4,406 results on '"Perry, W"'
Search Results
152. Repeatability of 18F-FDG PET Radiomic Features in Cervical Cancer
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Richard L. Wahl, Tyler J. Fraum, Min-Young Lee, John Crandall, Linda Jiang, and Perry W. Grigsby
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Cervical cancer ,Matrix difference equation ,business.industry ,Pattern recognition ,Repeatability ,computer.software_genre ,medicine.disease ,030218 nuclear medicine & medical imaging ,18f fdg pet ,03 medical and health sciences ,0302 clinical medicine ,Concordance correlation coefficient ,Voxel ,Feature (computer vision) ,030220 oncology & carcinogenesis ,Expectation–maximization algorithm ,medicine ,Radiology, Nuclear Medicine and imaging ,Artificial intelligence ,business ,computer ,Mathematics - Abstract
Knowledge of the intrinsic variability of radiomic features is essential to the proper interpretation of changes in these features over time. The primary aim of this study was to assess the test–retest repeatability of radiomic features extracted from 18F-FDG PET images of cervical tumors. The impact of different image preprocessing methods was also explored. Methods: Patients with cervical cancer underwent baseline and repeat 18F-FDG PET/CT imaging within 7 d. PET images were reconstructed using 2 methods: ordered-subset expectation maximization (PETOSEM) or ordered-subset expectation maximization with point-spread function (PETPSF). Tumors were segmented to produce whole-tumor volumes of interest (VOIWT) and 40% isocontours (VOI40). Voxels were either left at the default size or resampled to 3-mm isotropic voxels. SUV was discretized to a fixed number of bins (32, 64, or 128). Radiomic features were extracted from both VOIs, and repeatability was then assessed using the Lin concordance correlation coefficient (CCC). Results: Eleven patients were enrolled and completed the test–retest PET/CT imaging protocol. Shape, neighborhood gray-level difference matrix, and gray-level cooccurrence matrix features were repeatable, with a mean CCC value of 0.81. Radiomic features extracted from PETOSEM images showed significantly better repeatability than features extracted from PETPSF images (P 0.96) when extracted from VOI40. Conclusion: Shape, gray-level cooccurrence matrix, and neighborhood gray-level difference matrix radiomic features were consistently repeatable, whereas gray-level run length matrix and gray-level zone length matrix features were highly variable. Radiomic features extracted from VOI40 were more repeatable than features extracted from VOIWT. Changes in voxel size or SUV discretization parameters typically resulted in relatively small differences in feature value, though several features were highly sensitive to these changes.
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- 2020
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153. Early posttherapy clearance of human papillomavirus and treatment response in cervical carcinoma
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Perry W. Grigsby, A. Srivastava, Julie K. Schwarz, Jessika Contreras, Stephanie Markovina, and Melanie Davis
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Adult ,Male ,Subset Analysis ,Oncology ,Cancer Research ,medicine.medical_specialty ,Uterine Cervical Neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Papillomaviridae ,Aged ,Aged, 80 and over ,Cervical cancer ,medicine.diagnostic_test ,business.industry ,Papillomavirus Infections ,Hazard ratio ,HPV infection ,Middle Aged ,medicine.disease ,Confidence interval ,Positron emission tomography ,030220 oncology & carcinogenesis ,Biomarker (medicine) ,Female ,business ,Chemoradiotherapy - Abstract
BACKGROUND Among patients with cervical cancer, little is known about the significance of persistent human papillomavirus (HPV) expression after chemoradiation (CRT). This study evaluated associations between early posttreatment HPV clearance and patient outcomes with an added focus on the value of posttherapy positron emission tomography (PET) imaging. METHODS Included patients underwent pretreatment testing indicating a high-risk HPV infection and posttreatment testing with a messenger RNA (mRNA)-based genital swab after CRT. Posttherapy responses were stratified on the basis of HPV mRNA detection into an early clearance (EC) group (no mRNA) and a persistent expression (PE) group (detectable mRNA) on the basis of an evaluation at a median of 6 weeks after therapy. The Kaplan-Meier method was used to compare outcomes, and multivariable analysis was used to identify predictors of outcomes. RESULTS Seventy-two of the 97 eligible patients (74.2%) had EC. The mean follow-up time was 25 months (range, 4-56 months), and 2-year pelvic control (76.9% vs 50.2%; P = .01) and overall survival (OS; 80.9% vs 52.2%; P
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- 2020
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154. Long-term outcomes of intensity-modulated radiation therapy (IMRT) and high dose rate brachytherapy as adjuvant therapy after radical hysterectomy for cervical cancer
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Matthew A. Powell, Alexander J. Lin, Stephanie Markovina, Jessika Contreras, A. Srivastava, Anupama Chundury, L. Stewart Massad, Perry W. Grigsby, David G. Mutch, Premal H. Thaker, and Julie K. Schwarz
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Adult ,medicine.medical_specialty ,Time Factors ,Gastrointestinal Diseases ,medicine.medical_treatment ,Brachytherapy ,Uterine Cervical Neoplasms ,Hysterectomy ,Pelvis ,030218 nuclear medicine & medical imaging ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Adjuvant therapy ,Humans ,Medicine ,Radical Hysterectomy ,Aged ,Neoplasm Staging ,Retrospective Studies ,Cervical cancer ,business.industry ,Carcinoma ,Obstetrics and Gynecology ,Radiotherapy Dosage ,Chemoradiotherapy, Adjuvant ,Middle Aged ,medicine.disease ,Female Urogenital Diseases ,High-Dose Rate Brachytherapy ,Survival Rate ,Bowel obstruction ,Radiation therapy ,Oncology ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Lymph Node Excision ,Female ,Radiotherapy, Adjuvant ,Lymphadenectomy ,Radiotherapy, Intensity-Modulated ,Radiology ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
ObjectiveCompared with 3D-planned pelvic radiation, intensity-modulated radiation therapy (IMRT) has been shown to reduce acute toxicity in cervical cancer patients after radical hysterectomy. This study evaluated late toxicity and patterns of failure after post-operative pelvic IMRT interdigitated weekly with high dose rate brachytherapy.MethodsThis retrospective study included 53 cervical cancer patients treated between January 2006 and August 2019 with radical hysterectomy, lymphadenectomy, and post-operative IMRT and high dose rate brachytherapy. The decision to include chemotherapy was made by the treating gynecologic oncologist based on patient-specific criteria including positive pelvic lymph nodes, positive surgical margins, or positive parametrial invasion. The actuarial rates of genitourinary and gastrointestinal toxicity, vaginal cuff/regional nodal/distant failure, and overall survival were calculated using the Kaplan–Meier method.ResultsMedian follow-up was 70 months (range 5.4–148) months and age at diagnosis was 47 (range 24–73) years. The 2018 International Federation of Gynecology and Obstetrics (FIGO) clinical stages were IB1 (n=19), IB2 (n=7), IIB (n=7), IIIC1 (n=19), and IIIC2 (n=1). Median radiation dose delivered in 160 cGy daily fractions was 5120 (range 4640–5120) cGy. Median brachytherapy dose prescribed to the vaginal surface delivered in six weekly fractions was 2400 (range 1200–4800) cGy. Concurrent chemotherapy was delivered in 35 (66%) patients. There were no acute grade >3 genitourinary or gastrointestinal toxicities. Late grade >3 occurred in two (3.8%) patients, including a small bowel obstruction and a ureteral stricture. The 5-year actuarial rate for gastrointestinal or genitourinary toxicity was 1.9%. There were no vaginal cuff recurrences. The 5-year actuarial rates for regional nodal failure, distant failure outside the radiation field, any failure, and overall survival were 11%, 11%, 14%, and 85%, respectively.ConclusionsPost-operative IMRT with high dose rate brachytherapy for patients with cervical cancer is associated with excellent outcomes and limited rates of radiation-related non-hematologic toxicity.
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- 2020
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155. Investigating the effectiveness of drain infiltration to minimize peat oxidation in agricultural fields in Flevoland, the Netherlands
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Jouke Velstra, Arjen S. Roelandse, Frouke Hoogland, Perry W. Mooij, Beatriz de La Loma González, Maarten J. Waterloo, and Sabine A. Verhagen
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lcsh:GE1-350 ,Peat ,lcsh:QE1-996.5 ,Water extraction ,Soil science ,General Medicine ,Anoxic waters ,lcsh:Geology ,Infiltration (hydrology) ,Subirrigation ,Tile drainage ,Environmental science ,Drainage ,Water content ,lcsh:Environmental sciences - Abstract
In the Province of Flevoland, the Netherlands, land subsidence poses a problem to agriculture and water management. The peat layers in the soil are susceptible to compression and oxidation causing further subsidence. Applying subirrigation through the tile drain system to maintain saturation of the peat may be a measure to slow down subsidence. A study was therefore carried out at two sites, Nagele and Zeewolde, to assess the impact of subirrigation in the peat on the seasonal variation in soil moisture content, and corresponding redox conditions. Bacterial community analysis was carried out to verify the hydrochemical observations. Subirrigation proved to be an efficient measure to maintain a high water level in the peat soil as long as the permeability in the upper part of the peat was sufficient to allow transmission of water into the inter-drain area and when the peat layer extended enough below the minimum regional water level to prevent drainage to the sand layer underneath. The peat showed dual porosity and water levels could well be maintained by subirrigation at the Nagele site. At the Zeewolde site, the variability in the thin peat layer allowed drainage to occur in the sand layer, preventing subirrigation to maintain high water levels. However, at both sites the peat layer remained close to saturation throughout the summer, which may be caused by the fine-grained mineral layer isolating the peat from water extraction via evapotranspiration. Nitrate concentrations of up to 100 mg L−1 were observed were high (>50 mg L−1) in the oxic mineral top layer but were low in the peat (0.3 mg L−1) at both Nagele and Zeewolde sites. Sulphate concentrations also showed a decrease with depth in the peat at Nagele, indicating a transition from sub-oxic above 1.5 m depth to anoxic conditions at 3.5 m depth. The hydrochemical observations in the soil moisture in the peat at Nagele confirmed that conditions were sub-oxic in the upper part of the peat (0.7 m below soil surface) to anoxic at greater depth (3.5 m). Soil microbe analyses showed few nitrification bacteria in the peat, whereas communities specialised in denitrification and ammonification were present, as well as sulphate reducing bacteria and methanogenic species. This confirmed the sub-oxic to anoxic conditions in the peat deduced from the hydrochemical observations. At Zeewolde, conditions remained sub-oxic throughout the profile.
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- 2020
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156. Accelerated Discovery of Potent Fusion Inhibitors for Respiratory Syncytial Virus
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Perry W. Bartsch, Julien Sourimant, Thalia Le, Edgars Jecs, Nicole Pribut, Richard K. Plemper, Stephen C. Pelly, Robert Wilson, Zackery W. Dentmon, Savita Sharma, Pieter B. Burger, Jeong-Joong Yoon, Dennis C. Liotta, Thomas M. Kaiser, and Soyon S. Hwang
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0301 basic medicine ,Fusion ,Benzimidazole ,030106 microbiology ,Antiviral Agents ,Fusion protein ,Article ,Virus ,In vitro ,Structure-Activity Relationship ,03 medical and health sciences ,chemistry.chemical_compound ,030104 developmental biology ,Infectious Diseases ,Biochemistry ,chemistry ,Respiratory Syncytial Virus, Human ,Potency ,Benzimidazoles ,Respiratory system ,Viral Fusion Proteins ,EC50 - Abstract
A series of five benzimidazole-based compounds were identified using a machine learning algorithm as potential inhibitors of the respiratory syncytial virus (RSV) fusion protein. These compounds were synthesized, and compound 2 in particular exhibited excellent in vitro potency with an EC(50) value of 5 nM. This new scaffold was then further refined leading to the identification of compound 44, which exhibited a 10-fold improvement in activity with an EC(50) value of 0.5 nM.
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- 2020
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157. Use of portable air purifiers as local exhaust ventilation during COVID-19
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DuBois, Cheryl K., Murphy, Michael J., Kramer, Amanda J., Quam, Jodi D., Fox, Andrew R., Oberlin, Ty J., and Logan, Perry W.
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Aerosols ,Air Filters ,Air Pollution, Indoor ,Public Health, Environmental and Occupational Health ,COVID-19 ,Humans ,Ventilation ,Vehicle Emissions - Abstract
The purpose of this study was to determine if strategic placement of portable air purifiers would improve effectiveness of aerosol reduction in a space as compared to use as a general room air purifier. Two sizes of portable air purifiers were placed in two different positions intended to function similar to either a local exhaust ventilation hood or an air curtain to determine if strategic placement would lead to a reduction of particles in a worker’s position at a desk in an office environment. Particle generators were used to introduce particulate into the air and personal aerosol monitors measured particles during each test condition. Results showed that when the medium room portable air purifiers used in this study were set to high, corresponding to 98 CFM, and placed near the breathing zone of each office worker with the unit’s filter cover removed, the particle concentration was reduced 35% beyond the reduction that would be expected if the same units were placed on the floor behind the occupant’s workstation. Results also indicated that the larger portable air purifier tested, positioned as close as reasonable to each occupant’s breathing zone with the largest capture area possible (i.e., removing the unit’s filter cover), delivers the best aerosol reduction performance. The authors concluded that as a layer of protection against transmission of airborne infectious organisms for office occupants, installing a portable air purifier, sized and operated similar to the units tested in this study on the desk 12 inches from the breathing zone of the worker, has the potential to reduce airborne particulate to a greater degree than if the same units were placed outside of the breathing zone, in the general cubicle area.
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- 2022
158. Abstract 055: Neighborhood-Wide Association Study Of Hypertension In The Health And Retirement Study
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Kendra D Sims, Perry W Hystad, G. D Batty, Ellen Smit, Jessina C McGregor, and Michelle C Odden
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Physiology (medical) ,Cardiology and Cardiovascular Medicine - Abstract
Background: Systematic evaluation of neighborhood factors which capture an array of characteristics -analogous to genome-wide-association studies- may identify important patterns in spatial determinants of blood pressure control. Methods: Our sample included Health and Retirement Study participants (N=13180; 58% women, 13% non-Hispanic Black, 4% Hispanic/Latino) with at least one sphygmomanometer reading taken between 2006 and 2016. Our main study outcome was at least one hypertensive blood pressure measurement over the study period. Participants were randomly assigned to either a training or test dataset. Using generalized estimating equations, we summarized multivariable associations between each of 51 standardized American Community Survey sociodemographic, housing, and income-related census tract variables (2005-09) and the period prevalence of measured hypertension. We adjusted for individual factors and accounted for multiple comparisons in the training set using the Simes significance test. Neighborhood-based factors that revealed statistically significant associations (Simes-adjusted p-value Results: Thirty-two percent (4218 out of 13180) of participants had at least one hypertensive sphygmomanometer reading between 2006 and 2016. In the training set, two of the 51 census-tract level variables were independently associated with period prevalence of hypertension. In the full sample, we observed a lower likelihood of prevalent hypertension (OR: 0.95; 95% CI: 0.92, 0.99) among participants residing in a census tract with recent (since 2000) in-migration. A higher proportion of relatively recent (since 2000) renters in the census tract was associated with a lower hypertension prevalence (OR: 0.95; 95% CI: 0.91, 0.98). When stratified by racial/ethnic designation, these patterns were apparent among Non-Hispanic White and to some extent Hispanic/Latino but not Non-Hispanic Black participants. However, differences were not statistically significant by race or ethnicity. Conclusion: In conclusion, relatively more recent relocation to an area appears to be modestly associated with reduced prevalence of hypertension. These findings support possible differential cardiovascular health impacts of gentrification. Further investigation is needed to confirm these findings.
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- 2022
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159. Curbing the Delta Surge: Clinical Outcomes After Treatment With Bamlanivimab-Etesevimab, Casirivimab-Imdevimab, or Sotrovimab for Mild to Moderate Coronavirus Disease 2019
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Raymund R, Razonable, John C, O'Horo, Douglas W, Challener, Lori, Arndt, Richard F, Arndt, Caroline G, Clune, Tracy L, Culbertson, Scott T, Hall, Alexander, Heyliger, Tammy A, Jackson, Brian D, Kennedy, Jennifer, Larsen, Sara N, Hanson, Perry W, Sweeten, Sidna M, Tulledge-Scheitel, and Ravindra, Ganesh
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COVID-19 Vaccines ,SARS-CoV-2 ,Humans ,Antibodies, Monoclonal, Humanized ,Antibodies, Neutralizing ,Retrospective Studies ,COVID-19 Drug Treatment - Abstract
To describe and compare the clinical outcomes of bamlanivimab-etesevimab, casirivimab-imdevimab, and sotrovimab treatment of mild to moderate coronavirus disease 2019 (COVID-19) during the severe acute respiratory coronavirus 2 (SARS-CoV-2) B.1.617.2 Delta surge.This is a retrospective study of high-risk patients who received bamlanivimab-etesevimab, casirivimab-imdevimab, and sotrovimab for mild to moderate COVID-19 between August 1, 2021, and December 1, 2021. Rates of severe disease, hospitalization, intensive care unit admission, and death were assessed.Among 10,775 high-risk patients who received bamlanivimab-etesevimab, casirivimab-imdevimab, or sotrovimab for mild to moderate COVID-19 during the Delta surge, 287 patients (2.7%) developed severe disease that led to hospitalization, oxygen supplementation, or death within 30 days after treatment. The rates of severe disease were low among patients treated with bamlanivimab-etesevimab (1.2%), casirivimab-imdevimab (2.9%), and sotrovimab (1.6%; P.01). The higher rate of severe outcomes among patients treated with casirivimab-imdevimab may be related to a significantly lower COVID-19 vaccination rate in that cohort. Intensive care unit admission was comparable among patients treated bamlanivimab-etesevimab, casirivimab-imdevimab, or sotrovimab (1.0%, 1.0%, and 0.4%, respectively).This real-world study of a large cohort of high-risk patients shows low rates of severe disease, hospitalization, intensive care unit admission, and mortality after treatment with bamlanivimab-etesevimab, casirivimab-imdevimab, and sotrovimab for mild to moderate COVID-19 during the SARS-CoV-2 Delta surge.
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- 2022
160. Collegiate Alcohol Use and High-Risk Sexual Behavior: A Literature Review.
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Kaly, Perry W., Heesacker, Martin, and Frost, Hanna M.
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Discusses two theories of alcohol use and risky behavior: disinhibition theory and alcohol myopia theory. Reviews the empirical research on collegiate alcohol use and high-risk sexual behavior. Suggestions for future research and for student personnel professionals are provided. (Contains 58 references.) (GCP)
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- 2002
161. Letters
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Kavulla, Travis, Swanson, Frederick H., Mueller, George D., Bilyeu, Perry W., Thornton, Ralph, and Fulbright, Zane
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- 2010
162. Microstructure and Properties of SiC/SiC and SiC/III-V Nitride Thin Film Heterostructural Assemblies
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Davis, Robert F., Tanaka, S., Kern, S., Bremser, M., Ailey, K. S., Perry, W., Zheleva, T., Tomsia, Antoni P., editor, and Glaeser, Andreas M., editor
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- 1998
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163. A Comparative Survey of Aotearoa New Zealand and UK Social Workers on the Role of Religion and Spirituality in Practice
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Stirling, Blair, Furman, Leola Dyrud, Benson, Perry W., Canda, Edward R., and Grimwood, Cordelia
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- 2010
164. Comparison of apparent diffusion coefficient maps to T2-weighted images for target delineation in cervix cancer brachytherapy
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Vamsidhar R. Narra, Constantine A. Raptis, Daniel J. Ma, Jacqueline Esthappan, and Perry W. Grigsby
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cervix cancer ,brachytherapy ,diffusion weighted imaging ,target delineation ,Medicine - Abstract
Purpose: T2-weighted (T2W) magnetic resonance imaging (MRI) has been used for target delineation in cervix cancerbrachytherapy. The objective of this study was to examine the feasibility of using diffusion-weighted magnetic resonanceimaging (DWI) for target delineation as compared against T2W imaging. Material and methods: Fifteen cervix cancer patients, implanted with tandem and ovoid applicators, underwentT2W turbo-spin echo imaging and DWI with a maximum diffusion factor of 800 sec/mm2 on a 1.5-T MR scanner. Appa -rent diffusion coefficient (ADC) maps were derived from the DWI. The gross tumor volume was manually delineatedon the T2W and ADC datasets for each patient. The agreement between T2W- and ADC-delineated volumes was assessedusing the Dice similarity coefficient (DSC). An algorithm was developed to compare the edge contrast of the delineatedvolumes on T2W images and ADC maps by calculating the percentage difference in the intensity values of selectedregions of pixels inside versus outside the target contour. Results: ADC-delineated volumes were generally smaller than T2W-delineated volumes, yielding a low DSC of 0.54± 0.22. ADC maps were found to display superior definition of the target volume edge relative to T2W images, yieldinga statistically significant difference between the mean edge contrast on ADC (12.7 ± 7.7%) versus that on T2W images(4.6 ± 3.2%; p = 0.0010). Conclusions: These results suggest that incorporating the use of DWI for cervix cancer brachytherapy may yieldgross tumor volumes that are different from those based on T2W images alone.
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- 2011
165. HEALTH INSURANCE AND THE GENETIC INFORMATION NONDISCRIMINATION ACT OF 2008: IMPLICATIONS FOR PUBLIC HEALTH POLICY AND PRACTICE
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Payne, Perry W., Goldstein, Melissa M., Jarawan, Hani, and Rosenbaum, Sara
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- 2009
166. “Sense of community belonging” in health surveys: What social capital is it measuring?
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Carpiano, Richard M. and Hystad, Perry W.
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- 2011
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167. Tumor volume discrepancies between FDG-PET and MRI for cervical cancer
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Ma, Daniel J., Zhu, Jian-Ming, and Grigsby, Perry W.
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- 2011
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168. Massachusetts et al. v. Environmental Protection Agency: Implications for Public Health Policy and Practice
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Payne, Perry W. and Rosenbaum, Sara
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- 2007
169. Recent advances in the growth, doping and characterization of III–V nitride thin films
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Davis, Robert F., Ailey, K. S., Bremser, M. D., Carlson, E., Kern, R. S., Kester, D. J., Perry, W. G., Tanaka, S., Weeks, T. W., and Helbig, Reinhard, editor
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- 1995
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170. COVID-19 aerosol transmission modeling in support of company HVAC guideline
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Oberlin, Ty J., primary, DuBois, Cheryl K., additional, Sheppard, Mike, additional, Quam, Jodi D., additional, Kramer, Amanda J., additional, Logan, Perry W., additional, and Murphy, Michael J., additional
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- 2022
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171. Abstract 055: Neighborhood-Wide Association Study Of Hypertension In The Health And Retirement Study
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Sims, Kendra D, primary, Hystad, Perry W, additional, Batty, G. D, additional, Smit, Ellen, additional, McGregor, Jessina C, additional, and Odden, Michelle C, additional
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- 2022
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172. Phase I Trial of Stereotactic MRI-Guided Online Adaptive Radiation Therapy (SMART) for the Treatment of Oligometastatic Ovarian Cancer
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Henke, Lauren E., primary, Stanley, Jennifer A., additional, Robinson, Clifford, additional, Srivastava, Amar, additional, Contreras, Jessika A., additional, Curcuru, Austen, additional, Green, Olga L., additional, Massad, L. Stewart, additional, Kuroki, Lindsay, additional, Fuh, Katherine, additional, Hagemann, Andrea, additional, Mutch, David, additional, McCourt, Carolyn, additional, Thaker, Premal, additional, Powell, Matthew, additional, Markovina, Stephanie, additional, Grigsby, Perry W., additional, Schwarz, Julie K., additional, and Chundury, Anupama, additional
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- 2022
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173. Management and prognosis of cervical cancer patients treated with definitive radiation therapy who have partial metabolic response on post-therapy positron emission tomography
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Tyler R. Mckinnish, Molly M. Greenwade, Ivy Wilkinson-Ryan, Julie K. Schwarz, Matthew A. Powell, David G. Mutch, L. Stewart Massad, Perry W. Grigsby, Barry A. Siegel, and Premal H. Thaker
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Male ,Oncology ,Fluorodeoxyglucose F18 ,Positron Emission Tomography Computed Tomography ,Positron-Emission Tomography ,Obstetrics and Gynecology ,Humans ,Uterine Cervical Neoplasms ,Female ,Radiopharmaceuticals ,Prognosis - Abstract
To describe the management and outcomes of cervical cancer patients initially treated with radiation who had partial metabolic response (PMR) on three-month post-radiationCervical cancer patients treated with radiation between 1997 and 2013 who had PMR on initial post-therapy FDG-PET were identified from a prospectively maintained database. Descriptive statistics were used to summarize patient demographics, tumor characteristics, surveillance methods, and treatment modalities. Kaplan-Meier methods were used to estimate progression-free (PFS) and overall survival (OS) for patients who underwent cervical biopsy prior to additional therapies and for patients who were managed with chemotherapy, radiation, surgery or no intervention.PMR was identified in 81/542 (15%) women on initial post-radiation PET. Thirty women underwent cervical biopsy, of whom 14 (47%) had persistent cancer. Nine underwent treatment, (three surgery, five chemotherapy alone and one chemotherapy and radiation) but all died of disease; PFS and OS were similar whether women had surgery, chemoradiation therapy, or no treatment. A second surveillance FDG-PET had PPV and NPV of 91% and 75% for progression, respectively, and identified the 19% percent of patients with persistent disease outside of the cervix. Cervical biopsy had a higher PPV (100%) and lower NPV (62.5%) for progression. At the end of the study period, 46 (57%) patients were dead of disease, including all 8 patients (100%) with para-aortic or supraclavicular involvement.If PMR is identified on three-month FDG-PET following completion of radiation for cervical cancer, repeat FDG-PET and/or biopsy are indicated to detect persistence and assist in counseling. PMR predicts poor outcomes, particularly for those with positive cervical biopsies and lymphatic involvement.
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- 2022
174. SERPINB3 (SCCA1) inhibits cathepsin L and lysoptosis, protecting cervical cancer cells from chemoradiation
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Songyan Wang, Cliff J. Luke, Stephen C. Pak, Victoria Shi, Liyun Chen, Jonathan Moore, Arlise P. Andress, Kay Jayachandran, Jin Zhang, Yi Huang, Marina Platik, Anthony A. Apicelli, Julie K. Schwarz, Perry W. Grigsby, Gary A. Silverman, and Stephanie Markovina
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Cell death ,QH301-705.5 ,Cathepsin L ,Medicine (miscellaneous) ,Uterine Cervical Neoplasms ,Neoplastic Cells, Circulating ,Xenograft Model Antitumor Assays ,General Biochemistry, Genetics and Molecular Biology ,Article ,Cancer therapeutic resistance ,Mice ,Antigens, Neoplasm ,Cell Line, Tumor ,Radiation, Ionizing ,Cervical cancer ,Animals ,Humans ,Female ,Biology (General) ,General Agricultural and Biological Sciences ,Serpins - Abstract
The endogenous lysosomal cysteine protease inhibitor SERPINB3 (squamous cell carcinoma antigen 1, SCCA1) is elevated in patients with cervical cancer and other malignancies. High serum SERPINB3 is prognostic for recurrence and death following chemoradiation therapy. Cervical cancer cells genetically lacking SERPINB3 are more sensitive to ionizing radiation (IR), suggesting this protease inhibitor plays a role in therapeutic response. Here we demonstrate that SERPINB3-deficient cells have enhanced sensitivity to IR-induced cell death. Knock out of SERPINB3 sensitizes cells to a greater extent than cisplatin, the current standard of care. IR in SERPINB3 deficient cervical carcinoma cells induces predominantly necrotic cell death, with biochemical and cellular features of lysoptosis. Rescue with wild-type SERPINB3 or a reactive site loop mutant indicates that protease inhibitory activity is required to protect cervical tumor cells from radiation-induced death. Transcriptomics analysis of primary cervix tumor samples and genetic knock out demonstrates a role for the lysosomal protease cathepsin L in radiation-induced cell death in SERPINB3 knock-out cells. These data support targeting of SERPINB3 and lysoptosis to treat radioresistant cervical cancers., Wang et al. demonstrate the cytoprotective role of SERPINB3 against radiation-induced necrosis, showing that cells lacking SERPINB3 protein both in culture and in mice are more sensitive to radiation and cisplatin-induced cell death. The authors also report that the cell death induced by radiation in SERPINB3-lacking cells is lysoptosis and implicate the lysosomal protease cathepsin L in this process.
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- 2022
175. Cognitive Structures in Human Story Comprehension and Memory.
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Rand Corp., Santa Monica, CA. and Thorndyke, Perry W.
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This research examines the effects of structure and content variables on memory and comprehension of prose passages. A process model for the comprehension of stories is proposed which assumes that stories are encoded in a hierarchical organizational framework which represents the abstract structural relationships of the plot. The implications of the model for the quality and characteristics of subjects' memory for stories were tested in a series of experiments using undergraduate college students. The study revealed that: (1) recall of a story was a function of the amount of inherent plot structure in the story; (2) story summarizations from memory tended to emphasize general structural characteristics rather than specific content; (3) structure and content manipulations significantly influenced recall; and (4) false recognition rates for implicit inferences from a story were a function of the plausibility of the inferences and their roles as organizing and integrating devices for other information in the story. (Author/LL)
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- 1975
176. Individual Differences in Knowledge Acquisition from Maps. A Report Prepared for Office of Naval Research.
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Rand Corp., Santa Monica, CA., Thorndyke, Perry W., and Stasz, Cathleen
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This study investigates the strategies people use to acquire knowledge from maps. Among the questions examined were (1) what distinguishes poor learners from good learners, and (2) how do the learning strategies of map-using experts differ from those of nonexpert learners? Eight subjects participated in the study. Five were undergraduate students at the University of California at Los Angeles and three were experts with military or scientific expertise in map reading. All subjects were given two maps of an imaginary town and country. They were allowed six trials of two minutes each in which to learn the information in the maps well enough to draw them from memory and answer questions about their contents. During the six trials they were required to think aloud about how they were going about learning the maps. Analysis of the subjects' verbal reports and performance on a test of map content indicated that four types of learning processes were used: attention, encoding, evaluation, and control. The use of processes for encoding spatial information (storing it in long-term memory and relating it to other information already learned) was most predictive of learning performance. Good learners differed from poor learners in their ability to evaluate their learning progress and to focus their attention on unlearned information. (Author/AV)
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- 1979
177. Human Processing of Knowledge from Texts: Acquisition, Integration, and Reasoning.
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Rand Corp., Santa Monica, CA., Thorndyke, Perry W., and Hayes-Roth, Barbara
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This report documents a series of studies on how undergraduate students learn from and reason with textual information. The studies described were undertaken to produce models that could serve as the basis for designing computer systems capable of structuring and presenting text material in optimal formats. Divided into sections, the report presents five sets of studies evaluating particular processing models and optimization techniques to improve reading comprehension and retention, including the use of schemata in the acquisition and transfer of knowledge, knowledge acquisition from newspaper stories, the integration of knowledge from text, configural effects in memory, and text annotation as a technique for facilitating knowledge integration. The last section of the report discusses ten conclusions, among which are that presenting new information in well-learned structural organizations can facilitate learning that information, that eliminating redundancy and irrelevant commentary from newspaper stories facilitates assimilation and retention of important facts, and that annotating texts with references to related facts that have occurred in previous texts facilitates general inferential reasoning from the texts. (AEA)
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- 1979
178. Training Procedures for Map Learning.
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Rand Corp., Santa Monica, CA., Thorndyke, Perry W., and Stasz, Cathleen
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This paper discusses a study to determine the influence of study procedures on success at map-learning tasks. The hypothesis was that subjects who used certain (effective) learning procedures would perform better than subjects who stressed other (less effective) techniques. The effective procedures set comprised techniques for learning spatial information, using self-generated feedback to guide subsequent study behavior, and partitioning the map into sections. The less effective procedures set comprised subjects' random learning techniques, random sampling, and unrestricted focus of attention. Methodology involved directing 43 college students to learn and reproduce maps according to their own techniques. Subjects were then divided into three groups and instructed to participate in a second map-learning task in which they used 1) procedures previously determined as effective learning aids, 2) procedures unrelated to learning success, or 3) their own learning techniques. Findings from a comparison of performance on the first and second map-learning task indicated that performance improvement was directly related to the frequency with which subjects used procedures designated as most effective learning aids. The conclusion is that students can improve learning effectiveness and performance of complex tasks such as map learning if they use procedures designated as effective learning aids. (DB)
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- 1979
179. Knowledge Transfer in Learning from Texts.
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Rand Corp., Santa Monica, CA. and Thorndyke, Perry W.
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The process of acquiring knowledge from texts is considered from two perspectives: the learning of the individual facts in the text, and the integration of the facts into a coherent representation reflecting relations among the facts. The former process is presumed to depend on the linguistics content of the text, while the latter process depends primarily on the text structure or the manner in which the content is organized. The acquisition of information from a text can be influenced by alterations to either process. Repeating structure across successively presented texts facilitates memory for the later passages. This suggests that knowledge of text structure is used to guide encoding of specific facts. On the other hand, repeating some text content in passages with different structures produces interference in learning of the new content in later passages. The implications of these results for the selection of instructional strategies are discussed. (Author)
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- 1977
180. The Influence of Visual-Spatial Ability and Study Procedures on Map Learning Skill. A Rand Note.
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Rand Corp., Santa Monica, CA., Stasz, Cathleen, and Thorndyke, Perry W.
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The influence of two sources of individual differences in acquiring knowledge from maps was studied: abilities and learning procedures. Twenty-five undergraduate students provided verbal protocols while attempting to learn two maps, and six effective learning procedures were identified: partitioning, imagery, memory-directed sampling, pattern encoding, relation encoding, and evaluation. Visual spatial ability was highly correlated with recall of spatial attributes of the map and with overall learning performance, while associative memory ability was most correlated with verbal attribute recall. Subject-selected procedures for encoding spatial information and assessing learning progress also distinguished the behavior of successful and less successful learners. However, subjects of high and low ability differed little in the study procedures they chose. Although both ability differences and procedures were important contributors to performance, a direct comparison indicated that abilities are most predictive of map learning. It was concluded that the use of effective study procedures can influence map learning performance and that high-ability subjects benefit more from the use of these procedures than low-ability subjects. This report includes 27 references and an appendix detailing learning procedures observed in the protocols. (LMM)
- Published
- 1980
181. Orientational Correlations in Active and Passive Nematic Defects
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Daniel J. G. Pearce, Alberto Fernandez-Nieves, Jyothishraj Nambisan, Perry W. Ellis, and Luca Giomi
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Materials science ,Condensed matter physics ,Liquid crystal ,Polar structure ,Soft Condensed Matter (cond-mat.soft) ,FOS: Physical sciences ,General Physics and Astronomy ,Antiferromagnetism ,Order (ring theory) ,Condensed Matter - Soft Condensed Matter ,Experimental methods ,Material properties - Abstract
We investigate the emergence of orientational order among +1/2 disclinations in active nematic liquid crystals. Using a combination of theoretical and experimental methods, we show that +1/2 disclinations have short-range antiferromagnetic alignment, as a consequence of the elastic torques originating from their polar structure. The presence of intermediate -1/2 disclinations, however, turns this interaction from anti-aligning to aligning at scales that are smaller than the typical distance between like-sign defects. No long-range orientational order is observed. Strikingly, these effects are insensitive to material properties and qualitatively similar to what is found for defects in passive nematic liquid crystals., 6 pages, 4 figures
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- 2021
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182. Anal Fissure, Fistula, and Abscess
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Brian Perry, W., primary
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- 2016
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183. Religion and Spirituality in Social Work Education and Direct Practice at the Millennium: A Survey of UK Social Workers
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Furman, Leola Dyrud, Benson, Perry W., Grimwood, Cordelia, and Canda, Edward
- Published
- 2004
184. The Role of FDG-PET/CT in Cervical Cancer: Diagnosis, Staging, Radiation Treatment Planning and Follow-Up
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Haynes-Outlaw, Elesyia D. and Grigsby, Perry W.
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- 2010
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185. Anal cancer maximum F-18 fluorodeoxyglucose uptake on positron emission tomography is correlated with prognosis
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Kidd, Elizabeth A., Dehdashti, Farrokh, Siegel, Barry A., and Grigsby, Perry W.
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- 2010
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186. A new method of anatomically conformal vaginal Cuff HDR brachytherapy
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Miller, Douglas A., Richardson, Susan, and Grigsby, Perry W.
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- 2010
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187. Management of cervical nodal metastasis detected on I-131 scintigraphy after initial surgery of well-differentiated thyroid carcinoma
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Creach, Kimberly M., Gillanders, William E., Siegel, Barry A., Haughey, Bruce H., Moley, Jeffrey F., and Grigsby, Perry W.
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- 2010
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188. Efficacy of 5-Fluorouracil by Continuous Infusion and Other Agents as Radiopotentiators for Gynecological Malignancies
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Grigsby, Perry W., Perez, Carlos A., Rotman, Marvin, editor, and Rosenthal, C. Julian, editor
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- 1991
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189. P446 Long-term Clinical Effectiveness And Stoma Outcome Of Fecal Diversion In Refractory Crohn’s Proctitis
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Benammi, S, primary, Perry, W R, additional, Calini, G, additional, Abdalla, S, additional, Shawki, S F, additional, Larson, D W, additional, and Mathis, K L, additional
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- 2022
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190. Rates of Severe Outcomes After Bamlanivimab-Etesevimab and Casirivimab-Imdevimab Treatment of High-Risk Patients With Mild to Moderate Coronavirus Disease 2019
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John O’Horo, Douglas W. Challener, Ryan J. Anderson, Richard F. Arndt, Sara E. Ausman, Scott T. Hall, Alexander Heyliger, Brian D. Kennedy, Perry W. Sweeten, Ravindra Ganesh, and Raymund R. Razonable
- Subjects
SARS-CoV-2 ,Antibodies, Monoclonal ,Humans ,General Medicine ,Antibodies, Monoclonal, Humanized ,Antibodies, Neutralizing ,Retrospective Studies ,COVID-19 Drug Treatment - Abstract
Bamlanivimab-etesevimab and casirivimab-imdevimab are authorized by the US Food and Drug Administration for emergency treatment of mild to moderate coronavirus disease 2019 (COVID-19) in high-risk persons. There has been no study comparing their clinical efficacy. In this retrospective study of 681 patients with mild to moderate COVID-19 during a period dominated by severe acute respiratory syndrome coronavirus 2 wild-type and alpha variants, 25 patients (3.7%) had progression to a severe outcome requiring hospitalization and oxygen supplementation within 30 days after monoclonal antibody infusion. Severe outcome was significantly higher among the 181 patients who were treated with casirivimab-imdevimab when compared with the 500 patients who received bamlanivimab-etesevimab (21 [6.6%] vs 13 [2.6%]; P=.01). Patients treated with casirivimab-imdevimab had higher odds of severe outcomes compared with those who received bamlanivimab-etesevimab (odds ratio, 2.67; 95% CI, 1.17 to 6.06). The demographic and clinical characteristics, and the time to monoclonal antibody infusion, of the 2 treatment cohorts were not significantly different. The reason behind this significant difference in the clinical outcomes is unclear, but our observations emphasize potential efficacy differences among antispike monoclonal antibodies against COVID-19. Further clinical studies using larger cohorts of patients are needed to confirm or refute these observations.
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- 2021
191. Hematology and Serum Biochemistry Parameters of North American River Otters (Lontra canadensis)
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Tocidlowski, Maryanne E., Spelman, Lucy H., Sumner, Perry W., and Stoskopf, Michael K.
- Published
- 2000
192. Low-order non-spatial effects dominate second-order spatial effects in the texture quantifier analysis of 18F-FDG-PET images.
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Frank J Brooks and Perry W Grigsby
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Medicine ,Science - Abstract
BackgroundThere is increasing interest in applying image texture quantifiers to assess the intra-tumor heterogeneity observed in FDG-PET images of various cancers. Use of these quantifiers as prognostic indicators of disease outcome and/or treatment response has yielded inconsistent results. We study the general applicability of some well-established texture quantifiers to the image data unique to FDG-PET.MethodsWe first created computer-simulated test images with statistical properties consistent with clinical image data for cancers of the uterine cervix. We specifically isolated second-order statistical effects from low-order effects and analyzed the resulting variation in common texture quantifiers in response to contrived image variations. We then analyzed the quantifiers computed for FIGOIIb cervical cancers via receiver operating characteristic (ROC) curves and via contingency table analysis of detrended quantifier values.ResultsWe found that image texture quantifiers depend strongly on low-effects such as tumor volume and SUV distribution. When low-order effects are controlled, the image texture quantifiers tested were not able to discern only the second-order effects. Furthermore, the results of clinical tumor heterogeneity studies might be tunable via choice of patient population analyzed.ConclusionSome image texture quantifiers are strongly affected by factors distinct from the second-order effects researchers ostensibly seek to assess via those quantifiers.
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- 2015
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193. Decreased local immune response and retained HPV gene expression during chemoradiotherapy are associated with treatment resistance and death from cervical cancer
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Jason J. Chen, Iván González, Perry W. Grigsby, Nathan Wong, Karen E. Knudsen, Pippa F. Cosper, Stephanie Markovina, Julie K. Schwarz, Xiaowei Wang, and Christopher McNair
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Gene Expression Regulation, Viral ,Cancer Research ,Biopsy ,medicine.medical_treatment ,Lymphocyte ,Uterine Cervical Neoplasms ,Article ,Immunomodulation ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,T-Lymphocyte Subsets ,Antineoplastic Combined Chemotherapy Protocols ,Gene expression ,medicine ,Humans ,Papillomaviridae ,Neoplasm Staging ,Cervical cancer ,business.industry ,Gene Expression Profiling ,Papillomavirus Infections ,Prognosis ,medicine.disease ,Combined Modality Therapy ,Radiation therapy ,medicine.anatomical_structure ,Oncology ,Drug Resistance, Neoplasm ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Cancer research ,Immunohistochemistry ,Female ,business ,CD8 ,Chemoradiotherapy - Abstract
More than one-third of patients with locally advanced cervical cancer do not respond to chemoradiation therapy (CRT). We aimed to characterize the transcriptional landscape of paired human cervical tumors before and during CRT in order to gain insight into the evolution of treatment response and to elucidate mechanisms of treatment resistance. We prospectively collected cervical tumor biopsies from 115 patients both before and 3 weeks into CRT. RNA-sequencing, Gene Set Enrichment Analysis and HPV gene expression were performed on 20 paired samples that had adequate neoplastic tissue mid-treatment. Tumors from patients with no evidence of disease (NED) at last follow-up had enrichment in pathways related to the immune response both pretreatment and mid-treatment, while tumors from patients dead of disease (DOD) demonstrated enrichment in biosynthetic and mitotic pathways but not in immune-related pathways. Patients DOD had decreased expression of T-cell and cytolytic genes and increased expression of PD-L2 mid-treatment compared to patients NED. Histological and immunohistochemical analysis revealed a decrease in tumor-associated lymphocytes (TAL) during CRT in all patients but tumors from patients DOD had a significantly more pronounced decrease in TALs and CD8+ cells mid-treatment, which was validated in a larger mid-treatment cohort. Finally, patients DOD retained more HPV E6/E7 gene expression during CRT and this was associated with increased expression of genes driving mitosis, which was corroborated in vitro. Our results suggest that decreased local immune response and retained HPV gene expression may be acting together to promote treatment resistance during CRT in patients with cervical cancer.
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- 2019
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194. Impact of tumor histology on detection of pelvic and para-aortic nodal metastasis with 18F-fluorodeoxyglucose–positron emission tomography in stage IB cervical cancer
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Jason D. Wright, Farrokh Dehdashti, Alexander J. Lin, Julie K. Schwarz, Premal H. Thaker, Perry W. Grigsby, Stephanie Markovina, Matthew A. Powell, David G. Mutch, and Barry A. Siegel
- Subjects
Cervical cancer ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,medicine.disease ,030218 nuclear medicine & medical imaging ,Squamous carcinoma ,03 medical and health sciences ,Dissection ,0302 clinical medicine ,medicine.anatomical_structure ,Oncology ,Positron emission tomography ,030220 oncology & carcinogenesis ,medicine ,Adenocarcinoma ,Radiology ,Stage (cooking) ,Radical Hysterectomy ,business ,Lymph node - Abstract
Objective18F-fluorodeoxyglucose–positron emission tomography (FDG-PET) detection of metastatic nodal disease is useful for guiding cervical cancer treatment but the impact of tumor histology is unknown. This study reports the detection of FDG avid pelvic and para-aortic lymph nodes in patients with early stage cervical cancer with squamous carcinoma and adenocarcinoma tumor histology.MethodsPatients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB1-2 cervical cancer who underwent pre-surgical FDG-PET between March 1999 and February 2018 were identified in a tertiary academic center database. All patients had radical hysterectomy with pelvic and para-aortic lymph node dissection. Detection of pelvic and para-aortic lymph nodes by FDG-PET versus surgical dissection was compared. FDG-PET sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined and stratified by tumor histology.ResultsWe identified 212 patients with early stage cervical cancer (84% FIGO IB1, 16% IB2) who underwent pre-surgical FDG-PET; 137 (65%) patients had squamous carcinoma and 75 (35%) patients had adenocarcinoma. PET/computed tomography was performed in 189 (89%) patients and 23 (11%) had PET only. Surgical dissection revealed positive pelvic and para-aortic lymph nodes in 25% and 3.3% of patients, respectively. For squamous carcinoma, sensitivity, specificity, PPV, and NPV of FDG-PET for pelvic nodal metastasis were 44%, 99%, 95%, and 78%, respectively. For adenocarcinoma, the corresponding results for pelvic nodal metastasis were 25%, 99%, 67%, and 92%, respectively. The overall values for sensitivity, specificity, PPV, and NPV of FDG-PET for para-aortic nodal metastasis were 29%, 99%, 67%, and 98%, respectively.DiscussionPelvic nodal metastasis was less likely to be detected by FDG-PET in patients with early stage adenocarcinoma than with squamous carcinoma.
- Published
- 2019
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195. Intensity Modulated Radiation Therapy and Image-Guided Adapted Brachytherapy for Cervix Cancer
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Stephanie Markovina, Alexander J. Lin, Sasa Mutic, Barry A. Siegel, David G. Mutch, Elizabeth A. Kidd, Julie K. Schwarz, Premal H. Thaker, Perry W. Grigsby, Farrokh Dehdashti, Leslie S. Massad, and Matthew A. Powell
- Subjects
Cancer Research ,Time Factors ,medicine.medical_treatment ,Brachytherapy ,Uterine Cervical Neoplasms ,Kaplan-Meier Estimate ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Stage (cooking) ,Aged, 80 and over ,Cervical cancer ,Radiation ,Standard of Care ,Common Terminology Criteria for Adverse Events ,Chemoradiotherapy ,Middle Aged ,Survival Rate ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Female ,Radiology ,Adult ,medicine.medical_specialty ,Urogenital System ,Article ,Pelvis ,Young Adult ,03 medical and health sciences ,Fluorodeoxyglucose F18 ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Survival rate ,Cervix ,Aged ,business.industry ,Cancer ,medicine.disease ,Gastrointestinal Tract ,Radiation therapy ,Positron-Emission Tomography ,Lymph Nodes ,Radiotherapy, Intensity-Modulated ,Neoplasm Recurrence, Local ,Radiopharmaceuticals ,business ,Follow-Up Studies ,Radiotherapy, Image-Guided - Abstract
Intensity modulated radiation therapy and 3-dimensional image-guided adapted brachytherapy are increasingly used for definitive cervical cancer treatment. We compared patterns of failure and survival in patients treated with these modalities with results from patients treated with 2-dimensional external beam radiation therapy and brachytherapy. All patients received a pretreatment positron emission tomography scan, and all surviving patients had a minimum of 5 years of follow-up. Intensity modulated radiation therapy and 3-dimensional image-guided adapted brachytherapy were associated with higher survival and reduced late bowel and bladder toxicities compared with 2-dimensional external beam radiation therapy and brachytherapy. PURPOSE: This study reported long-term outcomes of patients with cervical cancer who were treated with intensity modulated radiation therapy and 3-dimensional (3D) image-guided adapted brachytherapy (IMRT/3D-IGABT) compared with those treated with 2-dimensional (2D) external irradiation and 2D brachytherapy (2D EBRT/BT). METHODS AND MATERIALS: This study included patients with newly diagnosed cervical cancer and pretreatment fluorodeoxyglucose positron emission tomography scans who were treated with curative-intent irradiation from 1997 to 2013. The treatment policy changed from using 2D EBRT/BT to IMRT/3D-IGABT in 2005. Patterns of recurrence, cancer-specific survival (CSS), and overall survival (OS) were evaluated. Late gastrointestinal and genitourinary toxicity were scored with National Cancer Institute Common Terminology Criteria for Adverse Events. RESULTS: The median follow-up for patients alive at the time of last follow-up in the 2D EBRT/BT group (n = 300) was 15.3 years (range, 10.8–20.5 years). In the IMRT/3D-IGABT group (n = 300), it was 7 years (range, 5–12.4 years). According to the International Federation of Gynecology and Obstetrics, 33% of tumors were stage IB1 to IB2, 41% were stage IIA to IIB, and 26% were stage IIIA to IVA. The results after 5 years for patients treated with 2D EBRT/BT showed that freedom from relapse (FFR) was 57%, CSS was 62%, and OS was 57%. For the IMRT/3D-IGABT group, the 5-year results showed that FFR was 65% (P = .04), CSS was 69% (P = .01), and OS was 61% (P = .04). When stratified by lymph node status according to positron emission tomography scan results, disease control was most improved with IMRT/3D-IGABT versus 2D EBRT/BT in patients with positive pelvic lymph nodes only (P = .02). Cumulatively, 88 of 600 patients (15%) had grade ≥3 late bowel/bladder toxicity. The 2D EBRT/BT group had 55 patients (18%), and the IMRT/3D-IGABT group had 33 patients (11%; P = .02). CONCLUSIONS: IMRT/3D-IGABT was associated with improved survival and decreased gastrointestinal and genitourinary toxicity in patients with cervical cancer compared with those who received 2D EBRT/BT.
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- 2019
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196. Detection of distant metastatic disease by positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) at initial staging of cervical carcinoma
- Author
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Sirui Ma, Matthew A. Powell, Perry W. Grigsby, Barry A. Siegel, Farrokh Dehdashti, Alexander J. Lin, Julie K. Schwarz, and Stephanie Markovina
- Subjects
Fluorodeoxyglucose ,Cervical cancer ,medicine.medical_specialty ,Lung ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,Disease ,medicine.disease ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Oncology ,Positron emission tomography ,030220 oncology & carcinogenesis ,Biopsy ,Cervical carcinoma ,medicine ,In patient ,Radiology ,business ,medicine.drug - Abstract
ObjectiveThe detection of distant metastatic disease in cervical cancer patients at diagnosis is critical in accurate prognostication and directing treatment strategies. This study describes the frequency and sites of distant metastatic disease at diagnosis in patients with cervical cancer as detected by positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET).MethodsPatients with newly diagnosed cervical cancer underwent pre-treatment whole-body FDG-PET starting in 1997 at an academic institution. Patients with evidence of distant FDG-avid disease, defined as disease outside of typical sites of lymphatic spread, were included for analyses. Patients were not surgically staged, but biopsy to confirm metastatic disease was attempted at the discretion of the treating physicians. Overall survival was calculated using Kaplan-Meier analysis.ResultsFrom 1997 to 2017, 72 (6.2%) of 1158 consecutively evaluated cervical cancer patients exhibited FDG-avid distant disease at diagnosis; 27 (38%) of these had biopsy confirmation of distant disease. Only 35 (49%) of FDG-detected metastases were clinically apparent. The sites of distant disease were lung (35%), multiple sites (25%), omentum (16.5%), bone (16.5%), and liver (7%). There were 12 (17%) patients with distant disease who did not display FDG-avid lymph nodes. Median overall survival among patients with distant FDG-avid disease was 7.0 months (95% CI 4.3 to 9.7). Patients with multiple sites of distant disease demonstrated the worst overall survival.ConclusionsDistant metastatic disease detected by FDG-PET is found in 6.2% of patients with cervical cancer at the time of initial diagnosis and the most common site of disease is the lung. Further prospective investigation is warranted to delineate best treatment practices for cervical cancer patients presenting with distant metastases.
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- 2019
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197. Measurement Repeatability of 18F-FDG PET/CT Versus 18F-FDG PET/MRI in Solid Tumors of the Pelvis
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John Crandall, Richard L. Wahl, Perry W. Grigsby, Hongyu An, Kathryn J. Fowler, Tyler J. Fraum, Richard Laforest, Farrokh Dehdashti, Amber Salter, and Michael A. Jacobs
- Subjects
medicine.diagnostic_test ,business.industry ,Coefficient of variation ,Magnetic resonance imaging ,Context (language use) ,Repeatability ,030218 nuclear medicine & medical imaging ,3. Good health ,03 medical and health sciences ,0302 clinical medicine ,Positron emission tomography ,030220 oncology & carcinogenesis ,medicine ,Effective diffusion coefficient ,Radiology, Nuclear Medicine and imaging ,business ,Nuclear medicine ,Prospective cohort study ,Diffusion MRI - Abstract
Knowledge of the within-subject variability of 18F-FDG PET/MRI measurements is necessary for proper interpretation of quantitative PET or MRI metrics in the context of therapeutic efficacy assessments with integrated PET/MRI scanners. The goal of this study was to determine the test-retest repeatability of these metrics on PET/MRI, with comparison to similar metrics acquired by PET/CT. Methods: This prospective study enrolled subjects with pathology-proven pelvic malignancies. Baseline imaging consisted of PET/CT immediately followed by PET/MRI, using a single 370-MBq 18F-FDG dose. Repeat imaging was performed within 7 d using an identical imaging protocol, with no oncologic therapy between sessions. PET imaging on both scanners consisted of a list-mode acquisition at a single pelvic station. The MRI consisted of 2-point Dixon imaging for attenuation correction, standard sequences for anatomic correlation, and diffusion-weighted imaging. PET data were statically reconstructed using various frame durations and minimizing uptake time differences between sessions. SUV metrics were extracted for both PET/CT and PET/MRI in each imaging session. Apparent diffusion coefficient (ADC) metrics were extracted for both PET/MRI sessions. Results: The study cohort consisted of 14 subjects (13 female, 1 male) with various pelvic cancers (11 cervical, 2 rectal, 1 endometrial). For SUVmax, the within-subject coefficient of variation (wCV) appeared higher for PET/CT (8.5%-12.8%) than PET/MRI (6.6%-8.7%) across all PET reconstructions, though with no significant repeatability differences (all P values ≥ 0.08) between modalities. For lean body mass-adjusted SUVpeak, the wCVs appeared similar for PET/CT (9.9%-11.5%) and PET/MRI (9.2%-11.3%) across all PET reconstructions, again with no significant repeatability differences (all P values ≥ 0.14) between modalities. For PET/MRI, the wCV for ADCmedian of 3.5% appeared lower than the wCVs for SUVmax (6.6%-8.7%) and SULpeak (9.2%-11.3%), though without significant repeatability differences (all P values ≥ 0.23). Conclusion: For solid tumors of the pelvis, the repeatability of the evaluated SUV and ADC metrics on 18F-FDG PET/MRI is both acceptably high and similar to previously published values for 18F-FDG PET/CT and MRI, supporting the use of 18F-FDG PET/MRI for quantitative oncologic treatment response assessments.
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- 2019
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198. Pragmatic Cluster Randomized Trials Using Covariate Constrained Randomization: A Method for Practice-based Research Networks (PBRNs)
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Dickinson, Miriam L., Beaty, Brenda, Fox, Chet, Pace, Wilson, Dickinson, Perry W., Emsermann, Caroline, and Kempe, Allison
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- 2015
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199. Technique of Mandibular Salivary Gland Biopsy in River Otters (Lutra canadensis)
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Tocidlowski, Maryanne E., Harms, Craig A., Sumner, Perry W., and Stoskopf, Michael K.
- Published
- 1999
200. A miR-200 microRNA cluster as prognostic marker in advanced ovarian cancer
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Hu, Xiaoxia, Macdonald, Dusten M., Huettner, Phyllis C., Feng, Zhihui, El Naqa, Issam M., Schwarz, Julie K., Mutch, David G., Grigsby, Perry W., Powell, Simon N., and Wang, Xiaowei
- Published
- 2009
- Full Text
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