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  • Ovid Technologies (Wolters Kluwer Health)  (32)
  • 2020-2024  (32)
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  • Ovid Technologies (Wolters Kluwer Health)  (32)
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  • 2020-2024  (32)
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  • 1
    Online Resource
    Online Resource
    Timing of endoscopy for acute variceal bleeding in patients with cirrhosis (CHESS1905): A nationwide cohort study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Hepatology Communications Vol. 7, No. 5 ( 2023-05-4)
    Details
    In: Hepatology Communications, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. 5 ( 2023-05-4)
    Abstract: Endoscopy plays an important role in the management of acute variceal bleeding (AVB) in patients with cirrhosis. This study aimed at determining the optimal endoscopy timing for cirrhotic AVB. Methods: Patients with cirrhosis with AVB across 34 university hospitals in 30 cities from February 2013 to May 2020 who underwent endoscopy within 24 hours were included in this study. Patients were divided into an urgent endoscopy group (endoscopy 〈 6 h after admission) and an early endoscopy group (endoscopy 6–24 h after admission). Multivariable analysis was performed to identify risk factors for treatment failure. Primary outcome was the incidence of 5-day treatment failure. Secondary outcomes included in-hospital mortality, need for intensive care unit, and length of hospital stay. A propensity score matching analysis was performed. In addition, we performed an analysis, in which we compared the 5-day treatment failure incidence and the in-hospital mortality among patients with endoscopy performed at 〈 12 hours and 12–24 hours. Results: A total of 3319 patients were enrolled: 2383 in the urgent endoscopy group and 936 in the early endoscopy group. After propensity score matching, on multivariable analysis, Child-Pugh class was identified as an independent risk factor for 5-day treatment failure (HR, 1.61; 95% CI: 1.09–2.37). The incidence of 5-day treatment failure was 3.0% in the urgent endoscopy group and 2.9% in the early group ( p = 0.90). The in-hospital mortality was 1.9% in the urgent endoscopy group and 1.2% in the early endoscopy group ( p = 0.26). The incidence of need for intensive care unit was 18.2% in the urgent endoscopy group and 21.4% in the early endoscopy group ( p = 0.11). The mean length of hospital stay was 17.9 days in the urgent endoscopy group and 12.9 days in the early endoscopy group ( p 〈 0.05). The incidence of 5-day treatment failure in the 〈 12-hour group was 2.3% and 2.2% in the 12–24 hours group ( p = 0.85). The in-hospital mortality was 2.2% in the 〈 12-hour group and 0.5% in the 12–24 hours group ( p 〈 0.05). Conclusions: The data suggest that performance of endoscopy within 6–12 or within 24 hours of presentation among patients with cirrhosis with AVB led to similar treatment failure outcomes.
    Type of Medium: Online Resource
    ISSN: 2471-254X
    URL: Article
    DOI: 10.1097/HC9.0000000000000152
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2881134-3
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  • 2
    Online Resource
    Online Resource
    Complementary Effect of the Proportion of Overspeed Frames of Withdrawal and Withdrawal Time on Reflecting Colonoscopy Quality: A Retrospective, Observational Study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Clinical and Translational Gastroenterology Vol. 14, No. 3 ( 2023-2-1), p. e00566-
    Details
    In: Clinical and Translational Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 14, No. 3 ( 2023-2-1), p. e00566-
    Abstract: Constructing quality indicators that reflect the defect of colonoscopy operation for quality audit and feedback is very important. Previously, we have established a real-time withdrawal speed monitoring system to control withdrawal speed below the safe speed. We aimed to explore the relationship between the proportion of overspeed frames (POF) of withdrawal and the adenoma detection rate (ADR) and to conjointly analyze the influence of POF and withdrawal time on ADR to evaluate the feasibility of POF combined with withdrawal time as a quality control indicator. METHODS: The POF was defined as the proportion of frames with instantaneous speed ≥44 in the whole colonoscopy video. First, we developed a system for the POF of withdrawal based on a perceptual hashing algorithm. Next, we retrospectively collected 1,804 colonoscopy videos to explore the relationship between POF and ADR. According to withdrawal time and POF cutoff, we conducted a complementary analysis on the effects of POF and withdrawal time on ADR. RESULTS: There was an inverse correlation between the POF and ADR (Pearson correlation coefficient −0.836). When withdrawal time was 〉 6 minutes, the ADR of the POF ≤10% was significantly higher than that of POF 〉 10% (25.30% vs 16.50%; odds ratio 0.463, 95% confidence interval 0.296–0.724, P 〈 0.01). When the POF was ≤10%, the ADR of withdrawal time 〉 6 minutes was higher than that of withdrawal time ≤6 minutes (25.30% vs 21.14%; odds ratio 0.877, 95% confidence interval 0.667–1.153, P = 0.35). DISCUSSION: The POF was strongly correlated with ADR. The combined assessment of the POF and withdrawal time has profound significance for colonoscopy quality control.
    Type of Medium: Online Resource
    ISSN: 2155-384X
    URL: Article
    DOI: 10.14309/ctg.0000000000000566
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2581516-7
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  • 3
    Online Resource
    Online Resource
    Human-Like Artificial Intelligent System for Predicting Invasion Depth of Esophageal Squamous Cell Carcinoma Using Magnifying Narrow-Band Imaging Endoscopy: A Retrospective Multicenter Study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Clinical and Translational Gastroenterology Vol. 14, No. 10 ( 2023-6-9), p. e00606-
    Details
    In: Clinical and Translational Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 14, No. 10 ( 2023-6-9), p. e00606-
    Abstract: Endoscopic evaluation is crucial for predicting the invasion depth of esophagus squamous cell carcinoma (ESCC) and selecting appropriate treatment strategies. Our study aimed to develop and validate an interpretable artificial intelligence–based invasion depth prediction system (AI-IDPS) for ESCC. METHODS: We reviewed the PubMed for eligible studies and collected potential visual feature indices associated with invasion depth. Multicenter data comprising 5,119 narrow-band imaging magnifying endoscopy images from 581 patients with ESCC were collected from 4 hospitals between April 2016 and November 2021. Thirteen models for feature extraction and 1 model for feature fitting were developed for AI-IDPS. The efficiency of AI-IDPS was evaluated on 196 images and 33 consecutively collected videos and compared with a pure deep learning model and performance of endoscopists. A crossover study and a questionnaire survey were conducted to investigate the system's impact on endoscopists' understanding of the AI predictions. RESULTS: AI-IDPS demonstrated the sensitivity, specificity, and accuracy of 85.7%, 86.3%, and 86.2% in image validation and 87.5%, 84%, and 84.9% in consecutively collected videos, respectively, for differentiating SM2-3 lesions. The pure deep learning model showed significantly lower sensitivity, specificity, and accuracy (83.7%, 52.1% and 60.0%, respectively). The endoscopists had significantly improved accuracy (from 79.7% to 84.9% on average, P = 0.03) and comparable sensitivity (from 37.5% to 55.4% on average, P = 0.27) and specificity (from 93.1% to 94.3% on average, P = 0.75) after AI-IDPS assistance. DISCUSSION: Based on domain knowledge, we developed an interpretable system for predicting ESCC invasion depth. The anthropopathic approach demonstrates the potential to outperform deep learning architecture in practice.
    Type of Medium: Online Resource
    ISSN: 2155-384X
    URL: Article
    DOI: 10.14309/ctg.0000000000000606
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2581516-7
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  • 4
    Online Resource
    Online Resource
    The difference of transcriptome of HPV-infected patients contributes more to the occurrence of cervical cancer than the mutations of E6 and E7 genes in HPV16
    Ovid Technologies (Wolters Kluwer Health) ; 2024
    In:  Medicine Vol. 103, No. 3 ( 2024-01-19), p. e36822-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 103, No. 3 ( 2024-01-19), p. e36822-
    Abstract: Human papillomavirus (HPV) E6 and E7 genes are biomarkers and drivers of the progression of cervical cancer (CxCa). The aim of this study was to investigate the relationship between HPV16 E6, E7 gene mutations and the occurrence and development of CxCa. Cervical exfoliated cells and clinical data of patients with cervical diseases were collected. Sample DNA was extracted, the E6 and E7 gene fragments were amplified by PCR, and the mutations were detected by Sanger sequencing and compared with standard sequences. Microarray was used to sequence the transcriptome of cells. Data of transcriptome analyzed and visualized using R software and its packages. Analysis of clinical characteristics demonstrated the association of HPV16 infection with CxCa ( P   〈  .05). Sanger sequencing results showed that the mutation sites of E6 gene included T178G/A, T350G, A131C, and T241G; among these, A131C and T241G were synonymous mutations. The mutation sites of E7 gene included A647G, T846C, G666A, T843C, and T760C, and all of them were synonymous mutations except A647G. There was no significant difference in the distribution of HPV16 E6, E7 mutations among CxCa, cervical intraepithelial neoplasia, and infection groups ( P   〉  .05). Compared with the non- CxCa group, gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis of differentially expressed genes (DEGs) showed more significant enrichment of DEGs in the biological processes, pathways, and diseases closely related to cancer. Compared with the non-mutation group, the DEGs in the E6, E7 gene mutation group were significantly enriched in the events related to infection and immunity. To summarize, HPV16 may be associated with the occurrence and development of CxCa, but HPV16 E6 and E7 gene mutations have little effect on the occurrence and development of CxCa. Individual differences may have a greater effect on the progression of CxCa.
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000036822
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2024
    detail.hit.zdb_id: 2049818-4
    detail.hit.zdb_id: 80184-7
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  • 5
    Online Resource
    Online Resource
    Evaluation of Cobas HPV and SeqHPV Assays in the Chinese Multicenter Screening Trial
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of Lower Genital Tract Disease Vol. 25, No. 1 ( 2021-1), p. 22-26
    Details
    In: Journal of Lower Genital Tract Disease, Ovid Technologies (Wolters Kluwer Health), Vol. 25, No. 1 ( 2021-1), p. 22-26
    Abstract: The aim of the study was to evaluate the Cobas 4800 Assay and the SeqHPV Assay with self (S) and direct (D) cervical samples in the Chinese Multicenter Screening Trial (CHIMUST). Materials and Methods The CHIMUST is a large population-based multicenter clinical trial, and 10,885 women aged 30–59 years from 15 sites in 7 provinces with no cervical cancer screening for 3 years were eligible. All participating women contributed one self-collected sample (S) and 1 physician-collected endocervical sample (DL). The self-collected sample was first applied to the solid media transport card (SS), and then, the brush placed in 6 mL of ThinPrepSolution (SL). All samples were tested with Cobas 4800 and SeqHPV high-risk HPV assays. Patients human papillomavirus positive (self or direct) were recalled for colposcopy and biopsies. Results A total of 10,399 women had complete data. The mean age was 43.9 years. A total of 1.4% (142/10,399) had cervical intraepithelial neoplasia (CIN) 2+ and 0.5% (54/10,339) had CIN 3+. In the liquid specimens, the overall HPV infection rates were 10.8% for Cobas and 10.9% for SeqHPV in D sample, and 13.7% for Cobas and 11.6% for SeqHPV in SL sample, respectively. The sensitivity of Cobas-DL, Cobas-SL, SeqHPV-DL, and SeqHPV-SL for CIN 2+ was 95.07%, 95.07%, 94.33%, and 96.48%, respectively. The specificity of Cobas-DL, Cobas-SL, SeqHPV-DL, and SeqHPV-SL for CIN 2+ was 90.38%, 87.35%, 90.21%, and 89.53%, respectively. There were no differences in sensitivity when applying the 2 assays to both self- and directly collected samples in liquid transport media ( p 〉 .05). Conclusions Both Cobas and SeqHPV screening assays using both self-collected and directly endocervical collected specimens demonstrate similar sensitivity for the detection of CIN 2+ and CIN 3+.
    Type of Medium: Online Resource
    ISSN: 1526-0976
    URL: Article
    DOI: 10.1097/LGT.0000000000000577
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2006922-4
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  • 6
    Online Resource
    Online Resource
    A Gastrointestinal Endoscopy Quality Control System Incorporated With Deep Learning Improved Endoscopist Performance in a Pretest and Post-Test Trial
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Clinical and Translational Gastroenterology Vol. 12, No. 6 ( 2021-6-15), p. e00366-
    Details
    In: Clinical and Translational Gastroenterology, Ovid Technologies (Wolters Kluwer Health), Vol. 12, No. 6 ( 2021-6-15), p. e00366-
    Abstract: Gastrointestinal endoscopic quality is operator-dependent. To ensure the endoscopy quality, we constructed an endoscopic audit and feedback system named Endo.Adm and evaluated its effect in a form of pretest and posttest trial. METHODS: Endo.Adm system was developed using Python and Deep Convolutional Neural Ne2rk models. Sixteen endoscopists were recruited from Renmin Hospital of Wuhan University and were randomly assigned to undergo feedback of Endo.Adm or not (8 for the feedback group and 8 for the control group). The feedback group received weekly quality report cards which were automatically generated by Endo.Adm. We then compared the adenoma detection rate (ADR) and gastric precancerous conditions detection rate between baseline and postintervention phase for endoscopists in each group to evaluate the impact of Endo.Adm feedback. In total, 1,191 colonoscopies and 3,515 gastroscopies were included for analysis. RESULTS: ADR was increased after Endo.Adm feedback (10.8%–20.3%, P 〈 0.01, 〈 odds ratio (OR) 2.13, 95% confidence interval (CI) 1.317–3.447), and endoscopists' ADR without feedback remained nearly unchanged (10.8%–10.9%, P = 0.57, OR 1.086, 95% CI 0.814–1.447). Gastric precancerous conditions detection rate increased in the feedback group (3%–7%, P 〈 0.01, OR 1.866, 95% CI 1.399–2.489) while no improvement was observed in the control group (3.9%–3.5%, P = 0.489, OR 0.856, 95% CI 0.550–1.332). DISCUSSION: Endo.Adm feedback contributed to multifaceted gastrointestinal endoscopic quality improvement. This system is practical to implement and may serve as a standard model for quality improvement in routine work (http://www.chictr.org.cn/, ChiCTR1900024153).
    Type of Medium: Online Resource
    ISSN: 2155-384X
    URL: Article
    DOI: 10.14309/ctg.0000000000000366
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 7
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    Online Resource
    Inhibition of Aryl Hydrocarbon Receptor Attenuates Hyperglycemia‐Induced Hematoma Expansion in an Intracerebral Hemorrhage Mouse Model
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of the American Heart Association Vol. 10, No. 20 ( 2021-10-19)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 20 ( 2021-10-19)
    Abstract: Hyperglycemia is associated with greater hematoma expansion (HE) and worse clinical prognosis after intracerebral hemorrhage (ICH). However, the clinical benefits of intensive glucose normalization remain controversial, and there are no approved therapies for reducing HE. The aryl hydrocarbon receptor (AHR) has been shown to participate in hyperglycemia‐induced blood–brain barrier (BBB) dysfunction and brain injury after stroke. Herein, we investigated the role of AHR in hyperglycemia‐induced HE in a male mouse model of ICH. Methods and Results CD1 mice (n=387) were used in this study. Mice were subjected to ICH by collagenase injection. Fifty percent dextrose was injected intraperitoneally 3 hours after ICH. AHR knockout clustered regularly interspaced short palindromic repeat was administered intracerebroventricularly to evaluate the role of AHR after ICH. A selective AHR inhibitor, 6,2′,4′‐trimethoxyflavone, was administered intraperitoneally 2 hours or 6 hours after ICH for outcome study. To evaluate the effect of AHR on HE, 3‐methylcholanthrene, an AHR agonist, was injected intraperitoneally 2 hours after ICH. The results showed hyperglycemic ICH upregulated AHR accompanied by greater HE. AHR inhibition provided neurological benefits by restricting HE and preserving BBB function after hyperglycemic ICH. In vivo knockdown of AHR further limited HE and enhanced the BBB integrity. Hyperglycemia directly activated AHR as a physiological stimulus in vivo. The thrombospondin‐1/transforming growth factor‐β/vascular endothelial growth factor axis partly participated in AHR signaling after ICH, which inhibited the expressions of BBB‐related proteins, ZO‐1 and Claudin‐5. Conclusions AHR may serve as a potential therapeutic target to attenuate hyperglycemia‐induced hematoma expansion and to preserve the BBB in patients with ICH.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.121.022701
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2653953-6
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  • 8
    Online Resource
    Online Resource
    USP5 promotes lipopolysaccharide-induced apoptosis and inflammatory response by stabilizing the TXNIP protein
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Hepatology Communications Vol. 7, No. 8 ( 2023-08-3)
    Details
    In: Hepatology Communications, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. 8 ( 2023-08-3)
    Abstract: The role of thioredoxin-interacting protein (TXNIP) in lipopolysaccharide-induced liver injury in mice has been reported, but the underlying mechanisms are poorly understood. Methods: We overexpressed deubiquitinase in cells overexpressing TXNIP and then detected the level of TXNIP to screen out the deubiquitinase regulating TXNIP; the interaction between TXNIP and deubiquitinase was verified by coimmunoprecipitation. After knockdown of a deubiquitinase and overexpression of TXNIP in Huh7 and HepG2 cells, lipopolysaccharide was used to establish a cellular inflammatory model to explore the role of deubiquitinase and TXNIP in hepatocyte inflammation. Results: In this study, we discovered that ubiquitin-specific protease 5 (USP5) interacts with TXNIP and stabilizes it through deubiquitylation in Huh-7 and HepG2 cells after treatment with lipopolysaccharide. In lipopolysaccharide-treated Huh-7 and HepG2 cells, USP5 knockdown increased cell viability, reduced apoptosis, and decreased the expression of inflammatory factors, including NLRP3, IL-1β, IL-18, ASC, and procaspase-1. Overexpression of TXNIP reversed the phenotype induced by knockdown USP5. Conclusions: In summary, USP5 promotes lipopolysaccharide-induced apoptosis and inflammatory response by stabilizing the TXNIP protein.
    Type of Medium: Online Resource
    ISSN: 2471-254X
    URL: Article
    DOI: 10.1097/HC9.0000000000000193
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2881134-3
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  • 9
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    Deep Learning Models for Severity Prediction of Acute Pancreatitis in the Early Phase From Abdominal Nonenhanced Computed Tomography Images
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Pancreas Vol. 52, No. 1 ( 2023-1), p. e45-e53
    Details
    In: Pancreas, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 1 ( 2023-1), p. e45-e53
    Abstract: To develop and validate deep learning (DL) models for predicting the severity of acute pancreatitis (AP) by using abdominal nonenhanced computed tomography (CT) images. Methods The study included 978 AP patients admitted within 72 hours after onset and performed abdominal CT on admission. The image DL model was built by the convolutional neural networks. The combined model was developed by integrating CT images and clinical markers. The performance of the models was evaluated by using the area under the receiver operating characteristic curve. Results The clinical, Image DL, and the combined DL models were developed in 783 AP patients and validated in 195 AP patients. The combined models possessed the predictive accuracy of 90.0%, 32.4%, and 74.2% for mild, moderately severe, and severe AP. The combined DL model outperformed clinical and image DL models with 0.820 (95% confidence interval, 0.759–0.871), the sensitivity of 84.76% and the specificity of 66.67% for predicting mild AP and the area under the receiver operating characteristic curve of 0.920 (95% confidence interval, 0.873–0.954), the sensitivity of 90.32%, and the specificity of 82.93% for predicting severe AP. Conclusions The DL technology allows nonenhanced CT images as a novel tool for predicting the severity of AP.
    Type of Medium: Online Resource
    ISSN: 1536-4828 , 0885-3177
    URL: Article
    DOI: 10.1097/MPA.0000000000002216
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2053902-2
    detail.hit.zdb_id: 632831-3
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  • 10
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    Abstract P144: One-year Change In Walking Performance And Mobility Loss In People With Peripheral Artery Disease: The Walking And Leg Circulation Study (walcs)
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 143, No. Suppl_1 ( 2021-05-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 143, No. Suppl_1 ( 2021-05-25)
    Abstract: Introduction: Peripheral artery disease (PAD) affects 10-15% of people age 65 and older, and the prevalence is expected to rise as the population ages. People with PAD have greater functional impairment and faster decline in walking performance than people without PAD. Objectives: To determine the association between 1-year change in walking performance and mobility loss. We hypothesized that greater declines in walking performance over one year would be associated with higher rates of mobility loss. Methods: Participants underwent measurement of 6-minute walk and 4-meter walking velocity at baseline, and returned yearly for repeat measurement of walking performance and assessment of mobility. Participants were categorized into tertiles based on their 1-year change in walking performance (Tertile 1: greatest decline). Mobility loss was defined as becoming newly unable to walk one-quarter mile or walk up and down 1 flight of stairs without assistance after the 1-year follow-up. We used Cox proportional hazards models to examine the association between 1-year change in walking performance and mobility loss, adjusting for potential confounders. Results: 907 participants with PAD (mean age 71 +/- 9 years, 40% female, 23% black) were included. Median follow-up time was 38 months. Participants in Tertile 1 were older (mean 73 ± 9 years compared to 71 ± 9 in Tertile 2, and 70 ± 9 in Tertile 3; p=0.0004), had lower ABI (p=0.001), and included a higher prevalence of female (42% vs. 40% in Tertile 2, and 37% in Tertile 3; p=0.36). Participants with greater decline in 6-minute walk at 1-year follow-up had higher rates of mobility loss than participants with less decline. No significant associations of change in 4-meter walking speed and mobility loss were observed (Table). Conclusion: Among people with PAD, greater 1-year declines in six-minute walk distance are associated with higher rates of mobility loss. Further study is needed to determine whether interventions that prevent decline in six-minute walk can also prevent mobility loss.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.143.suppl_1.P144
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
    detail.hit.zdb_id: 80099-5
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