1
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Zappia JL, Farrow JM, Song L, Peters AW, Fennerty ML, Sundaram CP, Boris RS. Outcomes of Robot-Assisted Laparoscopic Pyeloplasty Based on Degree of Obstruction on Preoperative Tc-99 MAG-3 Renal Scintigraphy. J Endourol 2023; 37:151-156. [PMID: 36254381 DOI: 10.1089/end.2022.0463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objective: Management of symptomatic ureteropelvic junction (UPJ) obstruction with hydronephrosis and discordant Tc-99 mercaptoacetyltriglycine (MAG-3) renal scintigraphy is challenging. In this study we describe long-term outcomes of patients who underwent robot-assisted laparoscopic pyeloplasty for the correction of symptomatic UPJ obstruction with discordant preoperative Tc-99m MAG-3 renal scintigraphy. Methods: Patients undergoing robot-assisted laparoscopic pyeloplasty for symptomatic UPJ obstruction at a single academic center from 2009 to 2021 were retrospectively reviewed. Patients were categorized into three groups with varying degrees of obstruction based on preoperative MAG-3 imaging: Group 1: no obstruction (Lasix T1/2 clearance <10 minutes), Group 2: equivocal obstruction (Lasix T1/2 clearance 10-20 minutes), and Group 3: obstruction (Lasix T1/2 clearance >20 minutes. Pyeloplasty success was defined as resolution of symptoms and improvement/stable computed tomography (CT) imaging or MAG-3 scintigraphy. Failure was defined as persistence of symptoms with either obstruction on functional imaging, worsening hydronephrosis, or subsequent intervention. Results: A total of 125 cases were identified, with a median patient age of 35 years. Dismembered pyeloplasty technique was performed in 98.4% of cases. Median preoperative split renal function on MAG-3 scintigraphy was the only statistically significant (p = 0.003) difference in preoperative characteristics between the three groups. There were 15 postoperative complications, with a rate of Clavien-Dindo grade 3 or higher complications of 4.8%. Overall pyeloplasty success was 92.8%, with success rates of 100% (15/15) and 97% (32/33) in the no obstruction and equivocal obstruction groups, respectively. Median time to pyeloplasty failure was 20.4 months. Conclusion: Robot-assisted laparoscopic pyeloplasty is a safe and effective surgical intervention for correcting UPJ obstruction. Patients with symptoms of UPJ obstruction and discordant functional imaging studies demonstrate similar or improved success rates after pyeloplasty compared with patients with documented high-grade obstruction. Based on these findings preoperative renal scan may not be reliable in appropriate selection of candidacy for pyeloplasty.
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Affiliation(s)
- Jason L Zappia
- Department of Urology, Indiana University, Indianapolis, Indiana, USA
| | - Jason M Farrow
- Department of Urology, Indiana University, Indianapolis, Indiana, USA
| | - Leo Song
- Department of Urology, Indiana University, Indianapolis, Indiana, USA
| | | | | | | | - Ronald S Boris
- Department of Urology, Indiana University, Indianapolis, Indiana, USA
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2
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Miranda E, Meara JG, Pendleton A, Peters AW, Santhirapala V, Ashraf N, Alonso N, Hakizimana S, Bekele A, Park KB, Farmer P. Harvard Medical School Department of Global Health and Social Medicine COVID-19 seminar series: COVID and surgical, anesthetic and obstetric care. BMC Proc 2021; 15:20. [PMID: 34551790 PMCID: PMC8457896 DOI: 10.1186/s12919-021-00218-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
On May 21, 2020, the Harvard Program in Global Surgery and Social Change (PGSSC) hosted a webinar as part of the Harvard Medical School Department of Global Health and Social Medicine’s COVID-19 webinar series. The goal of PGSSC’s virtual webinar was to share the experiences of surgical, anesthesia, and obstetric (SAO) providers on the frontlines of the COVID pandemic, from both high-income countries (HICs), such as the United States and the United Kingdom, as well as low- and middle-income countries (LMICs). Providers shared not only their experiences delivering SAO care during this global pandemic, but also solutions and innovations they and their colleagues developed to address these new challenges. Additionally, the seminar explored the relationship between surgery and health system strengthening and pandemic preparedness, and outlined the way forward, including a roadmap for prioritization and investment in surgical system strengthening. Throughout the discussion, other themes emerged as well, such as the definition of elective surgery and its implications during a persistent global pandemic, the safe and ethical reintroduction of surgical services, and the social inequities exposed by the stress placed on health systems by COVID-19. These proceedings document the perspectives shared by participants through their invited lectures as well as through the panel discussion at the end of the seminar.
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Affiliation(s)
- Elizabeth Miranda
- Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02215, USA. .,Division of Vascular Surgery, University of Southern California, Los Angeles, CA, USA.
| | - John G Meara
- Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02215, USA.,Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Alaska Pendleton
- Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02215, USA
| | | | | | | | - Nivaldo Alonso
- Department of Plastic Surgery, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Abebe Bekele
- University of Global Health Equity, Butaro, Rwanda
| | - Kee B Park
- Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02215, USA
| | - Paul Farmer
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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3
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Nottingham CU, Assmus MA, Peters AW, Large T, Agarwal DK, Rivera ME, Krambeck AE. Next generation sequencing in patients with nephrolithiasis: how does it perform compared with standard urine and stone cultures? Ther Adv Urol 2021; 13:1756287221994972. [PMID: 33680094 PMCID: PMC7900788 DOI: 10.1177/1756287221994972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/11/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Our aim was to compare microorganism detection between standard culture (Ctx)
and next generation sequencing (NGS) in patients undergoing surgery for
nephrolithiasis; we prospectively compared both urine and stone culture
results using these two techniques. Methods: We prospectively compared microorganism detection of urine and stone cultures
using Ctx versus NGS in patients undergoing surgery for
nephrolithiasis. We analyzed preoperative voided urine (Voided) using both
Ctx and NGS. Intraoperatively, renal stone (Stone) cultures were analyzed
with Ctx and NGS. The primary outcome was concordance in microorganism
detection between Voided Ctx and Stone NGS, as well as between Stone Ctx and
Stone NGS. Results: We prospectively evaluated 84 patients. The sensitivity, specificity,
positive predictive value (PPV), and negative predictive value (NPV) of
Voided Ctx predicting Stone Ctx were 66.7%, 73.7%, 54.5%, and 82.4%,
respectively. Concordance of Voided Ctx microorganisms to Stone
microorganisms decreased when NGS was used for the Stone compared with Ctx.
The sensitivity, specificity, PPV, and NPV of Voided NGS to predict Stone
Ctx microorganisms were 85.2%, 24.6%, 34.8%, and 77.8%, respectively. The
concordance of Voided NGS to Stone microorganisms improved when the Stone
was analyzed via NGS compared with Ctx. Conclusion: NGS has a higher detection rate of microorganisms than standard culture for
both preoperative urine and stone cultures. Voided NGS was the most
sensitive in predicting a positive Stone sample, but the specificity and PPV
were, overall, low. Further correlation of NGS microorganism detection with
patient outcomes will determine which clinical situations may benefit most
from NGS versus standard culture in patients with
urinary-tract stones.
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Affiliation(s)
- Charles U Nottingham
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mark A Assmus
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alexander W Peters
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tim Large
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Deepak K Agarwal
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Marcelino E Rivera
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Amy E Krambeck
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA
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4
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Peters AW, Yorlets RR, Shrime MG, Alkire BC. The Macroeconomic Consequences Of Firearm-Related Fatalities In OECD Countries, 2018-30: A Value-Of-Lost-Output Analysis. Health Aff (Millwood) 2020; 39:1961-1969. [PMID: 33136496 DOI: 10.1377/hlthaff.2019.01701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We modeled gross domestic product (GDP) losses attributable to firearm-related fatalities in each of thirty-six Organization for Economic Cooperation and Development (OECD) countries using the value-of-lost-output approach from 2018 to 2030. There are three categories of firearm-related fatalities: physical violence, self-harm, and unintentional injury. We project that the thirty-six OECD countries will lose $239.0 billion in cumulative GDP from 2018 to 2030 from firearm-related fatalities. Most of these losses ($152.5 billion) will occur as a result of fatalities in the US. In 2030 alone, the OECD countries will collectively lose $30.4 billion (0.04 percent) of their estimated annual GDP from firearm-related fatalities. The highest relative losses will occur in Mexico and the US; the lowest will occur in Japan. Firearm-related fatalities are expected to disproportionately affect the US and Mexican economies. Across the OECD, 48.5 percent of economic losses will be attributable to physical violence, 47.0 percent to self-harm, and 4.6 percent to unintentional injury. These findings provide a more complete picture of the toll of firearm-related fatalities, a global public health crisis that, without intervention, will continue to impose significant economic losses across OECD countries.
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Affiliation(s)
- Alexander W Peters
- Alexander W. Peters is a resident in surgery at NewYork-Presbyterian/Weill Cornell Medical Center, in New York, New York, and a former research fellow in the Program in Global Surgery and Social Change at Harvard Medical School and in the Department of Plastic and Oral Surgery at Boston Children's Hospital, both in Boston, Massachusetts
| | - Rachel R Yorlets
- Rachel R. Yorlets is a PhD student in epidemiology at the Brown University School of Public Health and a predoctoral fellow at the Population Studies and Training Center at Brown University, in Providence, Rhode Island
| | - Mark G Shrime
- Mark G. Shrime is the O'Brien Chair of Global Surgery at the Royal College of Surgeons in Ireland, in Dublin, Ireland, and a lecturer in global health and social medicine at Harvard Medical School
| | - Blake C Alkire
- Blake C. Alkire is an instructor in the Program in Global Surgery and Social Change at Harvard Medical School and an instructor in otolaryngology at the Massachusetts Eye and Ear Infirmary, in Boston, Massachusetts
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5
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Niyikuri A, Smith ER, Vervoort D, Shrime MG, Brown S, Peters AW, Yamey G, Makasa E. Top 10 Resources in Global Surgery. Glob Health Sci Pract 2020; 8:606-611. [PMID: 33008867 PMCID: PMC7541111 DOI: 10.9745/ghsp-d-20-00050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/05/2020] [Indexed: 11/15/2022]
Abstract
This resource list could serve to orient those interested in global surgery and could be supplemented with resources advocating for global surgery from clinical, population health, or policy perspectives.
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Affiliation(s)
- Alliance Niyikuri
- Frank Ogden Medical School, Hope Africa University, Bujumbura, Burundi
| | - Emily R Smith
- Duke Global Health Institute, Duke University, Durham, NC, USA. .,Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Dominique Vervoort
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - Mark G Shrime
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.,Center for Global Surgery Evaluation, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Stav Brown
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alexander W Peters
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.,Department of Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Gavin Yamey
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Emmanuel Makasa
- Cabinet Office, Government of the Republic of Zambia, Lusaka, Zambia.,Department of Surgery, School of Medicine, University of Witwatersrand, Johannesburg, South Africa
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6
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Juprasert JM, Gray KD, Moore MD, Obeid L, Peters AW, Fehling D, Fahey TJ, Yeo HL. Restructuring of a General Surgery Residency Program in an Epicenter of the Coronavirus Disease 2019 Pandemic: Lessons From New York City. JAMA Surg 2020; 155:870-875. [PMID: 32936281 DOI: 10.1001/jamasurg.2020.3107] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
On March 1, 2020, the first case of coronavirus disease 2019 (COVID-19) was confirmed in New York, New York. Since then, the city has emerged as an epicenter for the ongoing pandemic in the US. To meet the anticipated demand caused by the predicted surge of patients with COVID-19, the Department of Surgery at NewYork-Presbyterian Hospital/Weill Cornell Medicine developed and executed an emergent restructuring of general surgery resident teams and educational infrastructure. The restructuring of surgical services described in this Special Communication details the methodology used to safely deploy the necessary amount of the resident workforce to support pandemic efforts while maintaining staffing for emergency surgical care, limiting unnecessary exposure of residents to infection risk, effectively placing residents in critical care units, and maintaining surgical education and board eligibility for the training program as a whole.
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Affiliation(s)
- Jackly M Juprasert
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Katherine D Gray
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Maureen D Moore
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Lama Obeid
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Alexander W Peters
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - David Fehling
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Thomas J Fahey
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
| | - Heather L Yeo
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York
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7
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Sheshadri V, Wasserman I, Peters AW, Santhirapala V, Mitra S, Sandler S, Svensson E, Ljungman D, George R, Ambepu A, Krishnan J, Kataria R, Afshar S, Meara JG, Galea JT, Weinstock P, Roussin C, Taylor M, Menon N, McClain CD. Simulation capacity building in rural Indian hospitals: a 1-year follow-up
qualitative analysis. BMJ Simul Technol Enhanc Learn 2020; 7:140-145. [DOI: 10.1136/bmjstel-2019-000577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/08/2020] [Indexed: 11/03/2022]
Abstract
Introduction
The benefits of simulation-based medical training are well described. The
most effective way to plant and scale simulation training in rural locations
remains undescribed. We sought to plant simulation training programmes for
anaesthesia emergencies in two rural Indian hospitals.
Methods
Two Indian consultant anaesthetists without experience in medical
simulation underwent a 3-day course at the Boston Children’s Hospital’s (BCH)
Simulator Program. They returned to their institutions and launched simulation
programmes with an airway manikin and mock patient monitor. The 1-year
experience was evaluated using individual, in-depth interviews of simulation
facilitators. Three staff members (responsible for facilitating medical
simulations over the prior year) at two rural hospitals in India were
interviewed. None attended the BCH training; instead, they received on-the-job
training from the BCH-trained, consultant anaesthetist colleagues.
Results
Successes included organisational adoption of simulation training with
exercises 1 year after the initial BCH-training, increased interdisciplinary
teamwork and improved clinical competency in managing emergencies. Barriers to
effective, local implementation of simulation programmes fell into three
categories: time required to run simulations, fixed and rigid roles, and
variable resources. Thematic improvement requests were for standardised
resources to help train simulation facilitators and demonstrate to participants
a well-run simulation, in addition to context-sensitive scenarios.
Conclusion
An in-person training of simulation facilitators to promote medical
simulation programmes in rural hospitals produced ongoing simulation programmes
1 year later. In order to make these programmes sustainable, however, increased
investment in developing simulation facilitators is required. In particular,
simulation facilitators must be prepared to formally train other simulation
facilitators, too.
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8
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Wasserman I, Peters AW, Roa L, Amanullah F, Samad L. Breaking Specialty Silos: Improving Global Child Health Through Essential Surgical Care. Glob Health Sci Pract 2020; 8:183-189. [PMID: 32606090 PMCID: PMC7326524 DOI: 10.9745/ghsp-d-20-00009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 05/19/2020] [Indexed: 01/17/2023]
Abstract
Children’s health care providers and children’s surgery providers can partner to improve children’s health by developing the surgical workforce, focusing on “best buy” surgeries, integrating children’s surgery into national plans, streamlining data collection and research, and leveraging financing.
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Affiliation(s)
- Isaac Wasserman
- Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Alexander W Peters
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.,Department of Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Lina Roa
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA.,Department of Obstetrics & Gynecology, University of Alberta, Edmonton, Canada
| | | | - Lubna Samad
- Center for Essential Surgical and Acute Care, Indus Health Network, Karachi, Pakistan
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9
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Reddy CL, Peters AW, Jumbam DT, Caddell L, Alkire BC, Meara JG, Atun R. Innovative financing to fund surgical systems and expand surgical care in low-income and middle-income countries. BMJ Glob Health 2020; 5:e002375. [PMID: 32546586 PMCID: PMC7299051 DOI: 10.1136/bmjgh-2020-002375] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 02/02/2023] Open
Abstract
Strong surgical systems are necessary to prevent premature death and avoidable disability from surgical conditions. The epidemiological transition, which has led to a rising burden of non-communicable diseases and injuries worldwide, will increase the demand for surgical assessment and care as a definitive healthcare intervention. Yet, 5 billion people lack access to timely, affordable and safe surgical and anaesthesia care, with the unmet demand affecting predominantly low-income and middle-income countries (LMICs). Rapid surgical care scale-up is required in LMICs to strengthen health system capabilities, but adequate financing for this expansion is lacking. This article explores the critical role of innovative financing in scaling up surgical care in LMICs. We locate surgical system financing by using a modified fiscal space analysis. Through an analysis of published studies and case studies on recent trends in the financing of global health systems, we provide a conceptual framework that could assist policy-makers in health systems to develop innovative financing strategies to mobilise additional investments for scale-up of surgical care in LMICs. This is the first time such an analysis has been applied to the funding of surgical care. Innovative financing in global surgery is an untapped potential funding source for expanding fiscal space for health systems and financing scale-up of surgical care in LMICs.
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Affiliation(s)
- Ché L Reddy
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Alexander W Peters
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA
| | - Desmond Tanko Jumbam
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Luke Caddell
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Blake C Alkire
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Center for Global Surgery Evaluation, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
- Department of Global Health Equity, Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, USA
| | - John G Meara
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Rifat Atun
- Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
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10
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Peters AW, Savaglio MK, Gunderson ZJ, Adam G, Milto AJ, Whipple EC, Loder RT, Kacena MA. Comparative analysis of authorship trends in the Journal of Hand Surgery European and American volumes: A bibliometric analysis. Ann Med Surg (Lond) 2020; 55:200-206. [PMID: 32518641 PMCID: PMC7272499 DOI: 10.1016/j.amsu.2020.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/17/2022] Open
Abstract
Background The purpose of this study was to better understand the authorship publishing trends in the field of hand surgery. To accomplish this, a comparative analysis was completed between the European and American volumes of the Journal of Hand Surgery (JHSE and JHSA) over the past three decades. Well-established bibliometric methods were used to examine one representative year from each of the past three decades. The focus of the study was to examine changes in author gender over time as well as to compare authorship trends across the two volumes. Materials and methods All JHSA and JHSE publications from 1985, 1995, 2005, and 2015 were placed into a Microsoft Excel spreadsheet. Data was collected for each publication including the gender of first and corresponding authors, corresponding author position, corresponding author country of origin, number of credited institutions, authors, printed pages, and references. Countries were grouped by regions. Results A total of 450 and 763 manuscripts from JHSE and JHSA, respectively, met inclusion criteria. JHSE and JHSA both showed increases in most variables analyzed over time. Both journals showed an increase in female first and corresponding authors. JHSE and JHSA displayed a rise in collaboration between institutions and countries. Conclusions Both JHSE and JHSA display increasing female inclusion in the hand surgery literature, which has traditionally been a male dominated field. The observed increase in collaboration between institutions and countries is likely linked to advances in technology that allow sharing of information more conveniently and reliably than was previously possible. As further advances are made socially and technologically, hopefully these trends will continue, leading to faster and higher quality research being generated in the field of hand surgery. Orthopaedic hand literature has seen increases in collaboration over the past 30 years. Significant increase in female first authors in the orthopaedic hand literature. Female first and corresponding author manuscripts received the most citations.
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Affiliation(s)
- Alexander W Peters
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michael K Savaglio
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Zachary J Gunderson
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Gremah Adam
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Anthony J Milto
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Elizabeth C Whipple
- Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Randall T Loder
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Melissa A Kacena
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
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11
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Fatima I, Shoman H, Peters AW, Samad L, Nishtar S. Pakistan's National Surgical, Obstetric, and Anesthesia Plan: an adapted model for a devolved federal-provincial health system. Can J Anaesth 2020; 67:1212-1216. [PMID: 32409943 DOI: 10.1007/s12630-020-01708-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/10/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- Irum Fatima
- Global Health Directorate, Indus Health Network, Karachi, Pakistan.
| | - Haitham Shoman
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - Alexander W Peters
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.,Department of Surgery, Weill Cornell Medical College, New York, NY, USA
| | - Lubna Samad
- Global Health Directorate, Indus Health Network, Karachi, Pakistan
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12
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13
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Peters AW, Roa L, Rwamasirabo E, Ameh E, Ulisubisya MM, Samad L, Makasa EM, Meara JG. National Surgical, Obstetric, and Anesthesia Plans Supporting the Vision of Universal Health Coverage. Glob Health Sci Pract 2020; 8:1-9. [PMID: 32234839 PMCID: PMC7108944 DOI: 10.9745/ghsp-d-19-00314] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 03/02/2020] [Indexed: 12/11/2022]
Abstract
Developing a national surgical, obstetric, and anesthesia plan is an important first step for countries to strengthen their surgical systems and improve surgical care. Barriers to successful implementation of these plans include data collection, scalability, and financing, yet surgical system strengthening efforts are gaining momentum in achieving universal access to emergency and essential surgical care.
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Affiliation(s)
- Alexander W Peters
- Department of Surgery, Weill Cornell Medical College, New York, NY, USA.
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
| | - Lina Roa
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada
| | | | - Emmanuel Ameh
- Department of Surgery, National Hospital, Abuja, Nigeria
| | - Mpoki M Ulisubisya
- Ministry of Health Community Development Gender Elderly and Children, Dar es Salaam, Tanzania
| | - Lubna Samad
- Center for Essential Surgical and Acute Care, Indus Health Network, Karachi, Pakistan
| | - Emmanuel M Makasa
- Public Service Management Division Cabinet Office, Office of the President, Lusaka, Zambia
- Wits Centre of Surgical Care for Primary Health & Sustainable Development, School of Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - John G Meara
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
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14
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Mitra S, Ashby J, Muhumuza A, Ndayishimiye I, Wasserman I, Santhirapala V, Peters AW, Vervoort D, Jacob O, Gnanaraj J, Ganesh P, Afshar S. Surgathon: a new model for creating a surgical innovation ecosystem in low-resource settings. BMJ Glob Health 2020; 5:e002162. [PMID: 32133197 PMCID: PMC7042596 DOI: 10.1136/bmjgh-2019-002162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/06/2020] [Accepted: 01/13/2020] [Indexed: 11/12/2022] Open
Abstract
Innovation ecosystems and emerging technologies can potentially accelerate the access to safe, affordable surgical care in low-resource settings. There is a need to develop localised innovation ecosystems that can establish an initial culture and catalyse the creation, adoption and diffusion of innovation. The surgathon model outlines one approach to seeding surgical innovation ecosystems. International academic institutions collaborated on six global surgery, innovation and ethics-themed hackathons (‘surgathons’) across India and Rwanda between 2016 and 2019. Over 1598 local multidisciplinary students participated, learning about challenges in the delivery of surgical care and ideating solutions that could leverage appropriate technology and resources for impact. Pursuing student ideas and evaluating their implementation past the surgathons continues to be an active effort. Surgathons have unfolded in different permutations based on local faculty, institution and health system context. The surgathon model is a novel method of priority setting challenges in global surgery and utilises locally driven expertise and innovation capacity to derive ethical solutions. The model offers a path for low-resource setting students and faculty to learn, advocate and innovate for improved surgical care.
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Affiliation(s)
- Shivani Mitra
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Joanna Ashby
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Arsen Muhumuza
- Department of General Medicine, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Isaac Ndayishimiye
- Department of General Medicine, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Isaac Wasserman
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Vatshalan Santhirapala
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Alexander W Peters
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Dominique Vervoort
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Oshin Jacob
- Department of Electronics and Instrumentation, Karunya University, Coimbatore, Tamil Nadu, India
| | - Jesudian Gnanaraj
- Department of Electronics and Instrumentation, Karunya University, Coimbatore, Tamil Nadu, India.,Karunya Rural Community Hospital, Coimbatore, Tamil Nadu, India
| | - Praveen Ganesh
- Department of Plastic Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Salim Afshar
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.,Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
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15
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Wurdeman TD, Peters AW, Alkire B, Shrime MG. Firearm Prevalence and Pediatric Firearm Homicides: A State-Level Panel Data Analysis. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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16
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Peters AW, Fatima I, Vervoort D, Shoman H, Ashraf MN, Meara JG, Samad L. Pakistani National Vision for Surgical Care 2025: A Series of Firsts. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.1092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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17
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Peters AW, Yorlets RR, Shrime MG, Alkire BC. Macroeconomic burden of firearm-related fatality across OECD countries: an estimate of annual and cumulative gross domestic product losses, 2018–30. The Lancet Global Health 2019. [DOI: 10.1016/s2214-109x(19)30121-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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18
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Siddiqui S, Vervoort D, Peters AW, Shoman H, Ashraf NM, Fatima I, Samad L. Closing the gap of children’s surgery in Pakistan. World Jnl Ped Surgery 2019. [DOI: 10.1136/wjps-2018-000027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Peters AW, Shrime MG, Alkire B. Macroeconomic Burden of Firearm Mortality in the US, United Kingdom, and Australia. J Am Coll Surg 2018. [DOI: 10.1016/j.jamcollsurg.2018.07.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Alkire BC, Peters AW, Shrime MG, Meara JG. The Economic Consequences Of Mortality Amenable To High-Quality Health Care In Low- And Middle-Income Countries. Health Aff (Millwood) 2018; 37:988-996. [DOI: 10.1377/hlthaff.2017.1233] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Blake C. Alkire
- Blake C. Alkire is an instructor in the Program in Global Surgery and Social Change, Harvard Medical School, and an instructor in otolaryngology, Massachusetts Eye and Ear Infirmary, both in Boston, Massachusetts. Alkire and Alexander Peters share credit as co–first authors
| | - Alexander W. Peters
- Alexander W. Peters is a research fellow in the Program in Global Surgery and Social Change, Harvard Medical School, and in the Department of Plastic and Oral Surgery, Boston Children’s Hospital, in Boston, Massachusetts; and a resident in surgery at the NewYork-Presbyterian/Weill Cornell Medical Center, in New York City. Peters and Blake Alkire share credit as co–first authors
| | - Mark G. Shrime
- Mark G. Shrime is an assistant professor of global health and social medicine and research director of the Program in Global Surgery and Social Change, Harvard Medical School, and an assistant professor of otolaryngology, Massachusetts Eye and Ear Infirmary
| | - John G. Meara
- John G. Meara is the Kletjian Professor of Global Surgery and director of the Program in Global Surgery and Social Change, Harvard Medical School, and plastic surgeon-in-chief, Department of Plastic and Oral Surgery, Boston Children’s Hospital
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21
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Avila JR, Peters AW, Li Z, Ortuño MA, Martinson ABF, Cramer CJ, Hupp JT, Farha OK. Atomic layer deposition of Cu(i) oxide films using Cu(ii) bis(dimethylamino-2-propoxide) and water. Dalton Trans 2018; 46:5790-5795. [PMID: 28406498 DOI: 10.1039/c6dt02572b] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
To grow films of Cu2O, bis-(dimethylamino-2-propoxide)Cu(ii), or Cu(dmap), is used as an atomic layer deposition precursor using only water vapor as a co-reactant. Between 110 and 175 °C, a growth rate of 0.12 ± 0.02 Å per cycle was measured using an in situ quartz crystal microbalance (QCM). X-ray photoelectron spectroscopy (XPS) confirms the growth of metal-oxide films featuring Cu(i).
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Affiliation(s)
- J R Avila
- Department of Chemistry, Northwestern University, 2145 Sheridan Road, Evanston, Illinois 60208, USA.
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22
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Till BM, Peters AW, Afshar S, Meara JG, Meara J. From blockchain technology to global health equity: can cryptocurrencies finance universal health coverage? BMJ Glob Health 2017; 2:e000570. [PMID: 29177101 PMCID: PMC5687531 DOI: 10.1136/bmjgh-2017-000570] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/27/2017] [Accepted: 10/28/2017] [Indexed: 11/25/2022] Open
Abstract
Blockchain technology and cryptocurrencies could remake global health financing and usher in an era global health equity and universal health coverage. We outline and provide examples for at least four important ways in which this potential disruption of traditional global health funding mechanisms could occur: universal access to financing through direct transactions without third parties; novel new multilateral financing mechanisms; increased security and reduced fraud and corruption; and the opportunity for open markets for healthcare data that drive discovery and innovation. We see these issues as a paramount to the delivery of healthcare worldwide and relevant for payers and providers of healthcare at state, national and global levels; for government and non-governmental organisations; and for global aid organisations, including the WHO, International Monetary Fund and World Bank Group.
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Affiliation(s)
- Brian M Till
- Robert Larner College of Medicine, University of Vermont, Burlington, Vermont, USA.,Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.,Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Alexander W Peters
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.,Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Surgery, Weill Cornell Medical Center, New York, New York, USA
| | - Salim Afshar
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.,Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | | | - John Meara
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA.,Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
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23
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Telles CJ, Decker SE, Motley WW, Peters AW, Mehr AP, Frizzell RA, Forrest JN. Functional and molecular identification of a TASK-1 potassium channel regulating chloride secretion through CFTR channels in the shark rectal gland: implications for cystic fibrosis. Am J Physiol Cell Physiol 2016; 311:C884-C894. [PMID: 27653983 DOI: 10.1152/ajpcell.00030.2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 09/18/2016] [Indexed: 11/22/2022]
Abstract
In the shark rectal gland (SRG), apical chloride secretion through CFTR channels is electrically coupled to a basolateral K+ conductance whose type and molecular identity are unknown. We performed studies in the perfused SRG with 17 K+ channel inhibitors to begin this search. Maximal chloride secretion was markedly inhibited by low-perfusate pH, bupivicaine, anandamide, zinc, quinidine, and quinine, consistent with the properties of an acid-sensitive, four-transmembrane, two-pore-domain K+ channel (4TM-K2P). Using PCR with degenerate primers to this family, we identified a TASK-1 fragment in shark rectal gland, brain, gill, and kidney. Using 5' and 3' rapid amplification of cDNA ends PCR and genomic walking, we cloned the full-length shark gene (1,282 bp), whose open reading frame encodes a protein of 375 amino acids that was 80% identical to the human TASK-1 protein. We expressed shark and human TASK-1 cRNA in Xenopus oocytes and characterized these channels using two-electrode voltage clamping. Both channels had identical current-voltage relationships (outward rectifying) and a reversal potential of -90 mV. Both were inhibited by quinine, bupivicaine, and acidic pH. The pKa for current inhibition was 7.75 for shark TASK-1 vs. 7.37 for human TASK-1, values similar to the arterial pH for each species. We identified this protein in SRG by Western blot and confocal immunofluorescent microscopy and detected the protein in SRG and human airway cells. Shark TASK-1 is the major K+ channel coupled to chloride secretion in the SRG, is the oldest 4TM 2P family member identified, and is the first TASK-1 channel identified to play a role in setting the driving force for chloride secretion in epithelia. The detection of this potassium channel in mammalian lung tissue has implications for human biology and disease.
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Affiliation(s)
- Connor J Telles
- Nephrology Division, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.,Mount Desert Island Biological Laboratory, Salisbury Cove, Maine
| | - Sarah E Decker
- Nephrology Division, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.,Mount Desert Island Biological Laboratory, Salisbury Cove, Maine
| | - William W Motley
- Nephrology Division, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.,Mount Desert Island Biological Laboratory, Salisbury Cove, Maine
| | - Alexander W Peters
- Nephrology Division, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.,Mount Desert Island Biological Laboratory, Salisbury Cove, Maine
| | - Ali Poyan Mehr
- Nephrology Division, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut.,Mount Desert Island Biological Laboratory, Salisbury Cove, Maine
| | - Raymond A Frizzell
- Department of Cell Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and.,Mount Desert Island Biological Laboratory, Salisbury Cove, Maine
| | - John N Forrest
- Nephrology Division, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut; .,Mount Desert Island Biological Laboratory, Salisbury Cove, Maine
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