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Ahmed K, Thornton M, Taylor SJG. Mechanical load applied by Intraosseous Transcutaneous Amputation Prosthesis (ITAP) during walking on level and sloped treadmill: A case study. Med Eng Phys 2024; 124:104097. [PMID: 38418026 DOI: 10.1016/j.medengphy.2023.104097] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 03/01/2024]
Abstract
This proof of concept study presents a method to collect and analyse kinetic data from one participant with a transfemoral amputation fitted with a percutaneous osseointegrated implant walking on a level and sloped treadmill. We describe the construction of and results from a bespoke wireless six axis load cell built into one participant's prosthetic assembly. The load cell does not clinically compromise the participant in any way and is an initial milestone in the development of a light-weight wireless load cell for use with percutaneous osseointegrated implants. In this case, it is the first time that kinetic data from a participant fitted with an Intraosseous Transcutaneous Amputation Prosthesis has been published. We propose that the data can be used to model the load transfer to the host bone, with several clinically significant applications. The raw dynamic data are made available and quasi-static load cases for each functional phase of gait are presented. Peak forces obtained in the medio-lateral (X), cranio-caudal (Y) and antero-posterior (Z) axes over level ground respectively were -243.8 N (0.24 BW), 1321.5 N (1.31 BW) and -421.8 N (0.42 BW); uphill were -141.0 N (0.14 BW), 1604.2 N (1.59 BW), -498.1 N (0.49 BW); downhill were -206.0 N (0.20 BW), 1103.9 N (1.09 BW), -547.2 N (0.54 BW). The kinetics broadly followed able bodied gait patterns with some gait strategies consistent in participants with other implant designs or prosthetic socket connections, for example offloading the artificial limb downhill.
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Affiliation(s)
- K Ahmed
- Department of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK; Center for Bionics and Pain Research, Mölndals Sjukhus, 431 30 Sweden.
| | - M Thornton
- Department of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK; Motor Learning Laboratory, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - S J G Taylor
- Department of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
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2
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Masood KI, Qaiser S, Abidi SH, Khan E, Mahmood SF, Hussain A, Ghous Z, Imtiaz K, Ali N, Hasan M, Memon HA, Yameen M, Ali S, Baloch S, Lakhani G, Alves PM, Iqbal NT, Ahmed K, Iqbal J, Bhutta ZA, Hussain R, Rottenberg M, Simas JP, Veldhoen M, Ghias K, Hasan Z. Humoral and T cell responses to SARS-CoV-2 reveal insights into immunity during the early pandemic period in Pakistan. BMC Infect Dis 2023; 23:846. [PMID: 38041026 PMCID: PMC10691108 DOI: 10.1186/s12879-023-08829-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Protection against SARS-CoV-2 is mediated by humoral and T cell responses. Pakistan faced relatively low morbidity and mortality from COVID-19 through the pandemic. To examine the role of prior immunity in the population, we studied IgG antibody response levels, virus neutralizing activity and T cell reactivity to Spike protein in a healthy control group (HG) as compared with COVID-19 cases and individuals from the pre-pandemic period (PP). METHODS HG and COVID-19 participants were recruited between October 2020 and May 2021. Pre-pandemic sera was collected before 2018. IgG antibodies against Spike and its Receptor Binding Domain (RBD) were determined by ELISA. Virus neutralization activity was determined using a PCR-based micro-neutralization assay. T cell - IFN-γ activation was assessed by ELISpot. RESULTS Overall, the magnitude of anti-Spike IgG antibody levels as well as seropositivity was greatest in COVID-19 cases (90%) as compared with HG (39.8%) and PP (12.2%). During the study period, Pakistan experienced three COVID-19 waves. We observed that IgG seropositivity to Spike in HG increased from 10.3 to 83.5% during the study, whilst seropositivity to RBD increased from 7.5 to 33.3%. IgG antibodies to Spike and RBD were correlated positively in all three study groups. Virus neutralizing activity was identified in sera of COVID-19, HG and PP. Spike reactive T cells were present in COVID-19, HG and PP groups. Individuals with reactive T cells included those with and without IgG antibodies to Spike. CONCLUSIONS Antibody and T cell responses to Spike protein in individuals from the pre-pandemic period suggest prior immunity against SARS-CoV-2, most likely from cross-reactive responses. The rising seroprevalence observed in healthy individuals through the pandemic without known COVID-19 may be due to the activation of adaptive immunity from cross-reactive memory B and T cells. This may explain the more favourable COVID-19 outcomes observed in this population.
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Affiliation(s)
- Kiran Iqbal Masood
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Shama Qaiser
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Syed Hani Abidi
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Erum Khan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | | | - Areeba Hussain
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Zara Ghous
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Khekahsan Imtiaz
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Natasha Ali
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Muhammad Hasan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Haris Ali Memon
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Maliha Yameen
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Shiza Ali
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Sadaf Baloch
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Gulzar Lakhani
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Paula M Alves
- iBET - Instituto de Biologia Experimental E Tecnológica, Oeiras, Portugal
| | - Najeeha Talat Iqbal
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
- Department of Pediatrics, Aga Khan University, Karachi, Pakistan
| | - Kumail Ahmed
- Department of Pediatrics, Aga Khan University, Karachi, Pakistan
| | - Junaid Iqbal
- Department of Pediatrics, Aga Khan University, Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
| | - Rabia Hussain
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan
| | - Martin Rottenberg
- Department of Microbiology and Tumor Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - J Pedro Simas
- Católica Biomedical Research, Católica Medical School, Universidade Católica Portuguesa, Palma de Cima, 1649-023, Lisboa, Portugal
| | - Marc Veldhoen
- Instituto de Medicina Molecular | João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Kulsoom Ghias
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Zahra Hasan
- Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O.Box 3500, Karachi, 74800, Pakistan.
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3
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Dutta M, Kadirvel G, Borah P, Sinha S, Ahmed K, Hazarika G, Sharma R, Choudhury H, Deori S, Das Gupta M, Biswas RK, Tamuly S, Barua PM, Hussain J. Effect of membrane stabilizers on semen quality and sperm membrane protein expression during cryopreservation of goat semen. Cryo Letters 2023; 44:299-306. [PMID: 38032310] [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] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND Semen cryopreservation is a complex process during which there is alteration in the expression of sperm and seminal plasma proteins, molecular weight of protein or loss of membrane proteins during the process. In order to compensate for these changes, different membrane stabilizers are used in freezing semen extenders. However, there is scarcity of such studies during cryopreservation of goat semen. OBJECTIVE To investigate the effect of membrane stabilizers on sperm membrane protein expression during cryopreservation of goat semen. MATERIALS AND METHODS A total of 36 semen ejaculates from nine Assam Hill Goat bucks aged 2 to 2.5 years was collected by artificial vagina method. Three membrane stabilizers, each at two different concentrations viz. 50 and 80 mM sucrose, 50 and 100 mM trehalose, and 100 and 150 ng per mL IGF-1 (insulin-like growth factor 1 protein) were added to Tris-citric acid fructose egg yolk glycerol (TCFEYG) extender and semen samples were cryopreserved. The sperm membrane protein profile was studied in fresh and cryopreserved semen by SDS-PAGE. RESULTS SDS- PAGE of sperm membrane extract of fresh semen revealed the presence of 24 protein bands with molecular weights ranging from 10 kDa to 240 kDa. Samples supplemented with 50 mM sucrose and 80 mM sucrose revealed 21 protein bands with molecular weights ranging from 10 kDa to 240 kDa. All the 21 protein bands were same as those observed in the sperm membrane of fresh spermatozoa, except that the 23 kDa, 29 kDa and 42 kDa bands were absent in frozen semen. Similarly, frozen semen extended with 50 mM trehalose and 100 mM trehalose revealed 22 protein bands with molecular weights ranging from 10 kDa to 240 kDa, but lacking the 29 kDa and 42 kDa bands. Proteins with molecular weights of 29 kDa, 130 kDa and 240 kDa were absent in frozen semen supplemented with 100 ng per mL IGF-1 and 150 ng per mL IGF-1. CONCLUSION The present study revealed that supplementation of tris basic extender with trehalose at 100 mM and or IGF-1 at 100 ng/mL or 150 ng per mL improves the post-thaw semen characteristics and protects certain fertility related sperm membrane proteins. Doi.org/10.54680/fr23510110612.
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Affiliation(s)
- M Dutta
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - G Kadirvel
- ICAR Research Complex for NEH Region, Umiam, Meghalaya, India
| | - P Borah
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - S Sinha
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - K Ahmed
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - G Hazarika
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - R Sharma
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | | | - S Deori
- ICAR Research Complex for NEH Region, Umiam, Meghalaya, India.
| | - M Das Gupta
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - R K Biswas
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - S Tamuly
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - P M Barua
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - J Hussain
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
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Dunckley M, Ahmed K, Said A, Raza M, Dighe S, Al-Temimi A. Variability in the presentation of complicated jejunal diverticulosis. JRSM Open 2023; 14:20542704231183247. [PMID: 37425033 PMCID: PMC10328167 DOI: 10.1177/20542704231183247] [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] [Indexed: 07/11/2023] Open
Abstract
Jejunal diverticulosis is a rare disease which normally presents for the first time with acute complications, often requiring surgical intervention. The diverticulae are acquired, occurring more commonly after middle age, but their aetiology is unclear. We discuss this condition in the context of four cases which presented to our hospital as emergencies over a five year period: small bowel obstruction, gastrointestinal haemorrhage, small bowel volvulus, and visceral perforation. Our aim is to encourage clinicians to include jejunal diverticular disease as a differential diagnosis in patients with abdominal symptoms.
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Affiliation(s)
- M.G. Dunckley
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| | - K. Ahmed
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| | - A. Said
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| | - M. Raza
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| | - S. Dighe
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| | - A. Al-Temimi
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
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5
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Bowen JE, Park YJ, Stewart C, Brown JT, Sharkey WK, Walls AC, Joshi A, Sprouse KR, McCallum M, Tortorici MA, Franko NM, Logue JK, Mazzitelli IG, Nguyen AW, Silva RP, Huang Y, Low JS, Jerak J, Tiles SW, Ahmed K, Shariq A, Dan JM, Zhang Z, Weiskopf D, Sette A, Snell G, Posavad CM, Iqbal NT, Geffner J, Bandera A, Gori A, Sallusto F, Maynard JA, Crotty S, Van Voorhis WC, Simmerling C, Grifantini R, Chu HY, Corti D, Veesler D. SARS-CoV-2 spike conformation determines plasma neutralizing activity elicited by a wide panel of human vaccines. Sci Immunol 2022; 7:eadf1421. [PMID: 36356052 PMCID: PMC9765460 DOI: 10.1126/sciimmunol.adf1421] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Numerous safe and effective coronavirus disease 2019 vaccines have been developed worldwide that use various delivery technologies and engineering strategies. We show here that vaccines containing prefusion-stabilizing S mutations elicit antibody responses in humans with enhanced recognition of S and the S1 subunit relative to postfusion S as compared with vaccines lacking these mutations or natural infection. Prefusion S and S1 antibody binding titers positively and equivalently correlated with neutralizing activity, and depletion of S1-directed antibodies completely abrogated plasma neutralizing activity. We show that neutralizing activity is almost entirely directed to the S1 subunit and that variant cross-neutralization is mediated solely by receptor binding domain-specific antibodies. Our data provide a quantitative framework for guiding future S engineering efforts to develop vaccines with higher resilience to the emergence of variants than current technologies.
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Affiliation(s)
- John E. Bowen
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Young-Jun Park
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA.,Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Cameron Stewart
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Jack T. Brown
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - William K. Sharkey
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Alexandra C. Walls
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA.,Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Anshu Joshi
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Kaitlin R. Sprouse
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Matthew McCallum
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | | | - Nicholas M. Franko
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - Jennifer K. Logue
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - Ignacio G. Mazzitelli
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Buenos Aires C1121ABG, Argentina
| | - Annalee W. Nguyen
- McKetta Department of Chemical Engineering, The University of Texas at Austin, Austin, TX
| | - Rui P. Silva
- McKetta Department of Chemical Engineering, The University of Texas at Austin, Austin, TX
| | - Yimin Huang
- McKetta Department of Chemical Engineering, The University of Texas at Austin, Austin, TX
| | - Jun Siong Low
- Institute for Research in Biomedicine, Università della Svizzera Italiana, 6500 Bellinzona, Switzerland
| | - Josipa Jerak
- Institute for Research in Biomedicine, Università della Svizzera Italiana, 6500 Bellinzona, Switzerland
| | - Sasha W Tiles
- Center for Emerging and Re-emerging Infectious Diseases, Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Kumail Ahmed
- Department of Paediatrics and Child Health, and Biological & Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Asefa Shariq
- Department of Paediatrics and Child Health, and Biological & Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Jennifer M. Dan
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA.,Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA UC92037, USA
| | - Zeli Zhang
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA.,Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA UC92037, USA
| | - Daniela Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA.,Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA UC92037, USA
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA.,Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA UC92037, USA
| | | | - Christine M. Posavad
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Najeeha Talat Iqbal
- Department of Paediatrics and Child Health, and Biological & Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Buenos Aires C1121ABG, Argentina
| | - Alessandra Bandera
- Infectious Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Federica Sallusto
- Institute for Research in Biomedicine, Università della Svizzera Italiana, 6500 Bellinzona, Switzerland
| | - Jennifer A. Maynard
- McKetta Department of Chemical Engineering, The University of Texas at Austin, Austin, TX
| | - Shane Crotty
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA.,Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA UC92037, USA
| | - Wesley C. Van Voorhis
- Center for Emerging and Re-emerging Infectious Diseases, Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Carlos Simmerling
- Department of Chemistry, Stony Brook University, Stony Brook, New York 11794, United States.,Laufer Center for Physical and Quantitative Biology, Stony Brook University, Stony Brook, New York 11794, United States
| | - Renata Grifantini
- INGM, Istituto Nazionale Genetica Molecolare “Romeo ed Enrica Invernizzi”, 20122 Milan, Italy
| | - Helen Y. Chu
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - Davide Corti
- Humabs Biomed SA, a subsidiary of Vir Biotechnology, 6500 Bellinzona, Switzerland
| | - David Veesler
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA.,Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA.,Corresponding author.
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6
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Hussain M, Ahmed K, Begum SS, Kalita MK, Borah P, Bhuyan D, Tamuly S, Medhi D, Paul V, Chakravartya P, Sarkar M. 70 Effect of seasons and additives in Arunachali yak bull semen at different stages of processing and freezing along with fresh semen characteristics. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab70] [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: 12/12/2022] Open
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7
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Bowen JE, Addetia A, Dang HV, Stewart C, Brown JT, Sharkey WK, Sprouse KR, Walls AC, Mazzitelli IG, Logue JK, Franko NM, Czudnochowski N, Powell AE, Dellota E, Ahmed K, Ansari AS, Cameroni E, Gori A, Bandera A, Posavad CM, Dan JM, Zhang Z, Weiskopf D, Sette A, Crotty S, Iqbal NT, Corti D, Geffner J, Snell G, Grifantini R, Chu HY, Veesler D. Omicron spike function and neutralizing activity elicited by a comprehensive panel of vaccines. Science 2022; 377:890-894. [PMID: 35857529 PMCID: PMC9348749 DOI: 10.1126/science.abq0203] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/12/2022] [Indexed: 12/23/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant of concern comprises several sublineages, with BA.2 and BA.2.12.1 having replaced the previously dominant BA.1 and with BA.4 and BA.5 increasing in prevalence worldwide. We show that the large number of Omicron sublineage spike mutations leads to enhanced angiotensin-converting enzyme 2 (ACE2) binding, reduced fusogenicity, and severe dampening of plasma neutralizing activity elicited by infection or seven clinical vaccines relative to the ancestral virus. Administration of a homologous or heterologous booster based on the Wuhan-Hu-1 spike sequence markedly increased neutralizing antibody titers and breadth against BA.1, BA.2, BA.2.12.1, BA.4, and BA.5 across all vaccines evaluated. Our data suggest that although Omicron sublineages evade polyclonal neutralizing antibody responses elicited by primary vaccine series, vaccine boosters may provide sufficient protection against Omicron-induced severe disease.
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Affiliation(s)
- John E. Bowen
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Amin Addetia
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Ha V. Dang
- Vir Biotechnology, San Francisco, CA 94158, USA
| | - Cameron Stewart
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Jack T. Brown
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - William K. Sharkey
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Kaitlin R. Sprouse
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Alexandra C. Walls
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Ignacio G. Mazzitelli
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Buenos Aires C1121ABG, Argentina
| | - Jennifer K. Logue
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - Nicholas M. Franko
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | | | | | | | - Kumail Ahmed
- Departments of Paediatrics and Child Health and Biological and Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Asefa Shariq Ansari
- Departments of Paediatrics and Child Health and Biological and Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Elisabetta Cameroni
- Humabs Biomed SA, a subsidiary of Vir Biotechnology, 6500 Bellinzona, Switzerland
| | - Andrea Gori
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Christine M. Posavad
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Jennifer M. Dan
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA 92037, USA
| | - Zeli Zhang
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Daniela Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA 92037, USA
| | - Shane Crotty
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA 92037, USA
| | - Najeeha Talat Iqbal
- Departments of Paediatrics and Child Health and Biological and Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Davide Corti
- Humabs Biomed SA, a subsidiary of Vir Biotechnology, 6500 Bellinzona, Switzerland
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Buenos Aires C1121ABG, Argentina
| | | | - Renata Grifantini
- INGM, Istituto Nazionale Genetica Molecolare “Romeo ed Enrica Invernizzi,” Milan, Italy
| | - Helen Y. Chu
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - David Veesler
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
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8
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Tambat N, Mulani SK, Ahmad A, Shaikh SB, Ahmed K. Pyrazine Derivatives—Versatile Scaffold. Russ J Bioorg Chem 2022. [DOI: 10.1134/s1068162022050259] [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: 11/23/2022]
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9
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Ahmed K, Breuer J, Huynh K, Abi-Jaoudeh N. Abstract No. 277 Racial disparity in acute pulmonary embolism treatment. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.358] [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: 10/18/2022] Open
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10
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Abtahi S, Sailer A, Sadiq K, Iqbal N, Ahmed K, Kabir F, Ali SA, Turner JR. Abnormal transporter and tight junction protein expression in environmental enteric dysfunction. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r5615] [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] [Indexed: 11/11/2022]
Affiliation(s)
- Shabnam Abtahi
- PathologyBrigham and women's Hospital, Harvard Medical SchoolBostonMA
| | | | - Kamran Sadiq
- Department of Paediatrics and Child HealthAga Khan UniversityKarachi
| | - Najeeha Iqbal
- Department of Paediatrics and Child HealthAga Khan UniversityKarachi
| | - Kumail Ahmed
- Department of Paediatrics and Child HealthAga Khan UniversityKarachi
| | - Furqan Kabir
- Department of Paediatrics and Child HealthAga Khan UniversityKarachi
| | - S A. Ali
- Department of Paediatrics and Child HealthAga Khan UniversityKarachi
| | - Jerrold R. Turner
- PathologyUniversity of ChicagoChicagoIL
- Brigham and Women's Hospital, Harvard Medical SchoolBostonMA
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11
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Bowen JE, Sprouse KR, Walls AC, Mazzitelli IG, Logue JK, Franko NM, Ahmed K, Shariq A, Cameroni E, Gori A, Bandera A, Posavad CM, Dan JM, Zhang Z, Weiskopf D, Sette A, Crotty S, Iqbal NT, Corti D, Geffner J, Grifantini R, Chu HY, Veesler D. Omicron BA.1 and BA.2 neutralizing activity elicited by a comprehensive panel of human vaccines. bioRxiv 2022:2022.03.15.484542. [PMID: 35313570 PMCID: PMC8936098 DOI: 10.1101/2022.03.15.484542] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The SARS-CoV-2 Omicron variant of concern comprises three sublineages designated BA.1, BA.2, and BA.3, with BA.2 steadily replacing the globally dominant BA.1. We show that the large number of BA.1 and BA.2 spike mutations severely dampen plasma neutralizing activity elicited by infection or seven clinical vaccines, with cross-neutralization of BA.2 being consistently more potent than that of BA.1, independent of the vaccine platform and number of doses. Although mRNA vaccines induced the greatest magnitude of Omicron BA.1 and BA.2 plasma neutralizing activity, administration of a booster based on the Wuhan-Hu-1 spike sequence markedly increased neutralizing antibody titers and breadth against BA.1 and BA.2 across all vaccines evaluated. Our data suggest that although BA.1 and BA.2 evade polyclonal neutralizing antibody responses, current vaccine boosting regimens may provide sufficient protection against Omicron-induced disease.
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Affiliation(s)
- John E. Bowen
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Kaitlin R. Sprouse
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Alexandra C. Walls
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Ignacio G. Mazzitelli
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Buenos Aires C1121ABG, Argentina
| | - Jennifer K. Logue
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - Nicholas M. Franko
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - Kumail Ahmed
- Department of Paediatrics and Child Health, and Biological & Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Asefa Shariq
- Department of Paediatrics and Child Health, and Biological & Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Elisabetta Cameroni
- Humabs Biomed SA, a subsidiary of Vir Biotechnology, 6500 Bellinzona, Switzerland
| | - Andrea Gori
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation,, University of Milan, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Alessandra Bandera
- Infectious Diseases Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation,, University of Milan, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Christine M. Posavad
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Jennifer M. Dan
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA UC92037, USA
| | - Zeli Zhang
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Daniela Weiskopf
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
| | - Alessandro Sette
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA UC92037, USA
| | - Shane Crotty
- Center for Infectious Disease and Vaccine Research, La Jolla Institute for Immunology, La Jolla, CA 92037, USA
- Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA UC92037, USA
| | - Najeeha Talat Iqbal
- Department of Paediatrics and Child Health, and Biological & Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Davide Corti
- Humabs Biomed SA, a subsidiary of Vir Biotechnology, 6500 Bellinzona, Switzerland
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Buenos Aires C1121ABG, Argentina
| | - Renata Grifantini
- INGM, Istituto Nazionale Genetica Molecolare “Romeo ed Enrica Invernizzi”, 20122 Milan, Italy
| | - Helen Y. Chu
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - David Veesler
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
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12
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James C, Brunckhorst O, Fanshawe J, Hammadeh M, Sheriff M, Thomas R, Williams M, Khan S, Ahmed H, Van Hemelrijck M, Stewart R, Dasgupta P, Ahmed K. Evaluating the baseline mental wellbeing of newly diagnosed prostate cancer patients. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00355-4] [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: 11/27/2022]
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13
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Li Y, Li M, Ahmed K, Yang J, Song L, Cui ZG, Hiraku Y. Mechanistic Study of Macranthoside B Effects on Apoptotic Cell Death in Human Cervical Adenocarcinoma Cells. Folia Biol (Praha) 2022; 68:189-200. [PMID: 37256553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Macranthoside B (MB) is a triterpenoid saponin extracted from Lonicera macranthoides, a traditional Chinese medicine. In the current study, we investigated the anticancer potential of MB in various cancer cells and elucidated its underlying mechanisms. MB exposure inhibited cell proliferation, induced mitochondrial membrane potential (MMP) loss, increased sub-G1 accumulation, and resulted in cleavage of caspase-3 and PARP, which are reflective of apoptosis. In HeLa cells, MB induced down-regulation of SOD2 and GPx1, phosphorylation of Akt and PDK1, and thus promoted ROS-mediated apoptosis. This was further supported by the protection of sub-G1 accumulation, MMP loss, cleavage of caspase-3 and PARP in the presence of N-acetylcysteine (NAC). Additionally, MB induced cell death via down-regulation of ubiquitin-like with PHD and ringfinger domains 1 (UHRF1) and Bcl-xL. Taken together, this study provides a new insight into the apoptosis- inducing potential of MB, and its molecular mechanisms are associated with an increase in oxidative stress and inhibition of the PDK1/Akt pathway.
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Affiliation(s)
- Y Li
- School of Life Science and Technology, Henan Institute of Science and Technology, Xinxiang, China
| | - M Li
- School of Medicine, Xizang Minzu University, Weicheng District, Xianyang, Shaanxi, China
- Department of Environmental Health, University of Fukui School of Medical Sciences, Fukui, Japan
| | - K Ahmed
- Faculty of Eastern Medicine, Hamdard University, Islamabad, Pakistan
| | - J Yang
- School of Life Science and Technology, Henan Institute of Science and Technology, Xinxiang, China
| | - L Song
- School of Life Science and Technology, Henan Institute of Science and Technology, Xinxiang, China
| | - Z G Cui
- Department of Environmental Health, University of Fukui School of Medical Sciences, Fukui, Japan
| | - Y Hiraku
- Department of Environmental Health, University of Fukui School of Medical Sciences, Fukui, Japan
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14
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Bowen JE, Walls AC, Joshi A, Sprouse KR, Stewart C, Tortorici MA, Franko NM, Logue JK, Mazzitelli IG, Tiles SW, Ahmed K, Shariq A, Snell G, Iqbal NT, Geffner J, Bandera A, Gori A, Grifantini R, Chu HY, Van Voorhis WC, Corti D, Veesler D. SARS-CoV-2 spike conformation determines plasma neutralizing activity. bioRxiv 2021:2021.12.19.473391. [PMID: 34981060 PMCID: PMC8722597 DOI: 10.1101/2021.12.19.473391] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Numerous safe and effective COVID-19 vaccines have been developed that utilize various delivery technologies and engineering strategies. The influence of the SARS-CoV-2 spike (S) glycoprotein conformation on antibody responses induced by vaccination or infection in humans remains unknown. To address this question, we compared plasma antibodies elicited by six globally-distributed vaccines or infection and observed markedly higher binding titers for vaccines encoding a prefusion-stabilized S relative to other groups. Prefusion S binding titers positively correlated with plasma neutralizing activity, indicating that physical stabilization of the prefusion conformation enhances protection against SARS-CoV-2. We show that almost all plasma neutralizing activity is directed to prefusion S, in particular the S 1 subunit, and that variant cross-neutralization is mediated solely by RBD-specific antibodies. Our data provide a quantitative framework for guiding future S engineering efforts to develop vaccines with higher resilience to the emergence of variants and longer durability than current technologies.
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Affiliation(s)
- John E. Bowen
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Alexandra C. Walls
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Anshu Joshi
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Kaitlin R. Sprouse
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | - Cameron Stewart
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
| | | | - Nicholas M. Franko
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - Jennifer K. Logue
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - Ignacio G. Mazzitelli
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Buenos Aires C1121ABG, Argentina
| | - Sasha W Tiles
- Center for Emerging and Re-emerging Infectious Diseases, Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Kumail Ahmed
- Department of Paediatrics and Child Health, and Biological & Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Asefa Shariq
- Department of Paediatrics and Child Health, and Biological & Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | | | - Najeeha Talat Iqbal
- Department of Paediatrics and Child Health, and Biological & Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan
| | - Jorge Geffner
- Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS), Facultad de Medicina, Buenos Aires C1121ABG, Argentina
| | - Alessandra Bandera
- Infectious Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Renata Grifantini
- INGM, Istituto Nazionale Genetica Molecolare “Romeo ed Enrica Invernizzi”, 20122 Milan, Italy
| | - Helen Y. Chu
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA 98195, USA
| | - Wesley C. Van Voorhis
- Center for Emerging and Re-emerging Infectious Diseases, Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Davide Corti
- Humabs Biomed SA, a subsidiary of Vir Biotechnology, 6500 Bellinzona, Switzerland
| | - David Veesler
- Department of Biochemistry, University of Washington, Seattle, WA 98195, USA
- Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
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15
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Hoepli A, Ahmed K, Rickli H, Eberli F, Kobza R, Pedrazzini G, Radovanovic D. Achievement of guideline recommended LDL-C goals in patients with acute myocardial infarction (AMI) in Switzerland. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1422] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In 2016 and subsequently again in 2019 the ESC/EAS Guidelines for the Management of Dyslipidaemia established a more intensive reduction of LDL cholesterol (LDL-C) treatment recommendations. We aim to characterize patients with acute myocardial infarction (AMI) with regards to achievement of recommended LDL-C goals and their current lipid lowering therapy.
Methods
We retrospectively analysed patients with AMI admitted to Swiss hospitals between 2016 and 2020. Patients were classified as “very high risk” due to prior atherosclerotic cardiovascular disease (ACSVD) events including at least one of the following: Myocardial infarction (MI), stroke, peripheral arterial disease (PAD) and type 2 diabetes mellitus with target organ damage. The remaining patients were classified as “other risk”. LDL-C treatment recommendation goals for the “very high risk” population were set to 1.8mmol/L (2016 ESC/EAS Guidelines) or 1.4mmol/L (2019 ESC/EAS Guidelines) and for the “other risk” population to 2.6mmol/L or 1.8mmol/L. To identify differences between the two groups the Mann-Whitney test was used and for differences within a group the Kruskal-Wallis test. In-hospital outcomes were summarised as major adverse cardiac and cerebrovascular events (MACCE).
Results
Among 7114 patients included, 18.4% were categorized as “very high risk” and 81.6% as “other risk” (p<0.001). In general, the “very high risk” patients were older (69.2y vs. 63.6y, p<0.001), more likely to be men (78.8% vs. 75.3%, p=0.007), had poorer in-hospital outcomes (6.0% vs. 3.4%, p<0.001) and were more often on lipid lowering treatment (statin/ezetimibe/combination) (LLT) prior to admission (64.8% vs 14.0%, p<0.001). The overall LDL-C median for the “very high risk” population was significantly lower than for the “other risk” population (2.4mmol/L vs. 3.5mmol/L, p<0.001). In addition, median (IQR) LDL-C increased in the “other risk” group over the years from 3.5mmol/L (2.7; 4.2) in 2016 to 3.7mmol/L (3.1; 4.4) in 2020. In contrast, no change in LDL-C was observed in the patients at higher risk (Fig. 1).
Patients in the “other risk” group were more likely to miss the recommended LDL-C goals (2016 Guidelines: 80.0% vs. 75.4%, 2019 Guidelines: 94.2% vs. 89.1%). Patients without LLT prior to admission had a higher chance of not reaching the recommendations compared to patients with LLT prior to admission (without LLT: 2016: 85.3% vs. 91.0%, 2019: 96.1% vs. 96.6%), (with LLT: 2016: 50.8% vs. 66.8%, 2019: 83.2% vs.85.2%) (Fig. 2).
Conclusion
Median LDL-C levels have tended to increase in recent years in patients with very high CV risk and AMI admitted to Swiss hospitals. Despite existing lipid lowering therapies only few patients met guideline recommended LDL-C goals. Our results indicate that clinical implementation of guidelines remains to be optimised with regards to achievement of LDL-C goals to reduce CV risk and improve outcomes.
Funding Acknowledgement
Type of funding sources: None. Figure 1. LDL-C developmentFigure 2. Recommended LDL-C goal achievement
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Affiliation(s)
- A Hoepli
- University of Zurich, AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - K Ahmed
- Novartis Pharma Switzerland AG, Rotkreuz, Switzerland
| | - H Rickli
- Cantonal Hospital St. Gallen, Klinik für Kardiologie, St. Gallen, Switzerland
| | - F Eberli
- Triemli Hospital, Zurich, Switzerland
| | - R Kobza
- Kantonsspital Lucerne, Herzzentrum, Lucerne, Switzerland
| | - G Pedrazzini
- Cardiocentro Ticino, Department of Cardiology, Lugano, Switzerland
| | - D Radovanovic
- University of Zurich, AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
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Jamil Z, Iqbal NT, Idress R, Ahmed Z, Sadiq K, Mallawaarachchi I, Iqbal J, Syed S, Hotwani A, Kabir F, Ahmed K, Ahmed S, Umrani F, Ma JZ, Aziz F, Kalam A, Moore SR, Ali SA. Gut integrity and duodenal enteropathogen burden in undernourished children with environmental enteric dysfunction. PLoS Negl Trop Dis 2021; 15:e0009584. [PMID: 34264936 PMCID: PMC8352064 DOI: 10.1371/journal.pntd.0009584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 08/09/2021] [Accepted: 06/17/2021] [Indexed: 11/18/2022] Open
Abstract
Environmental enteric dysfunction (EED) is a subclinical condition of intestinal inflammation, barrier dysfunction and malabsorption associated with growth faltering in children living in poverty. This study explores association of altered duodenal permeability (lactulose, rhamnose and their ratio) with higher burden of enteropathogen in the duodenal aspirate, altered histopathological findings and higher morbidity (diarrhea) that is collectively associated with linear growth faltering in children living in EED endemic setting. In a longitudinal birth cohort, 51 controls (WHZ > 0, HAZ > −1.0) and 63 cases (WHZ< -2.0, refractory to nutritional intervention) were recruited. Anthropometry and morbidity were recorded on monthly bases up to 24 months of age. Dual sugar assay of urine collected after oral administration of lactulose and rhamnose was assessed in 96 children from both the groups. Duodenal histopathology (n = 63) and enteropathogen analysis of aspirate via Taqman array card (n = 60) was assessed in only cases. Giardia was the most frequent pathogen and was associated with raised L:R ratio (p = 0.068). Gastric microscopy was more sensitive than duodenal aspirate in H. pylori detection. Microscopically confirmed H. pylori negatively correlated with HAZ at 24 months (r = −0.313, p = 0.013). Regarding histopathological parameters, goblet cell reduction significantly correlated with decline in dual sugar excretion (p< 0.05). Between cases and controls, there were no significant differences in the median (25th, 75th percentile) of urinary concentrations (μg/ml) of lactulose [27.0 (11.50, 59.50) for cases vs. 38.0 (12.0, 61.0) for controls], rhamnose [66.0 (28.0, 178.0) vs. 86.5 (29.5, 190.5)] and L:R ratio [0.47 (0.24, 0.90) vs. 0.51 (0.31, 0.71)] respectively. In multivariable regression model, 31% of variability in HAZ at 24 months of age among cases and controls was explained by final model including dual sugars. In conclusion, enteropathogen burden is associated with altered histopathological features and intestinal permeability. In cases and controls living in settings of endemic enteropathy, intestinal permeability test may predict linear growth. However, for adoption as a screening tool for EED, further validation is required due to its complex intestinal pathophysiology. EED is a subclinical condition of compromised gut integrity secondary to frequent and repeated exposure to enteropathogens in global settings with a high prevalence of undernutrition. In this study, we reported association of gut mucosal architecture with a dual sugar intestinal permeability assay (lactulose-rhamnose) in Pakistani children. In the presence of duodenal enteropathogens, features such as chronic inflammation, intra-epithelial lymphocytosis, enterocyte injury and Paneth cell reduction were consistently observed. When comparing undernourished cases and controls living in the same setting, we found urinary excretion of the sugars was similar among groups; however, variability in HAZ among children at 24 months was partially explained by a model that includes excretion values.
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Affiliation(s)
- Zehra Jamil
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Najeeha Talat Iqbal
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Romana Idress
- Department of Pathology & Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Zubair Ahmed
- Department of Pathology & Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Kamran Sadiq
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Indika Mallawaarachchi
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, United States of America
| | - Junaid Iqbal
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sana Syed
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition; Department of Pediatrics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Aneeta Hotwani
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Furqan Kabir
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Kumail Ahmed
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sheraz Ahmed
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Fayaz Umrani
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jennie Z. Ma
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, United States of America
| | - Fatima Aziz
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Adil Kalam
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sean R. Moore
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition; Department of Pediatrics, University of Virginia, Charlottesville, Virginia, United States of America
- * E-mail: (SRM); (SAA)
| | - Syed Asad Ali
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- * E-mail: (SRM); (SAA)
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17
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Chong SMY, Hung RKY, Gwozdz A, Irwin S, Eastbury J, Cross T, Ahmed K, Taylor C, Goldenberg SD, Sanderson J, Olsburgh J. 30-Day postoperative COVID-19 outcomes in 398 patients from regional hospitals utilising a designated COVID-19 minimal surgical site pathway. Ann R Coll Surg Engl 2021; 103:395-403. [PMID: 33956529 PMCID: PMC10335038 DOI: 10.1308/rcsann.2020.7072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Postoperative pulmonary complications and mortality rates during the COVID-19 pandemic have been higher than expected, leading to mass cancellation of elective operating in the UK. To minimise this, the Guy's and St Thomas' Hospital NHS Foundation Trust elective surgery hub and the executive team at London Bridge Hospital (LBH) created an elective operating framework at LBH, a COVID-19 minimal site, in which patients self-isolated for two weeks and proceeded with surgery only following a negative preoperative SARS-CoV-2 polymerase chain reaction swab. The aim was to determine the rates of rates of postoperative COVID-19 infection. METHODS The collaboration involved three large hospital trusts, covering the geographic area of south-east London. All patients were referred to LBH for elective surgery. Patients were followed up by telephone interview at four weeks postoperatively. RESULTS Three hundred and ninety-eight patients from 13 surgical specialties were included in the analysis. The median age was 60 (IQR 29-71) years. Sixty-three per cent (252/398) were female. In total, 78.4% of patients had an American Society of Anesthesiologists grade of 1-2 and the average BMI was 27.2 (IQR 23.7-31.8) kg/m2. Some 83.6% (336/402) were 'major' operations. The rate of COVID-19-related death in our cohort was 0.25% (1/398). Overall, there was a 1.26% (5/398) 30-day postoperative all-cause mortality rate. Seven patients (1.76%) reported COVID-19 symptoms, but none attended the emergency department or were readmitted to hospital as a result. CONCLUSION The risk of contracting COVID-19 in our elective operating framework was very low. We demonstrate that high-volume major surgery is safe, even at the peak of the pandemic, if patients are screened appropriately preoperatively.
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Affiliation(s)
| | | | | | - S Irwin
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | | | | | | | - C Taylor
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | - SD Goldenberg
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | - J Sanderson
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | - J Olsburgh
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
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Ahmed Narikkoottungal S, Siddiqui A, Constantin A, Farrow S, Ahmed K. POS1177 REVAMPING BIOLOGIC THERAPY DURING COVID-19. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1008] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The COVID-19 pandemic has caught us all by surprise – from governments to individuals; the medical fraternity being no exception. It has affected all walks of life; with its immense contagiosity, diverse and intriguing pathogenesis and manifestations differing from other viruses. It has indeed left humanity in dark, unchartered waters; particularly in the early months of the pandemic.Objectives:This article shares the experience, in a Rheumatology department in a District General Hospital (DGH) in the United Kingdom, of managing patients on Biologic (b) and Targeted Synthetic (ts) DMARDs, in the midst of the COVID-19 Pandemic.Methods:All Rheumatology patients at the Princess Alexandra Hospital (PAH) in Harlow newly started on a biologic or targeted synthetic DMARD between 3rd July and 3rd Oct 2020 were identified. These patients had active inflammatory arthritis. Each patient was discussed in a dedicated Multi-Disciplinary Team (MDT) meeting and a consensus on treatment reached in-line with local and National guidelines.Figure 1.A slide presented at the Essex Rheumatology Association (ERA) meeting explaining the process adopted at the Rheumatology Department at Harlow during the peak of COVID-19 pandemic with new b/ts DMARD patients.Results:Of the 50 patients identified; 39 had Rheumatoid Arthritis, 6 had Ankylosing Spondylitis and 5 had Psoriatic Arthritis. Of these 50 patients, 5 patients decided against treatment during the stage of ‘Enhanced Verbal Consent’. These patients were flaring recurrently and were in regular contact with the department. However, they were afraid to start new Biologic treatment because of the risks of Covid-19. The breakdown of the biologic agents used in the remaining 45 patients were as follows: Adalimumab:11, Rituximab: 10, Etanercept: 9, Tofacitinib: 11, Tocilizumab SC: 3, Tocilizumab IV: 1, Sarilumab: 2, Secukinumab: 1, Infliximab: 1, Baricitinib: 1, Apremilast: 1Figure 2.Breakdown of the various b/ts DMARD agents newly started in the 45 patients between 3/7/20 - 3/10/20 at PA Hospital, Harlow, UKConclusion:The over-riding principle that guided the Department during the COVID crisis was: primum non nocere (first, do no harm). The adherence to the Case Based Discussions (CBDs) positively impacted on decision making, ensuring safe initiation of Biologic DMARDs even during the height of the pandemic. This is vital to achieve early disease remission. The MDT meetings comprising Doctors, Specialist Pharmacist and Nurse Specialists ensured prompt risk stratification of individual patients. It gave patients the opportunity to be part of the decision-making - evident in the five of the fifty patients, who opted to defer the start date of their treatments. The choice of the new Biologic agent was based on the latest National COVID-19 guidelines. The agents with the shortest half-life were selected. Moreover, patients for Rituximab were given one pulsed infusion, as opposed to two infusions. Only one of the 45 patients started on a Biologic agent over this period, either was tested positive or had symptoms suggestive of COVID-19.References:[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261974[2]https://rmdopen.bmj.com/content/6/2/e001314[3]https://www.nejm.org/doi/full/10.1056/nejmc2009567[4]https://www.jrheum.org/content/early/2020/05/13/jrheum.200527[5]https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-care-of-adult-patients-with-systemic-rheumatic-disease[6]www.england.nhs.uk/clinical-guide-rheumatology-patients-v1-19-march-2020.pdf[7]https://www.rheumatology.org.uk/practice-quality/covid-19-guidance[8]https://www.nice.org.uk/guidance/ng167/chapter/4-Treatment-considerations[9]https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/decision-making-and-consentAcknowledgements:We acknowledge the whole Rheumatology Dept at Harlow for their sincere team work during the COVID-19 pandemic – Sabaa Naz (Rheumatology Pharmacist), Mona Kamal Zou (Biologics Nurse Specialist), Lily Robinson (DMARD Nurse Specialist), Mary Surendran (Osteoporosis Nurse Specialist), Janet Bell (Secretary to Dr Ahmed) and Claire Stroud (Secretary to Dr Farrow).Disclosure of Interests:None declared.
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Aydin A, Ahmed K, Abe T, Raison N, Van Hemelrijck M, Ahmed H, Al-Jabir A, Brunckhorst O, Shinohara N, Zhu W, Zeng G, Sfakianos J, Tewari A, Gözen A, Rassweiler J, Skolarikos A, Kunit T, Knoll T, Moltzahn F, Thalmann G, Lantz Powers A, Chew B, Sarica K, Khan M, Dasgupta P. Simulation in urological training and Education (SIMULATE): A randomised controlled clinical and educational trial to determine the effect of simulation-based surgical training. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01334-8] [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: 10/20/2022]
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Jasionowska S, Bochinski A, Shiatis V, Singh S, Brunckhorst O, Rees R, Ahmed K. Anterior urethroplasty for the management of urethral strictures in males: A systematic review. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00780-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Dincer A, Brunckhorst O, Genel O, Ahmed K. Anxiety and depressive symptom prevalence in testicular cancer patients: A systematic review. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01030-7] [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: 11/17/2022]
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22
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Khaleeq T, Hanif U, Maqsood Y, Ahmed K, Patel A. 23 Reaudit and Completing the Audit Cycle of Quality of Informed Consent for Surgery on Neck of Femur Fracture in Royal Stoke University Hospital. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.349] [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]
Abstract
Abstract
Using guidelines highlighted by the British Orthopaedic Association an reaudit was performed within our department to assess the adequacy of informed consent for NOF fractures to complete the audit cycle. 50 patients were included in the Audit and reaudit. Risk was classified as common, less common, rare and ‘other’. The adequacy of informed consent was evaluated by assessing the quality and accuracy of documentation. Infection, bleeding risks, clots and anaesthetic risks were documented in all patients (100%). Areas of improvement were seen in the documentation of neurovascular injuries (98%), pain (90%) and altered wound healing (87%). There was no significant change in the documentation of failure of surgery (83%) and neurovascular injuries (98%). The Poorly documented risk factors from the initial audit were seen to improve which included mortality (70%), prosthetic dislocation (90%) and limb length discrepancy (50%). There has been a significant improvement in the quality of Informed consent in the department and this could be attributed to the installation of ward posters and verbal dissemination of information to junior doctors. Recommendation for interventions would be to present in the next clinical governance meeting and presenting at the new junior doctors’ induction at August.
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Affiliation(s)
- T Khaleeq
- Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| | - U Hanif
- Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| | - Y Maqsood
- Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| | - K Ahmed
- Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| | - A Patel
- Royal Stoke University Hospital, Stoke on Trent, United Kingdom
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23
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Hay D, Ahmed K, Dasgupta P, Challacombe B. O53: SO YOU WANT TO BE A ROBOTIC SURGEON? THE EFFECT OF BASELINE PSYCHOMOTOR ABILITY AND VIDEO-GAME EXPERIENCE ON ROBOTIC SURGICAL SKILL: A RANDOMISED CONTROL TRIAL. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.053] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
We assessed whether expert mentoring improved the rate of uptake of robotic surgical skill and whether general advanced psychomotor ability (PMA), and specific video-game experience (VGE) had any impact on robotic surgical skill.
Method
Twenty robotically naive medical students were blinded and randomised to two cohorts; control (CC) and intervention (IC). Each student's initial performance on a variety of da Vinci Skills Simulator (dVSSim) exercises was measured and then reassessed following an independent practice (CC) or mentor guided practice session (IC). Outcome metrics were overall score, time to completion, economy of motion and master workspace range. Quantitative, questionnaire data was collected to evaluate the relationship between robotic surgical skill, PMA and VGE. Statistical analysis was performed with SPSS software utilising the independent t-test.
Result
On average, overall score for CC improved by 16.8% compared to 43.3% for the IC (p=0.04). Time to completion improved by 26.2% (CC) vs. 40% (IC), economy of motion by 16.5% vs. 25% and master workspace range by 8% vs. 11%. PMA correlated with better initial performances for all metrics, especially for overall score (p=0.003) and economy of motion (p=0.03). Students with more VGE had overall scores that were on average 20% better than those with little or no experience and this relationship was also seen for economy of motion and master workspace range.
Conclusion
Expert mentoring leads to a greater improvement in performance than independent practice alone. Advanced PMA correlates with greater innate robotic skill, as does VGE, but to a lesser extent.
Take-home message
1) Expert mentoring leads to a greater improvement in performance than independent practice alone. 2) Advanced PMA correlates with greater innate robotic skill, as does VGE, but to a lesser extent.
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Slade AL, Retzer A, Ahmed K, Kyte D, Keeley T, Armes J, Brown JM, Calman L, Gavin A, Glaser AW, Greenfield DM, Lanceley A, Taylor RM, Velikova G, Turner G, Calvert MJ. Systematic review of the use of translated patient-reported outcome measures in cancer trials. Trials 2021; 22:306. [PMID: 33902699 PMCID: PMC8074490 DOI: 10.1186/s13063-021-05255-z] [Citation(s) in RCA: 4] [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: 07/17/2020] [Accepted: 04/08/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Patient-reported outcomes (PROs) are used in clinical trials to assess the effectiveness and tolerability of interventions. Inclusion of participants from different ethnic backgrounds is essential for generalisability of cancer trial results. PRO data collection should include appropriately translated patient-reported outcome measures (PROMs) to minimise missing data and sample attrition. METHODS Protocols and/or publications from cancer clinical trials using a PRO endpoint and registered on the National Institute for Health Research Portfolio were systematically reviewed for information on recruitment, inclusion of ethnicity data, and use of appropriately translated PROMs. Semi-structured interviews were conducted with key stakeholders to explore barriers and facilitators for optimal PRO trial design, diverse recruitment and reporting, and use of appropriately translated PROMs. RESULTS Eighty-four trials met the inclusion criteria, only 14 (17%) (n = 4754) reported ethnic group data, and ethnic group recruitment was low, 611 (13%). Although 8 (57%) studies were multi-centred and multi-national, none reported using translated PROMs, although available for 7 (88%) of the studies. Interviews with 44 international stakeholders identified a number of perceived barriers to ethnically diverse recruitment including diverse participant engagement, relevance of ethnicity to research question, prominence of PROs, and need to minimise investigator burden. Stakeholders had differing opinions on the use of translated PROMs, the impact of trial designs, and recruitment strategies on diverse recruitment. Facilitators of inclusive research were described and examples of good practice identified. CONCLUSIONS Greater transparency is required when PROs are used as primary or secondary outcomes in clinical trials. Protocols and publications should demonstrate that recruitment was accessible to diverse populations and facilitated by trial design, recruitment strategies, and appropriate PROM usage. The use of translated PROMs should be made explicit when used in cancer clinical trials.
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Affiliation(s)
- A L Slade
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. .,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK. .,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, West Midlands, UK.
| | - A Retzer
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - K Ahmed
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - D Kyte
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK.,National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK
| | - T Keeley
- Patient Centred Outcomes, GlaxoSmithKline, Brentford, UK
| | - J Armes
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,School of Health Sciences, University of Surrey, Guildford, UK.,NIHR Applied Research Collaboration Kent Surrey & Sussex University of Surrey, Guildford, UK
| | - J M Brown
- Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - L Calman
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Macmillan Survivorship Research Group, Health Sciences, University of Southampton, Highfield Campus, Southampton, UK
| | - A Gavin
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Northern Ireland Cancer Registry, Centre for Public Health, Queens University Belfast, Belfast, Northern Ireland
| | - A W Glaser
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - D M Greenfield
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | - A Lanceley
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - R M Taylor
- National Cancer Research Institute (NCRI) Psychosocial Oncology and Survivorship Clinical Studies Group subgroup: Understanding and measuring the consequences of cancer and its treatment, London, UK.,Cancer Clinical Trials Unit, University College London Hospitals NHS Foundation Trust, London, UK
| | - G Velikova
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - G Turner
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - M J Calvert
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK.,National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, West Midlands, UK.,National Institute for Health Research Applied Research Collaboration, University of Birmingham, Birmingham, West Midlands, UK.,Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, West Midlands, UK
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Hussain M, Ahmed K, Chakravarty P, Paul V, Deka BC, Begum SS, Bhuyan D, Borah P, Tamuly S, Medhi D, Barua PM. 148 Superovulation and embryo production response in oestrus-synchronized Arunachali yak. Reprod Fertil Dev 2021. [DOI: 10.1071/rdv33n2ab148] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Arunachali breed of yak is reared by the Monpa pastoral community of Arunachal Pradesh in India for their livelihood and nutritional security on highland pastures. In addition to fulfilling the basic needs of highlanders, this animal is associated with poor production potential linked to its inherent reproductive problems, including silent oestrus, seasonality, and inbreeding, making yak rearing a less-profitable venture. In the recent past, efforts have been made to improve reproductive efficiency of Arunachali yak through assisted reproductive techniques. However, a few regimens for superovulation have been tried to date with limited success in terms of superovulatory response and embryo recovery. Therefore, the present study was undertaken to evaluate the efficacy of two different doses and regimes of superovulation: Stimufol (400 and 200µg per animal) and Folligon (1500 and 1000IU per animal) in Arunachali yak. Twenty-four yaks were allotted in 4 groups (of 6 animals each) and subjected to respective superovulation treatment. Thereafter, the treatment response was assessed in terms of expression of oestrus, interval between treatment and oestrus onset, duration of oestrous, number of corpora lutea and embryos recovered, and analysed using two-way statistical analysis between treatment groups. The results (Table 1) showed a significant (P<0.01) variation in onset of oestrus after the treatment, whereas other responses did not differ among the groups. Further, the recovered embryos were categorized as excellent, good, fair, and poor according to cell size, shape, texture, and number of vesicles present in the blastomeres; 58.33, 20.83, 8.33, and 12.5% embryos in these categories were recovered, respectively. The overall embryo recovery rate was 30.77%, ranging from 10.53 to 52.38% in different treatment groups. The numbers of embryos recorded were less than the numbers of CL present, showing the possibility of non-availability of all ovulated oocytes for fertilization in the oviduct due to untrapping by the fimbriae. The effectiveness of treatments depended upon the precision of oestrus detection and the time of ovulation. In our study, the variation in onset of oestrus might be associated with poor expression of behavioural oestrus in the treated animals. Based on the present findings, we conclude that all the treatments are effective in superovulation and embryo recovery. However, the use of Folligon at 1500IU seemed to be comparatively more effective in Arunachali yak.
Table 1.
Mean (n=6) average of treatment responses in yak following different superovulatory treatment
Variable
Treatment
Stimufol
Folligon
400 µg/animal
200 µg/animal
1500 IU/animal
1000 IU/animal
Oestrus response (%)
100
100
100
100
Interval between treatment and oestrus onset (h)
17.67±0.56a
20.83±0.79b
21.17±0.79bc
23.67±1.43c
Duration of oestrous (h)
30.33±1.09
28.50±0.99
31.50±1.50
28.83±1.25
Corpora lutea (n)
2.83±1.22
3.50±1.18
3.50±0.67
3.17±0.87
Embryo recovered (n)
0.83±0.83
1.00±0.81
1.83±0.98
0.33±0.21
Recovery rate (%)
29.41
28.57
52.38
10.53
a–cMeans within a row with different superscripts differ P<0.05.
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Khan T, Paul BK, Hasan MT, Islam MR, Arefin M, Ahmed K, Islam MK, Moni MA. Significant pathway and biomarker identification of pancreatic cancer associated lung cancer. Informatics in Medicine Unlocked 2021. [DOI: 10.1016/j.imu.2021.100637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Byrne R, Curley S, Ahmed K, Ahmed M, Gibney J, Mcgillicuddy F. HDL efflux capacity, and particle remodelling in patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.202] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fontes D, Reyes J, Ahmed K, Kinzel M. A study of fluid dynamics and human physiology factors driving droplet dispersion from a human sneeze. Phys Fluids (1994) 2020; 32:111904. [PMID: 33244214 PMCID: PMC7682788 DOI: 10.1063/5.0032006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 10/30/2020] [Indexed: 05/04/2023]
Abstract
Recent studies have indicated that COVID-19 is an airborne disease, which has driven conservative social distancing and widescale usage of face coverings. Airborne virus transmission occurs through droplets formed during respiratory events (breathing, speaking, coughing, and sneezing) associated with the airflow through a network of nasal and buccal passages. The airflow interacts with saliva/mucus films where droplets are formed and dispersed, creating a route to transmit SARS-CoV-2. Here, we present a series of numerical simulations to investigate droplet dispersion from a sneeze while varying a series of human physiological factors that can be associated with illness, anatomy, stress condition, and sex of an individual. The model measures the transmission risk utilizing an approximated upper respiratory tract geometry for the following variations: (1) the effect of saliva properties and (2) the effect of geometric features within the buccal/nasal passages. These effects relate to natural human physiological responses to illness, stress, and sex of the host as well as features relating to poor dental health. The results find that the resulting exposure levels are highly dependent on the fluid dynamics that can vary depending on several human factors. For example, a sneeze without flow in the nasal passage (consistent with congestion) yields a 300% rise in the droplet content at 1.83 m (≈6 ft) and an increase over 60% on the spray distance 5 s after the sneeze. Alternatively, when the viscosity of the saliva is increased (consistent with the human response to illness), the number of droplets is both fewer and larger, which leads to an estimated 47% reduction in the transmission risk. These findings yield novel insight into variability in the exposure distance and indicate how physiological factors affect transmissibility rates. Such factors may partly relate to how the immune system of a human has evolved to prevent transmission or be an underlying factor driving superspreading events in the COVID-19 pandemic.
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Affiliation(s)
- D. Fontes
- Florida Space Institute, University of Central
Florida, Orlando, Florida 32826, USA
| | - J. Reyes
- Mechanical and Aerospace Engineering Department,
University of Central Florida, Orlando, Florida 32816,
USA
| | - K. Ahmed
- Mechanical and Aerospace Engineering Department,
University of Central Florida, Orlando, Florida 32816,
USA
| | - M. Kinzel
- Mechanical and Aerospace Engineering Department,
University of Central Florida, Orlando, Florida 32816,
USA
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Amin MSA, Brunckhorst O, Scott C, Wrench D, Gleeson M, Kazmi M, Ahmed K. ABVD and BEACOPP regimens' effects on fertility in young males with Hodgkin lymphoma. Clin Transl Oncol 2020; 23:1067-1077. [PMID: 32944834 PMCID: PMC8084804 DOI: 10.1007/s12094-020-02483-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 07/21/2020] [Accepted: 08/31/2020] [Indexed: 12/17/2022]
Abstract
Purpose Considering the increased cancer patient survivorship, the focus is now on addressing the impacts of treatment on quality of life. In young people, altered reproductive function is a major issue and its effects in young males are largely neglected by novel research. To improve clinician awareness, we systematically reviewed side effects of chemotherapy for Hodgkin lymphoma (HL) in young males. Methods The review was prospectively registered (PROSPERO N. CRD42019122868). Three databases (Medline via PUBMED, SCOPUS, and Cochrane Library) were searched for studies featuring males aged 13-51-years who underwent chemotherapy for HL using ABVD (Adriamycin® (doxorubicin), bleomycin, vinblastine, and dacarbazine) or BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone) regimens. These chemotherapy regimens were compared against each other using sperm characteristics, FSH, and inhibin B levels to measure fertility levels. Results Data were extracted from five studies featuring 1344 patients. 6 months post-ABVD saw marked deterioration in sperm count, further reduced by more cycles (P = 0.05). Patients treated with BEACOPP rather than ABVD were more prone to oligospermia. Receiving fewer cycles of both regimens increased the likelihood of sperm production recovering. Patients treated with 6-8 cycles of BEACOPP did not recover spermiogenesis. Conclusions ABVD and BEACOPP regimens significantly reduce fertility function to varying effects depending on treatment duration. ABVD temporarily causes significant reductions in male fertility, whereas BEACOPP’s effects are more permanent. Therefore, clinicians should discuss fertility preservation with male patients receiving infertility-inducing gonadotoxic therapy. Further high-quality studies are required to more adequality describe the risk to fertility by chemotherapy. Electronic supplementary material The online version of this article (10.1007/s12094-020-02483-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M S A Amin
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, SE1 9RT, UK
| | - O Brunckhorst
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, SE1 9RT, UK
| | - C Scott
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, SE1 9RT, UK
| | - D Wrench
- Department of Haematology, Guy's Hospital, London, UK
| | - M Gleeson
- Department of Haematology, Guy's Hospital, London, UK
| | - M Kazmi
- Department of Haematology, Guy's Hospital, London, UK
| | - K Ahmed
- MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, SE1 9RT, UK. .,Department of Urology, King's College Hospital, London, UK.
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Affiliation(s)
- C.J. Dickinson
- The Medical College of St. Bartholomew's Hospital, West Smithfield, London, UK
| | - D. Ingram
- The Medical College of St. Bartholomew's Hospital, West Smithfield, London, UK
| | - K. Ahmed
- Health Sciences Centre, McMaster University Medical School, Hamilton, Ontario, Canada
- School of Pharmacy, University of London Institute of Medical Education, Bonn, West Germany University College Hospital Medical School, London
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31
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Ahmed Khudhur H, Brunckhorst O, Muir G, Jalil R, Khan A, Ahmed K. Prostatic abscess: A systematic review of diagnosis, current treatment modalities and outcomes. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33971-9] [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: 11/16/2022] Open
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32
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Aydin A, Griffin C, Brunckhorst O, Mcilhenny C, Brewin J, Raison N, Al-Jabir A, Shabbir M, Palou Redorta J, Khan M, Dasgupta P, Ahmed K. Validity assessment of the Non-Technical Skills for Urological Surgeons (NoTSUS) curriculum and assessment scale. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33937-9] [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: 10/23/2022] Open
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Mekhaimar A, Goble M, Brunckhorst O, Alnajjar H, Ralph D, Muneer A, Ahmed K. A systematic review of the outcomes of transurethral resection of the ejaculatory ducts for obstructive azoospermia. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32929-3] [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: 11/25/2022] Open
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Hansen CL, McCormick BJJ, Azam SI, Ahmed K, Baker JM, Hussain E, Jahan A, Jamison AF, Knobler SL, Samji N, Shah WH, Spiro DJ, Thomas ED, Viboud C, Rasmussen ZA. Substantial and sustained reduction in under-5 mortality, diarrhea, and pneumonia in Oshikhandass, Pakistan: evidence from two longitudinal cohort studies 15 years apart. BMC Public Health 2020; 20:759. [PMID: 32448276 PMCID: PMC7245818 DOI: 10.1186/s12889-020-08847-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/23/2019] [Accepted: 05/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oshikhandass is a rural village in northern Pakistan where a 1989-1991 verbal autopsy study showed that diarrhea and pneumonia were the top causes of under-5 mortality. Intensive surveillance, active community health education and child health interventions were delivered in 1989-1996; here we assess improvements in under-5 mortality, diarrhea, and pneumonia over this period and 15 years later. METHODS Two prospective open-cohort studies in Oshikhandass from 1989 to 1996 (Study 1) and 2011-2014 (Study 2) enrolled all children under age 60 months. Study staff trained using WHO guidelines, conducted weekly household surveillance and promoted knowledge on causes and management of diarrhea and pneumonia. Information about household characteristics and socioeconomic status was collected. Hurdle models were constructed to examine putative risk factors for diarrhea and pneumonia. RESULTS Against a backdrop of considerable change in the socioeconomic status of the community, under-5 mortality, which declined over the course of Study 1 (from 114.3 to 79.5 deaths/1000 live births (LB) between 1989 and 1996), exceeded Sustainable Development Goal 3 by Study 2 (19.8 deaths/ 1000 LB). Reductions in diarrhea prevalence (20.3 to 2.2 days/ Child Year [CY]), incidence (2.1 to 0.5 episodes/ CY), and number of bloody diarrhea episodes (18.6 to 5.2%) seen during Study 1, were sustained in Study 2. Pneumonia incidence was 0.5 episodes /CY in Study 1 and 0.2/CY in Study 2; only 5% of episodes were categorized as severe or very severe in both studies. While no individual factors predicted a statistically significant difference in diarrhea or pneumonia episodes, the combined effect of water, toilet and housing materials was associated with a significant decrease in diarrhea; higher household income was the most protective factor for pneumonia in Study 1. CONCLUSIONS We report a 4-fold decrease in overall childhood mortality, and a 2-fold decrease in childhood morbidity from diarrhea and pneumonia in a remote rural village in Pakistan between 1989 and 2014. We conclude that significant, sustainable improvements in child health may be achieved through improved socioeconomic status and promoting interactions between locally engaged health workers and the community, but that continued efforts are needed to improve health worker training, supervision, and the rational use of medications. TRIAL REGISTRATION Not Applicable.
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Affiliation(s)
- C L Hansen
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - B J J McCormick
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - S I Azam
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - K Ahmed
- Karakoram International University, University Road, Gilgit, Pakistan
| | - J M Baker
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - E Hussain
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - A Jahan
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - A F Jamison
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - S L Knobler
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - N Samji
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - W H Shah
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - D J Spiro
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - E D Thomas
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - C Viboud
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Z A Rasmussen
- Fogarty International Center, National Institutes of Health, Bethesda, MD, 20892, USA.
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Mills M, Liveringhouse C, Lee F, Nanda R, Ahmed K, Washington I, Thapa R, Fridley B, Blumencranz P, Extermann M, Balducci L, Diaz R. THE PREVALENCE OF LUMINAL B SUBTYPE IS HIGHER IN OLDER POSTMENOPAUSAL WOMEN WITH ER+/HER2– BREAST CANCER AND IS ASSOCIATED WITH INFERIOR OUTCOMES. J Geriatr Oncol 2019. [DOI: 10.1016/s1879-4068(19)31150-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sangster P, Alnajjar HM, Ahmed K, Christodoulidou M, Williamson E, Kelly JD, Dawas K, Ralph D, Muneer A. Microdissection TESE (
mTESE
) following adult orchidopexy for undescended intra‐abdominal and inguinal testicles – surgical techniques and outcomes from a single‐centre cohort. Andrology 2019; 8:166-170. [DOI: 10.1111/andr.12679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 06/03/2019] [Accepted: 06/14/2019] [Indexed: 11/30/2022]
Affiliation(s)
- P. Sangster
- Institute of Andrology University College London Hospital London UK
| | - H. M. Alnajjar
- Institute of Andrology University College London Hospital London UK
| | - K. Ahmed
- Institute of Andrology University College London Hospital London UK
| | - M. Christodoulidou
- Institute of Andrology University College London Hospital London UK
- Division of Surgery and Interventional Science University College London London UK
| | - E. Williamson
- Institute of Andrology University College London Hospital London UK
| | - J. D. Kelly
- Institute of Andrology University College London Hospital London UK
- Division of Surgery and Interventional Science University College London London UK
| | - K. Dawas
- Department of Surgery University College London Hospital London UK
| | - D. Ralph
- Institute of Andrology University College London Hospital London UK
- Division of Surgery and Interventional Science University College London London UK
| | - A. Muneer
- Institute of Andrology University College London Hospital London UK
- Division of Surgery and Interventional Science University College London London UK
- NIHR Biomedical Research Centre University College London Hospital London UK
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Johnstone P, Grass G, Azizi M, Ahmed K, Yoder G, Welsh E, Fulp W, Dhillon J, Torres-Roca J, Giuliano A, Yuan Z, Spiess P. OC-0268 Intrinsic radiosensitivity, genomic-adjusted radiation dose and patterns of failure of penile cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30688-7] [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: 11/29/2022]
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Allen N, Allen M, Ahmed K, Gomm J, Nelan R, Nagano A, Chelala C, Gadaleta E, Thorat M, Cuzick J, Jones LJ. Abstract P5-18-08: Defining molecular signatures to personalise management of patients with early breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-18-08] [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: 11/16/2022]
Abstract
Abstract
Background
A review of breast screening highlighted the need to reduce overdiagnosis. Ductal Carcinoma In-Situ (DCIS) contributes significantly to this overdiagnosis. Epithelial cells in DCIS are as genetically advanced as those in invasive disease, focusing attention on the tumour microenvironment (ME). A key components of the ME in DCIS is the myoepithelial cell(MEC). These cells lie at the interface of the epithelial and stromal compartments, regulating cell function. We previously have identified changes in the MEC that contribute to tumour progression. Here we investigate the functional and clinical significance of a novel change in MEC phenotype: loss of Galectin-7 (Gal-7) expression. Gal-7 is proposed to play a role in apoptosis. We hypothesise that changes in MEC phenotype in DCIS alter the ME towards a pro-invasive phenotype, and hypothesise that loss of Gal-7 modifies the ME, destabilizes the MEC interface and ultimately may lead to loss of the MEC population through apoptosis.
Methods
Gal-7 expression and function was investigated in clinical samples and in-vitro model systems, respectively.
Gal-7 expression was assessed in a series of pure DCIS samples (low risk model) and DCIS with co-existant invasion (high risk model). Tissue sections were stained for Gal-7 and MEC expression scored on a duct-by-duct basis as positive, heterogeneous or negative.
An in-vitro model of normal primary myoepithelial cells isolated from reduction mammoplasty was used to investigate the functional impact of loss of Gal-7. These cells have high endogenous levels of Gal-7. Gal-7 was knocked down using siRNA and apoptosis assessed using cleaved caspase-3. The effect of Gal-7 on MEC layer integrity was assessed using immunofluorescence and adhesion assays.
The global impact of loss of Gal-7 was investigated using RNA sequencing.
Results
In the tissue analysis 1926 DCIS ducts were scored for MEC expression of Gal-7. Significantly more ducts showed loss of Gal-7 in DCIS with co-existant invasion, with pure DCIS showing 388 ducts positive and DCIS with invasion 144 DCIS ducts positive (p=0.0014). Pure DCIS and DCIS with invasion had 99 and 646 negative DCIS ducts respectively (p=0.0002).
In model systems of primary MEC, knockdown of Gal-7 resulted in increased expression of cleaved caspase-3, suggesting lower levels of Gal-7 increases apoptosis. In functional assays silencing Gal-7 reduces adhesion to both fibronectin and laminin extracellular matrices (p-value 0.005 and 0.001 respectively)
RNA sequencing indicates silencing Gal-7 increases LOX expression - a key regulator of the collagen matrix of the microenvironment.
Conclusion
Normal MEC strongly express Gal-7. Expression is lost in DCIS, with significantly more frequent loss in DCIS with co-existant invasion, suggesting that loss is associated with a more advanced phenotype. Functional assays indicate that loss of MEC Gal-7 enhances MEC apoptosis, which may be one mechanism by which this interface is lost during progression. Gal-7 negative MEC also show impaired adhesion to matrix proteins and lead to up-regulation of LOX, an enzyme key in promoting tumourigenesis. The incorporation of Gal-7 expression into a risk stratification algorithm has functional evidence and is currently being investigated.
Citation Format: Allen N, Allen M, Ahmed K, Gomm J, Nelan R, Nagano A, Chelala C, Gadaleta E, Thorat M, Cuzick J, Jones LJ. Defining molecular signatures to personalise management of patients with early breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-18-08.
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Affiliation(s)
- N Allen
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
| | - M Allen
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
| | - K Ahmed
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
| | - J Gomm
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
| | - R Nelan
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
| | - A Nagano
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
| | - C Chelala
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
| | - E Gadaleta
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
| | - M Thorat
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
| | - J Cuzick
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
| | - LJ Jones
- Barts Cancer Institute, London, United Kingdom; Wolfson Institute of Preventative Medicine, London, United Kingdom
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Mothojakan N, Ahmed K, Lock K, Antoni E, Gardezi S, Ashraf S, Chandio K, Patel P, Arnold Jellis J, S-C. Soo D. Malnutrition screening on admission and initial management at a district general hospital. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.055] [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: 11/25/2022]
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Ahmad SS, Ahmed K, Venkitaraman AR. Science in Focus: Genomic Instability and its Implications for Clinical Cancer Care. Clin Oncol (R Coll Radiol) 2018; 30:751-755. [PMID: 30269933 DOI: 10.1016/j.clon.2018.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 06/13/2018] [Accepted: 08/15/2018] [Indexed: 12/22/2022]
Affiliation(s)
- S S Ahmad
- Medical Research Council Cancer Unit, University of Cambridge, Cambridge, UK.
| | - K Ahmed
- Medical Research Council Cancer Unit, University of Cambridge, Cambridge, UK
| | - A R Venkitaraman
- Medical Research Council Cancer Unit, University of Cambridge, Cambridge, UK
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Islam MA, Haque S, Ahmed K, Bari MS, Hoque MM, Khan MK, Haque N, Haque N, Reza-Ul-Haq KM, Kobir MS. Outcome of Surgery in Chronic Inactive Mucosal Otitis Media. Mymensingh Med J 2018; 27:617-625. [PMID: 30141454] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Chronic otitis media is a common condition seen in patients attending the otorhinolaryngology Department. The discharging ear presents the otologists with the dilemma of operating on it or not. The aim of the this cross-sectional observational study was to find out the outcome of surgery in chronic inactive mucosal otitis media and was conducted on 62 patients of either sex in the age group of 15-60 years in the Department of ENT and Head Neck surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH), Dhaka, Bangladesh From July 2015 to January 2016. Pre and post operative hearing assessment was done with pure tone audiometry (PTA). Post operative graft status also noted. All the information's were recorded in the fixed protocol. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using updated computerized program SPSS-19. Among 62 cases the mean age were 36.79±10.33 in chronic inactive mucosal otitis media. Majority of the study population were in age group of between 15-25 in this group of which was 16(51.6%). Male were 36(58.06) and 26(41.94) were female. All patients presented with history of otorrhoea in this group, 52(83.87%) had hearing impairment in chronic inactive mucosal otitis media, 30(48.39%) involved in right ear and 26(41.94%) involved in left ear and 06(9.68%) in both ear in chronic inactive mucosal otitis media. Majority of perforation were medium in size in this group of which was 30(48.39%). anterior perforation was 24(38.71%), posterior perforation 28(45.16%) and subtotal 10(16.13%) in chronic inactive mucosal otitis media. Sixty two (100%) cases underwent myringoplasty. Post-auricular approach used in most of operation in this group of which was 60(96.77%). Preoperative air conduction threshold 32(51.61%) were in between 31-45 dB in myringoplasty group (p<0.05) that was statistically significant. Postoperative air conduction threshold 30(48.39%) were between 16-30 dB in myringoplasty group (p<0.05) that was statistically significant. Difference between preoperative and postoperative air conduction threshold mean difference was 11.38 dB and 36.75±5.84 and 25.37±7.46 respectively (p<0.001) in myringoplasty group. Hearing gain was 42(67.74%) in myringoplasty (p>0.05) that was not statistically significant. Graft uptake in myringoplasty was 52(83.9%). Graft failure in myringoplasty was 10(16.1%). post operative complication was tinnitus in 12(19.35%) cases in myringoplasty. Success rate was more in case of posterior perforation than anterior and subtotal perforation in both chronic inactive mucosal otitis media which was 92.86%. Success rate was more in case of medium size perforation than subtotal perforation in chronic inactive mucosal otitis media which was 86.67%. Success rate was (100%) in small perforation in this group. From this study it can be concluded that myringoplasty is a valid treatment modality for chronic inactive mucosal otitis media to achieve an intact tympanic membrane and to gain hearing.
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Affiliation(s)
- M A Islam
- Dr Md Amirul Islam, Associate Professor (CC), Department of ENT&HNS, Dhaka Community Medical College & Hospital, Dhaka, Bangladesh
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Aydin A, Ahmed K, Raison N, Abe T, Gözen A, Knoll T, Moltzahn F, Skolarikos A, Lantz A, Chew B, Thalmann G, Shinohara N, Rassweiler J, Zeng G, Khan M, Dasgupta P. International Multicentre Validation and Transferability of the SIMULATE Ureterorenoscopy Training Curriculum. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.689] [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: 10/28/2022]
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Quirke K, Aydin A, Khan M, Dasgupta P, Ahmed K. Learning Curves in Urolithiasis Surgery: A Systematic Review. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.714] [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: 11/29/2022]
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Lovegrove C, Bruce E, Raison N, Khan S, Brown C, Rane A, Sheriff M, Dasgupta P, Ahmed K. Development and validation of a training and assessment tool for laparoscopic radical nephrectomy. Actas Urol Esp 2018; 42:396-405. [PMID: 29609827 DOI: 10.1016/j.acuro.2017.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/29/2017] [Accepted: 10/30/2017] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Laparoscopic radical nephrectomy(LRN) is a cornerstone in managing renal cancer and small renal masses. Twenty-first century surgical training faces challenges, thus must be efficient and safe so surgeons attain relevant skills, protecting patients and operative outcomes. This study aimed to systematically develop a tool for training and assessment in LRN and validate the developed tool for use by trainee urologists. METHODS This prospective, longitudinal, multi-institutional study was undertaken from September 2014 - June 2015. Healthcare Failure Mode and Effect Analysis was utilised for development and followed by validation where the assessment tool was distributed to five specialists to increase content validity. Four experts were observed as a multi-institutional approach. Hand-assisted, transperitoneal and retroperitoneal approaches were considered. RESULTS The LRN Assessment Tool comprised four phases, 17 processes, 41 sub-processes. Four surgeons and operating teams were observed across four hospitals for 19.5hours (5.75h hand-assisted, 8.75h trans-peritoneal, 5h retro-peritoneal). After hazard analysis, three checklists were constructed. Those for hand-assisted LRN and transperitoneal LRN contained four phases, 20 processes, 33 sub-processes and that for retroperitoneal LRN contained four phases, 20 processes, 30 sub-processes. These were merged to form one assessment tool. The final result was a four phase LRN Assessment Tool with 17 processes, 41 sub-processes. All participants agreed the final LRN Assessment Tool included pertinent steps. CONCLUSIONS The LRN Assessment Tool was developed using Healthcare Failure Mode and Effect Analysis risk analysis to ensure hazardous procedural sub-steps were included. Validation ascertained important processes were not overlooked. Full application through a pilot study must be undertaken.
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Perveen R, Hoque MH, Ahmed K, Ahmed CM, Jalil MA, Parvin T, Osmany DF, Rashid S, Rashid MB, Nahar S, Shakil SS. An Echocardiographic Study of the Right Ventricular Diastolic Function in Systemic Hypertension and Its Relation with the Left Ventricular Homologous Changes. Mymensingh Med J 2018; 27:596-602. [PMID: 30141451] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Diastolic dysfunction is a major predictor of mortality and morbidity in hypertensive patients. Not only LV, the RV is also expected to be affected in this overall procedure. To observe the Echocardiographic changes of diastolic function of the RV in systemic HTN and their relation with similar parameters of the LV was the objective. TDI was used in association with standard Doppler modality. In this cross-sectional study, 50 hypertensive subjects were studied who were devoid of any other conditions that may influence the diastolic function of the RV from 01 May 2012 to 31 October 2012 at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. In addition to 2D and M-mode evaluation, standard Doppler and pulsed tissue Doppler assessment of both ventricles were performed. Measurements were obtained for diastolic as well as systolic function of both ventricles. The RV diastolic parameters were impaired in both standard Doppler and tissue Doppler analysis in association with LV parameters. Systolic functions (LV FS and RV TAPSE) were preserved. Doppler-derived tricuspid peak E and E/A were related negatively to septal thickness, but tissue Doppler-derived RV Em/Am showed negative association with both RVAWT and septal thickness. RV RTm was related positively to RVAWT. The RV diastolic parameters showed positive relation with the LV similar parameters both in standard Doppler (E peak velocity, E/A ratio and EDT) and tissue Doppler (Em peak velocity, Em/Am and PCTm) assessment. So, in systemic HTN, LV diastolic dysfunction is also associated with diastolic disturbances of the RV. Pulsed tissue Doppler is a useful tool to detect the changes. RV diastolic parameters correlate well with those of the LV. Prolongation of the active relaxation (RTm) phase of RV is due to its increased wall thickness.
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Affiliation(s)
- R Perveen
- Dr Roseyat Perveen, Junior Consultant, Cardiology, Upazilla Health Ccomplex, Dhamrai, Dhaka, Bangladesh
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Shah M, Aydin A, Moran A, Khan M, Dasgupta P, Ahmed K. The role of cognitive training in endourology: A randomized controlled trial. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.acuroe.2018.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Shah M, Aydin A, Moran A, Khan MS, Dasgupta P, Ahmed K. The role of cognitive training in endourology: a randomised controlled trial. Actas Urol Esp 2018; 42:163-169. [PMID: 29292040 DOI: 10.1016/j.acuro.2017.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/24/2017] [Accepted: 06/27/2017] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Cognitive training is an important training modality which allows the user to rehearse a procedure without physically carrying it out. This has led to recent interests to incorporate cognitive training within surgical education but research is currently limited. The use of cognitive training in surgery is not clear-cut and so this study aimed to determine whether, relative to a control condition, the use of cognitive training improves technical surgical skills on a ureteroscopy simulator, and if so whether one cognitive training method is superior. METHODS This prospective, comparative study recruited 59 medical students and randomised them to one of three groups: control- simulation training only (n=20), flashcards cognitive training group (n=20) or mental imagery cognitive training group (n=19). All participants completed three tasks at baseline on the URO Mentor simulator followed by the cognitive intervention if randomised to receive it. Participants then returned to perform an assessment task on the simulator. Outcome measures from the URO Mentor performance report was used for analysis and a quantitative survey was given to all participants to assess usefulness of training received. RESULTS This study showed cognitive training to have minimal effects on technical skills of participants. The mental imagery group had fewer laser misfires in the assessment task when compared to both control and flashcards group (P=.017, P=.036, respectively). The flashcards group rated their preparation to be most useful when compared to control (P=.0125). Other parameters analysed between the groups did not reach statistical significance. Cognitive training was found to be feasible and cost effective when carried out in addition to simulation training. CONCLUSION This study has shown that the role of cognitive training within acquisition of surgical skills is minimal and that no form of cognitive training was superior to another. Further research needs to be done to evaluate other ways of performing cognitive training.
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Affiliation(s)
- M Shah
- MRC Centre for Transplantation, King's College London, Londres, Reino Unido
| | - A Aydin
- MRC Centre for Transplantation, King's College London, Londres, Reino Unido
| | - A Moran
- School of Psychology, University College Dublin, Dublín, Irlanda
| | - M S Khan
- MRC Centre for Transplantation, King's College London, Londres, Reino Unido; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, Londres, Reino Unido
| | - P Dasgupta
- MRC Centre for Transplantation, King's College London, Londres, Reino Unido; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, Londres, Reino Unido
| | - K Ahmed
- MRC Centre for Transplantation, King's College London, Londres, Reino Unido; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, Londres, Reino Unido.
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Liveringhouse C, Ahmed K, Purcell J, Mills M, Grass G, Orman A, Torres-Roca J, Diaz R. EP-2302: Differences in the Radiosensitivty Index (RSI) Between Metastatic and Primary Breast Cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32611-2] [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: 11/28/2022]
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Syed S, Yeruva S, Herrmann J, Sailer A, Sadiq K, Iqbal N, Kabir F, Ahmed K, Qureshi S, Moore SR, Turner J, Ali SA. Environmental Enteropathy in Undernourished Pakistani Children: Clinical and Histomorphometric Analyses. Am J Trop Med Hyg 2018; 98:1577-1584. [PMID: 29611507 PMCID: PMC6086170 DOI: 10.4269/ajtmh.17-0306] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Despite nutrition interventions, stunting thought to be secondary to underlying environmental enteropathy (EE) remains pervasive among infants residing in resource-poor countries and remains poorly characterized. From a birth cohort of 380 children, 65 malnourished infants received 12 weeks of nutritional supplementation with ready-to-use therapeutic food (RUTF). Eleven children with insufficient response to RUTF underwent upper endoscopy with duodenal biopsies, which were compared with U.S., age-matched specimens for healthy, celiac disease, non-celiac villous atrophy, non-celiac intraepithelial lymphocytosis, and graft-versus-host disease patients. Of the 11 children biopsied, EE was found in 10 (91%) with one subject with celiac disease. Morphometry demonstrated decreased villus-to-crypt (V:C) ratios in EE relative to healthy and non-celiac lymphocytosis patients. Environmental enteropathy villus volumes were significantly decreased relative to healthy controls. In EE, average CD3+ cells per 100 epithelial cells and per 1,000 µm2 of lamina propria and the number of lamina propria CD20+ B-cell aggregates were increased relative to all other groups. Our results indicate that V:C ratios are reduced in EE but are less severe than in celiac disease. Environmental enteropathy intraepithelial and lamina propria T lymphocytosis is of greater magnitude than that in celiac disease. The increases in lamina propria B and T lymphocytes suggest that non-cytolytic lymphocytic activation may be a more prominent feature of EE relative to celiac disease. These results provide new insights into shared yet distinct histological and immunological features of EE and celiac disease in children.
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Affiliation(s)
- Sana Syed
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Pediatrics, University of Virginia, Charlottesville, Virginia.,Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan.,Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sunil Yeruva
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jeremy Herrmann
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anne Sailer
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Kamran Sadiq
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Najeeha Iqbal
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Furqan Kabir
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Kumail Ahmed
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Shahida Qureshi
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sean R Moore
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Jerrold Turner
- Department of Pathology, University of Chicago, Chicago, Illinois.,Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.,Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - S Asad Ali
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
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Khan FR, Iqbal NT, Ahmed K, Ahmad T, Hussain R, Bhutta ZA. Effect of Vitamin D Supplementation on the Salivary Cytokines of Pregnant Women: A Randomized Placebo-Controlled Trial. J Int Acad Periodontol 2017; 19:118-125. [PMID: 31473727] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE We aimed to determine the salivary cytokine profiles of IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ and IL-17 among pregnant women and determine if the cytokine profiles change upon administration of vitamin D to these women. METHODS It was a community-based, blinded, placebo-controlled, randomized trial. The intervention group comprised pregnant females (n = 36) who received oral vitamin D 4000 IU/day for 6 months (starting from 12 - 16 weeks until the end of pregnancy). Controls comprised pregnant females who received placebo (n = 49) for the same duration. Probing depth (PD), attachment loss (AL) and bleeding on probing (BOP) were recorded. Saliva samples were subjected to multiplex ELISA analysis of cytokines. Serum vitamin D levels were determined. Outcome was assessed within 14 days post-partum. Periodontal examinations were done; blood and saliva samples were subjected to the set of tests described at baseline. SPSS 19.0 and Graph Pad 6.0 were used for analysis. The study was registered at www.clinicaltrials.gov with identifier number NCT01422122. RESULTS The two study groups were comparable at the baseline. Although IL-6 showed wide variation, none of the pro-inflammatory cytokine levels was affected by six months of oral vitamin D supplementation. Similarly, the mean salivary levels of the anti-inflammatory cytokines IL-4 and IL-10 also remained unaffected in the two groups. CONCLUSION There was no association between hypovitaminosis D and periodontal disease among the studied sample of pregnant women. None of the salivary cytokines showed any significant change after six months of oral vitamin D supplementation to the pregnant women.
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Affiliation(s)
| | | | - Kumail Ahmed
- Aga Khan University and Hospital, Karachi, Pakistan
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