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arXiv 2020年

作者： Torkzadehmahani, Reihaneh Nasirigerdeh, Reza Blumenthal, David B. Kacprowski, Tim List, Markus Matschinske, Julian Späth, Julian Wenke, Nina Kerstin Bihari, Béla Frisch, Tobias Hartebrodt, Anne Hauschild, Anne-Christin Heider, Dominik Holzinger, Andreas Hötzendorfer, Walter Kastelitz, Markus Mayer, Rudolf Nogales, Cristian Pustozerova, Anastasia Röttger, Richard Schmidt, Harald H.H.W. Schwalber, Ameli Tschohl, Christof Wohner, Andrea Baumbach, Jan Chair of Experimental Bioinformatics Technical University of Munich Freising Germany Division of Data Science in Biomedicine Peter L. Reichertz Institute for Medical Informatics TU Braunschweig and Hannover Medical School Braunschweig Germany Gnome Design SRL Sfântu Gheorghe Romania Institute of Mathematics and Computer Science University of Southern Denmark Odense Denmark Department of Mathematics and Computer Science Philipps-University of Marburg Marburg Germany Institute for Medical Informatics/Statistics Medical University Graz Graz Austria Research Institute AG & Co KG Vienna Austria SBA Research Gemeinnützige GmbH Vienna Austria Department of Pharmacology and Personalised Medicine MeHNS FHML Maastricht University Maastricht Netherlands Concentris Research Management GmbH Fürstenfeldbruck Germany

Artificial intelligence (AI) has been successfully applied in numerous scientific domains. In biomedicine, AI has already shown tremendous potential, e.g. in the interpretation of next-generation sequencing data and in the design of clinical decision support systems. However, training an AI model on sensitive data raises concerns about the privacy of individual participants. For example, summary statistics of a genome-wide association study can be used to determine the presence or absence of an individual in a given dataset. This considerable privacy risk has led to restrictions in accessing genomic and other biomedical data, which is detrimental for collaborative research and impedes scientific progress. Hence, there has been a substantial effort to develop AI methods that can learn from sensitive data while protecting individuals’ privacy. This paper provides a structured overview of recent advances in privacy-preserving AI techniques in biomedicine. It places the most important state-of-the-art approaches within a unified taxonomy and discusses their strengths, limitations, and open problems. As the most promising direction, we suggest combining federated machine learning as a more scalable approach with other additional privacy preserving techniques. This would allow to merge the advantages to provide privacy guarantees in a distributed way for biomedical applications. Nonetheless, more research is necessary as hybrid approaches pose new challenges such as additional network or computation overhead. © 2020, CC BY.

关键词： Artificial intelligence

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Erratum for Sodsai et al., "Complete Genome Sequences of Mycobacterium farcinogenes Strains Isolated from Clinical Specimens from Patients in Thailand"

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Microbiology resource announcements 2021年第49期10卷 e0114521页

作者： Pimpayao Sodsai Piroon Jenjaroenpun Nattiya Hirankarn Thidathip Wongsurawat Suwatchareeporn Rotcheewaphan Center of Excellence in Immunology and Immune-Mediated Diseases Department of Microbiology Faculty of Medicine Chulalongkorn University Bangkok Thailand. Division of Immunology Department of Microbiology Faculty of Medicine Chulalongkorn University Bangkok Thailand. Division of Bioinformatics and Data Management for Research Research Group and Research Network Division Research Department Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand. Division of Bacteriology Department of Microbiology Faculty of Medicine Chulalongkorn University Bangkok Thailand.

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The featurecloud AI store for federated learning in biomedicine and beyond

arXiv

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arXiv 2021年

作者： Matschinske, Julian Späth, Julian Nasirigerdeh, Reza Torkzadehmahani, Reihaneh Hartebrodt, Anne Orbán, Balázs Fejér, Sándor Zolotareva, Olga Bakhtiari, Mohammad Bihari, Béla Bloice, Marcus Donner, Nina C. Fdhila, Walid Frisch, Tobias Hauschild, Anne-Christin Heider, Dominik Holzinger, Andreas Hötzendorfer, Walter Hospes, Jan Kacprowski, Tim Kastelitz, Markus List, Markus Mayer, Rudolf Moga, Mónika Müller, Heimo Pustozerova, Anastasia Röttger, Richard Saranti, Anna Schmidt, Harald H.H.W. Tschohl, Christof Wenke, Nina K. Baumbach, Jan Chair of Computational Systems Biology University of Hamburg Hamburg Germany Institute of AI in Medicine and Healthcare Technical University of Munich Munich Germany Institute of Mathematics and Computer Science University of Southern Denmark Odense Denmark Gnome Design SRL Sfântu Gheorghe Romania Chair of Experimental Bioinformatics Technical University of Munich Freising Germany Institute for Medical Informatics Statistics and Documentation Medical University of Graz Graz Austria concentris research management gmbh Fürstenfeldbruck Germany SBA Research Gemeinnützige GmbH Vienna Austria Department of Mathematics and Computer Science Philipps-University of Marburg Marburg Germany Research Institute AG & Co KG Vienna Austria Division Data Science in Biomedicine Peter L. Reichertz Institute for Medical Informatics TU Braunschweig and Hannover Medical School Brunswick Germany Brunswick Germany Department of Pharmacology and Personalised Medicine MeHNS FHML Maastricht University Maastricht Netherlands

Machine Learning (ML) and Artificial Intelligence (AI) have shown promising results in many areas and are driven by the increasing amount of available data. However, this data is often distributed across different institutions and cannot be shared due to privacy concerns. Privacy-preserving methods, such as Federated Learning (FL), allow for training ML models without sharing sensitive data, but their implementation is time-consuming and requires advanced programming skills. Here, we present the FeatureCloud AI Store for FL as an all-in-one platform for biomedical research and other applications. It removes large parts of this complexity for developers and end-users by providing an extensible AI Store with a collection of ready-to-use apps. We show that the federated apps produce similar results to centralized ML, scale well for a typical number of collaborators and can be combined with Secure Multiparty Computation (SMPC), thereby making FL algorithms safely and easily applicable in biomedical and clinical environments. © 2021, CC BY.

关键词： bioinformatics

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Thiazide diuretics versus loop diuretics in stage 3-5 CKD: impact on cardiorenal outcomes

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Postgraduate medicine 2024年第7期136卷 738-748页

作者： Li-Chin Sung Hui-Wen Chiu Samuel Mon-Wei Yu Liam Li-An Tsou Yung-Ho Hsu Mai-Szu Wu Cheng-Li Lin Fuu-Jen Tsai Chu-Lin Chou Division of Cardiology Department of Internal Medicine School of Medicine College of Medicine Taipei Medical University Taipei Taiwan. Division of Cardiology Department of Internal Medicine Shuang Ho Hospital Taipei Medical University New Taipei City Taiwan. Department of General Medicine School of Medicine College of Medicine Taipei Medical University Taipei Taiwan. Taipei Heart Institute Taipei Medical University Taipei Taiwan. Research Center of Urology and Kidney Taipei Medical University Taipei Taiwan. Division of Nephrology Department of Internal Medicine School of Medicine College of Medicine Taipei Medical University Taipei Taiwan. Graduate Institute of Clinical Medicine College of Medicine Taipei Medical University Taipei Taiwan. Department of Medical Research Shuang Ho Hospital Taipei Medical University New Taipei City Taiwan. Division of Nephrology Department of Medicine Icahn School of Medicine at Mount Sinai New York NY USA. Biochemistry Department of Chemistry Hofstra University Hempstead NY USA. Division of Nephrology Department of Internal Medicine Shuang Ho Hospital Taipei Medical University New Taipei City Taiwan. Division of Nephrology Department of Internal Medicine Hsin Kuo Min Hospital Taipei Medical University Taoyuan Taiwan. Management Office for Health Data China Medical University Hospital Taichung Taiwan. College of Medicine China Medical University Taichung Taiwan. School of Chinese Medicine College of Chinese Medicine China Medical University Taichung Taiwan. Department of Medical Research China Medical University Hospital China Medical University Taichung Taiwan. Division of Medical Genetics China Medical University Children's Hospital Taichung Taiwan. Department of Biotechnology and Bioinformatics Asia University Taichung Taiwan.

OBJECTIVES:The association between diuretic use and cardiorenal outcomes remains limited in patients with stage 3-5 chronic kidney disease (CKD) and hypertension. To address this gap, we aim to investigate the long-term clinical impact of diuretic use with its pharmacological classification in Taiwanese patients with stage 3-5 CKD and hypertension who were concurrently received angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs). METHODS:Using data from the National Health Insurance research database (January 2008 to December 2019), we focused on individuals with stage 3-5 CKD receiving ACEIs/ARBs between 2010 and 2018. We categorized the cohort into non-diuretic, loop diuretic (furosemide), thiazide diuretic, and combination diuretic groups. We used a Cox proportional hazards regression model with propensity score matching to analyze the influence of diuretics on all-cause mortality, cardiovascular (CV) death, and cardiorenal adverse outcomes. RESULTS:The study included 59,719 patients, with 17,585 in the non-diuretic group and 42,134 in the diuretic group. Diuretics including furosemide use was significantly associated the risks of hospitalization for decompensated congestive heart failure (CHF), acute renal failure (ARF), end-stage renal disease (ESRD) requiring dialysis, CV mortality, and all-cause mortality (-value <0.001). Thiazide diuretics showed no such adverse outcomes associations. The group receiving both thiazide and furosemide was more associated with all-cause mortality than the nondiuretic, thiazide, and furosemide monotherapy groups (all -value <0.001). CONCLUSION:Among stage 3-5 CKD patients on ACEIs/ARBs, loop diuretics exposure was associated with increased mortality and hospitalization for cardiorenal events, while thiazide diuretics exposure in isolation had no such associations. In the present data, we cannot evaluate the relationship between furosemide-associated adverse outcomes and worse renal functio

关键词： Adverse clinical outcomes Mortality chronic kidney disease cohort study diuretics

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Associations between organic erectile dysfunction and the risk of herpes zoster and postherpetic neuralgia in men

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Aging Male 2024年第1期27卷 2346310页

作者： Wang, Kuan-Hsun Hsieh, Wen-Che Lin, Heng-Jun Tsai, Fuu-Jen Hsu, Chao-Yu Department of Family Medicine Antai Medical Care Corporation Antai Tian-Sheng Memorial Hospital Pingtung Taiwan Department of Chinese Medicine Ditmanson Medical Foundation Chia-Yi Christian Hospital Chia-Yi Taiwan Management Office for Health Data Clinical Trial Research Center China Medical University Hospital Taichung Taiwan School of Chinese Medicine College of Chinese Medicine China Medical University Taichung Taiwan Department of Medical Research China Medical University Hospital Taichung Taiwan Division of Medical Genetics China Medical University Children’s Hospital Taichung Taiwan Department of Biotechnology and Bioinformatics Asia University Taichung Taiwan Department of Medical Education Ditmanson Medical Foundation Chia-Yi Christian Hospital Chia-Yi Taiwan Department of Artificial Intelligence and Healthcare Management Central Taiwan University of Science and Technology Taichung Taiwan Center for General Education National Taichung University of Science and Technology Taichung Taiwan Department of General Education National Chin-Yi University of Technology Taichung Taiwan

Background: Whether erectile dysfunction (ED) leads to considerable stress for affected men remains unclear? In this study, we investigated whether organic ED (OED) is associated with increased risks of herpes zoster (HZ) and postherpetic neuralgia (PHN). Methods: A representative subset of Taiwan’s National Health Insurance research database was employed for this study. Enrollees with OED from the years 2000 to 2018 were selected. To ensure comparability between the case and control groups, we implemented 1:1 propensity score matching based on age, index year, comorbidities, and medications. Results: The case group included 20,808 patients with OED, while the control group consisted of 20,808 individuals without OED. The OED group exhibited a significantly elevated risk of HZ (adjusted hazard ratio [aHR] = 1.74) and PHN (aHR = 1.56) compared to the non-OED group. Conclusions: Men experiencing OED seem to face elevated risks of HZ and PHN compared to those without OED. ED may serve as a warning sign for individuals at HZ risk. © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

关键词： Erectile dysfunction herpes zoster postherpetic neuralgia

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Polygenic risk modeling for prediction of epithelial ovarian cancer risk (vol 30, pg 349, 2021)

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EUROPEAN JOURNAL OF HUMAN GENETICS 2022年第5期30卷 630-631页

作者： Dareng, Eileen O. Tyrer, Jonathan P. Barnes, Daniel R. Jones, Michelle R. Yang, Xin Aben, Katja K. H. Adank, Muriel A. Agata, Simona Andrulis, Irene L. Anton-Culver, Hoda Antonenkova, Natalia N. Aravantinos, Gerasimos Arun, Banu K. Augustinsson, Annelie Balmana, Judith Bandera, Elisa V. Barkardottir, Rosa B. Barrowdale, Daniel Beckmann, Matthias W. Beeghly-Fadiel, Alicia Benitez, Javier Bermisheva, Marina Bernardini, Marcus Q. Bjorge, Line Black, Amanda Bogdanova, Natalia V. Bonanni, Bernardo Borg, Ake Brenton, James D. Budzilowska, Agnieszka Butzow, Ralf Buys, Saundra S. Cai, Hui Caligo, Maria A. Campbell, Ian Cannioto, Rikki Cassingham, Hayley Chang-Claude, Jenny Chanock, Stephen J. Chen, Kexin Chiew, Yoke-Eng Chung, Wendy K. Claes, Kathleen B. M. Colonna, Sarah Cook, Linda S. Couch, Fergus J. Daly, Mary B. Dao, Fanny Davies, Eleanor de la Hoya, Miguel de Putter, Robin Dennis, Joe DePersia, Allison Devilee, Peter Diez, Orland Ding, Yuan Chun Doherty, Jennifer A. Domchek, Susan M. Dork, Thilo du Bois, Andreas Durst, Matthias Eccles, Diana M. Eliassen, Heather A. Engel, Christoph Evans, Gareth D. Fasching, Peter A. Flanagan, James M. Fortner, Renee T. Machackova, Eva Friedman, Eitan Ganz, Patricia A. Garber, Judy Gensini, Francesca Giles, Graham G. Glendon, Gord Godwin, Andrew K. Goodman, Marc T. Greene, Mark H. Gronwald, Jacek Hahnen, Eric Haiman, Christopher A. Hakansson, Niclas Hamann, Ute Hansen, Thomas V. O. Harris, Holly R. Hartman, Mikael Heitz, Florian Hildebrandt, Michelle A. T. Hogdall, Estrid Hogdall, Claus K. Hopper, John L. Huang, Ruea-Yea Huff, Chad Hulick, Peter J. Huntsman, David G. Imyanitov, Evgeny N. Isaacs, Claudine Jakubowska, Anna James, Paul A. Janavicius, Ramunas Jensen, Allan Johannsson, Oskar Th. John, Esther M. Jones, Michael E. Kang, Daehee Karlan, Beth Y. Karnezis, Anthony Kelemen, Linda E. Khusnutdinova, Elza Kiemeney, Lambertus A. Kim, Byoung-Gie Kjaer, Susanne K. Komenaka, Ian Kupryjanczyk, Jolanta Kurian, Allison W. Kwong, Ava Lambrechts, Diether Larson, Melissa C. Lazaro, Conxi L University of Cambridge Centre for Cancer Genetic Epidemiology Department of Public Health and Primary Care Cambridge UK University of Cambridge Centre for Cancer Genetic Epidemiology Department of Oncology Cambridge UK Center for Bioinformatics and Functional Genomics Cedars-Sinai Medical Center Los Angeles CA USA Radboud University Medical Center Radboud Institute for Health Sciences Nijmegen The Netherlands Netherlands Comprehensive Cancer Organisation Utrecht The Netherlands The Netherlands Cancer Institute—Antoni van Leeuwenhoek hospital Family Cancer Clinic Amsterdam The Netherlands Veneto Institute of Oncology IOV—IRCCS Immunology and Molecular Oncology Unit Padua Italy Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital Fred A. Litwin Center for Cancer Genetics Toronto ON Canada University of Toronto Department of Molecular Genetics Toronto ON Canada University of California Irvine Department of Epidemiology Genetic Epidemiology Research Institute Irvine CA USA N.N. Alexandrov Research Institute of Oncology and Medical Radiology Minsk Belarus ‘Agii Anargiri’ Cancer Hospital Athens Greece University of Texas MD Anderson Cancer Center Department of Breast Medical Oncology Houston TX USA Lund University Department of Cancer Epidemiology Clinical Sciences Lund Sweden Vall d’Hebron Institute of Oncology Hereditary cancer Genetics Group Barcelona Spain University Hospital of Vall d’Hebron Department of Medical Oncology Barcelona Spain Rutgers Cancer Institute of New Jersey Cancer Prevention and Control Program New Brunswick NJ USA Landspitali University Hospital Department of Pathology Reykjavik Iceland University of Iceland BMC (Biomedical Centre) Faculty of Medicine Reykjavik Iceland University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg Department of Gynecology and Obstetrics Comprehensive Cancer Center ER-EMN Erlangen Germany Vanderbilt University School of Medicine Division of Epidemiology Department

Polygenic risk scores (PRS) for epithelial ovarian cancer (EOC) have the potential to improve risk stratification. Joint estimation of Single Nucleotide Polymorphism (SNP) effects in models could improve predictive performance over standard approaches of PRS construction. Here, we implemented computationally efficient, penalized, logistic regression models (lasso, elastic net, stepwise) to individual level genotype data and a Bayesian framework with continuous shrinkage, “select and shrink for summary statistics” (S4), to summary level data for epithelial non-mucinous ovarian cancer risk prediction. We developed the models in a dataset consisting of 23,564 non-mucinous EOC cases and 40,138 controls participating in the Ovarian Cancer Association Consortium (OCAC) and validated the best models in three populations of different ancestries: prospective data from 198,101 women of European ancestries; 7,669 women of East Asian ancestries; 1,072 women of African ancestries, and in 18,915 BRCA1 and 12,337 BRCA2 pathogenic variant carriers of European ancestries. In the external validation data, the model with the strongest association for non-mucinous EOC risk derived from the OCAC model development data was the S4 model (27,240 SNPs) with odds ratios (OR) of 1.38 (95% CI: 1.28–1.48, AUC: 0.588) per unit standard deviation, in women of European ancestries; 1.14 (95% CI: 1.08–1.19, AUC: 0.538) in women of East Asian ancestries; 1.38 (95% CI: 1.21–1.58, AUC: 0.593) in women of African ancestries; hazard ratios of 1.36 (95% CI: 1.29–1.43, AUC: 0.592) in BRCA1 pathogenic variant carriers and 1.49 (95% CI: 1.35–1.64, AUC: 0.624) in BRCA2 pathogenic variant carriers. Incorporation of the S4 PRS in risk prediction models for ovarian cancer may have clinical utility in ovarian cancer prevention programs.

关键词： Clinical genetics Genetic markers Risk factors Biomedicine general Human Genetics bioinformatics Gene Expression Cytogenetics

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Association between sodium-glucose cotransporter-2 (SGLT2) inhibitors and macular degeneration in patients with diabetes: a nationwide population-based study in Taiwan

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Acta diabetologica 2024年第9期61卷 1161-1168页

作者： Min-Yen Hsu Kai-Shin Luo Chien-Chih Chou Yu-Hsiang Lin Yu-Chien Hung Wu-Lung Chuang Stella Chin-Shaw Tsai Heng-Jun Lin Teng-Shun Yu Fuu-Jen Tsai Kuang-Hsi Chang School of Medicine Chung Shan Medical University Taichung City 402 Taiwan. Department of Ophthalmology Chung Shan Medical University Hospital Taichung City 402 Taiwan. Graduate Institute of Clinical Medicine College of Medicine National Taiwan University Taipei Taiwan. School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan. Department of Ophthalmology Taichung Veterans General Hospital Taichung Taiwan. Department of Post-Baccalaureate Medicine College of Medicine National Chung Hsing University Taichung Taiwan. Division of Endocrinology and Metabolism Department of Internal Medicine Changhua Christian Hospital Changhua City 500 Taiwan. Division of Endocrinology and Metabolism Department of Internal Medicine Lukang Christian Hospital Changhua County 505 Taiwan. Department of Otolaryngology Tungs' Taichung MetroHarbor Hospital Taichung 435 Taiwan. Rong Hsing Research Center for Translational Medicine College of Life Sciences National Chung Hsing University Taichung 402 Taiwan. Management Office for Health Data China Medical University Hospital Taichung 404 Taiwan. College of Medicine China Medical University Taichung City 404 Taiwan. School of Chinese Medicine College of Chinese Medicine China Medical University Taichung City 404 Taiwan. Department of Medical Research China Medical University Hospital China Medical University Taichung City 404 Taiwan. Division of Medical Genetics China Medical University Children's Hospital Taichung City 404 Taiwan. Department of Biotechnology and Bioinformatics Asia University Taichung City 413 Taiwan. Department of Medical Research Tungs' Taichung MetroHarbor Hospital Taichung City 435 Taiwan. kuanghsichang@***. Center for General Education China Medical University Taichung City 404 Taiwan. kuanghsichang@***. General Education Center Nursing and Management Jen-Teh Junior College of Medicine Miaoli County 356 Taiwan. kuanghsichang@gmail.com.

AIMS:Evidence showed that SGLT2 inhibitors have greater protective effects against retinal diseases compared to other hypoglycemic agents. Thus, we explore the association between SGLT2 inhibitor usage and macular degeneration (MD) in Taiwanese patients with diabetes. METHODS:The National Health Insurance (NHI) program's claim data are released as the National Health Insurance research database (NHIRD). This database covers more than 99% of the residents in Taiwan. We included data on patients who were newly diagnosed with type 2 diabetes mellitus (ICD-9-CM: 250, exclude 250.1x; ICD-10-CM: E11), with an age at diagnosis of over 20 years as our study population. Patients who received (sodium-glucose cotransporter 2 inhibitor) SGLT2i (ATC code: A10BK) over 90 days in 2016-2019 were defined as the SGLT2i cohort. Conversely, patients who did never received SGLT2i were defined as the non-SGLT2i cohort. The exclusion criteria were having MD before the index date, receiving SGLT2i within 1-89 days, and missing data on sex, age, or days of SGLT2i usage. Two cohorts were matched by 1:1 propensity score matching, which was based on age, sex, payroll bracket grade, urbanization, comorbidities, and medications. RESULTS:Compared to non-SGLT2i cohort, patients who received SGLT2i had a significantly lower risk of MD (adjusted hazard ratio = 0.70, 95%CI = 0.66-0.75). CONCLUSIONS:We found that SGLT2is has a strong protective effect against MD in patients with diabetes. SGLT2is may have benefits beyond glycemic control in patients with DR. However, additional clinical and experimental studies are required.

关键词： Macular degeneration (MD) National Health Insurance research database (NHIRD) Sodium-glucose cotransporter-2 (SGLT2)

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Antihypertensive medication and dementia risk in patients with hypertension: A nationwide population-based study

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Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia 2024年 125卷 83-94页

作者： Chih-Ying Lin Pei-Hsien Chen Chiu-Lin Tsai Yow-Wen Hsieh Kai-Chieh Hu Fuu-Jen Tsai Der-Yang Cho Hsien-Yin Liao Department of Chinese Traumatology Medicine China Medical University Hospital Taichung 40402 Taiwan. Department of Chinese Medicine China Medical University Hospital Taichung 40402 Taiwan. Department of Chinese Medicine Pharmacy China Medical University Hospital Taichung 40402 Taiwan. Graduate Institute of Pharmacy China Medical University Taichung 40402 Taiwan Department of Pharmacy China Medical University Hospital Taichung 40402 Taiwan. Management Office for Health Data (Dry Lab) Clinical Trial Center China Medical University Hospital Taichung 40402 Taiwan. School of Chinese Medicine College of Chinese Medicine China Medical University Taichung 40402 Taiwan Department of Medical Research China Medical University Hospital Taichung 40402 Taiwan Division of Medical Genetics China Medical University Children's Hospital Taichung 40447 Taiwan Department of Biotechnology and Bioinformatics Asia University Taichung Taiwan. Translational Cell Therapy Center Department of Medical Research China Medical University Hospital Taichung 40447 Taiwan Department of Neurosurgery China Medical University Hospital Taichung 40447 Taiwan Graduate Institute of Biomedical Sciences China Medical University Taichung 40447 Taiwan. School of Post-Baccalaureate Chinese Medicine College of Chinese Medicine China Medical University Taichung 40402 Taiwan Department of Acupuncture China Medical University Hospital Taichung 40402 Taiwan. Electronic address: jamesliao@mail.cmu.edu.tw.

The claim between hypertension and dementia needs more evidence due to limited data. We aim to examine the risk of dementia in patients with hypertension, and determine whether the use of antihypertensive medications (AHMs) could decrease the incidence of dementia diagnosed following the onset of hypertension. We employed the Taiwan National Health Insurance research database from 2000 to 2016 and performed a retrospective cohort study. We also carried out a case-control study to see if AHMs could reduce the incidence of newly diagnosed dementia in hypertensive patients. In the retrospective cohort study, we selected 587,762 participants with age and gender matched in experimental and control groups. The hypertension group had significantly higher adjusted hazard ratios (aHRs) of getting newly diagnosed dementia, including all-cause dementia, Alzheimer's disease, and vascular dementia (aHR, 2.86; 95 % confidence interval (CI), 2.74-2.99) than the control group. Three kinds of specific AHMs, namely, angiotensin II receptor blockers (aHR, 0.55; 95 % CI, 0.53-0.57), calcium channel blockers (aHR, 0.76; 95 % CI, 0.73-0.80), and diuretics (aHR,0.93; 95 % CI, 0.89-0.97) could significantly decrease the incidence of getting newly diagnosed dementia. Also, the application of traditional Chinese medicine (TCM) significantly associates with the lower aHRs of newly diagnosed dementia in hypertensive patients compared to patients without TCM (aHR, 0.90; 95 % CI, 0.81-1.00). Hypertension may be a significant risk factor for dementia. Both AHMs and TCM significantly associate with the lower incidence of newly diagnosed dementia in hypertensive patients.

关键词： Alzheimer’s disease Antihypertension medication Dementia Hypertension traditional Chinese medicine

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Prior COVID-19 vaccination and reduced risk of cerebrovascular diseases among COVID-19 survivors

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Journal of Medical Virology 2024年第5期96卷 e29648-e29648页

作者： Chen, Sheng-Yin Hsieh, Tina Yi Jin Hung, Yao-Min Oh, Jae Won Chen, Shen-Kai Wang, Shiow-Ing Chang, Renin Wei, James Cheng-Chung Clinical and Translational Epidemiology Unit Massachusetts General Hospital and Harvard Medical School Boston Morocco Division of Gastroenterology Massachusetts General Hospital and Harvard Medical School Boston Morocco Department of Epidemiology Harvard T. H. Chan School of Public Health Boston Morocco Department of Obstetrics & Gynecology Beth Israel Deaconess Medical Center Boston Morocco Department of Bioinformatics Harvard Medical School Boston Morocco Division of Nephrology Department of Internal Medicine Taipei Veterans General Hospital Taitung Branch Taiwan Master Program in Biomedicine College of Science and Engineering National Taitung University Taitung Taiwan College of Health and Nursing Meiho University Pingtung Taiwan Department of Neurology Brigham and Women's Hospital Boston Morocco Department of Neurology Harvard Medical School Boston MA United States Department of Education Kaohsiung Chang Gung Memorial Hospital Boston MA United States Center for Health Data Science Department of Medical Research Chung Shan Medical University Hospital Taichung Taiwan Institute of Medicine College of Medicine Chung Shan Medical University Taichung Taiwan Department of Nursing Jen-Teh Junior College of Medicine Nursing and Management Miaoli County Taiwan Department of Medical Education and Research Kaohsiung Veterans General Hospital Kaohsiung Taiwan Department of Emergency Medicine Kaohsiung Veterans General Hospital Kaohsiung Taiwan School of Medicine Chung Shan Medical University Taichung Taiwan Department of Recreation and Sports Management Tajen University Pintung Taiwan Department of Allergy Immunology & Rheumatology Chung Shan Medical University Hospital Taichung Taiwan Department of Nursing Chung Shan Medical University Taichung Taiwan Graduate Institute of Integrated Medicine China Medical University Taichung Taiwan Office of Research and Development Asia University Taichung Taiwan

The effects of COVID-19 vaccination on short-term and long-term cerebrovascular risks among COVID-19 survivors remained unknown. We conducted a national multi-center retrospective cohort study with 151 597 vaccinated and 151 597 unvaccinated COVID-19 patients using the TriNetX database, from January 1, 2020 to December 31, 2023. Patients baseline characteristics were balanced with propensity score matching (PSM). The outcomes were incident cerebrovascular diseases occurred between 1st and 30th days (short-term) after COVID-19 diagnosis. Nine subgroup analyses were conducted to explore potential effect modifications. We performed six sensitivity analyses, including evaluation of outcomes between 1st to 180th days, accounting for competing risk, and incorporating different variant timeline to test the robustness of our results. Kaplan-Meier curves and Log-Rank tests were performed to evaluate survival difference. Cox proportional hazards regressions were adopted to estimate the PSM-adjusted hazard ratios (HR). The overall short-term cerebrovascular risks were lower in the vaccinated group compared to the unvaccinated group (HR: 0.66, 95% CI: 0.56–0.77), specifically cerebral infarction (HR: 0.62, 95% CI: 0.48–0.79), occlusion and stenosis of precerebral arteries (HR: 0.74, 95% CI: 0.53–0.98), other cerebrovascular diseases (HR: 0.57, 95% CI: 0.42–0.77), and sequelae of cerebrovascular disease (HR: 0.39, 95% CI:0.23–0.68). Similarly, the overall cerebrovascular risks were lower in those vaccinated among most subgroups. The long-term outcomes, though slightly attenuated, were consistent (HR: 0.80, 95% CI: 0.73–0.87). Full 2-dose vaccination was associated with a further reduced risk of cerebrovascular diseases (HR: 0.63, 95% CI: 0.50–0.80) compared to unvaccinated patients. Unvaccinated COVID-19 survivors have significantly higher cerebrovascular risks than their vaccinated counterparts. Thus, clinicians are recommended to monitor this population closely for stroke even

关键词： cohort study COVID-19 vaccination strokes

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A Phase III, Randomized Study of Daratumumab, Cyclophosphamide, Bortezomib and Dexamethasone (DARA-VCD) Induction Followed By Autologous Stem Cell Transplant or Dara-VCD Consolidation and Daratumumab Maintenance in Patients with Newly Diagnosed AL Amyloidosis

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Blood 2024年 144卷 3309.1-3309.1页

作者： Patrick Hagen Surbhi Sidana Terri L. Parker Brian A. Walker Vaishali Sanchorawala Jeffrey A. Zonder Taxiarchis Kourelis Anita D'Souza Heather J. Landau Adam Rosenthal Antje Hoering Sikander Ailawadhi Robert Z. Orlowski Division of Hematology and Oncology Loyola University Health System Maywood IL Division of Blood and Marrow Transplantation and Cellular Therapy Stanford University School of Medicine Stanford CA Department of Internal Medicine Section of Hematology Yale University School of Medicine and Yale Cancer Center New Haven CT Center for Computational Biology and Bioinformatics Indiana University School of Medicine Indianapolis IN Amyloidosis Center Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center Boston MA Karmanos Cancer Institute Detroit MI Division of Hematology Mayo Clinic Rochester MN CIBMTR (Center for International Blood and Marrow Transplant Research) Department of Medicine Medical College of Wisconsin Milwaukee WI Center for International Blood and Marrow Transplant Research Department of Medicine Medical College of Wisconsin Milwaukee WI Adult Bone Marrow Transplant Service Department of Medicine Memorial Sloan Kettering Cancer Center New York NY SWOG Statistical and Data Management Center Seattle WA Cancer Research And Biostatistics Seattle WA Division of Hematology-Oncology Mayo Clinic-Florida Jacksonville FL Department of Lymphoma & Myeloma The University of Texas MD Anderson Cancer Center Houston TX

Background and significance: Light chain (AL) amyloidosis is a plasma cell malignancy characterized by the production of amyloidgenic clonal light chains that deposit in various tissues. The addition of daratumumab to bortezomib, cyclophosphamide and dexamethasone (Dara-VCD) has improved the depth of hematologic and organ responses and is an approved induction therapy in newly diagnosed AL amyloid patients (DOI: 10.1056/NEJMoa2028631). However, this approach has not yet demonstrated an overall survival (OS) benefit and follow up remains short. With strict adherence to eligibility criteria, in particular severity of cardiac involvement, autologous stem cell transplantation (ASCT) as consolidative therapy is safe with transplant related mortality on par with multiple myeloma. This approach generates deep and sustained responses, but it is unclear if it offers an additional survival benefit following Dara-VCD induction. The only randomized trial evaluating the role of ASCT in AL amyloid is outdated (DOI: 10.1056/NEJMoa070484) and no randomized data exist to inform the optimal use of ASCT in the era of Dara-VCD induction. Furthermore, multi-organ involvement in AL amyloid drives morbidity and mortality thus the impact of any consolidative therapy on cardiac and renal involvement in addition to overall survival but must be defined. Finally, the approval of Dara-VCD therapy was based on complete hematologic response rates but there is increasing data demonstrating that achieving minimal residual disease (MRD) negativity by either bone marrow next generation flow cytometry (DOI: 10.1002/ajh.26562) or peripheral blood mass spectrometry (DOI: 10.1038/s41408-020-0291-8) generates improved organ response, hematologic progression free survival, and possibly OS. Methods: This randomized phase 3 SWOG led intergroup trial (S2213; NCT06022939) is being conducted within the United States and will accrue a total of 143 participants per arm. The primary endpoint will compare MOD-PFS (

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