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Leung DYL, Lee CT, Chu SYJ, Ng F, Wen P, Fan J, Cheung DSK, Seto Nielsen L, Guruge S, Wong J. Chinese family care partners of older adults in Canada have grit: A qualitative study. J Adv Nurs 2024; 80:1018-1029. [PMID: 37828729 DOI: 10.1111/jan.15878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 08/03/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023]
Abstract
AIM To explain the process taken by Chinese family care partners of older adults in the Greater Toronto Area, Canada, to access health and social services in their communities. The research question was: What mechanisms and structures impact the agency of Chinese family care partners of older adults, in the process of assisting them to access health and social services? DESIGN This qualitative study was informed by critical realism. METHODS Chinese family care partners of older adults in the Greater Toronto Area, Canada, were interviewed from August 2020 to June 2021. Transcripts underwent thematic analysis. FINDINGS Twenty-eight Chinese family care partners expressed a firm commitment to maintain caregiving conditions and to judiciously access health and social services. Their commitment was made up of three parts: (a) legislative and cultural norms of family, work, and society; (b) their perseverance to fill gaps with limited social and financial resources; (c) the quality of their relationship to, and illness trajectory of the older adults. The social structures created tension in how Chinese family care partners made decisions, negotiated resources, and ultimately monitored and coordinated timely access with older adults. CONCLUSION Participants' commitment and perseverance were conceptualized as "grit," central to their agency to conform to legislative and cultural norms. Moreover, findings support grit's power to motivate and sustain family caregiving, in order for older adults to age in place as long as possible with finite resources. IMPLICATIONS FOR THE PROFESSION This study highlights the importance of cultural awareness education for nurses, enabling continuity of care at a systems level and for a more resilient healthcare system. IMPACT Family care partners' grit may be crucial for nurses to harness when together, they face limited access to culturally appropriate health and social services in a system grounded in values of equity and inclusion, as in Canada. REPORTING METHOD When writing this manuscript, we adhered to relevant EQUATOR guidelines of the Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC INVOLVEMENT AND ENGAGEMENT No patient or public involvement.
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Affiliation(s)
- D Y L Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - C T Lee
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - S Y J Chu
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - F Ng
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - P Wen
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - J Fan
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - D S K Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - L Seto Nielsen
- School of Nursing, York University, Toronto, Ontario, Canada
| | - S Guruge
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - J Wong
- Stronach Regional Cancer Centre at Southlake, Newmarket, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Trinh VQH, Ankenbauer KE, Liu J, Batardiere M, Maurer HC, Copeland C, Wong J, Ben-Levy O, Torbit SM, Jarvis B, Revetta F, Ivanov S, Jyotsana N, Makino Y, Ruelas AM, Means AL, Maitra A, Tan MCB, DelGiorno KE. Oncogenic GNAS drives a gastric pylorus program in intraductal papillary mucinous neoplasms of the pancreas. bioRxiv 2024:2024.02.25.581948. [PMID: 38464029 PMCID: PMC10925208 DOI: 10.1101/2024.02.25.581948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE Intraductal Papillary Mucinous Neoplasms (IPMNs) are cystic lesions and bona fide precursors for pancreatic ductal adenocarcinoma (PDAC). Recently, we showed that acinar to ductal metaplasia, an injury repair program, is characterized by a transcriptomic program similar to gastric spasmolytic polypeptide expressing metaplasia (SPEM), suggesting common mechanisms of reprogramming between the stomach and pancreas. The aims of this study were to assay IPMN for pyloric markers and to identify molecular drivers of this program. DESIGN We analyzed RNA-seq studies of IPMN for pyloric markers, which were validated by immunostaining in patient samples. Cell lines expressing Kras G12D +/- GNAS R201C were manipulated to identify distinct and overlapping transcriptomic programs driven by each oncogene. A PyScenic-based regulon analysis was performed to identify molecular drivers in the pancreas. Expression of candidate drivers was evaluated by RNA-seq and immunostaining. RESULTS Pyloric markers were identified in human IPMN. GNAS R201C drove expression of these markers in cell lines and siRNA targeting of GNAS R201C or Kras G12D demonstrates that GNAS R201C amplifies a mucinous, pyloric phenotype. Regulon analysis identified a role for transcription factors SPDEF, CREB3L1, and CREB3L4, which are expressed in patient samples. siRNA-targeting of Spdef inhibited mucin production. CONCLUSION De novo expression of a SPEM phenotype has been identified in pancreatitis and a pyloric phenotype in Kras G12D -driven PanIN and Kras G12D ;GNAS R201C -driven IPMN, suggesting common mechanisms of reprogramming between these lesions and the stomach. A transition from a SPEM to pyloric phenotype may reflect disease progression and/or oncogenic mutation. IPMN-specific GNAS R201C amplifies a mucinous phenotype, in part, through SPDEF.
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Wong J, Roy SF, McNiff JM, Xu ML. IRF8 in Conjunction With CD123 and CD20 to Distinguish Lupus Erythematosus Panniculitis From Subcutaneous Panniculitis-like T-Cell Lymphoma. Am J Surg Pathol 2023; 47:1425-1431. [PMID: 37767989 DOI: 10.1097/pas.0000000000002133] [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: 09/29/2023]
Abstract
Distinguishing lupus erythematosus panniculitis (LEP) from subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a diagnostic challenge with important clinical implications. Immunohistochemical expression of interferon regulatory factor 8 (IRF8) has been shown to highlight cells with plasmacytoid dendritic cell differentiation. Considering that the presence of plasmacytoid dendritic cells highlighted by CD123 immunolabeling is a well-described feature that supports LEP over SPTCL, we hypothesized that IRF8 immunohistochemistry can be used as a diagnostic test to improve accuracy in differentiating LEP from SPTCL. In this study, we assessed the expression of IRF8, CD123, and CD20 in 35 cutaneous biopsies from 31 distinct patients, which included 22 cases of LEP and 13 cases of SPTCL. We found that clusters of IRF8-positive cells within the dermis, and away from subcutaneous fat, could discriminate LEP from SPTCL ( P =0.005). Similarly, CD123-positive clusters in any location were observed in LEP but absent in all cases of SPTCL. In addition, we found that dermal CD20-predominant lymphoid aggregates could help discriminate LEP from SPTCL ( P =0.022). As individual assays, IRF8, CD123, and CD20 were highly specific (100%, 100%, and 92%, respectively) though poorly sensitive (45%, 29%, and 50%, respectively). However, a panel combining IRF8, CD123, and CD20, with at least 1 positive marker was more accurate than any individual marker by receiver operating characteristic curve analysis. Our study provides a rationale for potentially including IRF8 as part of an immunohistochemical panel composed of other currently available markers used to differentiate LEP from SPTCL.
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Affiliation(s)
- Jahg Wong
- Department of Pathology, University of Montreal Hospital Center, University of Montreal Faculty of Medicine, Montreal, QC, Canada
| | | | - Jennifer M McNiff
- Departments of Dermatology
- Pathology, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT
| | - Mina L Xu
- Pathology, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT
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Varsamis GD, Karafyllidis IG, Gilkes KM, Arranz U, Martin-Cuevas R, Calleja G, Dimitrakis P, Kolovos P, Sandaltzopoulos R, Jessen HC, Wong J. Quantum gate algorithm for reference-guided DNA sequence alignment. Comput Biol Chem 2023; 107:107959. [PMID: 37717360 DOI: 10.1016/j.compbiolchem.2023.107959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 09/19/2023]
Abstract
Reference-guided DNA sequencing and alignment is an important process in computational molecular biology. The amount of DNA data grows very fast, and many new genomes are waiting to be sequenced while millions of private genomes need to be re-sequenced. Each human genome has 3.2B base pairs, and each one could be stored with 2 bits of information, so one human genome would take 6.4B bits or ∼760MB of storage (National Institute of General Medical Sciences, n.d.). Today's most powerful tensor processing units cannot handle the volume of DNA data necessitating a major leap in computing power. It is, therefore, important to investigate the usefulness of quantum computers in genomic data analysis, especially in DNA sequence alignment. Quantum computers are expected to be involved in DNA sequencing, initially as parts of classical systems, acting as quantum accelerators. The number of available qubits is increasing annually, and future quantum computers could conduct DNA sequencing, taking the place of classical computing systems. We present a novel quantum algorithm for reference-guided DNA sequence alignment modeled with gate-based quantum computing. The algorithm is scalable, can be integrated into existing classical DNA sequencing systems and is intentionally structured to limit computational errors. The quantum algorithm has been tested using the quantum processing units and simulators provided by IBM Quantum, and its correctness has been confirmed.
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Affiliation(s)
- G D Varsamis
- Department of Electrical and Computer Engineering, Democritus University of Thrace, Xanthi 67100 Greece
| | - I G Karafyllidis
- Department of Electrical and Computer Engineering, Democritus University of Thrace, Xanthi 67100 Greece; National Centre for Scientific Research Demokritos, Athens 15342 Greece.
| | - K M Gilkes
- EY Global Innovation Quantum Computing Lab, USA
| | - U Arranz
- EY Global Innovation Quantum Computing Lab, Spain
| | | | - G Calleja
- EY Global Innovation Quantum Computing Lab, Spain
| | - P Dimitrakis
- National Centre for Scientific Research Demokritos, Athens 15342 Greece
| | - P Kolovos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - R Sandaltzopoulos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis 68100, Greece
| | - H C Jessen
- EY Global Innovation Quantum Computing Lab, Denmark
| | - J Wong
- EY Global Innovation Quantum Computing Lab, USA
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Wong J, Trinh VQ, Jyotsana N, Baig JF, Revetta F, Shi C, Means AL, DelGiorno KE, Tan M. Differential spatial distribution of HNF4α isoforms during dysplastic progression of intraductal papillary mucinous neoplasms of the pancreas. Sci Rep 2023; 13:20088. [PMID: 37974020 PMCID: PMC10654504 DOI: 10.1038/s41598-023-47238-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023] Open
Abstract
Hepatocyte Nuclear Factor 4-alpha (HNF4α) comprises a nuclear receptor superfamily of ligand-dependent transcription factors that yields twelve isoforms in humans, classified into promoters P1 or P2-associated groups with specific functions. Alterations in HNF4α isoforms have been associated with tumorigenesis. However, the distribution of its isoforms during progression from dysplasia to malignancy has not been studied, nor has it yet been studied in intraductal papillary mucinous neoplasms, where both malignant and pre-malignant forms are routinely clinically identified. We examined the expression patterns of pan-promoter, P1-specific, and P2-specific isoform groups in normal pancreatic components and IPMNs. Pan-promoter, P1 and P2 nuclear expression were weakly positive in normal pancreatic components. Nuclear expression for all isoform groups was increased in low-grade IPMN, high-grade IPMN, and well-differentiated invasive adenocarcinoma. Poorly differentiated invasive components in IPMNs showed loss of all forms of HNF4α. Pan-promoter, and P1-specific HNF4α expression showed shifts in subnuclear and sub-anatomical distribution in IPMN, whereas P2 expression was consistently nuclear. Tumor cells with high-grade dysplasia at the basal interface with the stroma showed reduced expression of P1, while P2 was equally expressed in both components. Additional functional studies are warranted to further explore the mechanisms underlying the spatial and differential distribution of HNF4α isoforms in IPMNs.
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Affiliation(s)
- Jahg Wong
- Department of Pathology, University of Montreal, Montreal, QC, Canada
| | - Vincent Q Trinh
- Department of Pathology, University of Montreal, Montreal, QC, Canada
- Institute for Research in Immunology and Cancer of the University of Montreal, Montreal, QC, Canada
- Centre Hospitalier de l'Université de Montréal Research Center, Montreal, QC, Canada
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Nidhi Jyotsana
- Cell and Developmental Biology, Vanderbilt University, Nashville, TN, USA
| | - Jumanah F Baig
- Department of Pathology, University of Montreal, Montreal, QC, Canada
- Institute for Research in Immunology and Cancer of the University of Montreal, Montreal, QC, Canada
| | - Frank Revetta
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chanjuan Shi
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | - Anna L Means
- Cell and Developmental Biology, Vanderbilt University, Nashville, TN, USA
- Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
- Vanderbilt Ingram Cancer Center, Nashville, TN, USA
| | - Kathleen E DelGiorno
- Cell and Developmental Biology, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Ingram Cancer Center, Nashville, TN, USA
- Vanderbilt Digestive Disease Research Center, Nashville, TN, USA
| | - Marcus Tan
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
- Cell and Developmental Biology, Vanderbilt University, Nashville, TN, USA.
- Division of Surgical Oncology and Endocrine Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA.
- Vanderbilt Ingram Cancer Center, Nashville, TN, USA.
- Vanderbilt Digestive Disease Research Center, Nashville, TN, USA.
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Varsamis GD, Karafyllidis IG, Gilkes KM, Arranz U, Martin-Cuevas R, Calleja G, Wong J, Jessen HC, Dimitrakis P, Kolovos P, Sandaltzopoulos R. Quantum algorithm for de novo DNA sequence assembly based on quantum walks on graphs. Biosystems 2023; 233:105037. [PMID: 37734700 DOI: 10.1016/j.biosystems.2023.105037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
De novo DNA sequence assembly is based on finding paths in overlap graphs, which is a NP-hard problem. We developed a quantum algorithm for de novo assembly based on quantum walks in graphs. The overlap graph is partitioned repeatedly to smaller graphs that form a hierarchical structure. We use quantum walks to find paths in low rank graphs and a quantum algorithm that finds Hamiltonian paths in high hierarchical rank. We tested the partitioning quantum algorithm, as well as the quantum algorithm that finds Hamiltonian paths in high hierarchical rank and confirmed its correct operation using Qiskit. We developed a custom simulation for quantum walks to search for paths in low rank graphs. The approach described in this paper may serve as a basis for the development of efficient quantum algorithms that solve the de novo DNA assembly problem.
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Affiliation(s)
- G D Varsamis
- Department of Electrical and Computer Engineering, Democritus University of Thrace, Xanthi, 67100, Greece
| | - I G Karafyllidis
- Department of Electrical and Computer Engineering, Democritus University of Thrace, Xanthi, 67100, Greece; National Centre for Scientific Research Demokritos, Athens, 15342, Greece.
| | - K M Gilkes
- EY Global Innovation Quantum Computing Lab, USA
| | - U Arranz
- EY Global Innovation Quantum Computing Lab, Spain
| | | | - G Calleja
- EY Global Innovation Quantum Computing Lab, Spain
| | - J Wong
- EY Global Innovation Quantum Computing Lab, USA
| | - H C Jessen
- EY Global Innovation Quantum Computing Lab, Denmark
| | - P Dimitrakis
- National Centre for Scientific Research Demokritos, Athens, 15342, Greece
| | - P Kolovos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, 68100, Greece
| | - R Sandaltzopoulos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, 68100, Greece
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Gallagher KJ, Oh K, Hyun M, Jenkins C, Graff B, Schott D, Wisnoskie SB, Lei Y, Hendley S, Rutar F, Wong J, Wang S, Ahmed M, McNeur J, Taylor J, Schmidt M, Dogan SK, Senadheera L, Smith W, Enke CA, Yan Y, Zhou SM. Initial Experience with the Commercial Electron FLASH Research Extension. Int J Radiat Oncol Biol Phys 2023; 117:S141-S142. [PMID: 37784362 DOI: 10.1016/j.ijrobp.2023.06.552] [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) The purpose of this study was to introduce a new commercial electron FLASH system that has the potential to become widely available for FLASH researchers globally. In this study, we first present the initial acceptance and commissioning tests for the FLASH system, and second, we highlight preliminary FLASH effect results from our cell studies. MATERIALS/METHODS A linear accelerator was converted into a commercial research platform with the FLASH Research Extension, enabling the generation of a powerful 16 MeV electron FLASH beam. The dosimetric and stability tests were conducted using various dosimeters (i.e., radiochromic film, optically stimulated luminescent dosimeters (OSLDs), and a plane-parallel ionization chamber). To evaluate the FLASH effect, normal and cancer cell lines were FLASH irradiated using different pulse repetition frequencies (PRF) of 18 pulses/s and 180 pulses/s. RESULTS The electron FLASH mode was able to generate over 1 Gy per pulse at the isocenter and a dose rate of up to 690 Gy/s near the accessory mount of the Linac gantry head. The charge collected by the plane-parallel ionization chamber at the highest PRF (i.e., 180 pulses/s) showed a linear relationship with the delivered number of pulses (i.e., 1 to 99 pulses) with a coefficient of determination (R2) of 0.9996. The absorbed dose measured using radiochromic film and OSLDs agreed within 3%, on average, and followed an inverse square law as the source-to-axis distance (SAD) varied for which the R2 values were 0.9972 and 0.9955 for radiochromic film and OSLDs, respectively. The profile of the FLASH beam was symmetrical but was not as flat as the conventional 16 MeV electron beam due to the use of a thinner custom scattering foil to reduce the degradation of the ultra-high dose rate. The depth-dose curve beyond the build-up region for the FLASH beam was similar to the conventional 16 MeV electron beam for which the range at 50% the maximum dose (R50) agreed within 0.5 mm. The FLASH beam output remained consistent over a 4-month period with a variation of 2.5%, on average. The FLASH sparing effect was observed in vitro for healthy human pancreatic cells. Furthermore, we observed that the highest PRF beam (180 pulses/s) was more effective at destroying pancreatic cancerous cells while minimizing damage to healthy cells compared to the lowest PRF beam (18 pulses/s). CONCLUSION The novel commercial FLASH Research Extension system was dosimetrically characterized for pre-clinical FLASH research, and preliminary in vitro results demonstrated the FLASH effect. Given the prevalence of linear accelerators, this new commercial system has the potential to greatly increase the access to FLASH research.
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Affiliation(s)
| | - K Oh
- University of Nebraska Medical Center, Omaha, NE
| | - M Hyun
- University of Nebraska Medical Center, Omaha, NE
| | - C Jenkins
- University of Nebraska Medical Center, Omaha, NE
| | - B Graff
- University of Nebraska Medical Center, Omaha, NE
| | - D Schott
- University of Nebraska Medical Center, Omaha, NE
| | | | - Y Lei
- University of Nebraska Medical Center, Omaha, NE
| | - S Hendley
- University of Nebraska Medical Center, Omaha, NE
| | - F Rutar
- University of Nebraska Medical Center, Omaha, NE
| | - J Wong
- University of Nebraska Medical Center, Omaha, NE
| | - S Wang
- University of Nebraska Medical Center, Omaha, NE
| | - M Ahmed
- Varian Medical Systems, Palo Alto, CA
| | - J McNeur
- Varian Medical Systems, Palo Alto, CA
| | - J Taylor
- Varian Medical Systems, Palo Alto, CA
| | - M Schmidt
- Varian Medical Systems, Palo Alto, CA
| | - S K Dogan
- Varian Medical Systems, Palo Alto, CA
| | | | - W Smith
- Varian Medical Systems, Palo Alto, CA
| | - C A Enke
- University of Nebraska Medical Center, Omaha, NE
| | - Y Yan
- University of Nebraska Medical Center, Omaha, NE
| | - S M Zhou
- University of Nebraska Medical Center, Omaha, NE
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Wong J, Pina A, Mayrand MH, Rahimi K. Pagetoid Squamous Intraepithelial Neoplasia of the Vulva as a Mimicker of Vulvar Extramammary Paget Disease: Two Cases with Basal Layer Sparing. Int J Surg Pathol 2023; 31:1302-1307. [PMID: 36476167 PMCID: PMC10557358 DOI: 10.1177/10668969221137527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/03/2022] [Accepted: 10/19/2022] [Indexed: 10/06/2023]
Abstract
Human papillomavirus-associated vulvar intraepithelial neoplasia (high-grade squamous intraepithelial neoplasia [HSIL] or VIN of usual type) is a lesion characterized by atypia extending from the basal layer to the upper epidermis. There are only rare reports of vulvar intraepithelial morphology exhibiting a pagetoid pattern of intraepithelial dissemination. We herein report two cases of vulvar HSIL in which a pagetoid pattern of spread and a largely uninvolved basal layer represented a diagnostic pitfall for extramammary Paget disease. Nuclear atypia reminiscent of HSIL in addition to expression of p16, KRT5/6, and p40 were however in favor of pagetoid HSIL. Although there is morphological and immunohistochemical overlap between these two entities, an accurate diagnosis is important, since an erroneous diagnosis of vulvar extramammary Paget disease may lead to an extensive workup comprising radiological imaging, colonoscopy, and cystoscopy.
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Affiliation(s)
- Jahg Wong
- Department of Pathology, Université de Montréal, Montreal, Quebec, Canada
| | - Annick Pina
- Department of Gynecologic Oncology, Université de Montréal, Montreal, Quebec, Canada
| | - Marie-Hélène Mayrand
- Department of Obstetrics and Gynecology, Université de Montréal and CRCHUM, Montreal, Quebec, Canada
| | - Kurosh Rahimi
- Department of Pathology, Université de Montréal, Montreal, Quebec, Canada
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Yilmaz S, Maspero M, Isakov R, Wong J, Foley N, Spivak A, Hull TL. Gracilis muscle interposition for recurrent rectovaginal fistula. Tech Coloproctol 2023; 27:945-946. [PMID: 37354333 DOI: 10.1007/s10151-023-02835-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/14/2023] [Indexed: 06/26/2023]
Affiliation(s)
- S Yilmaz
- Department of Colorectal Surgery, Digestive Disease and Surgery Institute, 9500 Euclid Avenue, Desk A-30, Cleveland, OH, 44195, USA
| | - M Maspero
- Department of Colorectal Surgery, Digestive Disease and Surgery Institute, 9500 Euclid Avenue, Desk A-30, Cleveland, OH, 44195, USA
- Università degli Studi di Milano, Milan, Italy
| | - R Isakov
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - J Wong
- Department of Colorectal Surgery, Digestive Disease and Surgery Institute, 9500 Euclid Avenue, Desk A-30, Cleveland, OH, 44195, USA
| | - N Foley
- Department of Colorectal Surgery, Digestive Disease and Surgery Institute, 9500 Euclid Avenue, Desk A-30, Cleveland, OH, 44195, USA
| | - A Spivak
- Department of Colorectal Surgery, Digestive Disease and Surgery Institute, 9500 Euclid Avenue, Desk A-30, Cleveland, OH, 44195, USA
| | - T L Hull
- Department of Colorectal Surgery, Digestive Disease and Surgery Institute, 9500 Euclid Avenue, Desk A-30, Cleveland, OH, 44195, USA.
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Wong J, Gologan O, Ahmad K, Seethala RR, Berdugo J. Epstein-Barr Virus-Associated Lymphoepithelial Carcinoma Arising in a Salivary Sebaceous Lymphadenoma. Head Neck Pathol 2023; 17:871-876. [PMID: 37022512 PMCID: PMC10513992 DOI: 10.1007/s12105-023-01546-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/06/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Lymphadenomas are rare benign tumors of the major salivary glands that are further classified as sebaceous and non-sebaceous. No association with viruses has been reported so far. Little is known about the mechanisms that allow lymphadenomas to undergo malignant transformation. Among these rare instances, there has never been a malignant transformation to Epstein-Barr virus (EBV)-associated lymphoepithelial carcinoma. METHODS Clinical data of the reported case were retrieved from the patient's electronic medical record. Hematoxylin & eosin-stained slides, immunohistochemical tests, and in situ hybridization performed for routine diagnostic purposes were reviewed. RESULTS We report a salivary gland sebaceous lymphadenoma in which the luminal components were mostly replaced by malignant epithelial cells with markedly atypical nuclear features. Presence of EBV was demonstrated in all components by EBER. The morphological and immunohistochemical findings were consistent with a lymphoepithelial carcinoma arising from a sebaceous lymphadenoma. CONCLUSION We report the first case of an Epstein-Barr virus-associated lymphoepithelial carcinoma arising from a sebaceous lymphadenoma.
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Affiliation(s)
- Jahg Wong
- Department of Pathology, University of Montreal, Montreal, QC, Canada
| | - Olga Gologan
- Department of Pathology, University of Montreal, Montreal, QC, Canada
| | - Khouloud Ahmad
- Department of Pathology, Saint-Jérôme Hospital, Montreal, QC, Canada
| | - Raja R Seethala
- Department of Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jérémie Berdugo
- Department of Pathology, University of Montreal, Montreal, QC, Canada.
- Department of Pathology, Maisonneuve-Rosemont Hospital, 5415, Boulevard L'Assomption, Montreal, QC, H1T 2M4, Canada.
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11
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Wong J, Ong D, Khan A. Interdisciplinary management of an adult patient with significant tooth wear. Aust Dent J 2023; 68:58-69. [PMID: 36214064 DOI: 10.1111/adj.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2022] [Indexed: 11/29/2022]
Abstract
Adult patients may present with compromised dentitions which require extensive oral rehabilitation. This case report shows the fulfilment of both functional and aesthetic treatment objectives for a patient with significant tooth wear through carefully planned interdisciplinary management. © 2022 Australian Dental Association.
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Affiliation(s)
- J Wong
- Private Practice, Sunshine Coast, Queensland, Australia
| | - Dcv Ong
- Discipline of Orthodontics, School of Dentistry, University of Queensland, Brisbane, Australia.,Private Practice, Townsville, Australia
| | - A Khan
- Discipline of Prosthodontics, School of Dentistry, University of Queensland, Brisbane, Australia
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Wong J, Roy SF, Provencher D, Rahimi K. Vulvar Squamous Cell Carcinoma With Sarcomatoid Features are HPV-independent Lesions: A Subset are Also Associated With TP 53-independent Lesions and Radiation Therapy. Int J Gynecol Pathol 2023; 42:207-211. [PMID: 35639348 DOI: 10.1097/pgp.0000000000000880] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Vulvar squamous cell carcinoma of the vulva (VSCC) with sarcomatoid features is a rare variant characterized by spindle-cell morphology and occasional heterologous elements. They are difficult to evaluate due to rarity and lack unified nomenclature and histopathologic criteria. Eight cases of sarcomatoid VSCC were retrieved from archival electronic medical records from 2013 to 2021. Patients often presented at a mean age of 78-yr-old at stage FIGO (2018) III or above. The mean greatest diameter was 4.5 cm and mean depth of invasion was 11.5 mm. Spindle cells exhibited fascicular, nested, and cord-like growth patterns, though a haphazard arrangement or a mix of patterns was frequently observed. The sarcomatoid component frequently arose in the context of prior conventional VSCC treated with radiation therapy (n=6, 75% and chemotherapy (n=5, 63%) with latency periods of 5.2 and 5.4 yr, respectively. Associated lesions included differentiated vulvar intraepithelial neoplasia (n=4, 50%), lichen sclerosus (n=5, 63%), and vulvar acanthosis with altered differentiation (n=1, 13%). Immunohistochemistry showed that VSCC with sarcomatoid features aberrantly expressed p53 (n=4, 60%) through diffuse overexpression or null-type patterns. P16 was invariably negative in all cases. These findings suggest that VSCC with sarcomatoid features does not arise from the HPV-related carcinogenic pathway, and that a subset may also arise from the TP53-independent pathway. Recognizing sarcomatoid morphology in VSCC is important since it may confer an elevated risk of nodal metastasis and poorer survival. Larger studies are required to assess the etiology and prognostic implications of VSCC with sarcomatoid features.
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Wong J, Roy SF, Provencher D, Maietta A, Rahimi K. Leiomyoma With Massive Lymphoid Infiltration: 2 Cases With Lymphocytic Vasculopathy and Angiocentric Germinal Centers. Int J Gynecol Pathol 2023; 42:155-158. [PMID: 35348475 DOI: 10.1097/pgp.0000000000000881] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Uterine leiomyoma with massive lymphoid infiltration is characterized by a dense lymphoid infiltrate and germinal centers sparing the adjacent myometrium. Only few reports describe this entity and its etiology is unknown. This rare lesion may also exhibit lymphocytic vasculopathy but this has only been reported in the setting of GnRH agonist exposure. We report 2 cases of uterine leiomyoma with massive lymphoid infiltration in which only 1 patient was exposed to GnRH agonists. In both cases, histopathologic analysis showed thick-walled vessels with swollen endothelial cells showing evidence of intramural lymphocytic infiltration, red blood cell extravasation, and medial edema. This constellation of findings represented frank vascular damage and lymphocytic vasculopathy. Our findings suggest that lymphocytic vasculopathy in these lesions may be secondary to factors other than GnRH agonists. Furthermore, both cases showed an angiocentric disposition of germinal centers that has scarcely been alluded to in prior reports. This finding may provide a clue in accurately recognizing leiomyoma with massive lymphoid infiltration. Recognition of this lesion will allow one to avoid mistaking it for mimickers such as inflammatory myofibroblastic tumor, lymphoid malignancies, or other inflammatory processes.
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Wong J, Mellor J, Memon G, Baker H, Allu S, Amin F, Sukthankar A, Mather S, Davenport R. 1301 OUTCOMES FROM A PILOT PROJECT OFFERING FRAIL OLDER ADULTS LIVING WITH HIV A VIRTUAL MDT COMPREHENSIVE GERIATRIC ASSESSMENT. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Advancements in HIV treatment has resulted in an ageing population in people living with HIV (PLWH). Increasing prevalence of frailty in older PLWH has been demonstrated, giving rise to multi-morbidities, polypharmacy and consequently, complex medical and social needs. Approximately 5650 people are living with HIV across Greater Manchester. With increasing patient complexity, a pathway was developed to help provide holistic care and improve quality of life for older adults living with HIV.
Methods
A pilot involving multi-disciplinary professionals from the hospital frailty, HIV and community teams was established. Patients were screened using the Clinical Frailty Scale and patients with a CFS ≥ 4 were referred for completion of a comprehensive geriatric assessment (CGA). Patients would then be discussed at the Frailty MDT meeting, where action plans were devised.
Results
47 patients were assessed between October 2020 to December 2021, with 30 eligible for review in the frailty clinic. Commonly reported issues were mobility n=26 (86.6%), pain n=23 (76.6%), low mood n= 14 (46.6%), memory issues n=3 (43.3%) and falls n=12 (40%). Following MDT recommendations, 8 (26.6%) referrals were completed for social care, 1 (3%) referral for safeguarding and 9 (30%) referrals for active case management community teams for co-ordination of care in the community. Deprescribing recommendations were suggested for 16 (53.3%) patients and new medicine recommendations made for 24 (80%) patients.
Conclusion
A collaborative MDT approach to managing older PLWH can facilitate formulation of action plans to address patients physical, psychological and social needs.
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Affiliation(s)
- J Wong
- Manchester University NHS Foundation Trust
| | - J Mellor
- Manchester University NHS Foundation Trust
| | - G Memon
- Manchester University NHS Foundation Trust
| | - H Baker
- Manchester University NHS Foundation Trust
| | - S Allu
- Manchester University NHS Foundation Trust
| | - F Amin
- Manchester University NHS Foundation Trust
| | | | - S Mather
- Manchester University NHS Foundation Trust
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Gwilym BL, Pallmann P, Waldron CA, Thomas-Jones E, Milosevic S, Brookes-Howell L, Harris D, Massey I, Burton J, Stewart P, Samuel K, Jones S, Cox D, Clothier A, Edwards A, Twine CP, Bosanquet DC, Benson R, Birmpili P, Blair R, Bosanquet DC, Dattani N, Dovell G, Forsythe R, Gwilym BL, Hitchman L, Machin M, Nandhra S, Onida S, Preece R, Saratzis A, Shalhoub J, Singh A, Forget P, Gannon M, Celnik A, Duguid M, Campbell A, Duncan K, Renwick B, Moore J, Maresch M, Kamal D, Kabis M, Hatem M, Juszczak M, Dattani N, Travers H, Shalan A, Elsabbagh M, Rocha-Neves J, Pereira-Neves A, Teixeira J, Lyons O, Lim E, Hamdulay K, Makar R, Zaki S, Francis CT, Azer A, Ghatwary-Tantawy T, Elsayed K, Mittapalli D, Melvin R, Barakat H, Taylor J, Veal S, Hamid HKS, Baili E, Kastrisios G, Maltezos C, Maltezos K, Anastasiadou C, Pachi A, Skotsimara A, Saratzis A, Vijaynagar B, Lau S, Velineni R, Bright E, Montague-Johnstone E, Stewart K, King W, Karkos C, Mitka M, Papadimitriou C, Smith G, Chan E, Shalhoub J, Machin M, Agbeko AE, Amoako J, Vijay A, Roditis K, Papaioannou V, Antoniou A, Tsiantoula P, Bessias N, Papas T, Dovell G, Goodchild F, Nandhra S, Rammell J, Dawkins C, Lapolla P, Sapienza P, Brachini G, Mingoli A, Hussey K, Meldrum A, Dearie L, Nair M, Duncan A, Webb B, Klimach S, Hardy T, Guest F, Hopkins L, Contractor U, Clothier A, McBride O, Hallatt M, Forsythe R, Pang D, Tan LE, Altaf N, Wong J, Thurston B, Ash O, Popplewell M, Grewal A, Jones S, Wardle B, Twine C, Ambler G, Condie N, Lam K, Heigberg-Gibbons F, Saha P, Hayes T, Patel S, Black S, Musajee M, Choudhry A, Hammond E, Costanza M, Shaw P, Feghali A, Chawla A, Surowiec S, Encalada RZ, Benson R, Cadwallader C, Clayton P, Van Herzeele I, Geenens M, Vermeir L, Moreels N, Geers S, Jawien A, Arentewicz T, Kontopodis N, Lioudaki S, Tavlas E, Nyktari V, Oberhuber A, Ibrahim A, Neu J, Nierhoff T, Moulakakis K, Kakkos S, Nikolakopoulos K, Papadoulas S, D'Oria M, Lepidi S, Lowry D, Ooi S, Patterson B, Williams S, Elrefaey GH, Gaba KA, Williams GF, Rodriguez DU, Khashram M, Gormley S, Hart O, Suthers E, French S. Short-term risk prediction after major lower limb amputation: PERCEIVE study. Br J Surg 2022; 109:1300-1311. [PMID: 36065602 DOI: 10.1093/bjs/znac309] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/06/2022] [Accepted: 07/31/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND The accuracy with which healthcare professionals (HCPs) and risk prediction tools predict outcomes after major lower limb amputation (MLLA) is uncertain. The aim of this study was to evaluate the accuracy of predicting short-term (30 days after MLLA) mortality, morbidity, and revisional surgery. METHODS The PERCEIVE (PrEdiction of Risk and Communication of outcomE following major lower limb amputation: a collaboratIVE) study was launched on 1 October 2020. It was an international multicentre study, including adults undergoing MLLA for complications of peripheral arterial disease and/or diabetes. Preoperative predictions of 30-day mortality, morbidity, and MLLA revision by surgeons and anaesthetists were recorded. Probabilities from relevant risk prediction tools were calculated. Evaluation of accuracy included measures of discrimination, calibration, and overall performance. RESULTS Some 537 patients were included. HCPs had acceptable discrimination in predicting mortality (931 predictions; C-statistic 0.758) and MLLA revision (565 predictions; C-statistic 0.756), but were poor at predicting morbidity (980 predictions; C-statistic 0.616). They overpredicted the risk of all outcomes. All except three risk prediction tools had worse discrimination than HCPs for predicting mortality (C-statistics 0.789, 0.774, and 0.773); two of these significantly overestimated the risk compared with HCPs. SORT version 2 (the only tool incorporating HCP predictions) demonstrated better calibration and overall performance (Brier score 0.082) than HCPs. Tools predicting morbidity and MLLA revision had poor discrimination (C-statistics 0.520 and 0.679). CONCLUSION Clinicians predicted mortality and MLLA revision well, but predicted morbidity poorly. They overestimated the risk of mortality, morbidity, and MLLA revision. Most short-term risk prediction tools had poorer discrimination or calibration than HCPs. The best method of predicting mortality was a statistical tool that incorporated HCP estimation.
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Affiliation(s)
- Brenig L Gwilym
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | | | | | | | | | | | - Debbie Harris
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Ian Massey
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Jo Burton
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Phillippa Stewart
- Artificial Limb and Appliance Centre, Rookwood Hospital, Cardiff and Vale University Health Board, Cardiff, UK
| | - Katie Samuel
- Department of Anaesthesia, North Bristol NHS Trust, Bristol, UK
| | - Sian Jones
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - David Cox
- c/o INVOLVE Health and Care Research Wales, Cardiff, UK
| | - Annie Clothier
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
| | - Adrian Edwards
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Christopher P Twine
- Bristol, Bath and Weston Vascular Network, North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - David C Bosanquet
- South East Wales Vascular Network, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, UK
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Kouri A, Lipscombe C, Wong J, Abu-Alnadi N. Optimizing Surgeon Longevity: Ergonomics in Robotic Surgery. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chu W, Taggar A, Ung Y, Chan K, Earle C, Karotki A, Pasetka M, Presutti J, Wong J, Wong S. Risk-Adjusted Chemoradiation according to Human Papilloma Virus Status for Anal Cancer: A Pilot Registry Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chatroux L, Singer J, Hansen K, Wong J, Ecker A. Surgical Management of Second Trimester Cesarean Scar Ectopic Pregnancy with Laparoscopic Wedge Resection. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mak J, Gangi A, Chan N, Vittay O, Ashok A, Rogers P, Jehanli L, Dhas K, Wong J, Lam S, Hall-Craggs M. How can the Radiology Academic Network for Trainees (RADIANT) reshape the future of radiology research? A follow-up survey at the RADIANT Annual Meeting 2022. Clin Radiol 2022; 77:e835-e838. [DOI: 10.1016/j.crad.2022.09.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 11/03/2022]
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Stark N, Wong J, Bains J, Wallin D. 230 Learning Smarter: An Adaptive Business Curriculum for Residents That Works. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Chen S, Wong J, Paul L, Long L, Alak A, Healey J. UTILITY OF A MEDICAL OPTIMIZATION CLINIC IN HEART FAILURE PATIENTS WITH AN IMPLANTED CARDIAC DEVICE. Can J Cardiol 2022. [DOI: 10.1016/j.cjca.2022.08.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Bartlett J, Xu K, Wong J, Pond G, Zhang Y, Spears M, Salunga R, Mallon E, Taylor K, Hasenburg A, Markopoulos C, Dirix L, Seynaeve C, van de Velde C, Rea D, Schnabel C, Treuner K, Bayani J. 138MO Prognostic performance of Breast Cancer Index (BCI) in postmenopausal women with early-stage HR+ breast cancer in the TEAM trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Trinh VQH, Roland JT, Wong J, Revetta F, Patel K, Shi C, DelGiorno KE, Carter BD, Tan MCB. Peak density of immature nerve cells occurs with high-grade dysplasia in intraductal papillary mucinous neoplasms of the pancreas. J Pathol 2022; 258:69-82. [PMID: 35686747 PMCID: PMC9378585 DOI: 10.1002/path.5978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/10/2022] [Accepted: 06/07/2022] [Indexed: 11/11/2022]
Abstract
The development of neural structures within tumors is now considered vital for carcinogenesis. However, the time course of this development in human pre-invasive neoplasia has been incompletely described. Therefore, we performed a detailed analysis of nerves across the neoplastic spectrum in resected intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. Histology and multiplexed immunochemistry demonstrated that nerve density increased from low-grade (LG) to high-grade dysplasia (HG) but did not further increase once invasive IPMN (INV IPMN) was present. Higher nerve density correlated with increasing expression of nerve growth factor (NGF) by the tumor cells. Intra-tumoral nerves were immature and lacked markers of sympathetic, parasympathetic, and sensory lineages. Here, we show for the first time the presence of neural precursor cells (NPCs) within the stroma of pancreatic tumors. The density of these doublecortin (DCX)-positive NPCs increased from LG to HG, but not from HG to INV IPMN. We conclude that peak neural density of tumors is reached in high-grade dysplasia (often termed carcinoma in situ) rather than after invasion. These findings suggest that nerve-tumor interactions are important in IPMN progression and may serve as the basis for future mechanistic studies and novel therapeutic modalities. © 2022 The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Vincent Quoc-Huy Trinh
- Section of Surgical Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Joseph Thomas Roland
- Section of Surgical Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
- Epithelial Biology Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jahg Wong
- Département de pathologie et biologie cellulaire, Université de Montréal, Montréal, Québec, Canada
| | - Frank Revetta
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Krutika Patel
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chanjuan Shi
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | - Kathleen E. DelGiorno
- Epithelial Biology Center, Vanderbilt University School of Medicine, Nashville, TN, USA
- Cell and Developmental Biology, Vanderbilt University, Nashville TN, USA
- Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bruce D. Carter
- Department of Biochemistry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marcus Chuan Beng Tan
- Section of Surgical Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
- Division of Surgical Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
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Velazquez-Garcia J, Basuroy K, Storozhuk D, Wong J, Demeshko S, Meyer F, Techert S. Rare low-spin to high-spin transition by cooling a desolvated [2×2] Fe(II) metallogrid revealed by crystallographic studies. Acta Cryst Sect A 2022. [DOI: 10.1107/s2053273322090842] [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: 03/19/2023]
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Lim Y, Wong J, Hussain SM, Estee M, Zolio L, Page M, Harrison C, Wluka A, Wang Y, Cicuttini F. AB0979 Recommendations for weight management in osteoarthritis: a systematic review of clinical practice guidelines. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundWeight loss interventions are often recommended to target overweight and obesity in the clinical practice guidelines (CPGs) for the management of osteoarthritis. This is despite evidence from meta-analyses of clinical trials that significant weight loss results in modest improvements in symptoms and minimal effects on disease progression1,2. There is evidence that weight gain is associated with increase in knee pain3,4. In countries such as USA, adults gain on average 0.5 to 1 kilogram per year from early to middle adulthood Preventing weight gain is easier to achieve and sustain than losing weight.ObjectivesGiven that weight loss is accepted as fundamental to osteoarthritis management, we systematically reviewed the recommendations and approaches for weight management in all current osteoarthritis CPGs.MethodsNine databases were searched (1st January 2010 to 30th September 2021) to identify guidelines informing the non-pharmacological management of osteoarthritis. Three reviewers appraised guidelines according to the AGREE II instrument, and independently extracted data on their characteristics. One author extracted and summarised guideline recommendations on weight management. This systematic review is registered on PROSPERO (CRD42021274195).ResultsFifteen CPGs from developed and developing countries were included. Weight loss was recommended for knee (12 of 13 guidelines) and hip (10 of 11 guidelines) but not hand osteoarthritis (0 of 4 guidelines). Combination approaches of diet and/or exercise were recommended for overweight or obese individuals (knee: 8 of 12; hip: 4 of 10), with 2 guidelines specifying ≥5% weight loss for knee and hip osteoarthritis. One of 15 guidelines specified strategies for weight loss and maintenance of lost weight. Two of 15 guidelines recommended controlling body weight for osteoarthritis, regardless of obesity status.ConclusionMost CPGs for knee and hip osteoarthritis include recommendations for weight loss in those with overweight or obesity as key to managing osteoarthritis, despite evidence of modest at best effect of weight loss on symptoms and no effect on joint structure1,2. Given obesity is a major risk factors for osteoarthritis, the prevention of weight gain may be more effective and practical in improving clinical outcomes for osteoarthritis, and hence should be considered as part of the key management in osteoarthritis.References[1]Chu IJH, Lim AYT, Ng CLW. Effects of meaningful weight loss beyond symptomatic relief in adults with knee osteoarthritis and obesity: a systematic review and meta-analysis. Obes Rev. 2018;19(11):1597-1607.[2]Daugaard CL, Hangaard S, Bartels EM, Gudbergsen H, Christensen R, Bliddal H, et al. The effects of weight loss on imaging outcomes in osteoarthritis of the hip or knee in people who are overweight or obese: a systematic review. Osteoarthritis Cartilage. 2020;28(1):10-21.[3]Tanamas SK, Wluka AE, Davies-Tuck M, Wang Y, Strauss BJ, Proietto J, et al. Association of weight gain with incident knee pain, stiffness, and functional difficulties: a longitudinal study. Arthritis Care Res (Hoboken). 2013;65(1):34-43.[4]Teichtahl AJ, Wluka AE, Tanamas SK, Wang Y, Strauss BJ, Proietto J, et al. Weight change and change in tibial cartilage volume and symptoms in obese adults. Annals of the rheumatic diseases. 2015;74(6):1024-1029.[5]Zheng Y, Manson JE, Yuan C, Liang MH, Grodstein F, Stampfer MJ, et al. Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes Later in Life. JAMA. 2017;318(3):255-269.Disclosure of InterestsNone declared
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Ladbury C, Rincon A, Song J, Armenian S, Liu A, Spielberger R, Popplewell L, Sahebi F, Parker P, Forman S, Snyder D, Dagis A, Frankel P, Yang D, Wong J, Somlo G. PO-1171 Ten-year follow-up of tandem autologous transplantation with total marrow irradiation for myeloma. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03135-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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McClurg A, Goodwin D, Wong J, Carey E. Technique for cost effective cystoscopy following laparoscopic hysterectomy. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wong J, Reid M, Moore K, Saul K, Carey E. Ergonomic simulation investigating the association between surgeon characteristics and laparoscopic device strain in gynecologic surgery. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Wong J, Roy SF, Rahimi K. Tubo-ovarian Ewing sarcoma with pseudovascular pattern and hemoperitoneum. Int J Gynecol Cancer 2022; 32:574-575. [PMID: 35149539 DOI: 10.1136/ijgc-2021-003322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Jahg Wong
- Department of Pathology, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
| | - Simon F Roy
- Department of Pathology, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
| | - Kurosh Rahimi
- Department of Pathology, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
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Spanaki A, Miller O, Wong J, Pushparajah K, Theocharis P. Long term non-invasive endothelial function assessment in patients with paediatric inflammatory multisystem syndrome temporarily associated with Covid 19 (PIMS TS). Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Patients with PIMS-TS present with features of vasculitis (bright coronary arteries and diffuse coronary ectasia on transthoracic echocardiography) and prothrombotic features (e.g. elevated D Dimers) indicating involvement of the endothelial layer in the inflammatory process. Impairment in endothelial function may contribute to the acute but also to possible long-term consequences in patients with PIMS-TS. The aim of this pilot study is to assess non-invasively the endothelial (dys)function using reactive hyperemic peripheral arterial tonometry (RH-PAT) 6 months after the acute inflammatory phase.
Methods
Ten patients with previous diagnosis of PIMS-TS were compared to age-matched controls. The endothelial function was assessed using the EndoPAT device which provides the reactive hyperemic index (RHI) of endothelial function in a 15-min test. Cardiac function indices by means of LV fractional shortening (FS) was also assessed.
Results
There were no significant differences regarding age (11.2 ± 3.0 vs 13.6 ± 2.4, p = 0.063), height, weight and body surface area, (BSA: 1.49 ± 0.36 vs 1.52 ± 0.25, p = 0.856) in patients with previous diagnosis of PIMS-TS and controls respectively. The two groups also had similar LV systolic function assessed by FS (36.3 ± 9.1% vs 36.7 ± 7.1%, p = 0.922). The RHI in the PIMS TS group was similar to the control group (1.65 ± 0.43 vs 1.81 ± 0.60, p = 0.533 respectively).
Conclusions. Patients with PIMS-TS who may present with features of vasculitis during the acute phase, do not show evidence of endothelial dysfunction during the long term follow-up, suggesting resolution. Further studies are required to accurately determine the endothelial (dys)function during the acute phase of the inflammatory syndrome and course.
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Affiliation(s)
- A Spanaki
- Evelina Children"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - O Miller
- Evelina Children"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - J Wong
- Evelina Children"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - K Pushparajah
- Evelina Children"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
| | - P Theocharis
- Evelina Children"s Hospital, London, United Kingdom of Great Britain & Northern Ireland
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Spinelli A, Fiorino C, Schwarz M, Tommasino F, Bellinzona E, Del Vecchio A, Mangili P, Shakarami Z, Deantoni C, Cianchetti M, Attili A, Galli R, Bisio A, Perani L, Simoniello P, Fuss M, Pawelke J, Wong J, Durante M, Scifoni E. FLASH Mechanisms Track (Oral Presentations) ADVANCED DOSIMETRY AND BIOPHYSICAL MODELING FOR PRECLINICAL FLASH RADIOTHERAPY. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01518-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Rezaee M, Iordachita I, Wong J. FLASH Modalities Track (Oral Presentations) A NOVEL SELF-SHIELDED X-RAY IRRADIATION SYSTEM FOR LABORATORY FLASH RADIATION RESEARCH. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01491-0] [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: 10/19/2022] Open
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Perera P, Jayadeva P, Wong J, Lefkovits J. Characteristics and Outcomes of Recurrent Spontaneous Coronary Artery Dissection (SCAD) – A Single Centre Experience. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Yao J, Wong J, Joshi S. Apical Hypertrophic Cardiomyopathy Masquerading as Takotsubo Cardiomyopathy: The Importance of Serial Echocardiography. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wang B, Wong J, Yao J, Grigg L, Wilson W. Early inflammatory reaction and thrombus formation post Gore® Septal Occluder Device insertion for an atrial septal defect. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yao J, Ward-Ambler E, Wong J, Kalman J. Polymorphic Ventricular Tachycardia Following Valsalva Manoeuvre Used to Terminate Supraventricular Tachycardia. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Plante A, Dallaire F, Grosset AA, Nguyen T, Birlea M, Wong J, Daoust F, Roy N, Kougioumoutzakis A, Azzi F, Aubertin K, Kadoury S, Latour M, Albadine R, Prendeville S, Boutros P, Fraser M, Bristow RG, van der Kwast T, Orain M, Brisson H, Benzerdjeb N, Hovington H, Bergeron A, Fradet Y, Têtu B, Saad F, Trudel D, Leblond F. Dimensional reduction based on peak fitting of Raman micro spectroscopy data improves detection of prostate cancer in tissue specimens. J Biomed Opt 2021; 26:JBO-210212R. [PMID: 34743445 PMCID: PMC8571651 DOI: 10.1117/1.jbo.26.11.116501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
SIGNIFICANCE Prostate cancer is the most common cancer among men. An accurate diagnosis of its severity at detection plays a major role in improving their survival. Recently, machine learning models using biomarkers identified from Raman micro-spectroscopy discriminated intraductal carcinoma of the prostate (IDC-P) from cancer tissue with a ≥85 % detection accuracy and differentiated high-grade prostatic intraepithelial neoplasia (HGPIN) from IDC-P with a ≥97.8 % accuracy. AIM To improve the classification performance of machine learning models identifying different types of prostate cancer tissue using a new dimensional reduction technique. APPROACH A radial basis function (RBF) kernel support vector machine (SVM) model was trained on Raman spectra of prostate tissue from a 272-patient cohort (Centre hospitalier de l'Université de Montréal, CHUM) and tested on two independent cohorts of 76 patients [University Health Network (UHN)] and 135 patients (Centre hospitalier universitaire de Québec-Université Laval, CHUQc-UL). Two types of engineered features were used. Individual intensity features, i.e., Raman signal intensity measured at particular wavelengths and novel Raman spectra fitted peak features consisting of peak heights and widths. RESULTS Combining engineered features improved classification performance for the three aforementioned classification tasks. The improvements for IDC-P/cancer classification for the UHN and CHUQc-UL testing sets in accuracy, sensitivity, specificity, and area under the curve (AUC) are (numbers in parenthesis are associated with the CHUQc-UL testing set): +4 % (+8 % ), +7 % (+9 % ), +2 % (6%), +9 (+9) with respect to the current best models. Discrimination between HGPIN and IDC-P was also improved in both testing cohorts: +2.2 % (+1.7 % ), +4.5 % (+3.6 % ), +0 % (+0 % ), +2.3 (+0). While no global improvements were obtained for the normal versus cancer classification task [+0 % (-2 % ), +0 % (-3 % ), +2 % (-2 % ), +4 (+3)], the AUC was improved in both testing sets. CONCLUSIONS Combining individual intensity features and novel Raman fitted peak features, improved the classification performance on two independent and multicenter testing sets in comparison to using only individual intensity features.
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Affiliation(s)
- Arthur Plante
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
| | - Frédérick Dallaire
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
| | - Andrée-Anne Grosset
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Université de Montréal, Department of Pathology and Cellular Biology, Montreal, Quebec, Canada
| | - Tien Nguyen
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
| | - Mirela Birlea
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Jahg Wong
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - François Daoust
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
| | - Noémi Roy
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - André Kougioumoutzakis
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Feryel Azzi
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Kelly Aubertin
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Samuel Kadoury
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Computer Engineering and Software Engineering, Montreal, Quebec, Canada
| | - Mathieu Latour
- Université de Montréal, Department of Pathology and Cellular Biology, Montreal, Quebec, Canada
- Centre hospitalier de l’Université de Montréal, Department of Pathology, Montreal, Quebec, Canada
| | - Roula Albadine
- Université de Montréal, Department of Pathology and Cellular Biology, Montreal, Quebec, Canada
- Centre hospitalier de l’Université de Montréal, Department of Pathology, Montreal, Quebec, Canada
| | - Susan Prendeville
- University Health Network, Laboratory Medicine Program, Toronto, Ontario, Canada
| | - Paul Boutros
- Informatics & Biocomputing Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- University of California, Los Angeles, Department of Human Genetics, Los Angeles, California, United States
- University of California, Los Angeles, Department of Urology, Los Angeles, California, United States
- University of California, Los Angeles, Institute for Precision Health, Los Angeles, California, United States
- University of California, Los Angeles, Jonsson Comprehensive Cancer Center, Los Angeles, California, United States
- University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Michael Fraser
- Informatics & Biocomputing Program, Ontario Institute for Cancer Research, Toronto, Ontario, Canada
- University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Rob G. Bristow
- University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | | | - Michèle Orain
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
| | - Hervé Brisson
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
| | - Nazim Benzerdjeb
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
| | - Hélène Hovington
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
| | - Alain Bergeron
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
- Université Laval, Department of Surgery, Quebec City, Quebec, Canada
| | - Yves Fradet
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
- Université Laval, Department of Surgery, Quebec City, Quebec, Canada
| | - Bernard Têtu
- Centre de recherche du Centre hospitalier universitaire de Québec-Université Laval, Oncology Division, Quebec City, Quebec, Canada
- Université Laval, Centre de recherche sur le cancer, Quebec City, Quebec, Canada
| | - Fred Saad
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
| | - Dominique Trudel
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
| | - Frédéric Leblond
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
- Institut du cancer de Montréal, Montreal, Quebec, Canada
- Polytechnique Montréal, Department of Engineering Physics, Montreal, Quebec, Canada
- Université de Montréal, Department of Pathology and Cellular Biology, Montreal, Quebec, Canada
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Urban R, Wong J, Lim P, Zhang S, Spadinger I, Olson R, Bachand F, Ho C, Tinker A, Lovedeep G, Hamilton S. Cervical Cancer Patient Reported Gastrointestinal Outcomes: Intensity/Volumetric Modulated vs. 3D Conformal Radiation Therapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wong J, McClurg A, Carey E. Abdominal Wall Injections for Chronic Pelvic Pain: An Introduction and How-to Guide. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wong J, Reid M, Moore K, Saul K, Carey E. Investigation of the Association between Surgeon Sex and Ergonomic Strain with Laparoscopic Device Use. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Yu D, Li P, Yu S, Yan B, Wong J. Does an empowerment-based self-care supportive intervention save cost for improving self-care and health service utilization among heart failure patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure (HF) evolves as a global pandemic and strains the over-stretched hospital service. Ineffective self-care remains the key factor to explain the avoidable hospital admission. Patient empowerment is as a theory-based strategy to optimize the patients' self-care changes for disease management [1]. Its cost-effectiveness to enhance self-care and health service utilization has yet to be determined.
Purpose
This was a double-blind randomized controlled trial to compare the effects and cost-effectiveness of a 12-week empowerment self-care program with a didactic education program on self-care maintenance and management as well as health service utilization among the community-dwelling HF patients.
Methods
A total of 236 HF patients were recruited from the specialist clinics of the Department of Cardiology in two regional hospitals. They were randomized to receive either the 12-week empowerment self-care program (Figure 1) or the 12-week didactic education. Outcome evaluation using the Self-care Heart Failure Index (SCHFI) at baseline, post-intervention (T1) and three months thereafter (T2), with record on the number of emergency room (ER) attendance and hospital admission. Cost effectiveness analyses were performed on total cost (medical, intervention and societal costs) incurred in both interventions as well as incremental cost-effectiveness ratios (ICER) expressed as incremental cost per 1) a reflected clinically meaningful improvement in self-care (i.e. a half standard deviation increase in SCHFI), 2) an ER attendance reduced, 3) a day of hospital stay reduced.
Results
As compared with the education group, the empowerment group reported significantly greater improvement in self-care management at T1 [B=13.77 (95% CI=6.07, 21.46), p<0.001] and T2 [B=10.98 (95% CI=3.21, 18.75), p=0.006]. For cost-effective analysis, The ICER (empowerment-education) was −USD220/0.5 SD increase in SCHFI, indicating the mean cost saved per patient for making a clinically significant improvement in self-care was USD 220. The cost-effectiveness acceptability curve showed patients were willing to pay at USD 207- 441 for a 80–90% chance of improved self-care, indicating that the empowerment approach was a cost saving strategy. Although the empowerment approach was associated with a lower risk of ER attendance [IRR=0.55, 95% CI=0.31–0.95)] and hospital admission [IRR=0.38 (95% CI=0.31–0.95)], it is not cost saving for reducing hospital service utilization.
Conclusions
The empowerment-based self-care program is a cost-saving strategy to produce a clinical significant change in HF-related self-care. Although it is associated with lower risk for hospital service utilization, its effect is not significant enough to be cost-saving. Future care model may explore the need to integrate dyadic science [2] and e-health [3] to strengthen the care continuity and effects of self-care intervention.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Health and Medical Research Fund, Food and Health Bureau, Hong Kong Special Administrative Region Figure 1
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Affiliation(s)
- D.S.F Yu
- The University of Hong Kong, Hong Kong Southern Region, Hong Kong
| | - P.W.C Li
- The University of Hong Kong, Hong Kong Southern Region, Hong Kong
| | - S Yu
- United Christian Hospital, Department of Medicine and Geriatrics, Hong Kong, Hong Kong
| | - B Yan
- Prince of Wales University Hospital, Department of Medicine and Therapeutics, Division of Cardiology, Hong Kong, Hong Kong
| | - J Wong
- Tseung Kwan O Hospital, Hong Kong, Hong Kong
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Wong J, Baliga S. 565 Predictors of Single Versus Multi-Level Lumbar Spinal Fusion: A Retrospective Cohort Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Degenerative spine disease (DSD) of the lumbar spine is a common disorder among the aging population in the world, with a substantial humanistic and economic burden. Although lumbar spinal fusion is currently the mainstay surgical management of DSD, surgery is also associated with adjacent segment disease due to the modification of spinal biomechanics. Therefore, it is important to identify potential risk factors of DSD in order to prevent progressive deterioration and provide early intervention before the surgical option is absolutely necessary.
Method
Adult patients who underwent posterior lumbar spinal fusion from 2006-2016 were identified via OPCS-4codes. Smoking status, weight, age of operation, gender, diagnosis of ischaemic heart disease (IHD) were obtained via TrakCare®. The degree of deprivation was extrapolated using the Scottish Index of Multiple Deprivation (SIMD) 2020 quintile score. Data were analysed using logistic regression.
Results
In total, 313 met inclusion criteria and had data available, of which 205 and 108 patients underwent single and multi-level lumbar fusion respectively. Within the study population, 66.8% (206) and 33.2% (104) were female and male. Adjusted for all outcome measures, age of operation achieved statistical significance (p = 0.040). There was a 1.021-fold increase in risk of multi-level spinal fusion with each additional year of age. Weight was approaching statistical significance (p = 0.068).
Conclusions
Lumbar spinal health declines over time, but some patients experience more progressive deterioration. While some components of the spine are irreparable, early prescription of regimented exercise programs may strengthen spinal musculature to maintain a healthy sagittal balance, particularly in older, overweight, female patients.
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Affiliation(s)
- J Wong
- University of Aberdeen, Aberdeen, United Kingdom
| | - S Baliga
- Department of Trauma and Orthopaedic Surgery, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
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Wong J, Roy SF, Kokta V. Neurocristic Cutaneous Hamartoma With Perineuriomatous Differentiation: Can It Be Distinguished From Perineuriomatous Melanocytic Nevi? Am J Dermatopathol 2021; 43:757-758. [PMID: 33767071 DOI: 10.1097/dad.0000000000001934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jahg Wong
- Division of Pathology, University of Montréal, Montréal, Québec, Canada
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Parikh K, Ma L, Treuner K, Wong J, Schnabel C, Gutierrez M. P59.05 Integration of Molecular Cancer Classification and NGS to Identify Metastatic Cancer Patients Eligible For Lung Cancer Directed Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Turner C, Childs A, Johnson A, Manzur A, Quinlivan R, Sarkozy A, Wong J, Guglieri M. DMD – CLINICAL CARE. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stark N, Wallin D, Wong J. 154 Getting Down to Business: The Creation and Implementation of a Novel Business Curriculum for Emergency Medicine Residents. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lee KF, Lo EYJ, Wong KKC, Fung AKY, Chong CCN, Wong J, Ng KKC, Lai PBS. Acute kidney injury following hepatectomy and its impact on long-term survival for patients with hepatocellular carcinoma. BJS Open 2021; 5:6380640. [PMID: 34601569 PMCID: PMC8487667 DOI: 10.1093/bjsopen/zrab077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/19/2021] [Indexed: 12/29/2022] Open
Abstract
Background Acute kidney injury (AKI) is increasingly being recognized after hepatectomy. This study aimed to identify factors predicting its occurrence and its impact on long-term outcome among patients with hepatocellular carcinoma (HCC). Methods This was a retrospective analysis of the incidence of AKI, factors predicting its occurrence, and its impact on patients undergoing hepatectomy between September 2007 and December 2018. A subgroup analysis included patients with histologically proven HCC. Results The incidence of AKI was 9.2 per cent in 930 patients. AKI was associated with increased mortality, morbidity, posthepatectomy liver failure (PHLF), and a longer hospital stay. On multivariable analysis, study period December 2013 to December 2018, diabetes mellitus, mean intraoperative BP below 72.1 mmHg, operative blood loss exceeding 377ml, high Model for End-Stage Liver Disease (MELD) score, and PHLF were predictive factors for AKI. Among 560 patients with HCC, hypertension, BP below 76.9 mmHg, blood loss greater than 378ml, MELD score, and PHLF were predictive factors. The 1-, 3-, and 5-year overall survival rates were 74.1, 59.2, and 51.6 per cent respectively for patients with AKI, and 91.8, 77.9, and 67.3 per cent for those without AKI. Corresponding 1-, 3-, and 5-year disease-free survival rates were 56.9, 42.3, and 35.4 per cent respectively in the AKI group, and 71.7, 54.5, and 46.2 per cent in the no-AKI group. AKI was an independent predictor of survival in multivariable analysis. Conclusion AKI is associated with longer hospital stay, and higher morbidity and mortality rates. It is also associated with shorter long-term survival among patients with HCC. To avoid AKI, control of blood loss and maintaining a reasonable BP (72–77 mmHg) during hepatectomy is important.
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Affiliation(s)
- K F Lee
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - E Y J Lo
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - K K C Wong
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - A K Y Fung
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - C C N Chong
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - J Wong
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - K K C Ng
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - P B S Lai
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
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Dupain C, Gutman T, Girard E, du Rusquec P, Sablin MP, Tresca P, Neuzillet C, Vincent-Salomon A, Antonio S, Franck C, Galut M, Allory Y, Cyrta J, Guillou I, Wong J, Le Tourneau C, Bièche I, Servant N, Kamal M, Masliah-Planchon J. 75P Tumor mutational burden in clinical routine practice: Identifying the right threshold? Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lo KL, Leung D, Lai Z, Li C, Ma SF, Wong J, Yuen KK, Li J, Chiu P, Mak SK, Wong J, Ng CF. Picture-in-picture video demonstration of systematic transperineal prostate biopsy. Hong Kong Med J 2021; 27:304-305. [PMID: 34413262 DOI: 10.12809/hkmj208864] [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: 11/05/2022] Open
Affiliation(s)
- K L Lo
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - D Leung
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Z Lai
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - C Li
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - S F Ma
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - J Wong
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - K K Yuen
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - J Li
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - P Chiu
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - S K Mak
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - J Wong
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - C F Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
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