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Article: An Appraisal of the Preventive Effect of Statins on the Development of Graves' Ophthalmopathy: A Hospital-Based Cohort Study.

Hsu, Grace Chia-Yen / Shih, Shyang-Rong / Chang, Fang-Yu / Liao, Shu-Lang / Wei, Yi-Hsuan

Ophthalmology and therapy

2024 Volume 13, Issue 6, Page(s) 1499–1511

Abstract: Introduction: Graves' ophthalmopathy (GO) is an autoimmune inflammatory disorder observed in a substantial proportion of patients with Graves' disease (GD), with debilitating symptoms of disfiguring, periorbital pain, dry eyes, diplopia, and even visual ...

Abstract	Introduction: Graves' ophthalmopathy (GO) is an autoimmune inflammatory disorder observed in a substantial proportion of patients with Graves' disease (GD), with debilitating symptoms of disfiguring, periorbital pain, dry eyes, diplopia, and even visual disturbances. Previous studies involving Western populations have noted discrepancies in risk factors for GO. Therefore, this study aimed to determine the risk factors for GO development and the protective effect of statins in newly diagnosed patients with GD in Taiwan. Methods: This retrospective case-control study was based on a tertiary center cohort involving patients with GD diagnosed between 2010 and 2019 at the National Taiwan University Hospital (n = 11,035). Patients who were diagnosed or treated elsewhere, had been followed up for less than 6 months or were with a diagnosis of orbital tumor were excluded. Overall, 3578 patients with GD met the inclusion criteria. Univariate and multivariate logistic regression analyses were used to ascertain the odds ratio (OR) of developing GO, with adjustment for sociodemographic factors, interventions for managing GD and thyroid hormone levels, to determine protective and risk factors for GO. Results: In our multivariate model, the use of statins reduced the risk of GO development (OR 0.2; 95% confidence interval [CI] 0.08-0.50; p < 0.001). Thyroid dysfunction including hyperthyroidism (OR 4.2; 95% CI 2.97-5.88; p < 0.001) and hypothyroidism (OR 4.7; 95% CI 3.02-7.19; p < 0.001) was associated with an increased risk of developing GO. Smoking status and lipid profile were not risk factors in our cohort. Conclusion: In newly diagnosed patients with GD, the use of statins decreased the risk of developing GO by 80%, whereas serum lipid levels were not considered risk factors. Further nationwide population-based studies may help clarify the differences in risk factors between various ethnic groups. Trail registration: This trial was approved by the Research Ethics Committee of National Taiwan University Hospital (202202066RINC), retrospectively registered from January 1, 2010 to December 31, 2019.
Language	English
Publishing date	2024-04-06
Publishing country	England
Document type	Journal Article
ISSN	2193-8245
ISSN	2193-8245
DOI	10.1007/s40123-024-00930-1
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Article: The Pediatric Difficult Airway: Updates and Innovations.

Hsu, Grace / Fiadjoe, John E

Anesthesiology clinics

2020 Volume 38, Issue 3, Page(s) 459–475

Abstract: Children have unique characteristics that make them particularly vulnerable to perioperative adverse events. Skilled airway management is a cornerstone of high-quality anesthetic management. The use of hybrid airway techniques is a critical tool for the ... ...

Abstract	Children have unique characteristics that make them particularly vulnerable to perioperative adverse events. Skilled airway management is a cornerstone of high-quality anesthetic management. The use of hybrid airway techniques is a critical tool for the pediatric anesthesiologist. Point-of-care ultrasonography has an expanding role in airway management, from preoperative assessment of airway pathology and gastric contents to confirmation of tracheal intubation and identification of the cricothyroid membrane. The exciting fields of 3-dimensional printing, artificial intelligence, and machine learning are areas of innovation that will transform pediatric difficult airway management in years to come.
MeSH term(s)	Airway Management/methods ; Airway Obstruction/diagnostic imaging ; Airway Obstruction/therapy ; Artificial Intelligence ; Child ; Humans ; Image Interpretation, Computer-Assisted/methods ; Point-of-Care Systems ; Respiratory System/diagnostic imaging ; Ultrasonography/methods
Language	English
Publishing date	2020-07-16
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2228899-5
ISSN	2210-3538 ; 1932-2275 ; 0889-8537
ISSN (online)	2210-3538
ISSN	1932-2275 ; 0889-8537
DOI	10.1016/j.anclin.2020.05.001
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Article ; Online: EPX: An R package for the ensemble of subsets of variables for highly unbalanced binary classification.

Hsu, Grace G / Tomal, Jabed H / Welch, William J

Computers in biology and medicine

2021 Volume 136, Page(s) 104760

Abstract: Background and objective: In binary classification problems with a rare class of interest, there is relatively little information available for the rare class to build a model. On the other hand, the number of useful variables to develop a model for ... ...

Abstract	Background and objective: In binary classification problems with a rare class of interest, there is relatively little information available for the rare class to build a model. On the other hand, the number of useful variables to develop a model for classification can be high-dimensional. For example, in drug discovery, there are usually a very few bioactive compounds in a large chemical library, whereas thousands of potentially useful explanatory variables characterize a compound's chemical structure. The sparsity of information for the rare class of interest makes it difficult for the standard classification models to exploit the richness of the useful feature variables. Thus, the objective of this paper is to develop an R package which clusters the feature variables into diverse subsets to be aggregated into a powerful ensemble for the detection of a rare class object. Methods: The ensemble of phalanxes (EPX) builds a classifier by exploiting the richness of feature variables using several diverse subsets of variables, called phalanxes, and outperforms many competitive state-of-the-art classification methods in terms of predictive ranking of the rare class of interest. Results: We present an R package EPX which implements the algorithm to form the ensemble of phalanxes as well as its associated functions. We further show how the ensemble of phalanxes can be constructed using parallel computing to lower the computational burden given high-dimensional data. Conclusions: The R package EPX shows a flexible way of clustering feature variable space into smaller and diverse subsets of variables to develop an ensemble of phalanxes which better ranks a rare class object in a highly unbalanced two class classification problem. The ensemble EPX will be useful to detect the rare drug-like active biomolecules for development in drug discovery (Tomal et al., Mar. 2016) [1] and homologous proteins using similarity scores of amino acid sequences in protein homology (Tomal et al., 2019) [2]. The package EPX is freely available to download from CRAN (https://CRAN.R-project.org/package=EPX).
MeSH term(s)	Algorithms ; Amino Acid Sequence ; Cluster Analysis
Language	English
Publishing date	2021-08-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	127557-4
ISSN	1879-0534 ; 0010-4825
ISSN (online)	1879-0534
ISSN	0010-4825
DOI	10.1016/j.compbiomed.2021.104760
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Article ; Online: Quantitative bias analysis for external control arms using real-world data in clinical trials: a primer for clinical researchers.

Thorlund, Kristian / Duffield, Stephen / Popat, Sanjay / Ramagopalan, Sreeram / Gupta, Alind / Hsu, Grace / Arora, Paul / Subbiah, Vivek

Journal of comparative effectiveness research

2024 Volume 13, Issue 3, Page(s) e230147

Abstract: Development of medicines in rare oncologic patient populations are growing, but well-powered randomized controlled trials are typically extremely challenging or unethical to conduct in such settings. External control arms using real-world data are ... ...

Abstract	Development of medicines in rare oncologic patient populations are growing, but well-powered randomized controlled trials are typically extremely challenging or unethical to conduct in such settings. External control arms using real-world data are increasingly used to supplement clinical trial evidence where no or little control arm data exists. The construction of an external control arm should always aim to match the population, treatment settings and outcome measurements of the corresponding treatment arm. Yet, external real-world data is typically fraught with limitations including missing data, measurement error and the potential for unmeasured confounding given a nonrandomized comparison. Quantitative bias analysis (QBA) comprises a collection of approaches for modelling the magnitude of systematic errors in data which cannot be addressed with conventional statistical adjustment. Their applications can range from simple deterministic equations to complex hierarchical models. QBA applied to external control arm represent an opportunity for evaluating the validity of the corresponding comparative efficacy estimates. We provide a brief overview of available QBA approaches and explore their application in practice. Using a motivating example of a comparison between pralsetinib single-arm trial data versus pembrolizumab alone or combined with chemotherapy real-world data for RET fusion-positive advanced non-small cell lung cancer (aNSCLC) patients (1-2% among all NSCLC), we illustrate how QBA can be applied to external control arms. We illustrate how QBA is used to ascertain robustness of results despite a large proportion of missing data on baseline ECOG performance status and suspicion of unknown confounding. The robustness of findings is illustrated by showing that no meaningful change to the comparative effect was observed across several 'tipping-point' scenario analyses, and by showing that suspicion of unknown confounding was ruled out by use of E-values. Full R code is also provided.
MeSH term(s)	Humans ; Carcinoma, Non-Small-Cell Lung ; Lung Neoplasms/drug therapy ; Bias ; Research Design ; Clinical Protocols
Language	English
Publishing date	2024-01-11
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2669725-7
ISSN	2042-6313 ; 2042-6305
ISSN (online)	2042-6313
ISSN	2042-6305
DOI	10.57264/cer-2023-0147
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Article ; Online: Predicting Progression of Oral Lesions to Malignancy Using Machine Learning.

Wu, Michael P / Hsu, Grace / Varvares, Mark A / Crowson, Matthew G

The Laryngoscope

2022 Volume 133, Issue 5, Page(s) 1156–1162

Abstract: Objective: To use large-scale electronic health record (EHR) data to develop machine learning models predicting malignant transformation of oral lesions.: Methods: A multi-institutional health system database was used to identify a retrospective ... ...

Abstract	Objective: To use large-scale electronic health record (EHR) data to develop machine learning models predicting malignant transformation of oral lesions. Methods: A multi-institutional health system database was used to identify a retrospective cohort of patients with biopsied oral lesions. The primary outcome was malignant transformation. Chart review and automated system database queries were used to identify a range of demographic, clinical, and pathologic variables. Machine learning was used to develop predictive models for progression to malignancy. Results: There were 2192 patients with a biopsied oral lesion, of whom 1232 had biopsy proven oral dysplasia. There was malignant transformation in 34% of patients in the oral lesions dataset, and in 54% of patients in the dysplasia subset. Multiple machine learning-based models were trained on the data in two experiments, (a) including all patients with biopsied oral lesions and (b) including only patients with biopsy-proven dysplasia. In the first experiment, the best machine learning models predicted malignant transformation among the biopsied oral lesions with an area under the curve (AUC) of 86%. In the second experiment, the random forest model predicted malignant transformation among lesions with dysplasia with an AUC of 0.75. The most influential features were dysplasia grade and the presence of multiple lesions, with smaller influences from other features including anemia, histopathologic description of atypia, and other prior cancer history. Conclusion: With diverse features from EHR data, machine learning approaches are feasible and allow for generation of models that predict which oral lesions are likely to progress to malignancy. Level of evidence: 3 Laryngoscope, 133:1156-1162, 2023.
MeSH term(s)	Humans ; Retrospective Studies ; Neoplasms ; Biopsy ; Hyperplasia ; Machine Learning
Language	English
Publishing date	2022-07-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.30285
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Article ; Online: The applicability and efficacy of magnetic resonance-guided high intensity focused ultrasound system in the treatment of primary trigeminal neuralgia.

Ma, Yaping / Hsu, Grace / Zhang, Fugui

Medical hypotheses

2020 Volume 139, Page(s) 109688

Abstract: Primary trigeminal neuralgia is a common clinical refractory neuralgia characterized by an onset of excruciating pain that can severely affect patients' quality of life. Long-term suffering from this pain may lead to depression, anxiety, and suicide. ... ...

Abstract	Primary trigeminal neuralgia is a common clinical refractory neuralgia characterized by an onset of excruciating pain that can severely affect patients' quality of life. Long-term suffering from this pain may lead to depression, anxiety, and suicide. Current treatments, however, are associated with high recurrent rates and severe complications. We hypothesize that both the applicability and efficacy of magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) treatment in primary trigeminal neuralgia can be achieved under the following conditions: a specific target focus and incident channel, a temperature measurement system that does not incur damage to surrounding tissues, and an optimal radiation dose. Successful non-invasive treatment of primary trigeminal neuralgia by MR-HIFU systems could represent a breakthrough of this technology applied to the oral and maxillofacial region.
MeSH term(s)	Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Pain Measurement ; Quality of Life ; Trigeminal Neuralgia/diagnostic imaging ; Trigeminal Neuralgia/therapy ; Ultrasonography, Interventional
Language	English
Publishing date	2020-03-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	193145-3
ISSN	1532-2777 ; 0306-9877
ISSN (online)	1532-2777
ISSN	0306-9877
DOI	10.1016/j.mehy.2020.109688
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Article ; Online: Pediatric airway management.

Hsu, Grace / von Ungern-Sternberg, Britta S / Engelhardt, Thomas

Current opinion in anaesthesiology

2021 Volume 34, Issue 3, Page(s) 276–283

Abstract: Purpose of review: Children are at risk of severe hypoxemia in the perioperative period owing to their unique anatomy and physiology. Safe and effective airway management strategies are therefore key to the practice of pediatric anesthesia. The goal of ... ...

Abstract	Purpose of review: Children are at risk of severe hypoxemia in the perioperative period owing to their unique anatomy and physiology. Safe and effective airway management strategies are therefore key to the practice of pediatric anesthesia. The goal of this review is to highlight recent publications (2019-2021) aimed to advance pediatric airway safety and to highlight a proposed simple, pediatric-specific, universal framework to guide clinical practice. Recent findings: Recent investigations demonstrate that infants with normal and difficult airways experience high incidences of multiple laryngoscopy attempts and resulting hypoxemia. Video laryngoscopy may improve tracheal intubation first attempt success rate in infants with normal airways. In infants with difficult airways, standard blade video laryngoscopy is associated with higher first attempt success rates over non-standard blade video laryngoscopy. Recent studies in children with Pierre Robin sequence and mucopolysaccharidoses help guide airway equipment and technique selection. Department airway leads and hospital difficult airway services are necessary to disseminate knowledge, lead quality improvement initiatives, and promote evidence-based practice guidelines. Summary: Pediatric airway management morbidity is a common problem in pediatric anesthesia. Improvements in individual practitioner preparation and management strategies as well as systems-based policies are required. A simple, pediatric-specific, universal airway management framework can be adopted for safe pediatric anesthesia practice.
MeSH term(s)	Airway Management ; Child ; Humans ; Hypoxia/etiology ; Hypoxia/therapy ; Infant ; Intubation, Intratracheal/adverse effects ; Laryngoscopes ; Laryngoscopy
Language	English
Publishing date	2021-02-26
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	645203-6
ISSN	1473-6500 ; 0952-7907
ISSN (online)	1473-6500
ISSN	0952-7907
DOI	10.1097/ACO.0000000000000993
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Article ; Online: Keeping it real: implications of real-world treatment outcomes for first-line immunotherapy in metastatic non-small-cell lung cancer.

Hsu, Grace G / MacKay, Eric / Scheuer, Nicolas / Ramagopalan, Sreeram V

Immunotherapy

2021 Volume 13, Issue 18, Page(s) 1453–1456

Abstract: Tweetable abstract Recent RWD studies suggest that the performance of immunotherapy in NSCLC is not as good as that seen in RCTs. However, analyses using RWD (and their interpretation) require careful appraisal and quantification of possible sources of ... ...

Abstract	Tweetable abstract Recent RWD studies suggest that the performance of immunotherapy in NSCLC is not as good as that seen in RCTs. However, analyses using RWD (and their interpretation) require careful appraisal and quantification of possible sources of bias.
MeSH term(s)	Carcinoma, Non-Small-Cell Lung/mortality ; Carcinoma, Non-Small-Cell Lung/therapy ; Humans ; Immunotherapy ; Lung Neoplasms/mortality ; Lung Neoplasms/therapy ; Progression-Free Survival ; Survival Rate
Language	English
Publishing date	2021-10-13
Publishing country	England
Document type	Editorial
ZDB-ID	2495964-9
ISSN	1750-7448 ; 1750-743X
ISSN (online)	1750-7448
ISSN	1750-743X
DOI	10.2217/imt-2021-0237
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Article ; Online: Olanzapine within steroid-sparing antiemetic regimen to prevent chemotherapy-induced nausea and vomiting in patients with acute leukemia receiving multi-day intensive chemotherapy.

Hsu, Grace / Bernhardi, Ciera / Lawson, Justin / Duong, Vu H / Emadi, Ashkan / Niyongere, Sandrine / Duffy, Alison

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

2023 , Page(s) 10781552231205824

Abstract: Introduction: Olanzapine use for chemotherapy-induced nausea and vomiting (CINV) in hematological malignancies, for multi-day chemotherapy, and with a steroid-sparing antiemetic strategy is poorly understood. This study investigated if olanzapine is ... ...

Abstract	Introduction: Olanzapine use for chemotherapy-induced nausea and vomiting (CINV) in hematological malignancies, for multi-day chemotherapy, and with a steroid-sparing antiemetic strategy is poorly understood. This study investigated if olanzapine is associated with improved prevention of CINV when added to a steroid-sparing antiemetic regimen in patients with acute leukemia receiving intensive, moderately emetogenic, multi-day chemotherapy. Methods: This was a single-center, retrospective cohort study in patients with acute leukemia. Patients who received olanzapine for CINV prevention were compared to those who did not. All patients received a 5-HT3 antagonist. Adult patients receiving moderately emetogenic, multi-day, intensive chemotherapy for acute leukemia were included. Patients were excluded if they received steroids greater than physiological doses during the study period. The primary endpoint was the complete response of CINV (no emesis or rescue antiemetic usage). Results: This study included 58 patients, 12 patients received olanzapine and 46 patients were in the control group. Baseline demographics were similar. In the study population, 89.7% had acute myeloid leukemia, median age was 54 (interquartile range 42-63) years, 34.5% were female, 27.6% had prior CINV. Complete response of CINV was similar between groups, 4 (33.3%) and 15 (32.6%) patients in the olanzapine and control groups, respectively. Safety events were similar between groups. Conclusion: Patients with acute leukemia receiving multi-day intensive chemotherapy are at high risk for CINV. The limited data in this study suggests that olanzapine use within a steroid-sparing antiemetic regimen was well tolerated and associated with similar incidence and severity of CINV compared to the control group.
Language	English
Publishing date	2023-10-10
Publishing country	England
Document type	Journal Article
ZDB-ID	1330764-2
ISSN	1477-092X ; 1078-1552
ISSN (online)	1477-092X
ISSN	1078-1552
DOI	10.1177/10781552231205824
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Article: Plant cytokinesis and the construction of new cell wall

Sinclair, Rosalie / Hsu, Grace / Davis, Destiny / Chang, Mingqin / Rosquete, Michel / Iwasa, Janet H. / Drakakaki, Georgia

FEBS letters. 2022 Sept., v. 596, no. 17

2022

Abstract: Cytokinesis in plants is fundamentally different from that in animals and fungi. In plant cells, a cell plate forms through the fusion of cytokinetic vesicles and then develops into the new cell wall, partitioning the cytoplasm of the dividing cell. The ... ...

Abstract	Cytokinesis in plants is fundamentally different from that in animals and fungi. In plant cells, a cell plate forms through the fusion of cytokinetic vesicles and then develops into the new cell wall, partitioning the cytoplasm of the dividing cell. The formation of the cell plate entails multiple stages that involve highly orchestrated vesicle accumulation, fusion and membrane maturation, which occur concurrently with the timely deposition of polysaccharides such as callose, cellulose and cross‐linking glycans. This review summarizes the major stages in cytokinesis, endomembrane components involved in cell plate assembly and its transition to a new cell wall. An animation that can be widely used for educational purposes further summarizes the process.
Keywords	callose ; cell walls ; cellulose ; crosslinking ; cytokinesis ; cytoplasm
Language	English
Dates of publication	2022-09
Size	p. 2243-2255.
Publishing place	John Wiley & Sons, Ltd
Document type	Article
Note	REVIEW
ZDB-ID	212746-5
ISSN	1873-3468 ; 0014-5793
ISSN (online)	1873-3468
ISSN	0014-5793
DOI	10.1002/1873-3468.14426
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