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Shirangi A, Lin T, Iva Nova I, Yun G, Williamson GJ, Franklin P, Jian L, Burch R, Dewan A, Santos B, Eaton N, Xiao J. Exposure to fine particulate matter (PM2.5) during landscape fire events and the risk of cardiorespiratory emergency department attendances: a time-series study in Perth, Western Australia. J Epidemiol Community Health 2022; 76:jech-2021-218229. [PMID: 35853664 DOI: 10.1136/jech-2021-218229] [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] [Received: 10/21/2021] [Accepted: 06/08/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Landscape fires (LFs) are the main source of elevated particulate matter (PM2.5) in Australian cities and towns. This study examined the associations between daily exposure to fine PM2.5 during LF events and daily emergency department attendances (EDA) for all causes, respiratory and cardiovascular outcomes. METHODS Daily PM2.5 was estimated using a model that included PM2.5 measurements on the previous day, remotely sensed aerosols and fires, hand-drawn tracing of smoke plumes from satellite images, fire danger ratings and the atmosphere venting index. Daily PM2.5 was then categorised as high (≥99th percentile), medium (96th-98th percentile) and low (≤95th percentile). Daily EDA for all-cause and cardiorespiratory conditions were obtained from the Western Australian Emergency Department Data Collection. We used population-based cohort time-series multivariate regressions with 95% CIs to assess modelled daily PM2.5 and EDA associations from 2015 to 2017. We estimated the lag-specific associations and cumulative risk ratios (RR) at lags of 0-3 days, adjusted for sociodemographic factors, weather and time. RESULTS All-cause EDA and overall cardiovascular presentations increased on all lagged days and up to 5% (RR 1.05, 95% CI 1.03 to 1.06) and 7% (RR 1.07, 95% CI 1.01 to 1.12), respectively, at the high level. High-level exposure was also associated with increased acute lower respiratory tract infections at 1 (RR 1.19, 95% CI 1.10 to 1.29) and 3 (RR 1.17, 95% CI 1.10 to 1.23) days lags and transient ischaemic attacks at 1 day (RR 1.25, 95% CI 1.02 to 1.53) and 2 (RR 1.20, 95% CI 1.01 to 1.42) days lag. CONCLUSIONS Exposure to PM2.5 concentrations during LFs was associated with an increased risk of all-cause EDA, overall EDA cardiovascular diseases, acute respiratory tract infections and transient ischaemic attacks.
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Affiliation(s)
- Adeleh Shirangi
- Epidemiology Branch, Department of Health, Government of Western Australia, East Perth, WA, Australia
- School of Population Health, Curtin University, Bentley, WA, Australia
- College of Arts, Business, Law, and Social Sciences, Murdoch University, Murdoch, WA, Australia
| | - Ting Lin
- Epidemiology Branch, Department of Health, Government of Western Australia, East Perth, WA, Australia
| | - Ivana Iva Nova
- Department of Spatial Sciences, School of Earth Sciences, Curtin University, Bentley, WA, Australia
| | - Grace Yun
- Epidemiology Branch, Department of Health, Government of Western Australia, East Perth, WA, Australia
| | - Grant J Williamson
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Peter Franklin
- School of Population Health, University of Western Australia, Crawley, WA, Australia
| | - Le Jian
- Epidemiology Branch, Department of Health, Government of Western Australia, East Perth, WA, Australia
| | - Rowena Burch
- Epidemiology Branch, Department of Health, Government of Western Australia, East Perth, WA, Australia
| | - Ashraf Dewan
- Department of Spatial Sciences, School of Earth Sciences, Curtin University, Bentley, WA, Australia
| | - Bradley Santos
- Environmental Prediction Services - Severe Weather, Bureau of Meteorology (WA Office), West Perth, WA, Australia
| | | | - Jianguo Xiao
- Epidemiology Branch, Department of Health, Government of Western Australia, East Perth, WA, Australia
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2
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Jones MP, Yun G, Wass F, Rixon H, Shah A, Walker MM, Koloski NA, Holtmann G, Talley NJ, Beath AP. The role of mood state and emotion regulation in the discrepancy between gastrointestinal symptom burden recorded prospectively and via recall questionnaire. Neurogastroenterol Motil 2022; 34:e14304. [PMID: 34854512 DOI: 10.1111/nmo.14304] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/17/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND There is limited empirical evidence of the magnitude of the discrepancy between prospectively recorded gastrointestinal symptom burden and that reported in recall questionnaires. Further, potential sources of the discrepancy are largely unknown. This study sought to quantify the discrepancy and to evaluate the potential role of mood disorder and emotion regulation in the discrepancy. METHODS One hundred and forty nine subjects (mean age 20 years, 75% female) who met Rome IV criteria for irritable bowel syndrome and/or functional dyspepsia completed a 7-day prospective recording of the symptoms on a smartphone implemented ecological momentary assessment app, and then on day 8 were asked to recall their symptoms for the preceding 7 days. KEY RESULTS Gastrointestinal symptom burden assessed by recall was exaggerated relative to that recorded prospectively. The discrepancy was moderate for overall score (Cohen d = 0.52), abdominal pain (d = 0.61) and indigestion (d = 0.49). The discrepancy was generally larger among subjects who reported a physician diagnosis of a gastrointestinal condition with d = 0.87 for overall score and d = 0.89 for abdominal pain. A number of correlations between the discrepancy and psychological traits were identified, including neuroticism with diarrhea discrepancy (r = 0.23, p = 0.004) and visceral-specific anxiety with abdominal pain discrepancy (r = -0.18, p = 0.03). There was no evidence of recency or Hawthorne (observer) effects. CONCLUSIONS AND INFERENCES Reports of gastrointestinal symptoms obtained via recall are likely to be exaggerated relative to the actual patient experience, particularly among healthcare seekers. While psychological traits are likely to play some role, much more needs to be understood about the discrepancy.
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Affiliation(s)
- Michael P Jones
- School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Grace Yun
- School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Fiona Wass
- School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Hayley Rixon
- School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
| | - Ayesha Shah
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI), Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Marjorie M Walker
- College of Health, Medicine and Well Being, University of Newcastle, Newcastle, New South Wales, Australia
| | - Natasha A Koloski
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI), Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.,College of Health, Medicine and Well Being, University of Newcastle, Newcastle, New South Wales, Australia
| | - Gerald Holtmann
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital and Translational Research Institute (TRI), Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Nicholas J Talley
- College of Health, Medicine and Well Being, University of Newcastle, Newcastle, New South Wales, Australia
| | - Alissa P Beath
- School of Psychological Sciences, Macquarie University, North Ryde, New South Wales, Australia
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Shirangi A, Xiao A, Ongee E, Ivánová I, Dewan A, Franklin P, Santos B, Yun G, Jian L, Ting L, Eaton N, Ball S, Clappinson L, Burch R, Fievez P. 131Spatio-temporal analysis to assess health effects of landscape fire smoke: an empirical model. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Understanding the health effects of smoke from landscape fires (LFs), including wildfires and prescribed burns, is limited due to lack of adequate smoke exposure measures.
Methods
We used the reported LFs to determine smoke plume shapes from satellite images. Daily remotely sensed fire radiative power, aerosol optical depth, smoke plumes, fire danger rating, venting index and previous day PM 2.5 were then used to estimate smoke-related particulate matter 2.5 (PM2.5). A population based time series design was used to assess associations between smoke-related PM2.5 and selected adverse health outcomes such as hospital admissions, emergency department visits and ambulance callouts.
Results
We found a significant dose-response relationship between increased smoke-related PM2.5 concentration and 1% to 5% increase for total emergency department attendances and total hospital admissions on the same day and the lag effects of 3 days where the PM2.5 was at medium level (95-98th percentile) and high level ( > =99th percentile) compared to the low level (<95th percentile). There was also 1% to 25% increased risk for individuals who were exposed to high level LF smoke with selected respiratory and cardiovascular diseases in selected health care utilisations.
Conclusions
Exposure to LF smoke at a high level was spatio-temporally associated with a wide range of adverse respiratory and cardiovascular diseases in selected health care utilisations.
Key messages
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Affiliation(s)
| | - Alex Xiao
- Department Of Health WA, East Perth, Australia
| | | | | | | | | | - Brad Santos
- Australian Bureau of Meteorology (WA Office), West Perth, Australia
| | - Grace Yun
- Department Of Health WA, East Perth, Australia
| | - Le Jian
- Department Of Health WA, East Perth, Australia
| | - Lin Ting
- Department Of Health WA, East Perth, Australia
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4
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Patel D, Jian L, Xiao J, Jansz J, Yun G, Lin T, Pereira G, Robertson A. 475Machine learning approach: identifying the impact of heatwaves and air quality on children’s health. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heatwaves, air pollution and their effects on children’s health can vary temporally and spatially. With the emergence of advanced methods such as machine learning, there is an opportunity to improve prediction of children’s health events associated with those exposures.
Methods
Daily records on emergency department attendances (EDA) for children <15 years, heatwaves, landscape fire burns and air pollutants (CO, SO2, NO2, O3, PM10, PM2.5) were collected for Western Australia, 2006-2015. Decision tree, random forest (RF) and geographical RF (GRF) were compared to predict EDA, identify important risk factors and locations at elevated risk. Validation was performed by comparing actual and predicted EDA.
Results
RF was the best model with the lowest root mean squared error (MSE). The best RF validation model had an r-squared (R2) =0.95. The percentage increase in MSE indicated that PM10 and PM2.5 were important predictors of EDA for all children. Number of burns was more important in 5-9 year age group than other groups. GRF models (R2 0.90-0.98) showed that heatwave and PM2.5 were the important predictors in southern part of the study area for all age groups.
Conclusions
The importance of risk factors to predict EDA was varied by age groups and locations. Such differences are important when developing targeted health promotion strategies tailored to age groups and geographical locations.
Key messages
RF predicted EDA better than other models. Evaluation of spatial variation of heatwave and air quality effects on EDA for children by GRF modelling is useful to identify at risk geographical locations.
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Affiliation(s)
| | - Le Jian
- Department of Health WA, Perth, Australia
- Curtin University, Perth, Australia
| | | | | | - Grace Yun
- Department of Health WA, Perth, Australia
| | - Ting Lin
- Department of Health WA, Perth, Australia
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5
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Horning MP, Delahunt CB, Bachman CM, Luchavez J, Luna C, Hu L, Jaiswal MS, Thompson CM, Kulhare S, Janko S, Wilson BK, Ostbye T, Mehanian M, Gebrehiwot R, Yun G, Bell D, Proux S, Carter JY, Oyibo W, Gamboa D, Dhorda M, Vongpromek R, Chiodini PL, Ogutu B, Long EG, Tun K, Burkot TR, Lilley K, Mehanian C. Performance of a fully-automated system on a WHO malaria microscopy evaluation slide set. Malar J 2021; 20:110. [PMID: 33632222 PMCID: PMC7905596 DOI: 10.1186/s12936-021-03631-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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] [Received: 10/17/2020] [Revised: 02/04/2021] [Accepted: 02/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Manual microscopy remains a widely-used tool for malaria diagnosis and clinical studies, but it has inconsistent quality in the field due to variability in training and field practices. Automated diagnostic systems based on machine learning hold promise to improve quality and reproducibility of field microscopy. The World Health Organization (WHO) has designed a 55-slide set (WHO 55) for their External Competence Assessment of Malaria Microscopists (ECAMM) programme, which can also serve as a valuable benchmark for automated systems. The performance of a fully-automated malaria diagnostic system, EasyScan GO, on a WHO 55 slide set was evaluated. METHODS The WHO 55 slide set is designed to evaluate microscopist competence in three areas of malaria diagnosis using Giemsa-stained blood films, focused on crucial field needs: malaria parasite detection, malaria parasite species identification (ID), and malaria parasite quantitation. The EasyScan GO is a fully-automated system that combines scanning of Giemsa-stained blood films with assessment algorithms to deliver malaria diagnoses. This system was tested on a WHO 55 slide set. RESULTS The EasyScan GO achieved 94.3 % detection accuracy, 82.9 % species ID accuracy, and 50 % quantitation accuracy, corresponding to WHO microscopy competence Levels 1, 2, and 1, respectively. This is, to our knowledge, the best performance of a fully-automated system on a WHO 55 set. CONCLUSIONS EasyScan GO's expert ratings in detection and quantitation on the WHO 55 slide set point towards its potential value in drug efficacy use-cases, as well as in some case management situations with less stringent species ID needs. Improved runtime may enable use in general case management settings.
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Affiliation(s)
- Matthew P Horning
- Global Health Labs (formerly at Intellectual Ventures Laboratory/Global Good), 14360 SE Eastgate Way, Bellevue, WA, 98007, USA.
| | - Charles B Delahunt
- Global Health Labs (formerly at Intellectual Ventures Laboratory/Global Good), 14360 SE Eastgate Way, Bellevue, WA, 98007, USA.,Applied Math Department, University of Washington, Seattle, WA, 98195, USA
| | - Christine M Bachman
- Global Health Labs (formerly at Intellectual Ventures Laboratory/Global Good), 14360 SE Eastgate Way, Bellevue, WA, 98007, USA
| | | | - Christian Luna
- Research Institute for Tropical Medicine, Muntinlupa, Philippines
| | - Liming Hu
- Global Health Labs (formerly at Intellectual Ventures Laboratory/Global Good), 14360 SE Eastgate Way, Bellevue, WA, 98007, USA
| | - Mayoore S Jaiswal
- formerly Intellectual Ventures Laboratory, 3150 139th AVE SE, Bellevue, WA, 98005, USA
| | | | - Sourabh Kulhare
- Global Health Labs (formerly at Intellectual Ventures Laboratory/Global Good), 14360 SE Eastgate Way, Bellevue, WA, 98007, USA
| | | | - Benjamin K Wilson
- Global Health Labs (formerly at Intellectual Ventures Laboratory/Global Good), 14360 SE Eastgate Way, Bellevue, WA, 98007, USA
| | - Travis Ostbye
- Global Health Labs (formerly at Intellectual Ventures Laboratory/Global Good), 14360 SE Eastgate Way, Bellevue, WA, 98007, USA
| | - Martha Mehanian
- Global Health Labs (formerly at Intellectual Ventures Laboratory/Global Good), 14360 SE Eastgate Way, Bellevue, WA, 98007, USA
| | - Roman Gebrehiwot
- formerly Intellectual Ventures Laboratory, 3150 139th AVE SE, Bellevue, WA, 98005, USA
| | - Grace Yun
- formerly Intellectual Ventures Laboratory, 3150 139th AVE SE, Bellevue, WA, 98005, USA
| | - David Bell
- Independent Consultant, Issaquah, WA, USA
| | - Stephane Proux
- Shoklo Malaria Research Unit, Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand
| | | | | | - Dionicia Gamboa
- Laboratorios de Investigacion y Desarrollo, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Mehul Dhorda
- World Wide Antimalarial Resistance Network and Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Ranitha Vongpromek
- Infectious Diseases Data Observatory and World Wide Antimalarial Resistance Network, Asia- Pacific Regional Centre, Bangkok, Thailand
| | - Peter L Chiodini
- Hospital for Tropical Diseases and the London School of Hygiene and Tropical Medicine, London, UK
| | | | - Earl G Long
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kyaw Tun
- Defence Services Medical Academy, Mingaladon, Myanmar
| | - Thomas R Burkot
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Ken Lilley
- Australian Defence Force Malaria and Infectious Disease Institute, Enoggera, Australia
| | - Courosh Mehanian
- Global Health Labs (formerly at Intellectual Ventures Laboratory/Global Good), 14360 SE Eastgate Way, Bellevue, WA, 98007, USA
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Muller J, Alizadeh M, Li L, Thalheimer S, Matias C, Tantawi M, Miao J, Silverman M, Zhang V, Yun G, Romo V, Mohamed FB, Wu C. Feasibility of diffusion and probabilistic white matter analysis in patients implanted with a deep brain stimulator. Neuroimage Clin 2019; 25:102135. [PMID: 31901789 PMCID: PMC6948366 DOI: 10.1016/j.nicl.2019.102135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/27/2019] [Accepted: 12/13/2019] [Indexed: 01/03/2023]
Abstract
Deep brain stimulation (DBS) for Parkinson's disease (PD) is an established advanced therapy that produces therapeutic effects through high frequency stimulation. Although this therapeutic option leads to improved clinical outcomes, the mechanisms of the underlying efficacy of this treatment are not well understood. Therefore, investigation of DBS and its postoperative effects on brain architecture is of great interest. Diffusion weighted imaging (DWI) is an advanced imaging technique, which has the ability to estimate the structure of white matter fibers; however, clinical application of DWI after DBS implantation is challenging due to the strong susceptibility artifacts caused by implanted devices. This study aims to evaluate the feasibility of generating meaningful white matter reconstructions after DBS implantation; and to subsequently quantify the degree to which these tracts are affected by post-operative device-related artifacts. DWI was safely performed before and after implanting electrodes for DBS in 9 PD patients. Differences within each subject between pre- and post-implantation FA, MD, and RD values for 123 regions of interest (ROIs) were calculated. While differences were noted globally, they were larger in regions directly affected by the artifact. White matter tracts were generated from each ROI with probabilistic tractography, revealing significant differences in the reconstruction of several white matter structures after DBS. Tracts pertinent to PD, such as regions of the substantia nigra and nigrostriatal tracts, were largely unaffected. The aim of this study was to demonstrate the feasibility and clinical applicability of acquiring and processing DWI post-operatively in PD patients after DBS implantation. The presence of global differences provides an impetus for acquiring DWI shortly after implantation to establish a new baseline against which longitudinal changes in brain connectivity in DBS patients can be compared. Understanding that post-operative fiber tracking in patients is feasible on a clinically-relevant scale has significant implications for increasing our current understanding of the pathophysiology of movement disorders, and may provide insights into better defining the pathophysiology and therapeutic effects of DBS.
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Affiliation(s)
- J Muller
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States.
| | - M Alizadeh
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - L Li
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - S Thalheimer
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - C Matias
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - M Tantawi
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - J Miao
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - M Silverman
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - V Zhang
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - G Yun
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States
| | - V Romo
- Department of Anesthesiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - F B Mohamed
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - C Wu
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, United States
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Patel D, Jian L, Xiao J, Jansz J, Yun G, Lin T, Robertson A. Joint effects of heatwaves and air quality on ambulance services for vulnerable populations in Perth, western Australia. Environ Pollut 2019; 252:532-542. [PMID: 31170565 DOI: 10.1016/j.envpol.2019.05.125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/24/2019] [Accepted: 05/24/2019] [Indexed: 06/09/2023]
Abstract
As the frequency, intensity, and duration of heatwaves increases, emergency health serviceutilization, including ambulance service, has correspondingly increased across the world. The negative effects of air pollution on health complicate these adverse health effects. This research work is the first known study to analyze the joint effects of heatwaves and air quality on the ambulance service in Western Australia (WA). The main objective is to investigate the potential joint effects of heatwaves and air quality on the ambulance service for vulnerable populations in the Perth metropolitan area. A time series design was used. Daily data on ambulance callouts, temperature and air pollutants (CO, SO2, NO2, O3, PM10 and PM2.5) were collected for the Perth metropolitan area, WA from 2006 to 2015. Poisson regression modeling was used to assess the association between heatwaves, air quality, and ambulance callouts. Risk assessments on age, gender, socio-economic status (SES), and joint effects between heatwaves and air quality on ambulance callouts were conducted. The ambulance callout rate was higher during heatwave days (14.20/100,000/day) compared to non-heatwave days (13.95/100,000/day) with a rate ratio of 1.017 (95% confidence interval 1.012, 1.023). The ambulance callout rate was higher in males, people over 60 years old, people with low SES, and those living in coastal areas during period of heatwaves. Exposure to CO, SO2, O3 and PM2.5 increased risk on ambulance callouts and exposure to NO2 showed joint effect with heatwave and increased risk of ambulance callouts by 3% after adjustment of all other risk factors. Ambulance callouts are an important indicator for evaluating heatwave-related emergency morbidity in WA. As the median concentrations of air pollutants in WA were lower than the Australian National Standards, the interactive effects of heatwaves and air quality on ambulance service need to be further examined, especially when air pollutants exceed the standards.
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Affiliation(s)
- Dimpalben Patel
- School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Le Jian
- Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia; School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Jianguo Xiao
- Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Janis Jansz
- School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Grace Yun
- Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Ting Lin
- Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Andrew Robertson
- Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
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Patel D, Jian L, Xiao J, Jansz J, Yun G, Robertson A. Joint effect of heatwaves and air quality on emergency department attendances for vulnerable population in Perth, Western Australia, 2006 to 2015. Environ Res 2019; 174:80-87. [PMID: 31054525 DOI: 10.1016/j.envres.2019.04.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/14/2019] [Accepted: 04/14/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND As global warming and the frequency and intensity of heatwaves increases, health service utilization, including emergency department attendances (EDA) have correspondingly increased across the world. The impact of air quality on health adds to the complexity of the effects. Potential joint effects between heatwaves and air quality on EDA have been rarely reported in the literature, prompting this study. OBJECTIVES To investigate the potential joint effect of heatwaves and air quality on the EDA for vulnerable populations in the Perth metropolitan area, Western Australia. METHODS A time series design was used. Daily data on EDA, heatwaves (excess heat factor>0) and air pollutants (CO, SO2, NO2, O3, PM10 and PM2.5) were collected for Perth, Western Australia from 2006 to 2015. Poisson regression modelling was used to assess the associations between heatwaves, air quality, and EDA. Risk assessments on age, gender, Aboriginality, socio-economic status (SES), and joint effect between heatwaves and air quality on EDA were conducted. RESULTS The EDA rate was higher in heatwave days (77.86/100,000/day) compared with non-heatwave days (73.90/100,000/day) with rate ratio of 1.053 (95% confidence interval 1.048, 1.058). The EDA rate was higher in males, people older than 60 years or younger than 15 years, Aboriginal people, and people with low SES. Exposure to CO, SO2, O3 and PM2.5 increased risk on EDA and exposure to PM2.5 showed joint effect with heatwave and increased risk of EDA by 6.6% after adjustment of all other risk factors. CONCLUSIONS EDA is an important indicator to evaluate heatwave related morbidity for emergency medical service as EDA rate increased during heatwaves with relative high concentrations of air pollutants. As all air pollutants measured in the study were lower than the Australian National Standards, the joint effect of heatwaves and air quality needs to be further examined when it exceeds the standards.
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Affiliation(s)
- Dimpalben Patel
- School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Le Jian
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia; School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Jianguo Xiao
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Janis Jansz
- School of Public Health, Curtin University, Perth, Western Australia, Australia.
| | - Grace Yun
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
| | - Andrew Robertson
- Epidemiology Branch, Public and Aboriginal Health Division, Department of Health, East Perth, Western Australia, Australia.
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Sabot R, Giacalone JC, Nam Y, Berne A, Brun C, Elbèze D, Faisse F, Gargiulo L, Kim M, Lee W, Lotte P, Park HK, Santraine B, Yun G. Development of Microwave Imaging Diagnostics for WEST Tokamak. J Fusion Energ 2019. [DOI: 10.1007/s10894-019-00216-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Moreau P, Bucalossi J, Missirlian M, Samaille F, Courtois X, Gil C, Lotte P, Meyer O, Nardon E, Nouailletas R, Ravenel N, Travere J, Alarcon T, Antusch S, Aumeunier M, Barjat P, Belsare S, Bernard J, Bhandarkar M, Bottereau C, Bourdelle C, Brémond S, Camenen Y, Chaudhari V, Chavda C, Chernyshova M, Clairet F, Colnel J, Czarski T, Choi M, Colledani G, Corre Y, Daniel R, Davis D, Dejarnac R, Devynck P, Dhongde J, Douai D, Elbeze D, Escarguel A, Fenzi C, Figacz W, Guangwu Z, Giacalone J, Guirlet R, Gunn J, Hacquin S, Hao X, Harris J, Hoang G, Houry M, Imbeaux F, Jablonski S, Jardin A, Joshi H, Kasprowicz G, Klepper C, Kowalska-Strzeciwilk E, Kubkowska M, Kumar A, Kumar V, Kumari P, Laqua H, Le-Luyer A, Lee W, Lewerentz M, Lyu B, Malard P, Manenc L, Mansuri I, Marandet Y, Masand H, Mazon D, Molina D, Moureau G, Nam Y, Park H, Pascal J, Patel K, Patel M, Pozniak K, Radloff D, Ranjan S, Rapson C, Raupp G, Rieth M, Sabot R, Santraine B, Sestac D, Sharma M, Shen J, Signoret J, Soni J, Spring A, Spuig P, Sugandhi R, Treuterrer W, Tsitrone E, Varshney S, Vartanian S, Volpe D, Wang F, Werner A, Yun G, Zabolotny W, Zhao W. Measurements and controls implementation for WEST. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.01.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chung CJ, Suarez CE, Bandaranayaka-Mudiyanselage CL, Bandaranayaka-Mudiyanselage CB, Rzepka J, Heiniger TJ, Chung G, Lee SS, Adams E, Yun G, Waldron SJ. A novel modified-indirect ELISA based on spherical body protein 4 for detecting antibody during acute and long-term infections with diverse Babesia bovis strains. Parasit Vectors 2017; 10:77. [PMID: 28193250 PMCID: PMC5307855 DOI: 10.1186/s13071-017-2016-9] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 02/07/2017] [Indexed: 11/20/2022] Open
Abstract
Background Cattle persistently infected with Babesia bovis are reservoirs for intra- and inter-herd transmission. Since B. bovis is considered a persistent infection, developing a reliable, high-throughput assay that detects antibody during all stages of the infection could be pivotal for establishing better control protocols. Methods A modified indirect enzyme-linked immunosorbent assay (MI-ELISA) was developed using the spherical body protein-4 (SBP4) of B. bovis to detect antibody against diverse strains through all infection stages in cattle. This SBP4 MI-ELISA was evaluated for sensitivity and specificity against field sera from regions with endemic and non-endemic B. bovis. Sera were also evaluated from cattle infected experimentally with various doses and strains during acute and persistent infection with parasitemia defined by nested PCR. Results The format variables for SBP4 MI-ELISA were optimized and the cutoff for positive and negative interpretation was determined based on receiver operating characteristic curve analysis using B. bovis positive and negative sera tested in the reference immunofluorescence assay (IFA). The diagnostic specificity of the SBP4 MI-ELISA using IFA-negative sera collected from Texas was 100%, significantly higher than the cELISA (90.4%) based on an epitope in the rhoptry-associated protein-1 (RAP-1 cELISA). The diagnostic sensitivity of the SBP4 MI-ELISA was 98.7% using the IFA-positive sera collected from several areas of Mexico, in contrast to that of the RAP-1 cELISA at 60% using these same sera. In cattle infected with low and high doses of three B. bovis strains, the SBP4 MI-ELISA remained antibody positive for 11 months or more after initial detection at 10 to 13 days post-inoculation. However, the RAP-1 cELISA did not reliably detect antibody after eight months post-inoculation despite the fact that parasitemia was occasionally detectable by PCR. Furthermore, initial antibody detection by RAP-1 cELISA in low-dose infected animals was delayed approximately nine and a half days compared to the SBP4 MI-ELISA. Conclusions These results demonstrate excellent diagnostic sensitivity and specificity of the novel SBP4 MI-ELISA for cattle with acute and long-term carrier infections. It is posited that use of this assay in countries that have B. bovis-endemic herds may be pivotal in preventing the spread of this disease to non-endemic herds. Electronic supplementary material The online version of this article (doi:10.1186/s13071-017-2016-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chungwon J Chung
- Washington State University, Pullman, WA, USA. .,VMRD, Inc., Pullman, WA, USA.
| | - Carlos E Suarez
- Washington State University, Pullman, WA, USA.,USDA-ADRU, Pullman, WA, USA
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Jardine A, Mullan N, Gudes O, Cosford J, Moncrieff S, West G, Xiao J, Yun G, Someford P. Web-based geo-visualisation of spatial information to support evidence-based health policy: a case study of the development process of HealthTracks. Health Inf Manag 2015; 43:7-16. [PMID: 24948661 DOI: 10.1177/183335831404300202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Place is of critical importance to health as it can reveal patterns of disease spread and clustering, associations with risk factors, and areas with greatest need for, or least access to healthcare services and promotion activities. Furthermore, in order to get a good understanding of the health status and needs of a particular area a broad range of data are required which can often be difficult and time consuming to obtain and collate. This process has been expedited by bringing together multiple data sources and making them available in an online geo-visualisation, HealthTracks, which consists of a mapping and reporting component. The overall aim of the HealthTracks project is to make spatial health information more accessible to policymakers, analysts, planners and program managers to inform decision-making across the Department of Health Western Australia. Preliminary mapping and reporting applications that have been utilised to inform service planning, increased awareness of the utility of spatial information and improved efficiency in data access were developed. The future for HealthTracks involves expanding the range of data available and developing new analytical capabilities in order to work towards providing external agencies, researchers and eventually the general public access to rich local area spatial data.
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Affiliation(s)
| | | | - Ori Gudes
- Curtin University, Perth, WA, Australia
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Ro J, Kim H, Hwang SH, Yun G, Lee J. Impact of pharmaceutical excipients on in vitro association of saquinavir to chylomicrons. Pharmazie 2014; 69:745-746. [PMID: 25985563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study was performed to investigate the impact of pharmaceutical excipients commonly used for lymphatic transport on in vitro drug association with chylomicrons (CM). A CM association study was conducted using saquinavir solubilized in four different pharmaceutical excipients. We observed a linear relationship between saquinavir solubility and drug association, suggesting that the solubility of saquinavir in excipients is a key determinant for successful lymphatic delivery. Broadly, these results suggest that excipients with good solubilization properties may be advantageous for enhancing lymphatic drug delivery.
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Miller LJ, Joyce S, Carter S, Yun G. Associations between childhood obesity and the availability of food outlets in the local environment: a retrospective cross-sectional study. Am J Health Promot 2013; 28:e137-45. [PMID: 24200247 DOI: 10.4278/ajhp.130214-quan-70] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Examine whether individual-level childhood obesity is related to residential availability of fast food and healthy food outlets. DESIGN Retrospective cross-sectional study. SETTING Perth, Western Australia. SUBJECTS A total of 1850 children aged 5 to 15 years in 2005-2010 who participated in the Western Australian Health and Wellbeing Surveillance System survey. MEASURES Geographical Information Systems were used to calculate a range of measures of fast food and healthy food outlet access and availability. For example, distance to nearest and access and density measures within 800 m and 3 km of each child's residence were all tested. ANALYSIS Multivariate logistic regression analysis, controlling for individual-level sociodemographic factors and lifestyle behaviors. RESULTS An increasing number of healthy food outlets within 800 m of a child's home was associated with a significantly reduced risk of being overweight/obese in all models tested. After controlling for age, physical activity, time spent sedentary, weekly takeaway consumption, area disadvantage, and count of fast food outlets, each additional healthy food outlet within 800 m was associated with a 20% decrease in the likelihood of a child being overweight or obese (odds ratio: .800, 95% confidence intervals: .686-.933). CONCLUSION The local food environment around children's homes has an independent effect on child weight status. These findings highlight the importance of the built environment as a potential contributor towards child health, which should be considered when developing community health promotion programs.
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Ping Y, Tao G, Yun-zhu P, Yu W, Ping Z, Hong-yan C, Zhi-ling L, Ling Z, Yun G, Hong-wen Y. A randomised, double-blind and placebo-controlled study of the extracorporeal cardiac shock wave therapy for coronary artery disease. Heart 2011. [DOI: 10.1136/heartjnl-2011-300867.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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McIver L, Xiao J, Lindsay MDA, Rowe T, Yun G. A climate-based early warning system to predict outbreaks of Ross River virus disease in the Broome region of Western Australia. Aust N Z J Public Health 2010; 34:89-90. [PMID: 20920112 DOI: 10.1111/j.1753-6405.2010.00480.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Arun B, Logan C, Yin G, Yun G, Hortobagyi GG, Browne D, Sneige N. Phase II prevention trial of celecoxib in women at increased risk for breast cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.1501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1501 Background: Tamoxifen and raloxifen reduce the risk of estrogen receptor (ER) positive breast cancer. Acceptance of SERMs is low due to toxicities. New agents with a better toxicity profile which also will prevent ER-negative breast cancer are needed. The cyclooxygenase II inhibitor celecoxib has antiproliferative, and antiangiogenetic properties and is a putative breast cancer prevention agent. Our objective in this prospective short-term prevention study was to evaluate the effect of celecoxib on biomarkers in breast tissue and serum of high risk women. Methods: High risk individuals with a history of atypical hyperplasia, or lobular carcinoma insitu, or Gail risk greater than 1.67%, or previous history of ER negative breast cancer were eligible. After signing informed consent subjects underwent baseline fine needle aspiration (FNA) of the breast and serum collection for biomarker analysis. Subjects started celecoxib at 400 mg po BID for 6 months and underwent repeat FNA and serum collection. Biomarker endpoints included changes in ER and KI-67 expression in breast tissue analyzed by immunohistochemistry and insulin like growth factor binding protein (IGFBP-1) in serum analyzed by ELISA. The difference in biomarkers before and after treatment was assessed using a Wilcoxon signed rank test. Results: 49 patients were enrolled and accrual has been completed. Median age was 51 years and 57% of women were postmenopausal. The mean pre- and post treatment ER expression was 35.5% and 31%, respectively. The difference in ER expression was not significant (p = 0.1). The mean pre- and post treatment KI-67 expression was 1.68% and 1.60%, respectively. The difference was not significant (p = 0.8). However, there was a statistically significant difference in pre- and post treatment IGFBP-1 levels (p=0.023), with pre-and post treatment levels being 6.81ng/ml and 11.51ng/ml, respectively. No grade 3 or 4 toxicities were observed and there was no drop-out from the study. Conclusions: We have found a significant modulation of IGFBP-1 levels with 6 months celecoxib treatment in women who are at increased risk of developing breast cancer. The acceptable side effect profile and modulation of the biomarker (IGFBP-1) provides support for continued evaluation of celecoxib as a breast cancer prevention agent. No significant financial relationships to disclose.
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Affiliation(s)
- B. Arun
- UT MD Anderson Cancer Ctr, Houston, TX; National Cancer Institute, Bethesda, MD
| | - C. Logan
- UT MD Anderson Cancer Ctr, Houston, TX; National Cancer Institute, Bethesda, MD
| | - G. Yin
- UT MD Anderson Cancer Ctr, Houston, TX; National Cancer Institute, Bethesda, MD
| | - G. Yun
- UT MD Anderson Cancer Ctr, Houston, TX; National Cancer Institute, Bethesda, MD
| | - G. G. Hortobagyi
- UT MD Anderson Cancer Ctr, Houston, TX; National Cancer Institute, Bethesda, MD
| | - D. Browne
- UT MD Anderson Cancer Ctr, Houston, TX; National Cancer Institute, Bethesda, MD
| | - N. Sneige
- UT MD Anderson Cancer Ctr, Houston, TX; National Cancer Institute, Bethesda, MD
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Mahady GB, Pendland SL, Yun G, Lu ZZ. Turmeric (Curcuma longa) and curcumin inhibit the growth of Helicobacter pylori, a group 1 carcinogen. Anticancer Res 2002; 22:4179-81. [PMID: 12553052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND Curcumin, a polyphenolic chemical constituent derived from turmeric (Curcuma longa), has been shown to prevent gastric and colon cancers in rodents. Many mechanisms have been proposed for the chemopreventative effects, although the effect of curcumin on the growth of Helicobacter pylori has not been reported. H. pylori is a Group 1 carcinogen and is associated with the development of gastric and colon cancer. MATERIALS AND METHODS A methanol extract of the dried powdered turmeric rhizome and curcumin were tested against 19 strains of H. pylori, including 5 cagA+ strains. RESULTS Both the methanol extract and curcumin inhibited the growth of all strains of H. pylori in vitro with a minimum inhibitory concentration range of 6.25-50 micrograms/ml. CONCLUSION These data demonstrate that curcumin inhibits the growth of H. pylori cagA+ strains in vitro, and this may be one of the mechanisms by which curcumin exerts its chemopreventative effects.
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Affiliation(s)
- G B Mahady
- Department of Pharmacy Practice, College of Pharmacy, WHO Collaborating Centre for Traditional Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Yong EL, Ng SC, Roy AC, Yun G, Ratnam SS. Pregnancy after hormonal correction of severe spermatogenic defect due to mutation in androgen receptor gene. Lancet 1994; 344:826-7. [PMID: 7993455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Zeng S, Hu C, Wei H, Lu Y, Zhang Y, Yang J, Yun G, Zou W, Song B. Intravitreal pharmacokinetics of liposome-encapsulated amikacin in a rabbit model. Ophthalmology 1993; 100:1640-4. [PMID: 8233389 DOI: 10.1016/s0161-6420(93)31423-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [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: 01/29/2023] Open
Abstract
BACKGROUND Intravitreal injection of antibiotics has become a standard therapy for bacterial endophthalmitis. The duration of effective antimicrobial levels in the vitreous after single injection, however, may not be long enough to get optimal response. The authors prepared liposome-encapsulated amikacin for prolonging the duration of intravitreal therapeutic concentrations and investigated the intravitreal pharmacokinetics of the liposomes and amikacin in phosphate buffer solution (PBS) as control. METHODS The liposome-encapsulated amikacin was prepared by reverse-phase evaporation method. The intravitreal pharmacokinetics of the liposomes was compared with amikacin in PBS by fluorescence polarization immunoassay. Albino rabbits were randomly distributed into 12 groups. Rabbits in groups 1 to 6 and in groups I to VI (control groups) received an intravitreal injection of the liposome-encapsulated amikacin and amikacin in PBS, respectively. RESULTS The encapsulation rate of amikacin was 91%. The time of 50% spontaneous degradation (half-life) of the liposomes in PBS (38 degrees C, pH 7.4) was 47.6 days, and the time of 50% release (half-life) of the drug from the liposomes in PBS was 84.8 hours. The vitreous amikacin concentrations in groups 1 to 6 were significantly greater (P < 0.05) than those in control groups I to VI in every time interval, except in groups 1 to 3 at 1 hour after injection. The difference was particularly obvious in the endophthalmitis groups. The clearance of encapsulated amikacin in vitreous appeared to be related to the state of blood-ocular barrier and to the structural integrity of vitreous. The distribution, the absorption, and the elimination of encapsulated amikacin in vitreous showed the first-order kinetics. CONCLUSION The liposome-encapsulated amikacin prolonged half-life of the drug in vitreous. The results of the pharmacokinetic analysis suggested that in endophthalmitis, especially in severe cases, the liposomes may be preferable to conventional preparation.
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Affiliation(s)
- S Zeng
- Department of Ophthalmology, Union Hospital, Tongji Medical University, Wuhan, People's Republic of China
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Qian RL, Feng JG, Yun G. [Causes of death and prognosis of myocardial infarction in patients with diabetes]. Zhonghua Nei Ke Za Zhi 1989; 28:469-72, 509. [PMID: 2598729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The long-term prognosis and causes of death of myocardial infarction (MI) in 62 patients with diabetes were studied. The mean follow-up time was 6.2 years. 11 cases died in the acute period of MI (8 weeks following onset of AMI), 9 cases of them (81.8%) had anterior infarction and their major causes of death were ventricular fibrillation and cardiogenic shock (72.2%). 19 cases died in the follow-up period, among them 14 cases (73.68%) had inferior and anterior-septal infarction; most of them died of reinfarction and sudden death. The cumulative survival rate 1.2 and 5 years after MI was 80.7%, 71.9% and 57.9%, respectively. The blood glucose level of the fatal group and the level of CPK and GOT of patients who died in the acute period were higher than those in the surviving group. The results suggest that treatment of myocardial infarction in patients with diabetes be more attentive to prevent ventricular fibrillation and cardiogenic shock during the acute period. After the acute period more attention should be paid to prevent reinfarction and and drop the blood glucose level at normal as possible.
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