Metastasis is the main cause of cancer death. As the tumor progresses, cells from the primary tumor site are shed into the bloodstream as circulating tumor cells (CTCs). Eventually, these cells ...colonize other organs and form distant metastases. It is therefore imperative that we gain a better understanding of the biological characteristics of CTCs for development of novel treatment modalities to minimize metastasis-associated cancer deaths. In recent years, rapid developments in technologies for the study of CTCs have taken place. We now have a variety of tools for the isolation and examination of CTCs which were not available before. This review introduces some commonly used protein markers in CTC investigations and summarizes a few advanced technologies which have been successfully applied for studying CTC biology at the protein level.
Molecular imaging probes can target abnormal gene expression patterns in patients and allow early diagnosis of disease. For selecting a suitable imaging probe, the current Molecular Imaging and ...Contrast Agent Database (MICAD) provides descriptive and qualitative information on imaging probe characteristics and properties. However, MICAD does not support linkage with the expression profiles of target genes. The proposed Disease-specific Imaging Probe Profiling (DIPP) database quantitatively archives and presents the gene expression profiles of targets across different diseases, anatomic regions, and subcellular locations, providing an objective reference for selecting imaging probes. The DIPP database was validated with a clinical positron emission tomography (PET) study on lung cancer and an in vitro study on neuroendocrine cancer. The retrieved records show that choline kinase beta and glucose transporters were positively and significantly associated with lung cancer among the targets of
C-choline and
Ffluoro-2- deoxy-2-D-glucose (FDG), respectively. Their significant overexpressions corresponded to the findings that the uptake rate of FDG increased with tumor size but that of
C-choline remained constant. Validated with the in vitro study, the expression profiles of disease-associated targets can indicate the eligibility of patients for clinical trials of the treatment probe. A Web search tool of the DIPP database is available at http://www.polyu.edu.hk/bmi/dipp/ .
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Multi-disciplinary platform is created to store and integrate DICOM objects from various clinical disciplines. With artificial intelligence, clinical decision support system is built to assess risk ...of disease complications using the features extracted from the DICOM objects and their interrelationship. Diabetes Mellitus is considered as the disease of interest and the risks of its complications are assessed based on the extracted features. The synergy of the DICOM-based multi-disciplinary platform and the clinical decision support system provides promising functions for extracting and interrelating consistent features of clinical information.
Successful brace treatment entails good control of scoliosis with avoidance of surgery. However, achieving curve regression may be an even better radiological result than prevention of curve ...progression for patients with adolescent idiopathic scoliosis. Vertebral remodeling may occur with well-fitted braces. Better in-brace curve correction may influence the likelihood of vertebral remodeling and the chance of curve regression. Only a few reports have evaluated curve regression with brace treatment, and the factors associated with these events are unknown.
(1) What changes in curvature are observed with brace treatment for adolescent idiopathic scoliosis? (2) What factors are associated with curve improvement? (3) What factors are associated with curve deterioration? (4) Is curve regression associated with improvements in patient-reported objective outcome scores?
Between September 2008 and December 2013, 666 patients with adolescent idiopathic scoliosis underwent underarm brace treatment and were followed until skeletal maturity at 18 years old. Among these patients, 80 were excluded because of early discontinuation of brace treatment (n = 66) and loss to follow-up (n = 14). Hence, 586 patients were included in this study, with a mean brace-wear duration of 3.8 ± 1.5 years and post-weaning follow-up duration of 2.0 ± 1.1 years. The mean age at baseline was 12.6 ± 1.2 years. Most patients were female (87%, 507 of 586) and up to 53% (267 of 507) of females were post-menarche. Bracing outcomes were based on changes in the Cobb angle measured out of brace. These included curve regression, as indicated by at least a 5° reduction in the Cobb angle, curve progression, as indicated by at least a 5° increase in the Cobb angle, and unchanged, as indicated by a change in the Cobb angle of less than 5°. We studied the pre-brace and supine Cobb angles, curve flexibility (pre-brace Cobb angle - supine Cobb angle / pre-brace Cobb angle x 100%), correction rate (pre-brace Cobb angle - in-brace Cobb angle / pre-brace Cobb angle x 100%), location of apical vertebrae, apical ratio (convex vertebral height/concave vertebral height), change in the major curve Cobb angle, and apical ratio post-bracing. The refined 22-item Scoliosis Research Society questionnaire was used for patient-reported outcomes and is composed of five domains (function, pain, appearance, mental health and satisfaction with treatment). Its minimum clinically important difference, based on a scale from 0 to 5, has been quoted as 0.2 for pain, 0.08 for activity and 0.98 for appearance domains. Mental health has no quoted minimum clinically important difference for the adolescent idiopathic scoliosis population. Satisfaction with treatment is described based on improvement or deterioration in domain scores. Intergroup differences between bracing outcomes were evaluated with the Kruskal Wallis test. Univariate analyses of bracing outcomes were performed with a point-biserial correlation coefficient for continuous variables and Pearson's chi-square test for categorical variables. Multivariate logistic regression models were created for improved and deteriorated outcomes. P values < 0.05 were considered significant.
In all, 17% of patients (98 of 586) had an improved angle and 40% of patients (234 of 586) had curve deterioration. In patients who improved, the mean reduction in the Cobb angle was 9 ± 4°, while in patients who deteriorated, the mean increase in the Cobb angle was 15 ± 9°, and this was maintained at the latest post-brace weaning follow-up. Despite a trend for patients with curve regression to have higher baseline flexibility and correction rate, after controlling for age, Risser staging, radius and ulnar grading, and Sanders staging, we found no clinically important differences with increased correction rate or flexibility. We did find that improvement in the Cobb angle after bracing was associated with reduced apical ratio (odds ratio OR 0.84 95% CI 0.80 to 0.87; p < 0.001). Curve progression was associated with younger age (OR 0.71 95% CI 0.55 to 0.91; p = 0.008), pre-menarche status (OR 2.46 95% CI 1.31 to 4.62; p = 0.005), and increased apical ratio (OR 1.24 95% CI 1.19 to 1.30; p < 0.001) but no clinically important differences were observed with less flexible curves and reduced correction rate. Improvements in scores of the refined 22-item Scoliosis Research Society domains of function (mean difference on a scale from 0 to 5: 0.2; p = 0.001 versus 0.1; p < 0.001) and pain (mean difference on a scale from 0 to 5: 0.2; p = 0.020 versus 0.0; p = 0.853) were greater in the post-brace improvement group than in the deterioration group and fulfilled the minimum clinically important difference threshold. The appearance domain did not fulfill the minimum clinically important difference. Satisfaction with treatment domain score minimally improved with the curve regression group (mean difference on a scale from 0 to 5: 0.2) but deteriorated in the curve progression group (mean difference on a scale from 0 to 5: -0.4).
Curve regression occurs after underarm bracing and is associated with superior patient-reported outcome scores. This possible change in Cobb angle should be explained to patients before and during bracing. Whether this may help improve patients' duration of brace-wear should be addressed in future studies. Patients with well-fitting braces may experience curve improvement and possible vertebral remodeling. Those braced at a younger age and with increased vertebral wedging are more likely to have curve progression.
Level III, therapeutic study.
Positron Emission Tomography (PET) with combined
F-FDG and
C-acetate (dual-tracer) is used for the management of hepatocellular carcinoma (HCC) patients, although its prognostic value and ...underlying molecular mechanism remain poorly understood. We hypothesized that radiotracer uptake might be associated with tumor hypoxia and validated our findings in public and local human HCC cohorts.
Twelve orthotopic HCC xenografts were established using MHCC97L cells in female nude mice, with 5 having undergone hepatic artery ligation (HAL) to create tumor hypoxia in vivo. Tumors in both Control and HAL-treated xenografts were imaged with
C-acetate and
F-FDG PET-MR and RNA sequencing was performed on the resected tumors. Semiquantitative analysis of PET findings was then performed, and the findings were then validated on the Cancer Genome Atlas Liver Hepatocellular Carcinoma (TCGA-LIHC) cohort and patients from our institution.
HAL-treated mice showed lower
C-acetate (HAL-treated vs. Control, tumor-to-liver SUV ratio (SUV
): 2.142.05-2.21 vs 3.112.75-5.43, p = 0.02) but not
F-FDG (HAL-treated vs. Control, SUV
: 3.733.12-4.35 vs 3.863.7-5.29, p = 0.83) tumor uptakes. Gene expression analysis showed the PET phenotype is associated with upregulation of hallmark hypoxia signature. The prognostic value of the hypoxia gene signature was tested on the TCGA-LIHC cohort with upregulation of hypoxia gene signature associated with poorer overall survival (OS) in late-stage (stage III and IV) HCC patients (n = 66, OS 2.05 vs 1.67 years, p = 0.046). Using a local cohort of late-stage HCC patients who underwent dual-tracer PET-CT, tumors without
C-acetate uptake are associated with poorer prognosis (n = 51, OS 0.25 versus 1.21 years, p < 0.0001) and multivariable analyses showed
C-acetate tumor uptake as an independent predictor of OS (HR 0.17 95%C 0.06-0.42, p < 0.0001).
C-acetate uptake is associated with alteration of tumor hypoxia gene expression and poorer prognosis in patients with advanced HCC.
Abstract
Hydrogen generation from water using noble metal-free photocatalysts presents a promising platform for renewable and sustainable energy. Copper-based chalcogenides of earth-abundant ...elements, especially Cu
2
ZnSnS
4
(CZTS), have recently arisen as a low-cost and environment-friendly material for photovoltaics and photocatalysis. Herein, we report a new heterostructure consisting of CZTS nanoparticles anchored onto a MoS
2
-reduced graphene oxide (rGO) hybrid. Using a facile two-step method, CZTS nanoparticles were
in situ
grown on the surface of MoS
2
-rGO hybrid, which generated high density of nanoscale interfacial contact between CZTS and MoS
2
-rGO hybrid. The photoexcited electrons of CZTS can be readily transported to MoS
2
through rGO backbone, reducing the electron-hole pair recombination. In photocatalytic hydrogen generation under visible light irradiation, the presence of MoS
2
-rGO hybrids enhanced the hydrogen production rate of CZTS by 320%, which can be attributed to the synergetic effect of increased charge separation by rGO and more catalytically active sites from MoS
2
. Furthermore, this CZTS/MoS
2
-rGO heterostructure showed much higher photocatalytic activity than both Au and Pt nanoparticle-decorated CZTS (Au/CZTS and Pt/CZTS) photocatalysts, indicating the MoS
2
-rGO hybrid is a better co-catalyst for photocatalytic hydrogen generation than the precious metal. The CZTS/MoS
2
-rGO system also demonstrated stable photocatalytic activity for a continuous 20 h reaction.
To discover specific circulating microRNA (miRNA) biomarkers for the early differentiation of necrotizing enterocolitis (NEC) from neonatal sepsis and inflammatory conditions.
The study comprised 3 ...distinct phases: differential microarray analysis to compare plasma miRNA expression profiles of NEC vs sepsis and non-NEC/nonsepsis cases, a case-control study to quantify dysregulated miRNAs as potential specific biomarkers of NEC, and a prospective cohort study to assess the diagnostic usefulness of the best miRNA biomarker(s).
A distinct miRNA expression profile was observed in the NEC compared with the sepsis and non-NEC/nonsepsis groups. miR-1290, miR-1246, and miR-375 were discovered to be specific biomarkers of NEC in the case-control study. In the cohort study (n = 301), plasma miR-1290 (day 0; >220 copies/µL) provided the greatest diagnostic usefulness for identifying both mild medical and severe surgical NEC cases. Of 20 infants with miR-1290 >650 copies/µL, 15 were diagnosed with NEC. Incorporating C-reactive protein (day 1; >15.8 mg/L) for cases with intermediate levels (220-650 copies/µL) in a 2-stage algorithm further optimized the diagnostic profile with a sensitivity of 0.83, a specificity of 0.96, a positive predictive value of 0.75, and a negative predictive value of 0.98. Importantly, 7 of 36 infants with NEC (19.4%) could be diagnosed 7.8-32.2 hours earlier (median, 13.3 hours) using miR-1290.
Plasma miR-1290 is a novel and specific biomarker that can effectively differentiate NEC cases from neonatal sepsis. miR-1290 facilitates neonatologists to confidently and timely reach a decision for early transfer of sick infants with NEC from community-based hospitals to tertiary surgical centers.
Introduction
This study aimed to examine the mental health of palliative care professionals in Hong Kong during the COVID-19 pandemic, the relationship of mental health with socio-demographic ...factors, and the impact of the pandemic on palliative care services.
Methods
A total of 142 palliative care professionals in Hong Kong participated in an online survey. The questionnaire includes measurements on depression, anxiety, perceived stress, post-traumatic stress, professional quality of life, items that measure the effect of COVID-19 on palliative care services, and one open-ended question for describing how the services were affected. Descriptive and multivariate regression analyses were conducted. Quantitative and qualitative data about the impact of COVID-19 on palliative care services were analyzed and triangulated using a mixed-methods approach.
Results
Up to 82%, 43%, and 42% of the participants felt moderately to highly stressed, anxious, and depressed, respectively, during the pandemic. Younger participants tended to have poorer mental health and professional quality of life. Around 82% felt stressed when communicating with patients and family members under the no-visiting policy during the pandemic. More than three-quarters of participants showed lack of confidence in the anti-epidemic policy of the government. Qualitative findings identified 3 themes affecting the provision of palliative care: 1. the tightening of restrictions on visitors; 2. the limited provision of services; and 3. staff deployment.
Conclusions
Appropriate responses are required to give extra support to palliative care professionals during the pandemic and facilitate their coping with the impact of COVID-19 on the provision of palliative care.
Diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin's lymphoma, is clinically heterogeneous: 40% of patients respond well to current therapy and have prolonged survival, ...whereas the remainder succumb to the disease. We proposed that this variability in natural history reflects unrecognized molecular heterogeneity in the tumours. Using DNA microarrays, we have conducted a systematic characterization of gene expression in B-cell malignancies. Here we show that there is diversity in gene expression among the tumours of DLBCL patients, apparently reflecting the variation in tumour proliferation rate, host response and differentiation state of the tumour. We identified two molecularly distinct forms of DLBCL which had gene expression patterns indicative of different stages of B-cell differentiation. One type expressed genes characteristic of germinal centre B cells ('germinal centre B-like DLBCL'); the second type expressed genes normally induced during in vitro activation of peripheral blood B cells ('activated B-like DLBCL'). Patients with germinal centre B-like DLBCL had a significantly better overall survival than those with activated B-like DLBCL. The molecular classification of tumours on the basis of gene expression can thus identify previously undetected and clinically significant subtypes of cancer.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background and Aim: With the Westernization of the lifestyle and the rising prevalence of obesity and diabetes mellitus, non‐alcoholic fatty liver disease (NAFLD) is an emerging health problem in ...the Asia–Pacific region. The purpose of this study was to determine the awareness of NAFLD among the general population in Hong Kong.
Methods: A random telephone survey was conducted from September 2007 to January 2008 using a structured multiple‐choice questionnaire. Subjects were Hong Kong residents aged 18 or above who spoke Cantonese.
Results: In the first phase of the telephone survey, 521 subjects were interviewed and the results showed that as high as 83% of respondents had never come across the term ‘NAFLD’. Upon completion of the second phase telephone survey, a total of 508 respondents who had heard of NAFLD were successfully interviewed. Of the 508 respondents, nearly half of them (42%) expressed no idea about the prevalence of NAFLD in Hong Kong. About half of respondents (47%) knew nothing about the clinical presentation of NAFLD. The majority of them (78%) had a misconception that blood tests could provide a definite diagnosis of NAFLD. Smoking, hepatitis B carriage and a past history of hepatitis A infection were cited as risk factors of NAFLD by 52%, 57% and 42% of respondents, respectively. Of the 508 respondents who had heard of NAFLD, most of them perceived that their knowledge of NAFLD was either inadequate (46%) or highly inadequate (35%).
Conclusion: This survey revealed an inadequate knowledge of NAFLD among the general population in Hong Kong.
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![Prognostic PET [ 11 C]-acet...](http://api.summon.serialssolutions.com/2.0.0/image/issn/XR4PS5YY4K/1470-7330_1740-5025/small "Prognostic PET [ 11 C]-acetate uptake is associated with hypoxia gene expression in patients with late-stage hepatocellular carcinoma - a bench to bed study")
