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  • Journal article
    Porter A, Youngstein T, Tombetti E, Mason Jet al., 2020,

    Biologic therapy in supra-aortic Takayasu arteritis can improve symptoms of cerebral ischaemia without surgical intervention

    , Rheumatology, Vol: 59, Pages: iii28-iii32, ISSN: 0080-2727

    Background: Takayasu arteritis typically results in severe arterial injury with stenoses, occlusions and occasionally aneurysms. Involvement of the supra-aortic arteries is common, and in its most severe form may compromise cerebral blood supply, resulting in signs of cerebral ischaemia including visual impairment, dysphasia, hemiparesis, loss of consciousness and stroke. In addition to combination immunosuppression, the management paradigm for symptomatic cerebral ischaemia includes revascularisation. The invasive nature of this surgery, the risk of complications and the relatively high rate of re-stenosis is of concern to patients and physicians alike.The aim of this study was to determine whether combined immunosuppression with early escalation to biologic therapy improved outcomes and reduced the need for high risk surgical intervention Methods: A retrospective review of 145 Takayasu arteritis patients attending Imperial College Healthcare between 2010-2018 was conducted to identify those with cerebral ischaemia secondary to supra-aortic disease and to analyse their treatment and outcomes. Results: Eight patients (5.5%) were identified. Seven received long-term combined immunosuppressive therapy and six were prescribed biologics. The data revealed a higher than expected comprehensive response to therapy, with significant falls in disease activity, cerebral ischaemia score and prednisolone dose required, over a median follow-up of 37 months. Serial imaging analysis detected no arterial disease progression after the initiation of optimal therapy. Only one patient required surgical intervention for persistent neurological symptoms. Conclusion: Early use of biologic therapy in those with supra-aortic Takayasu arteritis presenting with cerebral ischaemia may reduce the numbers of patients requiring surgical intervention and improve outcomes.

  • Journal article
    Weiner M, Goh SM, Mohammad AJ, Hrušková Z, Tanna A, Sharp P, Kang A, Bruchfeld A, Selga D, Chocová Z, Westman K, Eriksson P, Harper L, Pusey CD, Tesaŕ V, Salama AD, Segelmark Met al., 2020,

    Impact of treatment on damage and hospitalization in elderly patients with microscopic polyangiitis and granulomatosis with polyangiitis

    , J Rheumatol, Vol: 47, Pages: 580-588, ISSN: 0315-162X

    OBJECTIVE: Age is a risk factor for organ damage, adverse events, and mortality in microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA). However, the relationship between treatment and damage, hospitalizations, and causes of death in elderly patients is largely unknown. METHODS: Consecutive patients from Sweden, England, and the Czech Republic diagnosed between 1997 and 2013 were included. Inclusion criteria were a diagnosis of MPA or GPA and age 75 years or more at diagnosis. Treatment with cyclophosphamide, rituximab, and corticosteroids the first three months was registered. Outcomes up to two years from diagnosis included vasculitis damage index (VDI), hospitalization, and cause of death. RESULTS: Treatment data was available for 167 of 202 patients. At two years, 4% had no items of damage. There was a positive association between VDI score at two years and Birmingham Vasculitis Activity Score at onset, and a negative association with treatment using cyclophosphamide or rituximab. Intravenous methylprednisolone dose was associated with treatment-related damage. During the first year, 69% of patients were readmitted to hospital. MPO-ANCA positivity and lower creatinine levels decreased the odds for readmission. The most common cause of death was infection, and this was associated with cumulative oral prednisolone dose. CONCLUSION: Immunosuppressive treatment with cyclophosphamide or rituximab in elderly patients with MPA and GPA was associated with development of less permanent organ damage and was not associated with hospitalization. However, higher doses of corticosteroids during the first three months was associated with treatment-related damage and fatal infections.

  • Journal article
    Dufton NP, Peghaire CR, Osuna-Almagro L, Raimondi C, Kalna V, Chauhan A, Webb G, Yang Y, Birdsey GM, Lalor P, Mason JC, Adams DH, Randi AMet al., 2020,

    Dynamic regulation of canonical TGF beta signalling by endothelial transcription factor ERG protects from liver fibrogenesis (vol 31, pg 450, 2017)

    , Nature Communications, Vol: 11, Pages: 1-1, ISSN: 2041-1723
  • Journal article
    Gao Z, Zhang H, Dong S, Sun S, Wang X, Yang G, Wu W, Li S, de Albuquerque VHCet al., 2020,

    Salient Object Detection in the Distributed Cloud-Edge Intelligent Network

    , IEEE NETWORK, Vol: 34, Pages: 216-224, ISSN: 0890-8044
  • Journal article
    Walsh M, Merkel PA, Peh C-A, Szpirt WM, Puechal X, Fujimoto S, Hawley CM, Khalidi N, Flossmann O, Wald R, Girard LP, Levin A, Gregorini G, Harper L, Clark WF, Pagnoux C, Specks U, Smyth L, Tesar V, Ito-Ihara T, de Zoysa JR, Szczeklik W, Flores-Suarez LF, Carette S, Guillevin L, Pusey CD, Casian AL, Brezina B, Mazzetti A, McAlear CA, Broadhurst E, Reidlinger D, Mehta S, Ives N, Jayne DRWet al., 2020,

    Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis

    , NEW ENGLAND JOURNAL OF MEDICINE, Vol: 382, Pages: 622-631, ISSN: 0028-4793
  • Journal article
    Tarkin JM, Cole GD, Gopalan D, Flora R, McAdoo SP, Mason JC, Peters NS, Pusey CD, Varnava Aet al., 2020,

    Multimodal imaging of granulomatosis with polyangiitis aortitis complicated by severe aortic regurgitation and complete heart block

    , Circulation: Cardiovascular Imaging, Vol: 13, Pages: 1-3, ISSN: 1941-9651
  • Journal article
    Li L, Wu F, Yang G, Xu L, Wong T, Mohiaddin R, Firmin D, Keegan J, Zhuang Xet al., 2020,

    Atrial scar quantification via multi-scale CNN in the graph-cuts framework

    , Medical Image Analysis, Vol: 60, ISSN: 1361-8415

    Late gadolinium enhancement magnetic resonance imaging (LGE MRI) appears to be a promising alternative for scarassessment in patients with atrial fibrillation (AF). Automating the quantification and analysis of atrial scars can bechallenging due to the low image quality. In this work, we propose a fully automated method based on the graph-cutsframework, where the potentials of the graph are learned on a surface mesh of the left atrium (LA) using a multi-scaleconvolutional neural network (MS-CNN). For validation, we have included fifty-eight images with manual delineations.MS-CNN, which can efficiently incorporate both the local and global texture information of the images, has been shownto evidently improve the segmentation accuracy of the proposed graph-cuts based method. The segmentation could befurther improved when the contribution between the t-link and n-link weights of the graph is balanced. The proposedmethod achieves a mean accuracy of 0.856 ± 0.033 and mean Dice score of 0.702 ± 0.071 for LA scar quantification.Compared to the conventional methods, which are based on the manual delineation of LA for initialization, our methodis fully automatic and has demonstrated significantly better Dice score and accuracy (p < 0.01). The method is promisingand can be potentially useful in diagnosis and prognosis of AF.

  • Journal article
    Wang Y, Yue W, Li X, Liu S, Guo L, Xu H, Zhang H, Yang Get al., 2020,

    Comparison Study of Radiomics and Deep Learning-Based Methods for Thyroid Nodules Classification Using Ultrasound Images

    , IEEE ACCESS, Vol: 8, Pages: 52010-52017, ISSN: 2169-3536
  • Journal article
    Liu Y, Yang G, Hosseiny M, Azadikhah A, Mirak SA, Miao Q, Raman SS, Sung Ket al., 2020,

    Exploring Uncertainty Measures in Bayesian Deep Attentive Neural Networks for Prostate Zonal Segmentation

    , IEEE ACCESS, Vol: 8, Pages: 151817-151828, ISSN: 2169-3536
  • Journal article
    Ali A-RH, Li J, Yang G, 2020,

    Automating the ABCD Rule for Melanoma Detection: A Survey

    , IEEE ACCESS, Vol: 8, Pages: 83333-83346, ISSN: 2169-3536

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