu S, Iwaita Y, Iwakura T, Iwamoto M, Iwasa M, Iwasaki H, Iwasaki S, Izumi K, Izumi K, Izumi T, Jaafar SM, Jackson C, Jackson Y, Jafari G, Jahangiriesmaili M, Jain N, Jansson K, Jasim H, Jeffers L, Jenkins A, Jesky M, Jesus-Silva J, Jeyarajah D, Jiang Y, Jiao X, Jimenez G, Jin B, Jin Q, Jochims J, Johns B, Johnson C, Johnson T, Jolly S, Jones L, Jones L, Jones S, Jones T, Jones V, Joseph M, Joshi S, Judge P, Junejo N, Junus S, Kachele M, Kadowaki T, Kadoya H, Kaga H, Kai H, Kajio H, Kaluza-Schilling W, Kamaruzaman L, Kamarzarian A, Kamimura Y, Kamiya H, Kamundi C, Kan T, Kanaguchi Y, Kanazawa A, Kanda E, Kanegae S, Kaneko K, Kaneko K, Kang HY, Kano T, Karim M, Karounos D, Karsan W, Kasagi R, Kashihara N, Katagiri H, Katanosaka A, Katayama A, Katayama M, Katiman E, Kato K, Kato M, Kato N, Kato S, Kato T, Kato Y, Katsuda Y, Katsuno T, Kaufeld J, Kavak Y, Kawai I, Kawai M, Kawai M, Kawase A, Kawashima S, Kazory A, Kearney J, Keith B, Kellett J, Kelley S, Kershaw M, Ketteler M, Khai Q, Khairullah Q, Khandwala H, Khoo KKL, Khwaja A, Kidokoro K, Kielstein J, Kihara M, Kimber C, Kimura S, Kinashi H, Kingston H, Kinomura M, Kinsella-Perks E, Kitagawa M, Kitajima M, Kitamura S, Kiyosue A, Kiyota M, Klauser F, Klausmann G, Kmietschak W, Knapp K, Knight C, Knoppe A, Knott C, Kobayashi M, Kobayashi R, Kobayashi T, Koch M, Kodama S, Kodani N, Kogure E, Koizumi M, Kojima H, Kojo T, Kolhe N, Komaba H, Komiya T, Komori H, Kon SP, Kondo M, Kondo M, Kong W, Konishi M, Kono K, Koshino M, Kosugi T, Kothapalli B, Kozlowski T, Kraemer B, Kraemer-Guth A, Krappe J, Kraus D, Kriatselis C, Krieger C, Krish P, Kruger B, Ku Md Razi KR, Kuan Y, Kubota S, Kuhn S, Kumar P, Kume S, Kummer I, Kumuji R, Küpper A, Kuramae T, Kurian L, Kuribayashi C, Kurien R, Kuroda E, Kurose T, Kutschat A, Kuwabara N, Kuwata H, La Manna G, Lacey M, Lafferty K, LaFleur P, Lai V, Laity E, Lambert A, Landray MJ, Langlois M, Latif F, Latore E, Laundy E, Laurienti D, Lawson A, Lay M, Leal I, Leal I, Lee AK, Lee J, Lee KQ, Lee R, Lee SA, Lee YY, Lee-Barkey Y, Leonard N, Leoncini G, Leong CM, Lerario S, Leslie A, Levin A, Lewington A, Li J, Li N, Li X, Li Y, Liberti L, Liberti ME, Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, 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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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Liew A, Liew YF, Lilavivat U, Lim SK, Lim YS, Limon E, Lin H, Lioudaki E, Liu H, Liu J, Liu L, Liu Q, Liu WJ, Liu X, Liu Z, Loader D, Lochhead H, Loh CL, Lorimer A, Loudermilk L, Loutan J, Low CK, Low CL, Low YM, Lozon Z, Lu Y, Lucci D, Ludwig U, Luker N, Lund D, Lustig R, Lyle S, Macdonald C, MacDougall I, Machicado R, MacLean D, Macleod P, Madera A, Madore F, Maeda K, Maegawa H, Maeno S, Mafham M, Magee J, Maggioni AP, Mah DY, Mahabadi V, Maiguma M, Makita Y, Makos G, Manco L, Mangiacapra R, Manley J, Mann P, Mano S, Marcotte G, Maris J, Mark P, Markau S, Markovic M, Marshall C, Martin M, Martinez C, Martinez S, Martins G, Maruyama K, Maruyama S, Marx K, Maselli A, Masengu A, Maskill A, Masumoto S, Masutani K, Matsumoto M, Matsunaga T, Matsuoka N, Matsushita M, Matthews M, Matthias S, Matvienko E, Maurer M, Maxwell P, Mayne KJ, Mazlan N, Mazlan SA, Mbuyisa A, McCafferty K, McCarroll F, McCarthy T, McClary-Wright C, McCray K, McDermott P, McDonald C, McDougall R, McHaffie E, McIntosh K, McKinley T, McLaughlin S, McLean N, McNeil L, Measor A, Meek J, Mehta A, Mehta R, Melandri M, Mené P, Meng T, Menne J, Merritt K, Merscher S, Meshykhi C, Messa P, Messinger L, Miftari N, Miller R, Miller Y, Miller-Hodges E, Minatoguchi M, Miners M, Minutolo R, Mita T, Miura Y, Miyaji M, Miyamoto S, Miyatsuka T, Miyazaki M, Miyazawa I, Mizumachi R, Mizuno M, Moffat S, Mohamad Nor FS, Mohamad Zaini SN, Mohamed Affandi FA, Mohandas C, Mohd R, Mohd Fauzi NA, Mohd Sharif NH, Mohd Yusoff Y, Moist L, Moncada A, Montasser M, Moon A, Moran C, Morgan N, Moriarty J, Morig G, Morinaga H, Morino K, Morisaki T, Morishita Y, Morlok S, Morris A, Morris F, Mostafa S, Mostefai Y, Motegi M, Motherwell N, Motta D, Mottl A, Moys R, Mozaffari S, Muir J, Mulhern J, Mulligan S, Munakata Y, Murakami C, Murakoshi M, Murawska A, Murphy K, Murphy L, Murray S, Murtagh H, Musa MA, Mushahar L, Mustafa R, Mustafar R, Muto M, Nadar E, Nagano R, Nagasawa T, Nagashima E, Nagasu H, Nagelberg S, Nair H, Nakagawa Y, Nakahara M, Nakamura J, Nakamura R, Nakamura T, Nakaoka M, Nakashima E, Nakata J, Nakata M, Nakatani S, Nakatsuka A, Nakayama Y, Nakhoul G, Nangaku M, Naverrete G, Navivala A, Nazeer I, Negrea L, Nethaji C, Newman E, Ng SYA, Ng TJ, Ngu LLS, Nimbkar T, Nishi H, Nishi M, Nishi S, Nishida Y, Nishiyama A, Niu J, Niu P, Nobili G, Nohara N, Nojima I, Nolan J, Nosseir H, Nozawa M, Nunn M, Nunokawa S, Oda M, Oe M, Oe Y, Ogane K, Ogawa W, Ogihara T, Oguchi G, Ohsugi M, Oishi K, Okada Y, Okajyo J, Okamoto S, Okamura K, Olufuwa O, Oluyombo R, Omata A, Omori Y, Ong LM, Ong YC, Onyema J, Oomatia A, Oommen A, Oremus R, Orimo Y, Ortalda V, Osaki Y, Osawa Y, Osmond Foster J, O'Sullivan A, Otani T, Othman N, Otomo S, O'Toole J, Owen L, Ozawa T, Padiyar A, Page N, Pajak S, Paliege A, Pandey A, Pandey R, Pariani H, Park J, Parrigon M, Passauer J, Patecki M, Patel M, Patel R, Patel T, Patel Z, Paul R, Paul R, Paulsen L, Pavone L, Peixoto A, Peji J, Peng BC, Peng K, Pennino L, Pereira E, Perez E, Pergola P, Pesce F, Pessolano G, Petchey W, Petr EJ, Pfab T, Phelan P, Phillips R, Phillips T, Phipps M, Piccinni G, Pickett T, Pickworth S, Piemontese M, Pinto D, Piper J, Plummer-Morgan J, Poehler D, Polese L, Poma V, Pontremoli R, Postal A, Pötz C, Power A, Pradhan N, Pradhan R, Preiss D, Preiss E, Preston K, Prib N, Price L, Provenzano C, Pugay C, Pulido R, Putz F, Qiao Y, Quartagno R, Quashie-Akponeware M, Rabara R, Rabasa-Lhoret R, Radhakrishnan D, Radley M, Raff R, Raguwaran S, Rahbari-Oskoui F, Rahman M, Rahmat K, Ramadoss S, Ramanaidu S, Ramasamy S, Ramli R, Ramli S, Ramsey T, Rankin A, Rashidi A, Raymond L, Razali WAFA, Read K, Reiner H, Reisler A, Reith C, Renner J, Rettenmaier B, Richmond L, Rijos D, Rivera R, Rivers V, Robinson H, Rocco M, Rodriguez-Bachiller I, Rodriquez R, Roesch C, Roesch J, Rogers J, Rohnstock M, Rolfsmeier S, Roman M, Romo A, Rosati A, Rosenberg S, Ross T, Rossello X, Roura M, Roussel M, Rovner S, Roy S, Rucker S, Rump L, Ruocco M, Ruse S, Russo F, Russo M, Ryder M, Sabarai A, Saccà C, Sachson R, Sadler E, Safiee NS, Sahani M, Saillant A, Saini J, Saito C, Saito S, Sakaguchi K, Sakai M, Salim H, Salviani C, Sammons E, Sampson A, Samson F, Sandercock P, Sanguila S, Santorelli G, Santoro D, Sarabu N, Saram T, Sardell R, Sasajima H, Sasaki T, Satko S, Sato A, Sato D, Sato H, Sato H, Sato J, Sato T, Sato Y, Satoh M, Sawada K, Schanz M, Scheidemantel F, Schemmelmann M, Schettler E, Schettler V, Schlieper GR, Schmidt C, Schmidt G, Schmidt U, Schmidt-Gurtler H, Schmude M, Schneider A, Schneider I, Schneider-Danwitz C, Schomig M, Schramm T, Schreiber A, Schricker S, Schroppel B, Schulte-Kemna L, Schulz E, Schumacher B, Schuster A, Schwab A, Scolari F, Scott A, Seeger W, Seeger W, Segal M, Seifert L, Seifert M, Sekiya M, Sellars R, Seman MR, Shah S, Shah S, Shainberg L, Shanmuganathan M, Shao F, Sharma K, Sharpe C, Sheikh-Ali M, Sheldon J, Shenton C, Shepherd A, Shepperd M, Sheridan R, Sheriff Z, Shibata Y, Shigehara T, Shikata K, Shimamura K, Shimano H, Shimizu Y, Shimoda H, Shin K, Shivashankar G, Shojima N, Silva R, Sim CSB, Simmons K, Sinha S, Sitter T, Sivanandam S, Skipper M, Sloan K, Sloan L, Smith R, Smyth J, Sobande T, Sobata M, Somalanka S, Song X, Sonntag F, Sood B, Sor SY, Soufer J, Sparks H, Spatoliatore G, Spinola T, Squyres S, Srivastava A, Stanfield J, Staplin N, Staylor K, Steele A, Steen O, Steffl D, Stegbauer J, Stellbrink C, Stellbrink E, Stevens W, Stevenson A, Stewart-Ray V, Stickley J, Stoffler D, Stratmann B, Streitenberger S, Strutz F, Stubbs J, Stumpf J, Suazo N, Suchinda P, Suckling R, Sudin A, Sugamori K, Sugawara H, Sugawara K, Sugimoto D, Sugiyama H, Sugiyama H, Sugiyama T, Sullivan M, Sumi M, Suresh N, Sutton D, Suzuki H, Suzuki R, Suzuki Y, Suzuki Y, Suzuki Y, Swanson E, Swift P, Syed S, Szerlip H, Taal M, Taddeo M, Tailor C, Tajima K, Takagi M, Takahashi K, Takahashi K, Takahashi M, Takahashi T, Takahira E, Takai T, Takaoka M, Takeoka J, Takesada A, Takezawa M, Talbot M, Taliercio J, Talsania T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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Li PL, Huang GH, Zhu LM, Song X, Fu Y, Ge L, Tang HL, Li DM. [A cohort study of HIV infection in club drug abusers among men who have sex with men in Qingdao]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:1950-1955. [PMID: 38129152 DOI: 10.3760/cma.j.cn112338-20230402-00203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective: To understand and analyze the incidence of HIV infection in club drug abusers among men who have sex with men (MSM) in Qingdao and provide a reference for the prevention and intervention of this population. Methods: From March 2017 to July 2022, club drug abusers among MSM who are HIV-negative were recruited by snowball sampling of MSM social organizations in Qingdao, a prospective cohort was established, and a follow-up survey was conducted every six months, with the sample size estimated to be 436. The survey contents included demographic characteristics, sexual characteristics, AIDS knowledge awareness, club drug abuse, HIV testing, and other information. HIV infection was the outcome-dependent variable, and the interval between the recruitment into the cohort and the HIV infection was the time-dependent variable. Cox proportional hazards regression analysis was conducted to identify the related factors for HIV infection. Results: A total of 987 participants of club drug abusers among MSM were recruited during the baseline survey and 826 eligible participants were enrolled in this cohort. A total of 46 HIV infection cases were found, and the cumulative follow-up time was 1 960.68 person-years. The incidence of HIV infection was 2.35/100 person-years. The multivariate Cox regression analysis showed that <30 (aHR=3.04, 95%CI: 1.62-5.71) non-Shandong residents (aHR=2.29,95%CI:1.20-4.39) found their partners through offline (aHR=4.62,95%CI:2.05-10.41), homosexual sexual partners >4 (aHR=3.06,95%CI:1.59-5.88), condom broken during sex (aHR=2.24,95%CI:1.21-4.17) and hemorrhage sexual intercourse (aHR=2.56,95%CI:1.31-5.03) were significantly associated with HIV infection in this cohort. Conclusions: The incidence of HIV infection in club drug abusers among MSM in Qingdao is generally low, but knowledge and practice have separated, and the risk of HIV infection is high. The related factors of HIV infection included younger age, non-Shandong residents, finding their partners offline, multiple sexual partners, condom break during sex, and hemorrhage sexual intercourse; HIV-related behavioral intervention should be strengthened.
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Affiliation(s)
- P L Li
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - G H Huang
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L M Zhu
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X Song
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China
| | - Y Fu
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China
| | - L Ge
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - H L Tang
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - D M Li
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Waitman LR, Bailey LC, Becich MJ, Chung-Bridges K, Dusetzina SB, Espino JU, Hogan WR, Kaushal R, McClay JC, Merritt JG, Rothman RL, Shenkman EA, Song X, Nauman E. Avenues for Strengthening PCORnet's Capacity to Advance Patient-Centered Economic Outcomes in Patient-Centered Outcomes Research (PCOR). Med Care 2023; 61:S153-S160. [PMID: 37963035 PMCID: PMC10635342 DOI: 10.1097/mlr.0000000000001929] [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] [Indexed: 11/16/2023]
Abstract
PCORnet, the National Patient-Centered Clinical Research Network, provides the ability to conduct prospective and observational pragmatic research by leveraging standardized, curated electronic health records data together with patient and stakeholder engagement. PCORnet is funded by the Patient-Centered Outcomes Research Institute (PCORI) and is composed of 8 Clinical Research Networks that incorporate at total of 79 health system "sites." As the network developed, linkage to commercial health plans, federal insurance claims, disease registries, and other data resources demonstrated the value in extending the networks infrastructure to provide a more complete representation of patient's health and lived experiences. Initially, PCORnet studies avoided direct economic comparative effectiveness as a topic. However, PCORI's authorizing law was amended in 2019 to allow studies to incorporate patient-centered economic outcomes in primary research aims. With PCORI's expanded scope and PCORnet's phase 3 beginning in January 2022, there are opportunities to strengthen the network's ability to support economic patient-centered outcomes research. This commentary will discuss approaches that have been incorporated to date by the network and point to opportunities for the network to incorporate economic variables for analysis, informed by patient and stakeholder perspectives. Topics addressed include: (1) data linkage infrastructure; (2) commercial health plan partnerships; (3) Medicare and Medicaid linkage; (4) health system billing-based benchmarking; (5) area-level measures; (6) individual-level measures; (7) pharmacy benefits and retail pharmacy data; and (8) the importance of transparency and engagement while addressing the biases inherent in linking real-world data sources.
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Affiliation(s)
- Lemuel R. Waitman
- Department of Biomedical Informatics, Biostatistics, and Medical Epidemiology, University of Missouri School of Medicine, Greater Plains Collaborative, PCORnet Clinical Research Network, Columbia, MO
| | | | | | | | | | | | | | - Rainu Kaushal
- Weill Cornell University School of Medicine, New York, NY
| | | | | | | | | | - Xing Song
- University of Missouri School of Medicine, Columbia, MO
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Shen L, Li YT, Xu MY, Liu GY, Zhang XW, Cheng Y, Zhu GQ, Zhang M, Wang L, Zhang XF, Zuo LG, Geng ZJ, Li J, Wang YY, Song X. [The application of the non-woven fabric and filter paper "sandwich" fixation method in preventing the separation of the mucosal layer and muscular layer in mouse colon histopathological sections]. Zhonghua Bing Li Xue Za Zhi 2023; 52:1040-1043. [PMID: 37805399 DOI: 10.3760/cma.j.cn112151-20230228-00158] [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] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Affiliation(s)
- L Shen
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Bengbu Medical College, Bengbu 233000, China
| | - Y T Li
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Bengbu Medical College, Bengbu 233000, China
| | - M Y Xu
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Bengbu Medical College, Bengbu 233000, China
| | - G Y Liu
- Bengbu Medical College, Bengbu 233000, China
| | - X W Zhang
- Bengbu Medical College, Bengbu 233000, China
| | - Y Cheng
- Bengbu Medical College, Bengbu 233000, China
| | - G Q Zhu
- Bengbu Medical College, Bengbu 233000, China
| | - M Zhang
- Bengbu Medical College, Bengbu 233000, China
| | - L Wang
- Bengbu Medical College, Bengbu 233000, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - X F Zhang
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - L G Zuo
- Department of Gastrointestinal Surgery, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - Z J Geng
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - J Li
- Department of Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - Y Y Wang
- Department of Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
| | - X Song
- Department of Center Laboratory, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China Anhui Province Key Laboratory of Basic and Translational Research of Inflammation-related Diseases, Bengbu 233004, China
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Powell W, Song X, Mohamed Y, Walsh D, Parks EJ, McMahon TM, Khan M, Waitman LR. Medications and conditions associated with weight loss in patients prescribed semaglutide based on real-world data. Obesity (Silver Spring) 2023; 31:2482-2492. [PMID: 37593896 DOI: 10.1002/oby.23859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Approved by the Food and Drug Administration (FDA) in 2017 for diabetes and in 2021 for weight loss, semaglutide has seen widespread use among individuals who aim to lose weight. The aim of this study was to evaluate weight loss and the influence of clinical factors on semaglutide patients in real-world clinical practice. METHODS Using data from 10 health systems within the Greater Plains Collaborative (a PCORnet Clinical Research Network), nearly 4000 clinical factors encompassing demographic, diagnosis, and prescription information were extracted for semaglutide patients. A gradient-boosting, machine-learning classifier was developed for weight-loss prediction and identification of the most impactful factors via SHapley Additive exPlanations (SHAP) value extrapolation. RESULTS A total of 3555 eligible patients (539 of whom were observed 52 weeks following exposure) from March 2017 to April 2022 were studied. On average, individuals lost 4.44% (male individuals, 3.66%; female individuals, 5.08%) of their initial weight. History of diabetes mellitus diagnosis was associated with less weight loss, whereas prediabetes and linaclotide use were associated with more pronounced weight loss. CONCLUSIONS Weight loss in patients prescribed semaglutide from real-world evidence was strong but attenuated compared with previous clinical trials. Machine-learning analysis of electronic health record data identified factors that warrant further research and consideration when tailoring weight-loss therapy.
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Affiliation(s)
- William Powell
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Xing Song
- Department of Health Management and Informatics, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Yahia Mohamed
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Dave Walsh
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Elizabeth J Parks
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, USA
| | - Tamara M McMahon
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
| | - Mirza Khan
- Department of Cardiovascular Medicine, Saint Luke's Mid America Heart Institute, Kansas City, Missouri, USA
- Section of Cardiology, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Lemuel R Waitman
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA
- Department of Health Management and Informatics, University of Missouri School of Medicine, Columbia, Missouri, USA
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Sun R, Xi K, Song X, Yin W, Xi D, Shao Y, Gu W, Jiang J. The Effect of MDSC-Derived Exosomes Played in Esophageal Squamous Carcinoma Cells after Ionizing Radiation. Int J Radiat Oncol Biol Phys 2023; 117:e261. [PMID: 37785000 DOI: 10.1016/j.ijrobp.2023.06.1216] [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) Radiotherapy is the main treatment for esophageal cancer. Previous studies have shown that radiotherapy not only kills tumor cells directly, but also reshapes the immune microenvironment of the tumor. It has been reported an increase in the recruitment of myeloid-derived suppressor cells (MDSC) can occur in tumor tissue after ionizing radiation. Exosomes are mediators of intercellular information exchange and are also involved in the regulation of the tumor microenvironment. In this study, we wanted to understand whether MDSC in esophageal cancer tissue are involved in the regulation of tumor cell response to ionizing radiation via exosomes. MATERIALS/METHODS KYSE-150 was used to construct a subcutaneous transplantation tumor model in nude mice. And then mice irradiated with 5 Gy×5fx and 0 Gy×5fx respectively. After irradiation, the spleens of the mice were used to isolate MDSC, and collect the cell supernatants to extract the exosomes. Based on the exosomes, we divided the experiment into three groups (control, exosomes, exosomes+radiation). Exosomes were injected into a nude mouse model of esophageal cancer via the tail vein or co-cultured with KYSE-150 cells. Mice were irradiated with a 5 Gy×5fx after completion of injection, and KYSE-150 cells were irradiated with a single dose 4 Gy. After radiation, KYSE-150 cells were used to detect cell cloning, apoptosis and cell cycle by flow cytometry, cell proliferation by CCK 8. XRCC4,XRCC5,XRCC6,γH2AX,ATM expression in cells and tumor tissue were measured by Western blot and RT-PCR. RESULTS The tumor volume was significantly reduced after 5 Gy x 5fx radiation. When exosomes co-cultured with KYSE-150 cells, decrease in apoptosis and increase in cell cloning and cell proliferation were found in the exosomes+radiation group and exosomes group after radiation when compared with the control group, with this change being more pronounced in the exosome+radiation group. The results of the cell cycle assay showed that after ionizing radiation, the proportion of cells in the G0/G1 phase was significantly lower, and the proportion of cells in the S and G2/M phases were significantly higher in the exosomes+radiation group and exosomes group when compared to the Control group. The protein and mRNA expression of XRCC4,XRCC5,XRCC6,γH2AX,ATM in cells were increased in exosomes+radiation group and exosomes group after radiation when compared with the control group, with this change being more obvious in the exosome+radiation group. After irradiation, tumor volumes were measured in nude mice and the results showed that exosomes+radiation group tumors were the largest in volume, while the control group regressed most significantly after irradiation. CONCLUSION MDSC-derived exosomes have a tumor growth-promoting effect in esophageal squamous carcinoma, which is enhanced by ionizing radiation, and this may be related to the accelerated repair of damage in tumor tissue after radiation.
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Affiliation(s)
- R Sun
- Department of Radiotherapy & Oncology, The Third Affiliated Hospital of Soochow University, Chang Zhou, China
| | - K Xi
- Department of Oncology Radiotherapy, the Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - X Song
- Department of Oncology Radiotherapy, the Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - W Yin
- Department of Oncology Radiotherapy, the Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - D Xi
- Department of Oncology Radiotherapy, the Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Y Shao
- Department of Oncology Radiotherapy, the Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - W Gu
- Department of Oncology Radiotherapy, the Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - J Jiang
- Department of Tumor Biological Treatment, the Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
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Abstract
PURPOSE Patients with Graves' orbitopathy (GO) have characteristic facial expressions that are different from those of healthy individuals due to the combination of somatic and psychiatric symptoms. However, the facial expressions of GO patients have not yet been described and analyzed systematically. Thus, the present study aimed to present the facial expressions of GO patients and explore their applications in clinical practice. METHODS Facial image and clinical data of 943 GO patients were included, and 126 patients answered quality of life (GO-QOL) questionnaires. Each patient was labeled for one facial expression. Then, a portrait was drawn for every facial expression. Logistic and linear regression was performed to analyze the correlation between facial expression and clinical indicators, including QOL, disease activity and severity. The VGG-19 network model was utilized to discriminate facial expressions automatically. RESULTS Two groups, i.e., the non-negative emotion (neutral, happy) and the negative emotion (disgust, angry, fear, sadness, surprise), and seven expressions of GO patients were systematically analyzed. Facial expression was statistically associated with GO activity (P = 0.002), severity (P < 0.001), QOL visual functioning subscale scores (P = 0.001), and QOL appearance subscale score (P = 0.012). The deep learning model achieved satisfactory results (accuracy 0.851, sensitivity 0.899, precision 0.899, specificity 0.720, F1 score 0.899, and AUC 0.847). CONCLUSIONS As a novel clinical sign, facial expression holds the potential to be incorporated into GO assessment system in the future. The discrimination model may assist clinicians in real-life patient care.
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Affiliation(s)
- C Lei
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - M Qu
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - H Sun
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - J Huang
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - J Huang
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - X Song
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
| | - G Zhai
- School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, China.
| | - H Zhou
- Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China.
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Liu Y, Liu Y, Cai C, Hui F, Zhang Y, Wang B, Wang X, Zhang Y, Song X, He L, Yang H. Effect of Paxlovid on Tacrolimus Concentration in Perioperative Kidney Transplant Patients Infected With COVID-19: A Case Report. Transplant Proc 2023; 55:1822-1825. [PMID: 37558545 DOI: 10.1016/j.transproceed.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/10/2023] [Accepted: 07/19/2023] [Indexed: 08/11/2023]
Abstract
Paxlovid, as a new drug, received emergency approval for the treatment of COVID-19 in China; there is very little experience with kidney transplantation patients taking tacrolimus with perioperative COVID-19 infection. We discontinued tacrolimus on the day of using Paxlovid, and we chose to frequently monitor the concentration of tacrolimus and creatinine early in the course of treatment by enzyme multiplied immunoassay technique (EMIT) and liquid chromatography-mass spectrometry (LC-MS/MS). The results show varying degrees of elevation of creatinine levels in 3 patients, and EMIT may overestimate the true concentration of tacrolimus metabolites compared with LC-MS/MS. All the data comply with the Helsinki Congress and the Declaration of Istanbul.
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Affiliation(s)
- Yuewen Liu
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang, China
| | - Yanfang Liu
- Department of Clinical Trial Center, General Hospital of Northern Theater Command, Shenyang, China
| | - Chaohong Cai
- Department of Clinical Trial Center, General Hospital of Northern Theater Command, Shenyang, China
| | - Fuhai Hui
- Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Yan Zhang
- Department of Pharmacy, General Hospital of Northern Theater Command, Shenyang, China
| | - Boqian Wang
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang, China
| | - Xueyi Wang
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang, China
| | - Yijian Zhang
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang, China
| | - Xing Song
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang, China
| | - Long He
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang, China.
| | - Hongwei Yang
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang, China.
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Li L, Yuan S, Cui J, Yin Y, Song X, Yu J. Verification and Mechanism Exploration of CDK4 Alterations on Influencing Radiotherapy Sensitivity in Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e36. [PMID: 37785238 DOI: 10.1016/j.ijrobp.2023.06.727] [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) In this study, we aimed to explore the changes of functional phenotype before and after radiotherapy through vitro and vivo experiments. The potential pathway was preliminarily clarified. MATERIALS/METHODS Firstly, the relationships between the prognosis and the expression of CDK4 protein in SCLC patients treated with definitive chemoradiotherapy were explored. Then the stable overexpressed/knockdown CDK4 and negative control transfecting SCLC cell lines were established to monitor the changes of cell proliferation, migration, invasion, apoptosis and cell cycle after increasing radiation doses according to a cell counting kit assay, transwell cell migration and invasion assay, apoptosis cell cycle assay and BALB/c mouse model of subcutaneously transplanted tumor. The potential signal pathways were confirmed via KEGG pathway enrichment analysis and western blot. RESULTS Compared with patients with lower CDK4 protein expression, prognosis of those with high CDK4 protein expression was decreased significantly (p < 0.05). The cell activity, migration and invasion ability of overexpression/knockdown CDK4 and negative control group were all decreased with increasing radiation doses, but the activity, migration and invasion ability of cells with overexpression CDK4 was stronger after same dose X-ray irradiation (p<0.01). For group with knockdown CDK4, it showed lower cell activity, migration and invasion than negative control group. After X-ray irradiation, the apoptotic ratio of all groups increased. And cells with overexpressed CDK4 displayed significantly reduced apoptosis, less G0/G1 phase cells, and improved M phase cells than the control group. In addition, compared with negative control group, gross tumor volume of overexpression CDK4 group decreased much smaller after X-ray irradiation. H1339 cells with overexpression CDK4 and negative control group were sequenced by transcriptomic sequencing before and after radiotherapy. Taken together, differential genes were consistently enriched in MAPK pathway. Western blot showed that, compared with the negative control group, overexpression CDK4 group of H1339 and SW1271 cells after radiotherapy all showed significant changes on pERK proteins in the ERK pathway increased significantly (P<0.001). CONCLUSION In this study, the overexpression/knockdown CDK4 and negative control group were successfully constructed in H1339 and SW1271 cells, revealing the radiotherapy resistance of CDK4 alterations in vitro and in vivo experiment. And CDK4 alterations was shown to promote radiotherapy resistance through phosphorylation of MAPK/ERK signaling pathway in SCLC.
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Affiliation(s)
- L Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - S Yuan
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - J Cui
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Y Yin
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - X Song
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - J Yu
- Department of Radiation Oncology and Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
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Wang YB, He X, Song X, Li M, Zhu D, Zhang F, Chen Q, Lu Y, Wang Y. The radiomic biomarker in non-small cell lung cancer: 18F-FDG PET/CT characterisation of programmed death-ligand 1 status. Clin Radiol 2023; 78:e732-e740. [PMID: 37419772 DOI: 10.1016/j.crad.2023.06.003] [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] [Received: 07/28/2022] [Revised: 02/25/2023] [Accepted: 06/01/2023] [Indexed: 07/09/2023]
Abstract
AIM To present an integrated 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron-emission tomography (PET)/computed tomography (CT) radiomic characterisation of programmed death-ligand 1 (PD-L1) status in non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS In this retrospective study, 18F-FDG PET/CT images and clinical data of 394 eligible patients were divided into training (n=275) and test sets (n=119). Next, the corresponding nodule of interest was segmented manually on the axial CT images by radiologists. After which, the spatial position matching method was used to match the image positions of CT and PET, and radiomic features of the CT and PET images were extracted. Radiomic models were built using five different machine-learning classifiers and the performance of the radiomic models were further evaluated. Finally, a radiomic signature was established to predict the PD-L1 status in patients with NSCLC using the features in the best performing radiomic model. RESULTS The radiomic model based on the PET intranodular region determined using the logistic regression classifier preformed best, yielding an area under the receiver operating characteristics curve (AUC) of 0.813 (95% CI: 0.812, 0.821) on the test set. The clinical features did not improve the test set AUC (0.806, 95% CI: 0.801, 0.810). The final radiomic signature for PD-L1 status was consisted of three PET radiomic features. CONCLUSION This study showed that an 18F-FDG PET/CT-based radiomic signature could be used as a non-invasive biomarker to discriminate PD-L1-positive from PD-L1-negative in patients with NSCLC.
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Affiliation(s)
- Y B Wang
- Department of Nuclear Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - X He
- Department of Nuclear Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - X Song
- Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - M Li
- Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - D Zhu
- Department of Pathology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - F Zhang
- Department of Nuclear Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - Q Chen
- Department of Nuclear Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China
| | - Y Lu
- School of Computer Science and Engineering, Sun Yat-sen University, Guangzhou, 510006, China
| | - Y Wang
- Department of Nuclear Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong Province, China.
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Zhu HB, Song X. Analysis of soluble programmed death-1 ligand-1 of lung cancer patients with different characteristics. Eur Rev Med Pharmacol Sci 2023; 27:8690-8696. [PMID: 37782182 DOI: 10.26355/eurrev_202309_33792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To analyze the association of soluble programmed death-1 ligand-1 (sPD-L1) levels with clinicopathological characteristics, therapy efficacy, and survival outcomes in lung cancer patients. PATIENTS AND METHODS The study included two hundred treatment-naive patients with small cell lung cancer (SCLC) (n=12), and non-small cell lung cancer (NSCLC) (n=188). Plasma samples from 96 healthy individuals and 13 patients with benign tumors served as controls. Enzyme-linked immunosorbent assay (ELISA) was used to evaluate sPD-L1 expression. Blood samples of 67 NSCLC patients before and after therapy were collected. RESULTS sPD-L1 expression was significantly higher in lung cancer patients compared to the control groups (p=0.002). Moreover, patients with lower performance status had significantly higher sPD-L1 levels (p=0.005). NSCLC patients at later stages of the disease had greater sPD-L1 levels than those at the early stages (p<0.001). The presence of epidermal growth factor receptor (EGFR) mutation was not significantly different with higher sPD-L1 expression (p=0.334). Although sPD-L1 levels and progression-free survival (PFS) were linked with excellent response to therapy and advancing disease (p=0.307), no correlation was seen between sPD-L1 decrease and progression free survival (PFS). CONCLUSIONS Elevated sPD-L1 expression in NSCLC patients was associated with more advanced disease and worse overall health of the patients, suggesting a possible association with a negative clinical response and prognosis. sPD-L1 expression may be influenced by the mutation in EGFR.
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Affiliation(s)
- H-B Zhu
- Department of Pulmonary Oncology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
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Lorman V, Razzaghi H, Song X, Morse K, Utidjian L, Allen AJ, Rao S, Rogerson C, Bennett TD, Morizono H, Eckrich D, Jhaveri R, Huang Y, Ranade D, Pajor N, Lee GM, Forrest CB, Bailey LC. A machine learning-based phenotype for long COVID in children: An EHR-based study from the RECOVER program. PLoS One 2023; 18:e0289774. [PMID: 37561683 PMCID: PMC10414557 DOI: 10.1371/journal.pone.0289774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
As clinical understanding of pediatric Post-Acute Sequelae of SARS CoV-2 (PASC) develops, and hence the clinical definition evolves, it is desirable to have a method to reliably identify patients who are likely to have post-acute sequelae of SARS CoV-2 (PASC) in health systems data. In this study, we developed and validated a machine learning algorithm to classify which patients have PASC (distinguishing between Multisystem Inflammatory Syndrome in Children (MIS-C) and non-MIS-C variants) from a cohort of patients with positive SARS- CoV-2 test results in pediatric health systems within the PEDSnet EHR network. Patient features included in the model were selected from conditions, procedures, performance of diagnostic testing, and medications using a tree-based scan statistic approach. We used an XGboost model, with hyperparameters selected through cross-validated grid search, and model performance was assessed using 5-fold cross-validation. Model predictions and feature importance were evaluated using Shapley Additive exPlanation (SHAP) values. The model provides a tool for identifying patients with PASC and an approach to characterizing PASC using diagnosis, medication, laboratory, and procedure features in health systems data. Using appropriate threshold settings, the model can be used to identify PASC patients in health systems data at higher precision for inclusion in studies or at higher recall in screening for clinical trials, especially in settings where PASC diagnosis codes are used less frequently or less reliably. Analysis of how specific features contribute to the classification process may assist in gaining a better understanding of features that are associated with PASC diagnoses.
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Affiliation(s)
- Vitaly Lorman
- Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Hanieh Razzaghi
- Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Xing Song
- Department of Health Management and Informatics, University of Missouri School of Medicine, Columbia, Missouri, United States of America
| | - Keith Morse
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Levon Utidjian
- Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Andrea J. Allen
- Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - Suchitra Rao
- Department of Pediatrics, University of Colorado School of Medicine and Children’s Hospital of Colorado, Aurora, Colorado, United States of America
| | - Colin Rogerson
- Division of Critical Care, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America
| | - Tellen D. Bennett
- Departments of Biomedical Informatics and Pediatrics, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, United States of America
| | - Hiroki Morizono
- Center for Genetic Medicine Research, Children’s National Hospital, Washington, DC, United States of America
| | - Daniel Eckrich
- Biomedical Research Informatics Center, Nemours Children’s Health, Wilmington, Delaware, United States of America
| | - Ravi Jhaveri
- Division of Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, United States of America
| | - Yungui Huang
- IT Research and Innovation, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Daksha Ranade
- Research Informatics Department, Seattle Children’s Hospital, Seattle, Washington, United States of America
| | - Nathan Pajor
- Division of Pulmonary Medicine, Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
| | - Grace M. Lee
- Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America
| | - Christopher B. Forrest
- Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
| | - L. Charles Bailey
- Applied Clinical Research Center, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
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Zheng HS, Zhu WJ, Liu CH, Li YX, Song X, Han TT, Wang W, Guan K, Sha L. [Clinical characteristics of children with IgE-mediated cow's milk protein allergy]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1271-1279. [PMID: 37574323 DOI: 10.3760/cma.j.cn112150-20230514-00370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Objective: To analyze the clinical characteristics of children with IgE-mediated cow's milk protein allergy (CMPA) and provide a basis for disease management and prevention. Methods: A cross-sectional study was conducted to analyze 142 children aged 0-12 years who were diagnosed with IgE-mediated CMPA in Capital Institute of Pediatrics Affiliated Children's Hospital from 2020 to 2022. There were 79 males (55.6%) and 63 females (44.4%), with an average age of 14 (8, 27) months. 61 cases (43.0%) were in the <1-year-old group, 54 cases (38.0%) in the 1-3-year-old group, and 27 cases (19.0%) in the >3-year-old group. Data on demographic data, clinical manifestations, mean wheel diameter of skin prick test and serum specific IgE level were collected. The serum cow's milk protein sIgE and component sIgE were measured by ImmunoCAP fully automated system of fluorescence enzyme-linked immunosorbent assay, and statistically analyzed using chi-square test, nonparametric tests, correlation. Results: Cutaneous symptoms were the first and most frequent in 142 children (97.9%, 139/142 cases), followed by digestive (29.6%, 42/142 cases) and respiratory symptoms (27.5%, 39/142 cases).The proportion of children with respiratory symptoms after consuming cow's milk was significantly higher in the>3 years age group than those in the infant and toddler groups(66.7% vs 19.7%,χ2=18.396,P<0.01;66.7% vs 16.7%,χ2=20.250,P<0.01), and the symptoms involving ≥3 systems were also significantly higher than those in the other two groups(37.0% vs 13.1%,χ2=6.597,P<0.05;37.0% vs 7.4%,χ2=12.120,P<0.01). The average cow's milk SPT diameter and serum sIgE levels in the>3 years age group were significantly higher than those in the infant and toddler groups (Z=-4.682, P<0.01; Z=-3.498, P<0.01); (Z=-4.463, P<0.01; Z=-6.463, P<0.01). The most common cow's milk component protein were β-lactoglobulin(65.1%,56/86 cases) and casein (57.0%, 49/86 cases). Multiple-sensitization rate of the patients were 54.9%. Egg white (43.7%, 62/142 cases) was the most common co-sensitization food allergen while mold (12.7%, 18/142 cases) and weed pollen (12.7%, 18/142 cases) were the main co-sensitization aeroallergens. The proportion of multiple-sensitization to aeroallergens in the children group was the highest (51.9%, 14/27 cases), followed by the toddler group (29.6%, 16/54 cases), and the infant group was the least (3.3%, 2/61 cases). There was a significant difference among these three groups (χ2=7.476, P<0.05). Conclusion: Skin and mucosal symptoms are the most common in CMPA patients. The proportion of respiratory symptoms and multisystem involvement increased with age as well as the wheal diameter in skin test and serum sIgE level elevated. CMPA patients older than 3 years had the highest proportion of aeroallergen sensitization and airway allergic diseases.
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Affiliation(s)
- H S Zheng
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing 100730, China
| | - W J Zhu
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - C H Liu
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - Y X Li
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - X Song
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
| | - T T Han
- Department of Pediatric Respiratory,Department of Binzhou Medical University Hospital, Binzhou 256603, China
| | - W Wang
- Department of Biochemistry and Immunology, Capital Institute of Pediatrics, Beijing 100020, China
| | - K Guan
- Department of Allergy, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing 100730, China
| | - L Sha
- Department of Allergy, Capital Institute of Pediatrics Affiliated Children's Hospital, Beijing 100020, China
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Shao Y, Liu Z, Song X, Sun R, Zhou Y, Zhang D, Sun H, Huang J, Wu C, Gu W, Zheng X, Jiang J. ALKBH5/YTHDF2-mediated m6A modification of circAFF2 enhances radiosensitivity of colorectal cancer by inhibiting Cullin neddylation. Clin Transl Med 2023; 13:e1318. [PMID: 37381158 PMCID: PMC10307995 DOI: 10.1002/ctm2.1318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Circular RNA (circRNA) and N6-methyladenosine (m6A) play a critical role in tumour occurrence and development, including colorectal cancer (CRC). However, little is known about the interaction between circRNA and m6A in the radiosensitivity of CRC. Here, we investigated the role of a novel m6A-regulated circRNA in CRC. METHODS Differentially expressed circRNAs from radiosensitive and radioresistant CRC tissues were screened. Modifications of the selected circRNAs were examined by methylated RNA immunoprecipitation assay. Finally, the selected circRNAs were subjected to radiosensitivity assay. RESULTS We identified that circAFF2 is closely related to both radiosensitivity and m6A in CRC. CircAFF2 was highly expressed in patients with radiosensitive rectal cancer, and patients with high expression of circAFF2 had a better prognosis. In addition, circAFF2 can enhance the radiosensitivity of CRC cells both in vitro and in vivo. The regulation of circAFF2 involves ALKBH5-mediated demethylation, followed by its recognition and degradation via YTHDF2. Rescue experiments revealed that circAFF2 could reverse the radiosensitivity induced by ALKBH5 or YTHDF2. Mechanistically, circAFF2 binds with CAND1, promotes the binding of CAND1 to Cullin1 and inhibits its neddylation, subsequently impacting the radiosensitivity of CRC. CONCLUSION We identified and characterised circAFF2 as a novel m6A-modified circRNA and validated the ALKBH5/YTHDF2/circAFF2/Cullin-NEDD8 axis as a potential radiotherapy target for CRC.
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Affiliation(s)
- Yingjie Shao
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Zhenhua Liu
- Department of Radiotherapy, The Yancheng Clinical College of Xuzhou Medical University, The First people's Hospital of Yancheng, Yancheng, China
| | - Xing Song
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Rui Sun
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - You Zhou
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou, China
- Institute of Cell Therapy, Soochow University, Changzhou, China
| | - Dachuan Zhang
- Department of Pathology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Huihui Sun
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Junchao Huang
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Chenxi Wu
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Wendong Gu
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Xiao Zheng
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou, China
- Institute of Cell Therapy, Soochow University, Changzhou, China
| | - Jingting Jiang
- Department of Tumor Biological Treatment, The Third Affiliated Hospital of Soochow University, Changzhou, China
- Jiangsu Engineering Research Center for Tumor Immunotherapy, Changzhou, China
- Institute of Cell Therapy, Soochow University, Changzhou, China
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Sun Y, Xu Y, Xiao L, Zhu G, Li J, Song X, Xu L, Hu J. [Acetylcorynoline inhibits microglia activation by regulating EGFR/MAPK signaling to promote functional recovery of injured mouse spinal cord]. Nan Fang Yi Ke Da Xue Xue Bao 2023; 43:915-923. [PMID: 37439163 DOI: 10.12122/j.issn.1673-4254.2023.06.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
OBJECTIVE To investigate the effect of acetylcorynoline (Ace) for promoting functional recovery of injured spinal cord in rats and explore the underlying mechanism. METHODS Rat models of spinal cord injury (SCI) were treated with intraperitoneal injection of different concentrations of Ace, with the sham-operated rats as the control group. After the treatment, the changes in motor function of the rats and the area of spinal cord injury were assessed with BBB score and HE staining, and the changes in pro-inflammatory cytokine levels and microglial activation were determined using PCR, ELISA and immunofluorescence staining. In a lipopolysaccharide (LPS)-treated BV2 cell model, the effects of different concentrations of Ace or DMSO on microglial activation and inflammatory cytokine production were observed. Network pharmacology analysis was performed to predict the target protein and signaling mechanism that mediated the inhibitory effect of Ace on microglia activation, and AutoDock software was used for molecular docking between Ace and the target protein. A signaling pathway blocker (Osimertinib) was used to verify the signaling mechanism in rat models of SCI and LPS-treated BV2 cell model. RESULTS In rat models of SCI, Ace treatment significantly increased the BBB score, reduced the area of spinal cord injury, and lowered the number of activated microglia cells and the levels of pro-inflammatory cytokines (P < 0.05). The cell experiments showed that Ace treatment significantly lower the level of cell activation and the production of inflammatory cytokines in LPS-treated BV2 cells (P < 0.05). Network pharmacology analysis suggested that EGFR was the main target of Ace, and they bound to each other via hydrogen bonds as shown by molecular docking. Western blotting confirmed that Ace inhibited the activation of the EGFR/MAPK signaling pathway in injured mouse spinal cord tissue and in LPS-treated BV2 cells, and its inhibitory effect was comparable to that of Osimertinib. CONCLUSION In rat models of SCI, treatment with Ace can inhibit microglia-mediated inflammatory response by regulating the EGFR/MAPK pathway, thus promoting tissue repair and motor function recovery.
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Affiliation(s)
- Y Sun
- Department of Rehabilitation, First Affiliated Hospital of Bengbu Medical College, Bengbu 233030, China
| | - Y Xu
- Bengbu Medical College, First Affiliated Hospital of Bengbu Medical College,Bengbu 233030, China
| | - L Xiao
- Department of Rehabilitation, First Affiliated Hospital of Bengbu Medical College, Bengbu 233030, China
| | - G Zhu
- Clinical Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu 233030, China
| | - J Li
- Clinical Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu 233030, China
| | - X Song
- Central Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu 233030, China
| | - L Xu
- Department of Rehabilitation, First Affiliated Hospital of Bengbu Medical College, Bengbu 233030, China
| | - J Hu
- Clinical Laboratory, First Affiliated Hospital of Bengbu Medical College, Bengbu 233030, China
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Rana MKZ, Song X, Islam H, Paul T, Alaboud K, Waitman LR, Mosa ASM. Enrichment of a Data Lake to Support Population Health Outcomes Studies Using Social Determinants Linked EHR Data. AMIA Jt Summits Transl Sci Proc 2023; 2023:448-457. [PMID: 37350893 PMCID: PMC10283101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
The integration of electronic health records (EHRs) with social determinants of health (SDoH) is crucial for population health outcome research, but it requires the collection of identifiable information and poses security risks. This study presents a framework for facilitating de-identified clinical data with privacy-preserved geocoded linked SDoH data in a Data Lake. A reidentification risk detection algorithm was also developed to evaluate the transmission risk of the data. The utility of this framework was demonstrated through one population health outcomes research analyzing the correlation between socioeconomic status and the risk of having chronic conditions. The results of this study inform the development of evidence-based interventions and support the use of this framework in understanding the complex relationships between SDoH and health outcomes. This framework reduces computational and administrative workload and security risks for researchers and preserves data privacy and enables rapid and reliable research on SDoH-connected clinical data for research institutes.
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Affiliation(s)
- Md Kamruz Zaman Rana
- Department of Health Management and Informatics, University of Missouri, Columbia, Missouri
| | - Xing Song
- Department of Health Management and Informatics, University of Missouri, Columbia, Missouri
- Institute for Data Science and Informatics, University of Missouri, Columbia, Missouri
| | - Humayera Islam
- Department of Health Management and Informatics, University of Missouri, Columbia, Missouri
- Institute for Data Science and Informatics, University of Missouri, Columbia, Missouri
| | - Tanmoy Paul
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, Missouri
| | - Khuder Alaboud
- Institute for Data Science and Informatics, University of Missouri, Columbia, Missouri
| | - Lemuel R Waitman
- Department of Health Management and Informatics, University of Missouri, Columbia, Missouri
- Institute for Data Science and Informatics, University of Missouri, Columbia, Missouri
| | - Abu S M Mosa
- Department of Health Management and Informatics, University of Missouri, Columbia, Missouri
- Institute for Data Science and Informatics, University of Missouri, Columbia, Missouri
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, Missouri
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Yin MX, Su QN, Song X, Zhang JX. [Based on CT radiomics model for predicting the response to first-line chemotherapy of diffuse large B-cell lymphoma]. Zhonghua Zhong Liu Za Zhi 2023; 45:438-444. [PMID: 37188630 DOI: 10.3760/cma.j.cn112152-20220628-00459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Objective: To investigate the potential value of CT Radiomics model in predicting the response to first-line chemotherapy in diffuse large B-cell lymphoma (DLBCL). Methods: Pre-treatment CT images and clinical data of DLBCL patients treated at Shanxi Cancer Hospital from January 2013 to May 2018 were retrospectively analyzed and divided into refractory patients (73 cases) and non-refractory patients (57 cases) according to the Lugano 2014 efficacy evaluation criteria. The least absolute shrinkage and selection operator (LASSO) regression algorithm, univariate and multivariate logistic regression analyses were used to screen out clinical factors and CT radiomics features associated with efficacy response, followed by radiomics model and nomogram model. Receiver operating characteristic (ROC) curve, calibration curve and clinical decision curve were used to evaluate the models in terms of the diagnostic efficacy, calibration and clinical value in predicting chemotherapy response. Results: Based on pre-chemotherapy CT images, 850 CT texture features were extracted from each patient, and 6 features highly correlated with the first-line chemotherapy effect of DLBCL were selected, including 1 first order feature, 1 gray level co-occurence matrix, 3 grey level dependence matrix, 1 neighboring grey tone difference matrix. Then, the corresponding radiomics model was established, whose ROC curves showed AUC values of 0.82 (95% CI: 0.76-0.89) and 0.73 (95% CI: 0.60-0.86) in the training and validation groups, respectively. The nomogram model, built by combining validated clinical factors (Ann Arbor stage, serum LDH level) and CT radiomics features, showed an AUC of 0.95 (95% CI: 0.90-0.99) and 0.91 (95% CI: 0.82-1.00) in the training group and the validation group, respectively, with significantly better diagnostic efficacy than that of the radiomics model. In addition, the calibration curve and clinical decision curve showed that the nomogram model had good consistency and high clinical value in the assessment of DLBCL efficacy. Conclusion: The nomogram model based on clinical factors and radiomics features shows potential clinical value in predicting the response to first-line chemotherapy of DLBCL patients.
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Affiliation(s)
- M X Yin
- Department of Medical imaging, Shanxi Medical University, Taiyuan 030013, China
| | - Q N Su
- Department of Medical imaging, Shanxi Medical University, Taiyuan 030013, China
| | - X Song
- Department of Public Health, Shanxi Medical University, Taiyuan 030013, China
| | - J X Zhang
- Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan 030013, China
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Mohamed Y, Song X, McMahon TM, Sahil S, Zozus M, Wang Z, Waitman LR. Electronic health record data quality variability across a multistate clinical research network. J Clin Transl Sci 2023; 7:e130. [PMID: 37396818 PMCID: PMC10308424 DOI: 10.1017/cts.2023.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/25/2023] [Accepted: 05/05/2023] [Indexed: 07/04/2023] Open
Abstract
Background Electronic health record (EHR) data have many quality problems that may affect the outcome of research results and decision support systems. Many methods have been used to evaluate EHR data quality. However, there has yet to be a consensus on the best practice. We used a rule-based approach to assess the variability of EHR data quality across multiple healthcare systems. Methods To quantify data quality concerns across healthcare systems in a PCORnet Clinical Research Network, we used a previously tested rule-based framework tailored to the PCORnet Common Data Model to perform data quality assessment at 13 clinical sites across eight states. Results were compared with the current PCORnet data curation process to explore the differences between both methods. Additional analyses of testosterone therapy prescribing were used to explore clinical care variability and quality. Results The framework detected discrepancies across sites, revealing evident data quality variability between sites. The detailed requirements encoded the rules captured additional data errors with a specificity that aids in remediation of technical errors compared to the current PCORnet data curation process. Other rules designed to detect logical and clinical inconsistencies may also support clinical care variability and quality programs. Conclusion Rule-based EHR data quality methods quantify significant discrepancies across all sites. Medication and laboratory sources are causes of data errors.
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Affiliation(s)
- Yahia Mohamed
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Xing Song
- University of Missouri School of Medicine, Columbia, MO, USA
| | - Tamara M. McMahon
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Suman Sahil
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
| | - Meredith Zozus
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Zhan Wang
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | | | - Lemuel R. Waitman
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
- University of Missouri School of Medicine, Columbia, MO, USA
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Huang GH, Zhu LM, Song X, Fu Y, Ge L, Li PL, Li DM. [A cohort study of incidence of club drug abuse in men who have sex with men in Qingdao]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:802-808. [PMID: 37221071 DOI: 10.3760/cma.j.cn112338-20221129-01011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Objective: To understand and analyze the incidence of club drug abuse and influencing factors in men who have sex with men (MSM) in Qingdao, and provide reference for the AIDS prevention and intervention in this population. Methods: From March 2017 to July 31, 2022, MSM who did not abuse club drug were recruited by snowball sampling of MSM social organizations in Qingdao, a prospective cohort was established, and a follow-up survey was conducted every 6 months. The survey collected the information about the MSM's demographic characteristics, sexual characteristics, club drug abuse and others. The incidence of club drug abuse was the outcome dependent variable and the interval between the recruitment into the cohort and the incidence of club drug abuse was the time dependent variable. Cox regression analysis was conducted to identify the influencing factors for club drug abuse. Results: A total of 509 MSM were recruited at baseline survey, and 369 eligible MSM were enrolled in this cohort. A total of 62 MSM began to abuse club drug during the study period, and the cumulative follow-up time was 911.54 person-years, the incidence of club drug abuse was 6.80/100 person-years. All the club drug abusers shared drugs with others in the first club drug abuse, and 16.13% (10/62) had mix-use of club drugs. The multivariate Cox proportional risk regression analysis showed that being students (aHR=2.17, 95%CI: 1.15-4.10), receiving no HIV testing or receiving 1 HIV testing during past 6 months (aHR=4.57, 95%CI:1.80-11.60; aHR=5.15, 95%CI: 2.83-9.36), having sex only with regular sexual partners during past 6 months (aHR=4.75,95%CI:2.32-9.75), having more than 4 homosexual partners (aHR=1.70, 95%CI:1.01-2.87) and abuse of club drug of sexual partners during past 6 months (aHR=12.78, 95%CI:3.06-53.35) were significantly associated with club drug abuse in the MSM. Conclusions: The incidence of club drug abuse was at a high level in the MSM cohort in Qingdao, indicating a high risk for HIV infection. Being student, receiving less HIV testing, having sex only with regular sexual partners, having more homosexual partners and abuse of club drug of sexual partners during past 6 months were risk factors for the incidence of club drug abuse in the MSM. Targeted surveillance and intervention measures should be strengthened to reduce the risk of club drug abuse in MSM.
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Affiliation(s)
- G H Huang
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - L M Zhu
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - X Song
- Qingdao Center for Disease Control and Prevention, Qingdao 266033, China
| | - Y Fu
- Qingdao Center for Disease Control and Prevention, Qingdao 266033, China
| | - L Ge
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - P L Li
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - D M Li
- Division of Epidemiology, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Gupta A, Ellis SD, Burkhardt C, Young K, Mazzotti DR, Mahnken J, Abu-el-rub N, Chandaka S, Comfort B, Shanks D, Woodward J, Unrein A, Anderson H, Loucks J, Song X, Waitman LR, Burns JM. Implementing a home-based virtual hypertension programme-a pilot feasibility study. Fam Pract 2023; 40:414-422. [PMID: 35994031 PMCID: PMC10047620 DOI: 10.1093/fampra/cmac084] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Implementing a health system-based hypertension programme may lower blood pressure (BP). METHODS We performed a randomized, controlled pilot study to assess feasibility, acceptability, and safety of a home-based virtual hypertension programme integrating evidence-based strategies to overcome current barriers to BP control. Trained clinical pharmacists staffed the virtual collaborative care clinic (vCCC) to remotely manage hypertension using a BP dashboard and phone "visits" to monitor BP, adherence, side effects of medications, and prescribe anti-hypertensives. Patients with uncontrolled hypertension were identified via electronic health records. Enrolled patients were randomized to either vCCC or usual care for 3 months. We assessed patients' home BP monitoring behaviour, and patients', physicians', and pharmacists' perspectives on feasibility and acceptability of individual programme components. RESULTS Thirty-one patients (vCCC = 17, usual care = 14) from six physician clinics completed the pilot study. After 3 months, average BP decreased in the vCCC arm (P = 0.01), but not in the control arm (P = 0.45). The vCCC participants measured BP more (9.9 vs. 1.2 per week, P < 0.001). There were no intervention-related adverse events. Participating physicians (n = 6), pharmacists (n = 5), and patients (n = 31) rated all programme components with average scores of >4.0, a pre-specified benchmark. Nine adaptations in vCCC design and delivery were made based on potential barriers to implementing the programme and suggestions. CONCLUSION A home-based virtual hypertension programme using team-based care, technology, and a logical integration of evidence-based strategies is safe, acceptable, and feasible to intended users. These pilot data support studies to assess the effectiveness of this programme at a larger scale.
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Affiliation(s)
- Aditi Gupta
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
- KU Alzheimer’s Disease Research Center, Kansas City, KS, United States
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Shellie D Ellis
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, United States
| | - Crystal Burkhardt
- Department of Pharmacy, University of Kansas, Lawrence, KS, United States
| | - Kate Young
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States
| | - Diego R Mazzotti
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jonathan Mahnken
- KU Alzheimer’s Disease Research Center, Kansas City, KS, United States
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, KS, United States
| | - Noor Abu-el-rub
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Sravani Chandaka
- Division of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Branden Comfort
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Denton Shanks
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jennifer Woodward
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Amber Unrein
- KU Alzheimer’s Disease Research Center, Kansas City, KS, United States
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Heidi Anderson
- KU Alzheimer’s Disease Research Center, Kansas City, KS, United States
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Jennifer Loucks
- Department of Pharmacy, University of Kansas Health System, Kansas City, KS, United States
| | - Xing Song
- Health Management and Informatics, University of Missouri, Columbia, MO, United States
| | - Lemuel R Waitman
- Health Management and Informatics, University of Missouri, Columbia, MO, United States
| | - Jeffrey M Burns
- KU Alzheimer’s Disease Research Center, Kansas City, KS, United States
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, United States
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Song X, Wei J, Sun R, Jiang W, Chen Y, Shao Y, Gu W. Stereotactic Body Radiation Therapy Versus Conventional Radiation Therapy in Pain Relief for Bone Metastases: A Systematic Review and Meta-Analysis. Int J Radiat Oncol Biol Phys 2023; 115:909-921. [PMID: 36273520 DOI: 10.1016/j.ijrobp.2022.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 09/15/2022] [Accepted: 10/08/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE This study aimed to investigate the difference in pain relief between stereotactic body radiation therapy (SBRT) and conventional radiation therapy (cRT) for patients with bone metastases. METHODS AND MATERIALS Clinical trials and observational studies comparing SBRT versus cRT for bone metastases were retrieved. The main endpoint was pain relief after radiation therapy; the secondary endpoints were pain score change, local progression-free survival, reirradiation rate, and toxic events. When there was a significant heterogeneity, the random-effects model was applied. Otherwise, the fixed-effects model was used. Analyses of all included studies were performed first, followed by analyses of randomized controlled trials (RCTs) only. RESULTS Six RCTs, 1 prospective cohort study, and 3 retrospective observational studies were enrolled. Between 2004 and 2019, 448 patients received SBRT, and 445 patients received cRT. All prospective studies defined the lesions as oligometastatic. Pooled results based on all included studies indicated that SBRT was generally associated with a higher overall relief rate (P < .001 at 3 months; P = .015 at 6 months) and complete relief rate (P = .029 at 1 month; P < .001 at 6 months). Pooled results based on RCTs indicated that at 3 and 6 months, SBRT was associated with a higher overall relief rate (P < .001 and P = .017, respectively) and complete relief rate (P < .001 and P < .00, respectively). Subgroup analyses indicated that in more cases, the analgesic advantage of SBRT was more obvious when spinal lesions were irradiated, when the difference in the mean biological effective dose (BED) was less, or when intensity modulated radiation therapy was used to deliver SBRT. CONCLUSIONS Excessive elevation of BED introduces the risk of diminishing the analgesic effect of SBRT. SBRT delivered using intensity modulated radiation therapy is preferred for pain relief in spinal oligometastases. More RCTs are required to determine the most appropriate BED or dose regimen for SBRT.
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Affiliation(s)
- Xing Song
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Jiangsu, China
| | - Jun Wei
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Jiangsu, China
| | - Rui Sun
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Jiangsu, China
| | - Wenjie Jiang
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Jiangsu, China
| | - Yuan Chen
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Jiangsu, China
| | - Yingjie Shao
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Jiangsu, China.
| | - Wendong Gu
- Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University, Jiangsu, China.
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Cantwell C, Song X, Li X, Zhang B. Prediction of adsorption capacity and biodegradability of polybrominated diphenyl ethers in soil. Environ Sci Pollut Res Int 2023; 30:12207-12222. [PMID: 36109482 DOI: 10.1007/s11356-022-22996-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 09/07/2022] [Indexed: 06/15/2023]
Abstract
Polybrominated diphenyl ethers (PBDEs) are widely used brominated flame retardants with strong toxicity concerns. Understanding the behaviors of PBDEs in soil is essential to evaluate their environmental impact. However, the limited, incoherent, and inaccurate data has challenged predicting the adsorption capacity and biodegradability of all 209 PBDE congeners in the soil. Moreover, there are minimal studies regarding the interactions between adsorption and biodegradation behaviors of PBDEs in the soil. Herein, in this study, we adopted quantitative structure-property relationship (QSAR) modeling to predict the adsorption behavior of 209 PBDE congeners by estimating their organic carbon-water partition coefficient (KOC) values. In addition, the biodegradability of commonly occurring PBDE congeners was evaluated by analyzing their affinity to extracellular enzymes responsible for biodegradation using molecular docking. The results highlight that the degree of bromination plays a significant role in both the absorption and biodegradation of PBDEs in the soil due to compound stability and molecular geometry. Our findings help to advance the knowledge on PBDE behaviors in the soil and facilitate PBDE remediation associated with a soil environment.
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Affiliation(s)
- Cuirin Cantwell
- Department of Civil Engineering, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL, A1B 3X5, Canada
| | - Xing Song
- Department of Civil Engineering, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL, A1B 3X5, Canada
| | - Xixi Li
- Department of Civil Engineering, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL, A1B 3X5, Canada
| | - Baiyu Zhang
- Department of Civil Engineering, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL, A1B 3X5, Canada.
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44
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He L, Wang B, Wang X, Liu Y, Song X, Zhang Y, Li X, Yang H. Uncover diagnostic immunity/hypoxia/ferroptosis/epithelial mesenchymal transformation-related CCR5, CD86, CD8A, ITGAM, and PTPRC in kidney transplantation patients with allograft rejection. Ren Fail 2022; 44:1850-1865. [PMID: 36330810 PMCID: PMC9639483 DOI: 10.1080/0886022x.2022.2141648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to identify predictive immunity/hypoxia/ferroptosis/epithelial mesenchymal transformation (EMT)-related biomarkers, pathways and new drugs in allograft rejection in kidney transplant patients. First, gene expression data were downloaded followed by identification of differentially expressed genes (DEGs), weighted gene co-expression network analysis (WGCNA) and protein–protein interaction (PPI) analysis. Second, diagnostic model was construction based on key genes, followed by correlation analysis between immune/hypoxia/ferroptosis/EMT and key diagnostic genes. Finally, drug prediction of diagnostic key genes was carried out. Five diagnostic genes were further identified, including CCR5, CD86, CD8A, ITGAM, and PTPRC, which were positively correlated with allograft rejection after the kidney transplant. Highly infiltrated immune cells, highly expression of hypoxia-related genes and activated status of EMT were significantly positively correlated with five diagnostic genes. Interestingly, suppressors of ferroptosis (SOFs) and drivers of ferroptosis (DOFs) showed a complex regulatory relationship between ferroptosis and five diagnostic genes. CD86, CCR5, and ITGAM were respectively drug target of ABATACEPT, MARAVIROC, and CLARITHROMYCIN. PTPRC was drug target of both PREDNISONE and EPOETIN BETA. In conclusion, the study could be useful in understanding changes in the microenvironment within transplantation, which may promote or sustain the development of allograft rejection after kidney transplantation.
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Affiliation(s)
- Long He
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang City, China
| | - Boqian Wang
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang City, China
| | - Xueyi Wang
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang City, China
| | - Yuewen Liu
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang City, China
| | - Xing Song
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang City, China
| | - Yijian Zhang
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang City, China
| | - Xin Li
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang City, China
| | - Hongwei Yang
- Organ Transplantation Center, General Hospital of Northern Theater Command, Shenyang City, China
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Yang Y, Zhu Y, Luo Y, Liu Q, Hua X, Li J, Gao F, Hofer J, Gao X, Xiao L, Song X, Gao S, Hao R. Transcriptome analysis of Mesobuthus martensii revealed the differences of their toxins between females and males. The European Zoological Journal 2022. [DOI: 10.1080/24750263.2022.2143584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Y. Yang
- College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, TaiGu, China
| | - Y. Zhu
- Faculty of Naval Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Y. Luo
- Central Medical District of Chinese PLA General Hospital, Beijing, China
| | - Q. Liu
- College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, TaiGu, China
| | - X. Hua
- Faculty of Naval Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
| | - J. Li
- Faculty of Naval Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
| | - F. Gao
- Faculty of Naval Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
| | - J. Hofer
- Instituto de Ciencias Marinas Y Limnológicas, Universidad Austral de Chile, Valdivia, Chile
| | - X. Gao
- College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, TaiGu, China
| | - L. Xiao
- Faculty of Naval Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
| | - X. Song
- Faculty of Naval Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
| | - S. Gao
- Faculty of Naval Medicine, Naval Medical University (Second Military Medical University), Shanghai, China
| | - R. Hao
- College of Animal Science and Veterinary Medicine, Shanxi Agricultural University, TaiGu, China
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46
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Lorman V, Razzaghi H, Song X, Morse K, Utidjian L, Allen AJ, Rao S, Rogerson C, Bennett TD, Morizono H, Eckrich D, Jhaveri R, Huang Y, Ranade D, Pajor N, Lee GM, Forrest CB, Bailey LC. A machine learning-based phenotype for long COVID in children: an EHR-based study from the RECOVER program. medRxiv 2022:2022.12.22.22283791. [PMID: 36597534 PMCID: PMC9810222 DOI: 10.1101/2022.12.22.22283791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background As clinical understanding of pediatric Post-Acute Sequelae of SARS CoV-2 (PASC) develops, and hence the clinical definition evolves, it is desirable to have a method to reliably identify patients who are likely to have post-acute sequelae of SARS CoV-2 (PASC) in health systems data. Methods and Findings In this study, we developed and validated a machine learning algorithm to classify which patients have PASC (distinguishing between Multisystem Inflammatory Syndrome in Children (MIS-C) and non-MIS-C variants) from a cohort of patients with positive SARS-CoV-2 test results in pediatric health systems within the PEDSnet EHR network. Patient features included in the model were selected from conditions, procedures, performance of diagnostic testing, and medications using a tree-based scan statistic approach. We used an XGboost model, with hyperparameters selected through cross-validated grid search, and model performance was assessed using 5-fold cross-validation. Model predictions and feature importance were evaluated using Shapley Additive exPlanation (SHAP) values. Conclusions The model provides a tool for identifying patients with PASC and an approach to characterizing PASC using diagnosis, medication, laboratory, and procedure features in health systems data. Using appropriate threshold settings, the model can be used to identify PASC patients in health systems data at higher precision for inclusion in studies or at higher recall in screening for clinical trials, especially in settings where PASC diagnosis codes are used less frequently or less reliably. Analysis of how specific features contribute to the classification process may assist in gaining a better understanding of features that are associated with PASC diagnoses. Funding Source This research was funded by the National Institutes of Health (NIH) Agreement OT2HL161847-01 as part of the Researching COVID to Enhance Recovery (RECOVER) program of research. Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the RECOVER Program, the NIH or other funders.
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Affiliation(s)
- Vitaly Lorman
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Hanieh Razzaghi
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Xing Song
- Department of Health Management and Informatics, University of Missouri School of Medicine, Columbia, MO, United States
| | - Keith Morse
- Division of Pediatric Hospital Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States
| | - Levon Utidjian
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Andrea J Allen
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Suchitra Rao
- Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital of Colorado, Aurora, CO, United States
| | - Colin Rogerson
- Division of Critical Care, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Tellen D Bennett
- Departments of Biomedical Informatics and Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, United States
| | - Hiroki Morizono
- Center for Genetic Medicine Research, Children's National Hospital, Washington DC, United States
| | - Daniel Eckrich
- Biomedical Research Informatics Center, Nemours Children's Health, Wilmington, DE, United States
| | - Ravi Jhaveri
- Division of Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Yungui Huang
- IT Research and Innovation, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - Daksha Ranade
- Research Informatics Department, Seattle Children's Hospital, Seattle, WA, United States
| | - Nathan Pajor
- Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Grace M Lee
- Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Christopher B Forrest
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - L Charles Bailey
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States
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Mazzotti D, Waitman L, Gozal D, Song X. Positive Airway Pressure Utilization, Major Adverse Cardiovascular Events Incidence Risk and Mortality in Medicare Beneficiaries with Obstructive Sleep Apnea. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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48
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Xu L, Chen J, Yang J, Gong W, Zhang Y, Zhao H, Yan S, Jia W, Wu Z, Liu C, Song X, Ma Y, Yang X, Gao Z, Zhang N, Zheng X, Li M, Zhang X, Chen M. 165P Efficacy and safety of tislelizumab (TIS) plus lenvatinib (LEN) as first-line treatment in patients (pts) with unresectable hepatocellular carcinoma (uHCC): A single-arm, multicenter, phase II trial. Immuno-Oncology and Technology 2022. [DOI: 10.1016/j.iotech.2022.100277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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49
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Xin X, Chen B, Péquin B, Song P, Yang M, Song X, Zhang B. Binary toxicity of polystyrene nanoplastics and polybrominated diphenyl ethers to Arctic Cyanobacteria under ambient and future climates. Water Res 2022; 226:119188. [PMID: 36323199 DOI: 10.1016/j.watres.2022.119188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/22/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
Cyanobacteria are the predominant biota in the Arctic. Interactive effects on Arctic cyanobacteria between climate-change-shifting parameters and anthropogenic contaminants are largely unknown. We utilized a fractional factorial experiment and Arctic cyanobacteria Pseudanabaena biceps Strain PCCC_O-153 to capture the complexity of interacting climate factors, nano-polystyrene (nano-PS) and 2,2´,4,4´-tetrabromodipenyl ether (BDE-47). The short-term binary toxicity of nano-PS and BDE-47 was then examined through experiments, toxicity units, and reference models. The toxic mechanism was further revealed through biochemical analyses and multivariate statistics. We found that BDE-47 and nano-PS had more hazardous effects than changing climate conditions. The mixture had antagonistic effects on PCCC_O-153, attributing to the aggregation of nano-PS, the adsorption of BDE-47, and the wrapping of both contaminants by released extracellular polymeric substances. Binary toxicity was caused by the chain reactions triggered by combining individual contaminants. Total protein was a sensitive target and positively correlated to chlorophyll pigment. Oxidative stress for the mixture mainly resulted from the presence of nano-PS. This is the first study to access the hazardous effects of a mixture of anthropogenic contaminants on Arctic cyanobacteria under ambient and future climates.
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Affiliation(s)
- Xiaying Xin
- Department of Civil Engineering, Queen's University, Kingston, Ontario K7L 3N6, Canada; Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL A1B 3×5, Canada.
| | - Bing Chen
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL A1B 3×5, Canada
| | - Bérangère Péquin
- Natural Resource Sciences, McGill University, Ste-Anne-de-Bellevue, QC H9×3V9, Canada
| | - Pei Song
- Institute of Green and Low-Carbon Eco-Environment Technology, CNCEC Lang, Zheng Environmental Protection Technology Co., Ltd, Xi'an, Shannxi 710065, China
| | - Min Yang
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL A1B 3×5, Canada
| | - Xing Song
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL A1B 3×5, Canada
| | - Baiyu Zhang
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL A1B 3×5, Canada.
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50
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Song X, Zhang B, Cao Y, Liu B, Chen B. Shrimp-waste based dispersant as oil spill treating agent: Biodegradation of dispersant and dispersed oil. J Hazard Mater 2022; 439:129617. [PMID: 35872457 DOI: 10.1016/j.jhazmat.2022.129617] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/08/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
The emerging demand for the enhancement of biodegradation of persistent organic pollutants from marine oil spills using oil-treating agents to minimize the environmental impacts promotes the development of green dispersants. Shrimp waste is a potential raw material to generate green dispersants. The biodegradability of dispersed oil and dispersants themselves are key factors for the national consideration of the approval, stockpile, and usage of dispersants. However, it is unknown whether shrimp-waste-based dispersant (SWD) has high bioavailability or facilitates the biodegradation of dispersed oil. In this study, we tackled the biodegradation of oil dispersed by a purified SWD. Furthermore, the SWD biodegradability was evaluated by exploring the degradation genes via metagenomic sequencing, analyzing the enzymatic activities for dispersant biodegradation by molecular docking, and discussing the SWD toxicity. We discovered that the SWD facilitated the biodegradation of two crude oils (Alaska North Slope and Marine Fuel-No.6). The metagenomic analysis with molecular docking showed that fresh seawater had feasible enzymes to degrade the SWD to safety components. Additionally, the SWD was low toxic and high bioactive. The findings helped confirm that the purified SWD is an effective and eco-sustainable marine oil spill treating agent and tracked the biodegradation of dispersed oil and the SWD.
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Affiliation(s)
- Xing Song
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL A1B 3×5, Canada
| | - Baiyu Zhang
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL A1B 3×5, Canada.
| | - Yiqi Cao
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL A1B 3×5, Canada
| | - Bo Liu
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL A1B 3×5, Canada
| | - Bing Chen
- Northern Region Persistent Organic Pollution Control (NRPOP) Laboratory, Faculty of Engineering and Applied Science, Memorial University of Newfoundland, St. John's, NL A1B 3×5, Canada
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