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- Elhai, M, et al.
(författare)
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Outcomes of patients with systemic sclerosis treated with rituximab in contemporary practice: a prospective cohort study
- 2019
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Ingår i: Annals of the rheumatic diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 78:7, s. 979-987
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Tidskriftsartikel (refereegranskat)abstract
- To assess the safety and efficacy of rituximab in systemic sclerosis (SSc) in clinical practice.MethodsWe performed a prospective study including patients with SSc from the European Scleroderma Trials and Research (EUSTAR) network treated with rituximab and matched with untreated patients with SSc. The main outcomes measures were adverse events, skin fibrosis improvement, lung fibrosis worsening and steroids use among propensity score-matched patients treated or not with rituximab.Results254 patients were treated with rituximab, in 58% for lung and in 32% for skin involvement. After a median follow-up of 2 years, about 70% of the patients had no side effect. Comparison of treated patients with 9575 propensity-score matched patients showed that patients treated with rituximab were more likely to have skin fibrosis improvement (22.7 vs 14.03 events per 100 person-years; OR: 2.79 [1.47–5.32]; p=0.002). Treated patients did not have significantly different rates of decrease in forced vital capacity (FVC)>10% (OR: 1.03 [0.55–1.94]; p=0.93) nor in carbon monoxide diffusing capacity (DLCO) decrease. Patients having received rituximab were more prone to stop or decrease steroids (OR: 2.34 [1.56–3.53], p<0.0001). Patients treated concomitantly with mycophenolate mofetil had a trend for better outcomes as compared with patients receiving rituximab alone (delta FVC: 5.22 [0.83–9.62]; p=0.019 as compared with controls vs 3 [0.66–5.35]; p=0.012).ConclusionRituximab use was associated with a good safety profile in this large SSc-cohort. Significant change was observed on skin fibrosis, but not on lung. However, the limitation is the observational design. The potential stabilisation of lung fibrosis by rituximab has to be addressed by a randomised trial.
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| 3. |
- Hassan, Ayah M., et al.
(författare)
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Molecular detection, phylogenetic analysis and genetic diversity of recently isolated foot-and-mouth disease virus serotype A African topotype, Genotype IV
- 2022
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Ingår i: Virology Journal. - : BioMed Central (BMC). - 1743-422X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSurveillance for circulating emerging diseases of economic importance has a major role in the rapid response to major pathogen outbreaks. Foot-and-mouth disease virus (FMDV) is one of the significant endemic viruses in Egypt. FMDV is periodically investigated for monitoring evolution and emergence of new variants. The genetic characterization of foot-and-mouth disease (FMD) virus serotype A responsible for recent outbreaks of FMD in Egypt was determined.MethodsSamples were collected from different locations and virus isolation was performed using BHK-21 cells. Viral RNA was extracted and samples were screened for FMDV using real-time RT-PCR. DNA sequence analysis was performed and computational and bioinformatics analyses were used to determine the substitution rates and phylogenetic relationship.ResultsSequence and phylogenetic analyses of full-length 1D region of FMDV samples collected from different governorates in 2020 showed close similarity to Egyptian FMDV strains from serotype A-African topotype-G-IV with genetic variation of 6.5%. Recently isolated FMDV strains showed high genetic variations from locally used vaccine strains in the major antigenic sites of VP1 region.ConclusionsAlthough, efforts made by the veterinary authorities to implement an effective mass vaccination plan, the recently detected FMDV strains in this study could not be subtyped using the FMDV primers routinely used for molecular serotyping. These dissimilarities raise the alarm for reconsideration of the FMDV isolates used in vaccine manufacture. Clearly close monitoring of FMD in Egypt is urgently required to define the risks of future outbreaks and to ensure appropriate control measures against FMD major outbreaks.
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| 5. |
- Elghamrawy, Sally M., et al.
(författare)
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Genetic-based adaptive momentum estimation for predicting mortality risk factors for COVID-19 patients using deep learning
- 2022
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Ingår i: International journal of imaging systems and technology (Print). - : John Wiley & Sons. - 0899-9457 .- 1098-1098. ; 32:2, s. 614-628
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Tidskriftsartikel (refereegranskat)abstract
- The mortality risk factors for coronavirus disease (COVID-19) must be early predicted, especially for severe cases, to provide intensive care before they develop to critically ill immediately. This paper aims to develop an optimized convolution neural network (CNN) for predicting mortality risk factors for COVID-19 patients. The proposed model supports two types of input data clinical variables and the computed tomography (CT) scans. The features are extracted from the optimized CNN phase and then applied to the classification phase. The CNN model's hyperparameters were optimized using a proposed genetic-based adaptive momentum estimation (GB-ADAM) algorithm. The GB-ADAM algorithm employs the genetic algorithm (GA) to optimize Adam optimizer's configuration parameters, consequently improving the classification accuracy. The model is validated using three recent cohorts from New York, Mexico, and Wuhan, consisting of 3055, 7497,504 patients, respectively. The results indicated that the most significant mortality risk factors are: CD 8+ T Lymphocyte (Count), D-dimer greater than 1 Ug/ml, high values of lactate dehydrogenase (LDH), C-reactive protein (CRP), hypertension, and diabetes. Early identification of these factors would help the clinicians in providing immediate care. The results also show that the most frequent COVID-19 signs in CT scans included ground-glass opacity (GGO), followed by crazy-paving pattern, consolidations, and the number of lobes. Moreover, the experimental results show encouraging performance for the proposed model compared with different predicting models.
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