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  • 1
    Online Resource
    Online Resource
    Precision Science on Incidence and Progression of Early-Detected Small Breast Invasive Cancers by Mammographic Features
    MDPI AG ; 2020
    In:  Cancers Vol. 12, No. 7 ( 2020-07-10), p. 1855-
    Details
    In: Cancers, MDPI AG, Vol. 12, No. 7 ( 2020-07-10), p. 1855-
    Abstract: The aim was to evaluate how the inter-screening interval affected the performance of screening by mammographic appearances. This was a Swedish retrospective screening cohort study with information on screening history and mammography features in two periods (1977–1985 and 1996–2010). The pre-clinical incidence and the mean sojourn time (MST) for small breast cancer allowing for sensitivity by mammographic appearances were estimated. The percentage of interval cancer against background incidence (I/E ratio) was used to assess the performance of mammography screening by different inter-screening intervals. The sensitivity-adjusted MSTs (in years) were heterogeneous with mammographic features, being longer for powdery and crushed stone-like calcifications (4.26, (95% CI, 3.50–5.26)) and stellate masses (3.76, (95% CI, 3.15–4.53)) but shorter for circular masses (2.65, (95% CI, 2.06–3.55)) in 1996–2010. The similar trends, albeit longer MSTs, were also noted in 1977–1985. The I/E ratios for the stellate type were 23% and 32% for biennial and triennial screening, respectively. The corresponding figures were 32% and 43% for the circular type and 21% and 29% for powdery and crushed stone-like calcifications, respectively. Mammography-featured progressions of small invasive breast cancer provides a new insight into personalized quality assurance, surveillance, treatment and therapy of early-detected breast cancer.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers12071855
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2527080-1
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  • 2
    Online Resource
    Online Resource
    The Preventive Role of mRNA Vaccines in Reducing Death among Moderate Omicron-Infected Patients: A Follow-Up Study
    MDPI AG ; 2022
    In:  Viruses Vol. 14, No. 12 ( 2022-11-24), p. 2622-
    Details
    In: Viruses, MDPI AG, Vol. 14, No. 12 ( 2022-11-24), p. 2622-
    Abstract: Very few studies have been conducted to assess the potential preventive role of vaccines, particularly mRNA vaccines, in the improvement of survival among moderate and severe hospitalized patients with COVID-19. After community-acquired outbreaks of the Omicron variant from 18 March until 31 May 2022, occurred in Taiwan, this retrospective cohort of 4090 moderate and 1378 severe patients admitted to hospital was classified according to whether they were administered an mRNA-based vaccine, and followed up to ascertain rates of death in both the vaccinated (≥2 doses) and unvaccinated (no or 1 dose) groups. The age-adjusted hazard ratio (aHR) of less than 1 was used to assess the preventive role of mRNA vaccines in reducing deaths among moderate and severe Omicron-infected patients. Survival was statistically significantly better for the ≥2 dose jab group (aHR, 0.75, 95% confidence interval [CI], 0.60 to 0.94) and even higher among those who had received a booster jab (aHR, 0.71;95% CI, 0.55 to 0.91) compared with the unvaccinated group among moderate patients, but not among severe patients. In conclusion, unveiling the role of mRNA vaccines in preventing moderate but not severe COVID-19 patients from death provides new insights into how mRNA vaccines play a role in the pathway leading to a severe outcome due to Omicron COVID-19.
    Type of Medium: Online Resource
    ISSN: 1999-4915
    URL: Article
    DOI: 10.3390/v14122622
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2516098-9
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  • 3
    Online Resource
    Online Resource
    Impact of Overdiagnosis on Long-Term Breast Cancer Survival
    MDPI AG ; 2019
    In:  Cancers Vol. 11, No. 3 ( 2019-03-07), p. 325-
    Details
    In: Cancers, MDPI AG, Vol. 11, No. 3 ( 2019-03-07), p. 325-
    Abstract: Elucidating whether and how long-term survival of breast cancer is mainly due to cure after early detection and effective treatment and therapy or overdiagnosis resulting from the widespread use of mammography provides a new insight into the role mammography plays in screening, surveillance, and treatment of breast cancer. Given information on detection modes, the impact of overdiagnosis due to mammography screening on long-term breast cancer survival was quantitatively assessed by applying a zero (cured or overdiagnosis)-inflated model design and analysis to a 15-year follow-up breast cancer cohort in Dalarna, Sweden. The probability for non-progressive breast cancer (the zero part) was 56.14% including the 44.34% complete cure after early detection and initial treatment and a small 11.80% overdiagnosis resulting from mammography screening program (8.94%) and high awareness (2.86%). The 15-year adjusted cumulative survival of breast cancer was dropped from 88.25% to 74.80% after correcting for the zero-inflated part of overdiagnosis. The present findings reveal that the majority of survivors among women diagnosed with breast cancer could be attributed to the cure resulting from mammography screening and accompanying effective treatment and therapy and only a small fraction of those were due to overdiagnosis.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers11030325
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2527080-1
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  • 4
    Online Resource
    Online Resource
    Estimating the Global Spread of Epidemic Human Monkeypox with Bayesian Directed Acyclic Graphic Model
    MDPI AG ; 2023
    In:  Vaccines Vol. 11, No. 2 ( 2023-02-17), p. 468-
    Details
    In: Vaccines, MDPI AG, Vol. 11, No. 2 ( 2023-02-17), p. 468-
    Abstract: A “Public Health Emergency of International Concern (PHEIC)” monkeypox outbreak was declared by the World Health Organization on 23 June 2022. More than 16,000 monkeypox cases were reported in more than 75 countries across six regions as of July 25. The Bayesian SIR (Susceptible–Infected–Recovered) model with the directed acyclic graphic method was used to estimate the basic/effective reproductive number (R0/Re) and to assess the epidemic spread of monkeypox across the globe. The maximum estimated R0/Re was 1.16 (1.15–1.17), 1.20 (1.20–1.20), 1.34 (1.34–1.35), 1.33 (1.33–1.33) and 2.52 (2.41–2.66) in the United States, Spain, Brazil, the United Kingdom and the Democratic Republic of the Congo, respectively. The values of R0/Re were below 1 after August 2022. The estimated infectious time before isolation ranged from 2.05 to 2.74 days. The PHEIC of the global spreading of human monkeypox has been contained so as to avoid a pandemic in the light of the reasoning-based epidemic model assessment.
    Type of Medium: Online Resource
    ISSN: 2076-393X
    URL: Article
    DOI: 10.3390/vaccines11020468
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2703319-3
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  • 5
    Online Resource
    Online Resource
    Cost-Effectiveness Analysis of Personalized Hypertension Prevention
    MDPI AG ; 2023
    In:  Journal of Personalized Medicine Vol. 13, No. 6 ( 2023-06-15), p. 1001-
    Details
    In: Journal of Personalized Medicine, MDPI AG, Vol. 13, No. 6 ( 2023-06-15), p. 1001-
    Abstract: Background: While a population-wide strategy involving lifestyle changes and a high-risk strategy involving pharmacological interventions have been described, the recently proposed personalized medicine approach combining both strategies for the prevention of hypertension has increasingly gained attention. However, a cost-effectiveness analysis has been hardly addressed. This study was set out to build a Markov analytical decision model with a variety of prevention strategies in order to conduct an economic analysis for tailored preventative methods. Methods: The Markov decision model was used to perform an economic analysis of four preventative strategies: usual care, a population-based universal approach, a population-based high-risk approach, and a personalized strategy. In all decisions, the cohort in each prevention method was tracked throughout time to clarify the four-state model-based natural history of hypertension. Utilizing the Monte Carlo simulation, a probabilistic cost-effectiveness analysis was carried out. The incremental cost-effectiveness ratio was calculated to estimate the additional cost to save an additional life year. Results: The incremental cost-effectiveness ratios (ICER) for the personalized preventive strategy versus those for standard care were -USD 3317 per QALY gained, whereas they were, respectively, USD 120,781 and USD 53,223 per Quality-Adjusted Life Year (QALY) gained for the population-wide universal approach and the population-based high-risk approach. When the ceiling ratio of willingness to pay was USD 300,000, the probability of being cost-effective reached 74% for the universal approach and was almost certain for the personalized preventive strategy. The equivalent analysis for the personalized strategy against a general plan showed that the former was still cost-effective. Conclusions: To support a health economic decision model for the financial evaluation of hypertension preventative measures, a personalized four-state natural history of hypertension model was created. The personalized preventive treatment appeared more cost-effective than population-based conventional care. These findings are extremely valuable for making hypertension-based health decisions based on precise preventive medication.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    URL: Article
    DOI: 10.3390/jpm13061001
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662248-8
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  • 6
    Online Resource
    Online Resource
    Gene‒Prostate-Specific-Antigen-Guided Personalized Screening for Prostate Cancer
    MDPI AG ; 2019
    In:  Genes Vol. 10, No. 9 ( 2019-08-24), p. 641-
    Details
    In: Genes, MDPI AG, Vol. 10, No. 9 ( 2019-08-24), p. 641-
    Abstract: (1) Background: A simulation approach for prostate cancer (PrCa) with a prostate-specific antigen (PSA) test incorporating genetic information provides a new avenue for the development of personalized screening for PrCa. Going by the evidence-based principle, we use the simulation method to evaluate the effectiveness of mortality reduction resulting from PSA screening and its utilization using a personalized screening regime as opposed to a universal screening program. (2) Methods: A six-state (normal, over-detected, low-grade, and high-grade PrCa in pre-clinical phase, and low-grade and high-grade PrCa in clinical phase) Markov model with genetic and PSA information was developed after a systematic review of genetic variant studies and dose-dependent PSA studies. This gene‒PSA-guided model was used for personalized risk assessment and risk stratification. A computer-based simulated randomized controlled trial was designed to estimate the reduction of mortality achieved by three different screening methods, personalized screening, universal screening, and a non-screening group. (3) Results: The effectiveness of PrCa mortality reduction for a personalized screening program compared to a non-screening group (22% (9%‒33%)) was similar to that noted in the universal screening group (20% (7%‒21%). However, a personalized screening program could dispense with 26% of unnecessary PSA testing, and avoid over-detection by 2%. (4) Conclusions: Gene‒PSA-guided personalized screening for PrCa leads to fewer unnecessary PSA tests without compromising the benefits of mortality reduction (as happens with the universal screening program).
    Type of Medium: Online Resource
    ISSN: 2073-4425
    URL: Article
    DOI: 10.3390/genes10090641
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2527218-4
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  • 7
    Online Resource
    Online Resource
    Does Diffusely Infiltrating Lobular Carcinoma of the Breast Arise from Epithelial–Mesenchymal Hybrid Cells?
    MDPI AG ; 2023
    In:  International Journal of Molecular Sciences Vol. 24, No. 13 ( 2023-06-28), p. 10752-
    Details
    In: International Journal of Molecular Sciences, MDPI AG, Vol. 24, No. 13 ( 2023-06-28), p. 10752-
    Abstract: Classic diffusely infiltrating lobular carcinoma has imaging features divergent from the breast cancers originating from the terminal ductal lobular units and from the major lactiferous ducts. Although the term “invasive lobular carcinoma” implies a site of origin within the breast lobular epithelium, we were unable to find evidence supporting this assumption. Exceptional excess of fibrous connective tissue and the unique cell architecture combined with the aberrant features at breast imaging suggest that this breast malignancy has not originated from cells lining the breast ducts and lobules. The only remaining relevant component of the fibroglandular tissue is the mesenchyme. The cells freshly isolated and cultured from diffusely infiltrating lobular carcinoma cases contained epithelial–mesenchymal hybrid cells with both epithelial and mesenchymal properties. The radiologic and histopathologic features of the tumours and expression of the mesenchymal stem cell positive markers CD73, CD90, and CD105 all suggest development in the direction of mesenchymal transition. These hybrid cells have tumour-initiating potential and have been shown to have poor prognosis and resistance to therapy targeted for malignancies of breast epithelial origin. Our work emphasizes the need for new approaches to the diagnosis and therapy of this highly fatal breast cancer subtype.
    Type of Medium: Online Resource
    ISSN: 1422-0067
    URL: Article
    DOI: 10.3390/ijms241310752
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2019364-6
    SSG: 12
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  • 8
    Online Resource
    Online Resource
    Low Cardiorespiratory Fitness, Muscular Fitness, and Flexibility Are Associated with Body Fat Distribution and Obesity Risk Using Bioelectrical Impedance in Taiwanese Adults
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 14 ( 2022-07-21), p. 8858-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 14 ( 2022-07-21), p. 8858-
    Abstract: In terms of public health, obesity and overweight have become major concerns worldwide. Nevertheless, regarding body composition, it is important to have a more precise understanding of the fat-to-muscle ratio. Hence, this study aimed to adopt bioelectrical impedance measurements to test body fat percentage (BF%) and to determine the associations between health-related physical fitness and both body fat (BF) distribution and BF obesity risk in Taiwanese adults. We conducted a cross-sectional study and reviewed data derived from Taiwan’s Scientific Physical Fitness Survey. From the database, responses from 17,970 participants aged 23–64 years were collected in this study. Each participant completed a series of health-related physical fitness measurements, including cardiorespiratory fitness (3 min of a progressive knee-up and step (3MPKS) test), muscular fitness (hand-grip strength), and flexibility (sit-and-reach test). The BF% of each participant was assessed using the bioelectrical impedance analysis method. BF% was negatively associated with low performance on the 3MPKS (β = 11.314, p 〈 0.0001 for men; β = 12.308, p 〈 0.0001 for women), hand-grip strength (β = 2.071, p 〈 0.0001 for men; β = 0.859, p 〈 0.0001 for women), and sit-and-reach (β = 0.337, p = 0.008 for women) tests but was positively associated with sit-and-reach (β = −0.394, p = 0.004 for men). A risk of BF obesity for low performance of 3MPKS (odds ratio (OR) = 26.554, p 〈 0.0001 for men; OR = 25.808, p 〈 0.0001 for women), hand-grip strength (OR = 1.682, p 〈 0.0001 for men; OR = 1.234, p 〈 0.0001 for women), and sit-and-reach (OR = 1.142, p = 0.007 for women) tests was observed. These results suggest that low levels of cardiorespiratory fitness, muscular fitness, and flexibility are associated with an increased risk of BF obesity.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph19148858
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 9
    Online Resource
    Online Resource
    Tomotherapy as an Alternative Irradiative Treatment for Complicated Keloids
    MDPI AG ; 2020
    In:  Journal of Clinical Medicine Vol. 9, No. 11 ( 2020-11-20), p. 3732-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 9, No. 11 ( 2020-11-20), p. 3732-
    Abstract: The aim of this study was to investigate the treatment of complicated keloids with helical tomotherapy (HT) and electron beam radiotherapy. From July 2018 to September 2018, 11 patients with 23 keloid lesions treated with HT were enrolled. Additionally, 11 patients with 20 lesions treated with electron beam radiotherapy in the same period were enrolled. Patients in both groups were treated within 24 h after surgical excision of the keloid lesion with 13.5 Gy in three consecutive daily fractions. The median follow-up period was 15 months. The local control rate was 91.3% and 80% in the HT group and the electron beam group, respectively. No acute adverse effects were observed in either group, but most patients exhibited pigmentation. No radiation-induced cancer occurred in these patients up to the time of this report. Pain and pruritus improved for all patients and more obviously for three patients with complicated keloids treated with HT. The measured surface dose was 103.7–112.5% and 92.8–97.6% of the prescribed dose in the HT group and the electron beam group, respectively. HT can be considered an alternative in cases where it is not feasible to use multiple electron fields, due to encouraging clinical outcomes.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm9113732
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2662592-1
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  • 10
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    Early Response Monitoring Following Radiation Therapy by Using [18F]FDG and [11C]Acetate PET in Prostate Cancer Xenograft Model with Metabolomics Corroboration
    MDPI AG ; 2017
    In:  Molecules Vol. 22, No. 11 ( 2017-11-10), p. 1946-
    Details
    In: Molecules, MDPI AG, Vol. 22, No. 11 ( 2017-11-10), p. 1946-
    Type of Medium: Online Resource
    ISSN: 1420-3049
    URL: Article
    DOI: 10.3390/molecules22111946
    Language: English
    Publisher: MDPI AG
    Publication Date: 2017
    detail.hit.zdb_id: 2008644-1
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