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Development of a classification system based on corneal biomechanical properties using artificial intelligence predicting keratoconus severity

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Eye and Vision 2021年第3期8卷 203-213页

作者： Robert Herber Lutz E.Pillunat Frederik Raiskup department of Ophthalmology University Hospital Carl Gustav CarusUniversitätsklinikum Carl Gustav Carus an der Technischen Universität DresdenFetscherstraße 74TU 01307 DresdenGermany

Background:To investigate machine-learning(ML)algorithms to differentiate corneal biomechanical properties between different topographical stages of keratoconus(KC)by dynamic Scheimpflug tonometry(CST,Corvis ST,Oculus,Wetzlar,Germany).In the following,ML models were used to predict the severity in a training and validation ***:Three hundred and eighteen keratoconic and one hundred sixteen healthy eyes were included in this monocentric and cross-sectional pilot *** corneal response(DCR)and corneal thickness related(pachymetric)parameters from CST were chosen by appropriated selection techniques to develop a ML *** stage of KC was determined by the topographical keratoconus classification system(TKC,Pentacam,Oculus).Patients who were classified as TKC 1,TKC 2 and TKC 3 were assigned to subgroup mild,moderate,and advanced *** patients were classified as TKC 1-2,TKC 2-3 or TKC 3-4,they were assigned to subgroups according to the normative range of further corneal indices(index of surface variance,keratoconus index and minimum radius).Patients classified as TKC 4 were not included in this study due to the limited amount of *** discriminant analysis(LDA)and random forest(RF)algorithms were used to develop the classification *** were divided into training(70%of cases)and validation(30%of cases)***:LDA model predicted healthy,mild,moderate,and advanced KC eyes with a sensitivity(S_(n))/specificity(S_(p))of 82%/97%,73%/81%,62%/83%and 68%/95%from a validation dataset,*** the RF model,a S_(n)/S_(p) of 91%/94%,80%/90%,63%/87%,72%/95%could be reached for predicting healthy,mild,moderate,and advanced KC eyes,*** overall accuracy of LDA and RF was 71%and 78%,*** accuracy for KC detection including all subgroups of KC severity was 93%in both ***:The RF model showed good accuracy in predicting healthy eyes and various stages of *** accuracy was superior with respec

关键词： Artificial intelligence Corneal biomechanics Corvis ST Grading Keratoconus Machine learning

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Tumor mutational burden as a new biomarker for PD-1 antibody treatment in gastric cancer

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Cancer Communications 2019年第1期39卷 632-633页

作者： Gunnar Folprecht medical department I University Hospital Carl Gustav Carus01307 DresdenGermany

Gastric cancer is the fifth most frequently occurring can-cer *** has the largest gastric cancer pop-ulation and nearly half of the patients are diagnosed as advanced-stage[1].The prognosis of most patients with advanced gastric cancer(AGC)remains dismal even despite the approval of several novel chemotherapy drugs and targeted therapy ***,immune check-point inhibitors(ICIs)such as programmed death-1(PD-1)antibody have shown promising activity in various solid *** PD-1 antibodies,pembrolizumab[2]and nivolumab[3],were approved for AGC patients who had treatment failure with ***,the overall response rate(ORR)and the survival benefits of pembrolizumab(11.6%;OS 5.6 months)and nivolumab(nivolumab vs placebo ORR 11%vs 0%,P<0.0001;OS 5.3 vs 4.1 months,P<0.0001)were moderate.

关键词： chemotherapy drugs treatment

3omorbidity and survival of patients selected for radica prostatectomy at an age of 75 years or older

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Asian Journal of Andrology 2013年第5期15卷 667-671页

作者： Michael Froehner Rainer Koch Manfred P Wirth departments of Urology University Hospital 'Carl Gustav Carus' Dresden University of Technology Dresden D-01307 Germany department of medical Statistics and Biometry University Hospital 'Carl Gustav Carus' Dresden University of Technology Dresden D-01307 Germany

Radical prostatectomy in elderly patients is controversial. To identify very old candidates for radical prostatectomy with the highest probability of long-term survival, we studied 47 consecutive men who underwent radical prostatectomy between 1992 and 2005 at an age of 75 years or older. A heuristic approach was used to search for subgroups with particularly high long-term survival. Several two-sided comorbidity measures and combinations of these measures were investigated to find classifications best identifying healthy, long-living elderly candidates for radical prostatectomy. Four of the 25 two-sided comorbidity classifications or combinations reached the significance level with hazard ratios between 4.00 and 4.80. After 10 years, patients identified as healthy patients according to these comorbidity measurements had exhibited relative survival rates between 129% and 137% and overall survival rates between 86% and 95%, whereas those with comorbidities had exhibited relative survival rates of only 66%-84% and overall survival rates of 44%-58%. In conclusion, classifying comorbidity may identify a meaningful proportion of men selected for radical prostatectomy at an age of 75 years or older with an excellent long-term survival probability superseding that of the general population.

关键词： comorbidity old age overall survival prostate cancer radical prostatectomy relative survival

Level of education and mortality after radical prostatectomy

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Asian Journal of Andrology 2017年第2期19卷 173-177页

作者： Michael Froehner Rainer Koch Stefan Propping Dorothea Liebeheim Matthias Hfibler gustavo B Baretton Oliver W Hakenberg Manfred P Wirth department of Urology University Hospital 'Carl Gustav Carus' Technische Universit~t Dresden Fetscherstrasse 74 D-01307 Dresden Germany department of medical Statistics and Biometry University Hospital 'Carl Gustav Carus' Technische Universitat Dresden Fetscherstrasse 74 D-01307 Dresden Germany department of Anesthesiology University Hospital 'Carl Gustav Carus' Technische Universitat Dresden Fetscherstrasse 74 D-01307 Dresden Germany department of Pathology University Hospital 'Carl Gustav Carus' Technische Universitat Dresden Fetscherstrasse 74 D-01307 Dresden Germany department of Urology University of Rostock Ernst-Heydemann-Strasse 6 D-18055 Rostock Germany

Estimating the risk of competing mortality is of importance in men with early prostate cancer to choose the most appropriate way of management and to avoid over- or under-treatment. In this study, we investigated the impact of the level of education in this context. The study sample consisted of 2630 patients with complete data on level of education （college, university degree, master craftsmen, comparable profession, or others）, histopathological tumor stage （organ confined or extracapsular）, lymph node status （negative or positive）, and prostatectomy specimen Gleason score （〈7, 7, or 8-10） who underwent radical prostatectomy between 1992 and 2007. Overall, prostate cancer-specific, competing, and second cancer-related mortalities were study endpoints. Cox proportional hazard models for competing risks were used to study combined effects of the variables on these endpoints. A higher level of education was independently associated with decreased overall mortality after radical prostatectomy （hazard ratio [HR]： 0.75, 95% confidence interval [95% CI]： 0.62-0.91, P = 0.0037）. The mortality difference was attributable to decreased second cancer mortality （HR： 0.59, 95% Ch 0.40-0.85, P = 0.0052） and noncancer mortality （HR： 0.73, 95% Ch 0.55-0.98, P = 0.0345） but not to differences in prostate cancer-specific mortality （HR： 1.16, 95% Ch 0.79-1.69, P = 0.4536 in the full model）. In conclusion, the level of education might serve as an independent prognostic parameter supplementary to age, comorbidity, and smoking status to estimate the risk of competing mortality and to choose optimal treatment for men with early prostate cancer who are candidates for radical prostatectomy.

关键词： comorbidity competing risk analysis level of education life expectancy mortality proportional hazards model prostate cancer radical prostatectomy smoking socioeconomic status

Treatment of critical bone defects using calcium phosphate cement and mesoporous bioactive glass providing spatiotemporal drug delivery

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Bioactive Materials 2023年第10期28卷 402-419页

作者： Richard Frank Richter Corina Vater Margarete Korn Tilman Ahlfeld Martina Rauner Winnie Pradel Bernd Stadlinger Michael Gelinsky Anja Lode Paula Korn Centre for Translational Bone Joint and Soft Tissue ResearchUniversity Hospital Carl Gustav Carus and Faculty of MedicineTechnische Universitat DresdenDresdenGermany department of Oral and Maxillofacial Surgery University Hospital Carl Gustav CarusTechnische Universitat DresdenGermany department of Medicine III and Center for Healthy Aging University Hospital Carl Gustav CarusTechnische Universitat DresdenGermany Clinic of Cranio-Maxillofacial and Oral Surgery Center of Dental MedicineUniversity of ZurichSwitzerland

Calcium phosphate cements (CPC) are currently widely used bone replacement materials with excellent bioactivity, but have considerable disadvantages like slow degradation. For critical-sized defects, however, an improved degradation is essential to match the tissue regeneration, especially in younger patients who are still growing. We demonstrate that a combination of CPC with mesoporous bioactive glass (MBG) particles led to an enhanced degradation in vitro and in a critical alveolar cleft defect in rats. Additionally, to support new bone formation the MBG was functionalized with hypoxia conditioned medium (HCM) derived from rat bone marrow stromal cells. HCM-functionalized scaffolds showed an improved cell proliferation and the highest formation of new bone volume. This highly flexible material system together with the drug delivery capacity is adaptable to patient specific needs and has great potential for clinical translation.

关键词： Drug delivery 3D plotting Alveolar cleft defect Calcium phosphate cement Mesoporous bioactive glass

FamilyCoviDD19: results of a cross-sectional study—long-term outcomes of infected and uninfected household members

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Family Medicine and Community Health 2023年第3期11卷 31-44页

作者： Theresa S Horst Jakob P Armann Maren Doenhardt Svenja Dresen Paula Czyborra Josephine Schneider Christin Gano Alexander Dalpke Christian Luck Annet Bluschke Magdalena Wekenborg Reinhard Berner Judith Blankenburg department of Pediatrics University Hospital and Medical Faculty Carl Gustav CarusTechnische UniversitatDresdenDresdenGermany department of Infectious Diseases Medical Microbiology and HygieneUniversity Hospital HeidelbergHeidelbergGermany Institute of medical Microbiology and Virology University Hospital and Medical Faculty Carl Gustav CarusTechnische UniversitatDresdenDresdenGermany department of Child and Adolescent Psychiatry University Hospital and Medical Faculty Carl Gustav CarusTechnische UniversitatDresdenDresdenGermany Biological Psychology Technische UniversitatDresdenDresdenGermany Else Kroner Fresenius Center for Digital Health University Hospital and Medical Faculty Carl Gustav CarusTechnische UniversitatDresdenDresdenGermany

Objective In this study,we aimed to compare long-term physical and mental health outcome between SARS-CoV-2 infected and uninfected household members to differentiate between infection-related and pandemic-related outcomes after about two and a half years of the ***,possible differences in the outcome of adults and children and young people(CYP)were of *** In a cross-sectional study design,we compared the long-term physical and mental health outcome of between infected and uninfected as well as between adult and CYP(household members).Setting The FamilyCoviDD19 study—a serology study in households—was initially conducted to evaluate virus transmission in a close contact setting focusing on households with children and adolescents in *** least 1year after initial infection in the respective households,a follow-up took place in which the prevalence and type of possible long-term consequences were surveyed on the basis of self-reported information on physical and mental *** In this study,a total of 533 household members of 146 families participated and responded to our survey,including 296(55.5%)adults and 237(44.5%)*** The difference in frequency of reported symptoms between infected and uninfected individuals was very moderate,suggesting that the vast majority of reported symptoms were not attributable to a previous SARS-CoV-2 ***,regardless of age and infection status,this study showed overall high rates of self-reported symptoms with CYP having fewer long-term sequelae than adults oneyear after ***,over 50%of those reporting symptoms were not affected in their daily life,with CYPs reporting an even lower percentage compared with *** CYP are at reduced risk not only to develop symptomatic infection or severe disease courses(previous analyses)but also to develop infection-associated long-term sequelae(this study).Independent of infection CYP reported high rates of

关键词： infected sectional consequences

Between evidence and new perspectives on the current state of the multimodal approach to gastric cancer:Is there still a role for radiation therapy?

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World Journal of Gastrointestinal Oncology 2018年第9期10卷 271-281页

作者： Linda Agolli Luca Nicosia department of Radiation Oncology Faculty of Medicine and University Hospital Carl Gustav CarusTechnische Universit?t Dresden department of Radiation Oncology Sant'Andrea HospitalSapienza University of Rome

In patients affected by gastric cancer(GC), especially those in advanced stage, the multidisciplinary app-roach of treatment is fundamental to obtain a good disease control and quality of life. Although many chemotherapeutics in combination to radiotherapy are adopted in the peri- or postoperative setting, the most optimal timing, regimens and doses remains con-troversial. In the era of radical surgery performed with D2-lymphadenectomy, the role of radiation therapy remains to be better defined. Categories of patients, who could benefit more from an intensified local trea-tment rather than more toxic systemic therapy, are still under investigation. Evidence and recent updates of the randomized trials, meta-analysis and prospective trials show that the postoperative radiotherapy plays a fundamental role in reducing the loco-regional recurrence and in turn the disease-free survival in operable advanced GC patients, also after a well performed D2 surgery. Therapeutic decisions should be taken considering the individual patients, but the multimodal approach is necessary to guarantee a longer survival and a good quality of life. Ongoing randomized trials could better define the timing and the combination of radiotherapy and systemic therapy.

关键词： Adjuvant chemoradiation Locally advanced Perioperative chemotherapy Gastric cancer Combined treatment

Identification of an immune classifier for predicting the prognosis and therapeutic response in triple-negative breast cancer

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BIOCELL 2023年第12期47卷 2681-2696页

作者： KUAILU LIN QIANYU GU XIXI LAI department of Breast Surgery The First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina department of Visceral Thoracic and Vascular SurgeryCarl Gustav Carus University Hospital DresdenTechnische Universität DresdenDresdenGermany department of Respiratory and Critical Medicine The First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina

Triple-negative breast cancer(TNBC)poses a significant challenge due to the lack of reliable prognostic gene signatures and an understanding of its immune ***:We analyzed clinical information and mRNA expression data from 162 TNBC patients in TCGA-BRCA and 320 patients in *** weighted gene coexpression network analysis,we pinpointed 34 TNBC immune genes linked to *** least absolute shrinkage and selection operator Cox regression method identified key TNBC immune candidates for prognosis *** calculated chemotherapy sensitivity scores using the“pRRophetic”package in R software and assessed immunotherapy response using the Tumor Immune Dysfunction and Exclusion ***:In this study,34 survival-related TNBC immune gene expression profiles were identified.A least absolute shrinkage and selection operator-Cox regression model was used and 15 candidates were prioritized,with a concomitant establishment of a robust risk immune *** high-risk TNBC immune groups showed increased sensitivity to therapeutic agents like RO-3306,Tamoxifen,Sunitinib,JNK Inhibitor VIII,XMD11-85h,BX-912,and *** analysis of the Search Tool for Interaction of Chemicals database revealed the associations between the high-risk group and signaling pathways,such as those involving Rap1,Ras,and *** low-risk group showed a higher immunotherapy response rate,as observed through the tumor immune dysfunction and exclusion analysis in the TCGA-TNBC and METABRIC-TNBC ***:This study provides insights into the immune complexities of TNBC,paving the way for novel diagnostic approaches and precision treatment methods that exploit its immunological intricacies,thus offering hope for improved management and outcomes of this challenging disease.

关键词： Triple-negative breast cancer Immune classifier Least absolute shrinkage and selection operator Prognosis Precision treatment

Pediatric radiological diagnostic procedures in cases of suspected child abuse

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Health 2010年第3期2卷 237-245页

作者： C. Erfurt G. Hahn D. Roesner U. Schmidt Pediatric Radiology department University Hospital “Carl Gustav Carus” Dresden Germany technical university Dresden Dresden Germany university hospital “carl gustav carus” Dresden Germany

Advanced and specialized radiological diagnostic procedures are essential in cases of clinically diagnosed injuries to the head, thorax, abdomen or extremities of a child, especially if there is no case history or if the reporting of an inadequate trauma suggests battered child syndrome. In particular, these diagnostic procedures should aim at detecting lesions of the central nervous system (CNS), so that the treatment can be immediately initiated. If the diagnostic imaging reveals findings typically associated with child abuse, accurate documentation constituting evidence, which will stand up in court, is required to prevent any further endangerment of the child’s welfare.

关键词： Child Abuse Battered Child Syndrome Shaken Baby Syndrome Non-Accidental Injury Pediatric Radiological Diagnostics