Therapeutic Advances in Chronic Disease最新文献

{"title":"Distinguishing bronchoscopically observed anatomical positions of airway under by convolutional neural network.","authors":"Chongxiang Chen,&nbsp;Felix Jf Herth,&nbsp;Yingnan Zuo,&nbsp;Hongjia Li,&nbsp;Xinyuan Liang,&nbsp;Yaqing Chen,&nbsp;Jiangtao Ren,&nbsp;Wenhua Jian,&nbsp;Changhao Zhong,&nbsp;Shiyue Li","doi":"10.1177/20406223231181495","DOIUrl":"https://doi.org/10.1177/20406223231181495","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) technology has been used for finding lesions <i>via</i> gastrointestinal endoscopy. However, there were few AI-associated studies that discuss bronchoscopy.</p><p><strong>Objectives: </strong>To use convolutional neural network (CNN) to recognize the observed anatomical positions of the airway under bronchoscopy.</p><p><strong>Design: </strong>We designed the study by comparing the imaging data of patients undergoing bronchoscopy from March 2022 to October 2022 by using EfficientNet (one of the CNNs) and U-Net.</p><p><strong>Methods: </strong>Based on the inclusion and exclusion criteria, 1527 clear images of normal anatomical positions of the airways from 200 patients were used for training, and 475 clear images from 72 patients were utilized for validation. Further, 20 bronchoscopic videos of examination procedures in another 20 patients with normal airway structures were used to extract the bronchoscopic images of normal anatomical positions to evaluate the accuracy for the model. Finally, 21 respiratory doctors were enrolled for the test of recognizing corrected anatomical positions using the validating datasets.</p><p><strong>Results: </strong>In all, 1527 bronchoscopic images of 200 patients with nine anatomical positions of the airway, including carina, right main bronchus, right upper lobe bronchus, right intermediate bronchus, right middle lobe bronchus, right lower lobe bronchus, left main bronchus, left upper lobe bronchus, and left lower lobe bronchus, were used for supervised machine learning and training, and 475 clear bronchoscopic images of 72 patients were used for validation. The mean accuracy of recognizing these 9 positions was 91% (carina: 98%, right main bronchus: 98%, right intermediate bronchus: 90%, right upper lobe bronchus: 91%, right middle lobe bronchus 92%, right lower lobe bronchus: 83%, left main bronchus: 89%, left upper bronchus: 91%, left lower bronchus: 76%). The area under the curves for these nine positions were >0.98. In addition, the accuracy of extracting the images <i>via</i> the video by the trained model was 94.7%. We also conducted a deep learning study to segment 10 segment bronchi in right lung, and 8 segment bronchi in Left lung. Because of the problem of radial depth, only segment bronchi distributions below right upper bronchus and right middle bronchus could be correctly recognized. The accuracy of recognizing was 84.33 ± 7.52% by doctors receiving interventional pulmonology education in our hospital over 6 months.</p><p><strong>Conclusion: </strong>Our study proved that AI technology can be used to distinguish the normal anatomical positions of the airway, and the model we trained could extract the corrected images <i>via</i> the video to help standardize data collection and control quality.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231181495"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/9b/10.1177_20406223231181495.PMC10457519.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10100822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for the long-term incidence and progression of knee osteoarthritis in older adults: role of nonsurgical injury.","authors":"Jean-Pierre Pelletier,&nbsp;Patrice Paiement,&nbsp;Marc Dorais,&nbsp;Jean-Pierre Raynauld,&nbsp;Johanne Martel-Pelletier","doi":"10.1177/20406223231169715","DOIUrl":"https://doi.org/10.1177/20406223231169715","url":null,"abstract":"<p><strong>Background: </strong>For one of the most chronic medical conditions, osteoarthritis, uncertainties remain on the impact of injury chronology, the role of repeat injury on the incidence/progression of this disease and the need for knee arthroplasty.</p><p><strong>Objectives: </strong>To explore, in an older adult population, how nonsurgical knee injuries relate to osteoarthritis incidence/progression and the weight of independent risk factors for arthroplasty.</p><p><strong>Design: </strong>A cohort study design evaluates the long-term impact of injuries on knee osteoarthritis outcomes.</p><p><strong>Methods: </strong>Knees with no prior injury (<i>n</i> = 6358) and with at least one injury (<i>n</i> = 819) ⩽20 years before study inclusion were from the Osteoarthritis Initiative cohort. Sociodemographic, clinical and structural [X-ray, magnetic resonance imaging (MRI)] data at study inclusion and changes within 96 months were analysed. Statistics included a mixed model for repeated measurements, generalized estimating equations and multivariable Cox regression with covariates.</p><p><strong>Results: </strong>At inclusion, knees with prior injury demonstrated greater incidence and severity of osteoarthritis (<i>p</i> ⩽ 0.001). At 96 months, there was a greater increase in symptoms [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, <i>p</i> = 0.002], joint space width (JSW, <i>p</i> = 0.039) loss, medial cartilage volume loss (CVL, <i>p</i> ⩽ 0.001) and bone marrow lesion size (BML, <i>p</i> ⩽ 0.049). Knees with/without injury at inclusion but with new ones over time had a pronounced increase in symptoms (all WOMAC scores, <i>p</i> ⩽ 0.001), JSW loss, lateral (without) and medial CVL, lateral (without) and medial meniscal extrusion and medial BML (without; all <i>p</i> ⩽ 0.030). Levels of lateral and medial meniscal extrusion (without) and symptoms (with/without; all WOMAC scores, <i>p</i> ⩽ 0.001) were all accentuated with a repeated new injury. Risk factors associated with the highest knee arthroplasty occurrence are new meniscal extrusion and new injury (<i>p</i> ⩽ 0.001).</p><p><strong>Conclusion: </strong>This study highlights the importance of nonsurgical knee injury in older adults as an independent risk factor for knee osteoarthritis and arthroplasty. These data will be beneficial in clinical practice as they will help identify individuals at greater risk of significant disease progression and worst disease outcomes for a customized therapeutic approach.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231169715"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/c8/10.1177_20406223231169715.PMC10184209.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10290161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in mortality from infection among patients with hematologic malignancies: differences according to hematologic malignancy subtype.","authors":"Xuejiao Yin,&nbsp;Xuelian Hu,&nbsp;Hongyan Tong,&nbsp;Liangshun You","doi":"10.1177/20406223231173891","DOIUrl":"https://doi.org/10.1177/20406223231173891","url":null,"abstract":"<p><strong>Background: </strong>Infection is the most important cause of non-relapse mortality in hematologic malignancy patients, leading to increased costs and prolonged hospitalization times. However, comprehensive and comparable reports on infection-specific mortality (ISM) trends in hematologic malignancy patients are lacking.</p><p><strong>Objectives: </strong>We aimed to provide updated ISM trends and factors associated with ISM among hematologic malignancy patients.</p><p><strong>Design: </strong>This is a retrospective study.</p><p><strong>Methods: </strong>Patients diagnosed with the five most common hematologic malignancies from 1983 to 2016 from the Surveillance, Epidemiology, and End Results database were included. Joinpoint regression was used to analyze mortality trends.</p><p><strong>Results: </strong>ISM decreased beginning in 1983, 1988, and 1994, with yearly decreases of -2.1% for acute leukemia (AL), -1.3% for Hodgkin lymphoma (HL), and -14.3% for non-Hodgkin lymphoma (NHL). In contrast, ISM in patients with chronic leukemia (CL) and multiple myeloma (MM) increased dramatically beginning in 2000, with yearly increases of 2.8% and 3.3%, respectively. ISM rates were higher in males than in females across all hematologic malignancy subtypes. The mortality trends significantly differed according to race, age, sex, and stage, which could help in further etiological investigations. Moreover, male sex, older age at diagnosis, black race, and unmarried status were poor prognostic factors for ISM across all hematologic malignancy subtypes.</p><p><strong>Conclusion: </strong>A promising downward trend in ISM in recent years occurred in patients with AL, HL, and NHL; however, ISM increased dramatically in patients with CL and MM. Our data suggest that risk assessment and careful infection monitoring are recommended for hematologic malignancy patients, particularly those with CL and MM.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231173891"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/36/10.1177_20406223231173891.PMC10288445.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mineralocorticoid receptor antagonist treatment improved arterial stiffness in patients with primary aldosteronism: a cohort study compared with adrenalectomy.","authors":"Che-Wei Liao,&nbsp;Yen-Tin Lin,&nbsp;Cheng-Hsuan Tsai,&nbsp;Yi-Yao Chang,&nbsp;Zheng-Wei Chen,&nbsp;Ching-Chu Lu,&nbsp;Chien-Ting Pan,&nbsp;Chin-Chen Chang,&nbsp;Bo-Ching Lee,&nbsp;Yu-Wei Chiu,&nbsp;Wei-Chieh Huang,&nbsp;Kuo-How Huang,&nbsp;Tai-Shuan Lai,&nbsp;Chi-Shen Hung,&nbsp;Vin-Cent Wu,&nbsp;Xue-Ming Wu,&nbsp;Yen-Hung Lin","doi":"10.1177/20406223221143233","DOIUrl":"https://doi.org/10.1177/20406223221143233","url":null,"abstract":"<p><strong>Background: </strong>Elevated arterial stiffness in patients with primary aldosteronism (PA) can be reversed after adrenalectomy; however, the effect of medical treatment with mineralocorticoid receptor antagonist (MRAs) is unknown.</p><p><strong>Objectives: </strong>The aim of this study was to evaluate the effect of MRAs and compare both treatment strategies on arterial stiffness in PA patients.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>We prospectively enrolled PA patients from 2006 to 2019 who received either adrenalectomy or MRA treatment (spironolactone). We compared their baseline and 1-year post-treatment biochemistry characteristics and arterial pulse wave velocity (PWV) to verify the effects of treatment and related determinant factors.</p><p><strong>Results: </strong>A total 459 PA patients were enrolled. After 1:1 propensity score matching for age, sex and blood pressure (BP), each group had 176 patients. The major determinant factors of baseline PWV were age and baseline BP. The adrenalectomy group had greater improvements in BP, serum potassium level, plasma aldosterone concentration, and aldosterone-to-renin ratio. The MRA group had a significant improvement in PWV after 1 year of treatment (1706.2 ± 340.05 to 1613.6 ± 349.51 cm/s, <i>p</i> < 0.001). There were no significant differences in post-treatment PWV (<i>p</i> = 0.173) and improvement in PWV (<i>p</i> = 0.579) between the adrenalectomy and MRA groups. The determinant factors for an improvement in PWV after treatment were hypertension duration, baseline PWV, and the decrease in BP.</p><p><strong>Conclusion: </strong>The PA patients who received medical treatment with MRAs had a significant improvement in arterial stiffness. There was no significant difference in the improvement in arterial stiffness between the two treatment strategies.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223221143233"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/70/10.1177_20406223221143233.PMC9846303.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10583361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between sensitivity to thyroid hormone indices and osteoporosis in euthyroid patients with type 2 diabetes mellitus.","authors":"Xuelun Wu,&nbsp;Furui Zhai,&nbsp;Ailing Chang,&nbsp;Jing Wei,&nbsp;Yanan Guo,&nbsp;Jincheng Zhang","doi":"10.1177/20406223231189230","DOIUrl":"https://doi.org/10.1177/20406223231189230","url":null,"abstract":"<p><strong>Background: </strong>Thyroid hormones are known to regulate bone metabolism and may influence bone mineral density (BMD), as well as the risk of osteoporosis (OP) and fractures in patients with type 2 diabetes mellitus (T2DM). Recently, sensitivity to thyroid hormone indices has been linked with T2DM and OP independently. However, the relationship between thyroid hormone sensitivity and OP in euthyroid T2DM patients has yet to be investigated.</p><p><strong>Objectives: </strong>The aim of this study was to determine the association between sensitivity to thyroid hormone indices and the risk of OP in euthyroid patients with T2DM.</p><p><strong>Design: </strong>This study employed a retrospective, cross-sectional design and utilized data acquired from the Cangzhou Central Hospital in China between 2019 and 2020.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 433 patients with T2DM for anthropometric measurements, clinical laboratory test results, and BMD. The thyroid-stimulating hormone index, thyrotroph thyroxine resistance index, and thyroid feedback quantile-based index (TFQI) were calculated to determine thyroid hormone sensitivity. Finally, multivariable logistic regression, generalized additive models, and subgroup analysis were performed to detect the association between sensitivity to thyroid hormone indices and the risk of OP in these patients.</p><p><strong>Results: </strong>We did not observe a statistically significant linear relationship between sensitivity to thyroid hormones indices and OP after covariate adjustment. However, a nonlinear relationship existed between TFQI and the prevalence of OP. The inflection point of the TFQI was at -0.29. The effect sizes (odds ratio) on the left and right of the inflection point were 0.07 [95% confidence interval (CI): 0.01-0.71; <i>p</i> = 0.024] and 2.78 (95% CI: 1.02-7.58; <i>p</i> = 0.046), respectively. This trend was consistent in older female patients with higher body mass index (BMI; 25-30 kg/m²).</p><p><strong>Conclusion: </strong>An approximate U-shaped relationship was observed between sensitivity to thyroid hormone indices and OP risk in euthyroid patients with T2DM with variations in sex, age, and BMI. These findings provide a new perspective to elucidate the role of thyroid hormones in OP, specifically in patients with T2DM.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231189230"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/83/10.1177_20406223231189230.PMC10395177.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10649812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin adherence and the risk of cardiovascular disease: a population-based cohort study.","authors":"Shun-Fan Yu,&nbsp;Chien-Tai Hong,&nbsp;Wan-Ting Chen,&nbsp;Lung Chan,&nbsp;Li-Nien Chien","doi":"10.1177/20406223231163115","DOIUrl":"https://doi.org/10.1177/20406223231163115","url":null,"abstract":"<p><strong>Background: </strong>Metformin is a potent antiglycemic agent, but its importance has receded owing to the launch of novel antidiabetic medications. The benefit of metformin includes not only blood sugar control but also anti-inflammation, autophagy activation, and neuroprotection. This study investigated the risk of cardiovascular disease (CVD) in people with type II diabetes mellitus (T2DM) who adhered to metformin after adding on a second-line antiglycemic agent.</p><p><strong>Objectives: </strong>The purpose of this study was to investigate the benefits of metformin in CVD prevention in patients with T2DM.</p><p><strong>Design: </strong>We designed the study by comparing the incident rate of CVD events in patients with T2DM who received metformin continually and who ceased metformin during 2002-2014.</p><p><strong>Methods: </strong>Medical information was obtained from the National Health Insurance Research Database, and patients with T2DM receiving second-line antiglycemic agents were categorized into metformin-adherent and nonadherent groups according to prescription claims. The study outcomes were the incidence of CVD hospitalization, including stroke (ischemic and hemorrhagic) and myocardial infarction (MI).</p><p><strong>Results: </strong>A total of 31,384 patients with T2DM constituted the metformin-adherent group and were 1:1 matched to nonadherent patients. Metformin adherence was associated with a lower risk of hospitalization due to stroke [adjusted hazard ratio (aHR) = 0.51, 95% confidence interval (CI): 0.43-0.59, <i>p</i> < 0.001] and MI (aHR = 0.47, 95% CI: 0.43-0.53, <i>p</i> < 0.001). The risk reduction persisted in both ischemic and hemorrhagic strokes. Our subgroup analysis revealed that the protective effect on stroke and MI hospitalization persisted in metformin-adherent patients, both sexes, patients aged ⩽65 or >65 years, and patients with or without concurrent insulin treatment.</p><p><strong>Conclusions: </strong>This study revealed that metformin adherence in patients with T2DM who required a first-line treatment may reduce the risk of subsequent CVD. Despite the availability of numerous novel antiglycemic agents, metformin adherence by patients who require a combination of antiglycemic agents provides an additional benefit of CVD protection.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231163115"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/1e/10.1177_20406223231163115.PMC10084537.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9358943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of serum polyunsaturated fatty acid profile in patients with inflammatory bowel disease.","authors":"Jingjing Jiang,&nbsp;Lu Chen,&nbsp;Rui Sun,&nbsp;Ting Yu,&nbsp;Shuyu Jiang,&nbsp;Hong Chen","doi":"10.1177/20406223231156826","DOIUrl":"https://doi.org/10.1177/20406223231156826","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the digestive tract. The aetiology and pathogenesis of IBD are complex, which may lead to metabolic disorders. As a kind of metabolite, polyunsaturated fatty acid (PUFA) is closely related to IBD.</p><p><strong>Objectives: </strong>The aim of this study was to explore the correlation between the serum PUFAs and the pathogenesis of IBD.</p><p><strong>Design: </strong>The study is a hospital-based case-control study.</p><p><strong>Methods: </strong>The serum free PUFAs of all participants, including 104 patients with IBD and 101 normal controls, were detected by liquid chromatography-mass spectrometry (LC-MS).</p><p><strong>Results: </strong>Compared with the normal control, the levels of C18:2, α-C18:3 (ALA), ɤ-C18:3, C20:4 (AA), C20:5 (EPA), ω-3 C22:5, ω-6 C22:5 and C22:6 (DHA) PUFAs in patients with Crohn's disease (CD) were obviously decreased. However, in patients with ulcerative colitis (UC), the levels of AA, EPA, ω-3 C22:5, ω-6 C22:5 and DHA were downregulated. The concentrations of seven PUFAs were significantly downregulated in the active CD group. In addition, four PUFAs had comparatively higher levels in the remission UC group.</p><p><strong>Conclusion: </strong>The present study revealed substantial differences in the levels of serum fatty acids between normal controls and patients with IBD. In detail, patients with CD were deficient in PUFAs, including the essential fatty acids. Moreover, as the disease activity aggravated, some PUFAs decreased dramatically.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231156826"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/de/10.1177_20406223231156826.PMC10052691.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9242442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and outcomes of patients with psoriasis treated with apremilast in the real-world in Austria - results the APPRECIATE study.","authors":"Constanze Jonak,&nbsp;Isolde Göttfried,&nbsp;Sylvia Perl-Convalexius,&nbsp;Barbara Gruber,&nbsp;Martina Schütz-Bergmayr,&nbsp;Igor Vujic,&nbsp;Wolfgang Weger,&nbsp;Nikolaus Schicher,&nbsp;Lydia Semlin,&nbsp;Margit Hemetsberger,&nbsp;Myriam Cordey,&nbsp;Paul Sator","doi":"10.1177/20406223231152785","DOIUrl":"https://doi.org/10.1177/20406223231152785","url":null,"abstract":"<p><strong>Background: </strong>Apremilast, an oral phosphodiesterase 4 inhibitor, is approved in the European Union for the treatment of moderate-to-severe chronic plaque psoriasis in adult patients refractory or contraindicated to or intolerant of other systemic therapies.</p><p><strong>Objectives: </strong>The APPRECIATE study assessed apremilast use in real-world practice and its clinical value to physicians and patients. APPRECIATE was a multinational, observational, retrospective, cross-sectional study.</p><p><strong>Methods: </strong>Apremilast effectiveness at 6 (±1) months was assessed on the basis of psoriasis severity and health-related quality-of-life scores and treatment satisfaction using physician/patient-reported outcomes, respectively. We report the Austrian cohort of 72 patients.</p><p><strong>Results: </strong>At 6 (±1) months, three-quarters of patients remained on apremilast, while physicians and patients reported treatment benefits across all psoriasis symptoms and manifestations. Of patients, the majority were satisfied with their treatment and achieved treatment goals considered most relevant. Patients' and physicians' perceptions of treatment effectiveness were aligned, and health-related quality-of-life scores indicated an improvement in the majority of patients. Apremilast tolerability was consistent with the known safety profile.</p><p><strong>Conclusions: </strong>Among psoriasis patients receiving apremilast in Austria, improvement in clinical outcomes were observed and satisfaction with apremilast treatment among patients and physicians was high.</p><p><strong>Registration: </strong>ClinicalTrials.gov NCT02740218.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231152785"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4b/b6/10.1177_20406223231152785.PMC9909071.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9275284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CMS-NET: deep learning algorithm to segment and quantify the ciliary muscle in swept-source optical coherence tomography images.","authors":"Wen Chen,&nbsp;Xiangle Yu,&nbsp;Yiru Ye,&nbsp;Hebei Gao,&nbsp;Xinyuan Cao,&nbsp;Guangqing Lin,&nbsp;Riyan Zhang,&nbsp;Zixuan Li,&nbsp;Xinmin Wang,&nbsp;Yuheng Zhou,&nbsp;Meixiao Shen,&nbsp;Yilei Shao","doi":"10.1177/20406223231159616","DOIUrl":"https://doi.org/10.1177/20406223231159616","url":null,"abstract":"Background: The ciliary muscle plays a role in changing the shape of the crystalline lens to maintain the clear retinal image during near work. Studying the dynamic changes of the ciliary muscle during accommodation is necessary for understanding the mechanism of presbyopia. Optical coherence tomography (OCT) has been frequently used to image the ciliary muscle and its changes during accommodation in vivo. However, the segmentation process is cumbersome and time-consuming due to the large image data sets and the impact of low imaging quality. Objectives: This study aimed to establish a fully automatic method for segmenting and quantifying the ciliary muscle on the basis of optical coherence tomography (OCT) images. Design: A perspective cross-sectional study. Methods: In this study, 3500 signed images were used to develop a deep learning system. A novel deep learning algorithm was created from the widely used U-net and a full-resolution residual network to realize automatic segmentation and quantification of the ciliary muscle. Finally, the algorithm-predicted results and manual annotation were compared. Results: For segmentation performed by the system, the total mean pixel value difference (PVD) was 1.12, and the Dice coefficient, intersection over union (IoU), and sensitivity values were 93.8%, 88.7%, and 93.9%, respectively. The performance of the system was comparable with that of experienced specialists. The system could also successfully segment ciliary muscle images and quantify ciliary muscle thickness changes during accommodation. Conclusion: We developed an automatic segmentation framework for the ciliary muscle that can be used to analyze the morphological parameters of the ciliary muscle and its dynamic changes during accommodation.","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231159616"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/29/10.1177_20406223231159616.PMC10017933.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9146781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-domain full-field optical coherence tomography (TD-FF-OCT) in ophthalmic imaging.","authors":"Jinze Zhang,&nbsp;Viacheslav Mazlin,&nbsp;Keyi Fei,&nbsp;Albert Claude Boccara,&nbsp;Jin Yuan,&nbsp;Peng Xiao","doi":"10.1177/20406223231170146","DOIUrl":"https://doi.org/10.1177/20406223231170146","url":null,"abstract":"<p><p>Ocular imaging plays an irreplaceable role in the evaluation of eye diseases. Developing cellular-resolution ophthalmic imaging technique for more accurate and effective diagnosis and pathogenesis analysis of ocular diseases is a hot topic in the cross-cutting areas of ophthalmology and imaging. Currently, ocular imaging with traditional optical coherence tomography (OCT) is limited in lateral resolution and thus can hardly resolve cellular structures. Conventional OCT technology obtains ultra-high resolution at the expense of a certain imaging range and cannot achieve full field of view imaging. In the early years, Time-domain full-field OCT (TD-FF-OCT) has been mainly used for <i>ex vivo</i> ophthalmic tissue studies, limited by the low speed and low full-well capacity of existing two-dimensional (2D) cameras. The recent improvements in system design opened new imaging possibilities for <i>in vivo</i> applications thanks to its distinctive optical properties of TD-FF-OCT such as a spatial resolution almost insensitive to aberrations, and the possibility to control the curvature of the optical slice. This review also attempts to look at the future directions of TD-FF-OCT evolution, for example, the potential transfer of the functional-imaging dynamic TD-FF-OCT from the <i>ex vivo</i> into <i>in vivo</i> use and its expected benefit in basic and clinical ophthalmic research. Through non-invasive, wide-field, and cellular-resolution imaging, TD-FF-OCT has great potential to be the next-generation imaging modality to improve our understanding of human eye physiology and pathology.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231170146"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/1e/10.1177_20406223231170146.PMC10161339.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10644888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}