1
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Lee J, Acosta N, Waddell BJ, Du K, Xiang K, Van Doorn J, Low K, Bautista MA, McCalder J, Dai X, Lu X, Chekouo T, Pradhan P, Sedaghat N, Papparis C, Buchner Beaudet A, Chen J, Chan L, Vivas L, Westlund P, Bhatnagar S, Stefani S, Visser G, Cabaj J, Bertazzon S, Sarabi S, Achari G, Clark RG, Hrudey SE, Lee BE, Pang X, Webster B, Ghali WA, Buret AG, Williamson T, Southern DA, Meddings J, Frankowski K, Hubert CRJ, Parkins MD. Campus node-based wastewater surveillance enables COVID-19 case localization and confirms lower SARS-CoV-2 burden relative to the surrounding community. Water Res 2023; 244:120469. [PMID: 37634459 DOI: 10.1016/j.watres.2023.120469] [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] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/29/2023]
Abstract
Wastewater-based surveillance (WBS) has been established as a powerful tool that can guide health policy at multiple levels of government. However, this approach has not been well assessed at more granular scales, including large work sites such as University campuses. Between August 2021 and April 2022, we explored the occurrence of SARS-CoV-2 RNA in wastewater using qPCR assays from multiple complimentary sewer catchments and residential buildings spanning the University of Calgary's campus and how this compared to levels from the municipal wastewater treatment plant servicing the campus. Real-time contact tracing data was used to evaluate an association between wastewater SARS-CoV-2 burden and clinically confirmed cases and to assess the potential of WBS as a tool for disease monitoring across worksites. Concentrations of wastewater SARS-CoV-2 N1 and N2 RNA varied significantly across six sampling sites - regardless of several normalization strategies - with certain catchments consistently demonstrating values 1-2 orders higher than the others. Relative to clinical cases identified in specific sewersheds, WBS provided one-week leading indicator. Additionally, our comprehensive monitoring strategy enabled an estimation of the total burden of SARS-CoV-2 for the campus per capita, which was significantly lower than the surrounding community (p≤0.001). Allele-specific qPCR assays confirmed that variants across campus were representative of the community at large, and at no time did emerging variants first debut on campus. This study demonstrates how WBS can be efficiently applied to locate hotspots of disease activity at a very granular scale, and predict disease burden across large, complex worksites.
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Affiliation(s)
- Jangwoo Lee
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada; Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Nicole Acosta
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada
| | - Barbara J Waddell
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada
| | - Kristine Du
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada
| | - Kevin Xiang
- Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Jennifer Van Doorn
- Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Kashtin Low
- Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Maria A Bautista
- Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Janine McCalder
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada; Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Xiaotian Dai
- Department of Mathematics and Statistics, University of Calgary, Calgary, Canada
| | - Xuewen Lu
- Department of Mathematics and Statistics, University of Calgary, Calgary, Canada
| | - Thierry Chekouo
- Department of Mathematics and Statistics, University of Calgary, Calgary, Canada; Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Puja Pradhan
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada; Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Navid Sedaghat
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada; Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Chloe Papparis
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada; Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Alexander Buchner Beaudet
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada
| | - Jianwei Chen
- Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Leslie Chan
- Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Laura Vivas
- Department of Biological Sciences, University of Calgary, Calgary, Canada
| | | | - Srijak Bhatnagar
- Department of Biological Sciences, University of Calgary, Calgary, Canada; Faculty of Science and Technology, Athabasca University, Athabasca, Alberta, Canada
| | - September Stefani
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada
| | - Gail Visser
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada
| | - Jason Cabaj
- Department of Community Health Sciences, University of Calgary, Calgary, Canada; Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Canada; Provincial Population & Public Health, Alberta Health Services, Calgary, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | | | - Shahrzad Sarabi
- Department of Geography, University of Calgary, Calgary, Canada
| | - Gopal Achari
- Department of Civil Engineering, University of Calgary, Calgary, Canada
| | - Rhonda G Clark
- Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Steve E Hrudey
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Analytical and Environmental Toxicology, University of Alberta, Edmonton, Alberta, Canada
| | - Bonita E Lee
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada; Women & Children's Health Research Institute, Li Ka Shing Institute of Virology, Edmonton, Alberta, Canada
| | - Xiaoli Pang
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada; Alberta Precision Laboratories, Public Health Laboratory, Alberta Health Services, Edmonton, Alberta, Canada; Li Ka Shing Institute of Virology, University of Alberta, Edmonton, Alberta, Canada
| | - Brendan Webster
- Occupational Health Staff Wellness, University of Calgary, Calgary, Canada
| | - William Amin Ghali
- Department of Community Health Sciences, University of Calgary, Calgary, Canada; Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Canada; Centre for Health Informatics, University of Calgary, Calgary, Canada
| | - Andre Gerald Buret
- Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Tyler Williamson
- Department of Community Health Sciences, University of Calgary, Calgary, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Canada; Centre for Health Informatics, University of Calgary, Calgary, Canada
| | - Danielle A Southern
- Department of Community Health Sciences, University of Calgary, Calgary, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Canada; Centre for Health Informatics, University of Calgary, Calgary, Canada
| | - Jon Meddings
- Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Canada
| | - Kevin Frankowski
- Advancing Canadian Water Assets, University of Calgary, Calgary, Canada
| | - Casey R J Hubert
- Department of Biological Sciences, University of Calgary, Calgary, Canada
| | - Michael D Parkins
- Department of Microbiology, Immunology and Infectious Diseases, University of Calgary, 3330 Hospital Drive, NW, Calgary, Alberta T2N 2V5, Canada; Department of Medicine, University of Calgary and Alberta Health Services, Calgary, Canada; O'Brien Institute for Public Health, University of Calgary, Calgary, Canada.
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2
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Brembs B, Lenardic A, Murray-Rust P, Chan L, Irawan DE. Mastodon over Mammon: towards publicly owned scholarly knowledge. R Soc Open Sci 2023; 10:230207. [PMID: 38033719 PMCID: PMC10688381 DOI: 10.1098/rsos.230207] [Citation(s) in RCA: 1] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/30/2023] [Indexed: 12/02/2023]
Abstract
Twitter is in turmoil and the scholarly community on the platform is once again starting to migrate. As with the early internet, scholarly organizations are at the forefront of developing and implementing a decentralized alternative to Twitter, Mastodon. Both historically and conceptually, this is not a new situation for the scholarly community. Historically, scholars were forced to leave social media platform FriendFeed after it was bought by Facebook in 2006. Conceptually, the problems associated with public scholarly discourse subjected to the whims of corporate owners are not unlike those of scholarly journals owned by monopolistic corporations: in both cases the perils associated with a public good in private hands are palpable. For both short form (Twitter/Mastodon) and longer form (journals) scholarly discourse, decentralized solutions exist, some of which are already enjoying some institutional support. Here we argue that scholarly organizations, in particular learned societies, are now facing a golden opportunity to rethink their hesitations towards such alternatives and support the migration of the scholarly community from Twitter to Mastodon by hosting Mastodon instances. Demonstrating that the scholarly community is capable of creating a truly public square for scholarly discourse, impervious to private takeover, might renew confidence and inspire the community to focus on analogous solutions for the remaining scholarly record-encompassing text, data and code-to safeguard all publicly owned scholarly knowledge.
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Affiliation(s)
- Björn Brembs
- Institut für Zoologie - Neurogenetik, University of Regensburg, Regensburg 93040, Germany
| | - Adrian Lenardic
- Wiess School of Natural Sciences Ringgold Standard Institution - Earth Science, Rice University, Houston, Texas 77005, USA
| | - Peter Murray-Rust
- Department of Chemistry, University of Cambridge, Cambridge, CB2 1EW UK
| | - Leslie Chan
- Global Development, University of Toronto, Toronto Scarborough, Ontario M1C 1A4 Canada
| | - Dasapta Erwin Irawan
- Department of Earth Science, Institut Teknologi Bandung, Bandung, 40132 Indonesia
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3
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Tadepalli S, Clements DR, Saravanan S, Hornero RA, Lüdtke A, Blackmore B, Paulo JA, Gottfried-Blackmore A, Seong D, Park S, Chan L, Kopecky BJ, Liu Z, Ginhoux F, Lavine KJ, Murphy JP, Mack M, Graves EE, Idoyaga J. Rapid recruitment and IFN-I-mediated activation of monocytes dictate focal radiotherapy efficacy. Sci Immunol 2023; 8:eadd7446. [PMID: 37294749 PMCID: PMC10340791 DOI: 10.1126/sciimmunol.add7446] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 05/18/2023] [Indexed: 06/11/2023]
Abstract
The recruitment of monocytes and their differentiation into immunosuppressive cells is associated with the low efficacy of preclinical nonconformal radiotherapy (RT) for tumors. However, nonconformal RT (non-CRT) does not mimic clinical practice, and little is known about the role of monocytes after RT modes used in patients, such as conformal RT (CRT). Here, we investigated the acute immune response induced by after CRT. Contrary to non-CRT approaches, we found that CRT induces a rapid and robust recruitment of monocytes to the tumor that minimally differentiate into tumor-associated macrophages or dendritic cells but instead up-regulate major histocompatibility complex II and costimulatory molecules. We found that these large numbers of infiltrating monocytes are responsible for activating effector polyfunctional CD8+ tumor-infiltrating lymphocytes that reduce tumor burden. Mechanistically, we show that monocyte-derived type I interferon is pivotal in promoting monocyte accumulation and immunostimulatory function in a positive feedback loop. We also demonstrate that monocyte accumulation in the tumor microenvironment is hindered when RT inadvertently affects healthy tissues, as occurs in non-CRT. Our results unravel the immunostimulatory function of monocytes during clinically relevant modes of RT and demonstrate that limiting the exposure of healthy tissues to radiation has a positive therapeutic effect on the overall antitumor immune response.
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Affiliation(s)
- Sirimuvva Tadepalli
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
- Immunology Program, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Derek R. Clements
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
- Immunology Program, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Sanjana Saravanan
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
- Immunology Program, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Rebeca Arroyo Hornero
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
- Immunology Program, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Anja Lüdtke
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
- Immunology Program, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Beau Blackmore
- Department of Biology, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | - Joao A. Paulo
- Department of Cell Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Andres Gottfried-Blackmore
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
- Immunology Program, Stanford University School of Medicine, Stanford, CA 94304, USA
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Redwood City, CA 94063, USA
| | - David Seong
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
- Immunology Program, Stanford University School of Medicine, Stanford, CA 94304, USA
- Medical Scientist Training Program, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
| | - Soyoon Park
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
- Immunology Program, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Leslie Chan
- Immunology Program, Stanford University School of Medicine, Stanford, CA 94304, USA
| | - Benjamin J. Kopecky
- Center for Cardiovascular Research, Departmental of Medicine, Cardiovascular Division, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Zhaoyuan Liu
- Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Florent Ginhoux
- Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Institut Gustave Roussy, INSERM U1015, Bâtiment de Médecine Moléculaire, Villejuif 94800, France
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A*STAR), Singapore 138648, Republic of Singapore
| | - Kory J. Lavine
- Center for Cardiovascular Research, Departmental of Medicine, Cardiovascular Division, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - John Patrick Murphy
- Department of Biology, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | - Matthias Mack
- Department of Nephrology, University Hospital Regensburg, Regensburg 93053, Germany
| | - Edward E. Graves
- Department of Radiation Oncology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
| | - Juliana Idoyaga
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305-5101, USA
- Immunology Program, Stanford University School of Medicine, Stanford, CA 94304, USA
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4
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Acosta N, Bautista MA, Waddell BJ, Du K, McCalder J, Pradhan P, Sedaghat N, Papparis C, Beaudet AB, Chen J, Van Doorn J, Xiang K, Chan L, Vivas L, Low K, Lu X, Lee J, Westlund P, Chekouo T, Dai X, Cabaj J, Bhatnagar S, Ruecker N, Achari G, Clark RG, Pearce C, Harrison JJ, Meddings J, Leal J, Ellison J, Missaghi B, Kanji JN, Larios O, Rennert‐May E, Kim J, Hrudey SE, Lee BE, Pang X, Frankowski K, Conly J, Hubert CRJ, Parkins MD. Surveillance for SARS-CoV-2 and its variants in wastewater of tertiary care hospitals correlates with increasing case burden and outbreaks. J Med Virol 2023; 95:e28442. [PMID: 36579780 PMCID: PMC9880705 DOI: 10.1002/jmv.28442] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 12/30/2022]
Abstract
Wastewater-based SARS-CoV-2 surveillance enables unbiased and comprehensive monitoring of defined sewersheds. We performed real-time monitoring of hospital wastewater that differentiated Delta and Omicron variants within total SARS-CoV-2-RNA, enabling correlation to COVID-19 cases from three tertiary-care facilities with >2100 inpatient beds in Calgary, Canada. RNA was extracted from hospital wastewater between August/2021 and January/2022, and SARS-CoV-2 quantified using RT-qPCR. Assays targeting R203M and R203K/G204R established the proportional abundance of Delta and Omicron, respectively. Total and variant-specific SARS-CoV-2 in wastewater was compared to data for variant specific COVID-19 hospitalizations, hospital-acquired infections, and outbreaks. Ninety-six percent (188/196) of wastewater samples were SARS-CoV-2 positive. Total SARS-CoV-2 RNA levels in wastewater increased in tandem with total prevalent cases (Delta plus Omicron). Variant-specific assessments showed this increase to be mainly driven by Omicron. Hospital-acquired cases of COVID-19 were associated with large spikes in wastewater SARS-CoV-2 and levels were significantly increased during outbreaks relative to nonoutbreak periods for total SARS-CoV2, Delta and Omicron. SARS-CoV-2 in hospital wastewater was significantly higher during the Omicron-wave irrespective of outbreaks. Wastewater-based monitoring of SARS-CoV-2 and its variants represents a novel tool for passive COVID-19 infection surveillance, case identification, containment, and potentially to mitigate viral spread in hospitals.
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Affiliation(s)
- Nicole Acosta
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada
| | | | - Barbara J. Waddell
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada
| | - Kristine Du
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada
| | - Janine McCalder
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada,Department of Biological SciencesUniversity of CalgaryCalgaryCanada
| | - Puja Pradhan
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada,Department of Biological SciencesUniversity of CalgaryCalgaryCanada
| | - Navid Sedaghat
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada,Department of Biological SciencesUniversity of CalgaryCalgaryCanada
| | - Chloe Papparis
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada,Department of Biological SciencesUniversity of CalgaryCalgaryCanada
| | | | - Jianwei Chen
- Department of Biological SciencesUniversity of CalgaryCalgaryCanada
| | | | - Kevin Xiang
- Department of Biological SciencesUniversity of CalgaryCalgaryCanada
| | - Leslie Chan
- Department of Biological SciencesUniversity of CalgaryCalgaryCanada
| | - Laura Vivas
- Department of Biological SciencesUniversity of CalgaryCalgaryCanada
| | - Kashtin Low
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada
| | - Xuewen Lu
- Department of Mathematics and StatisticsUniversity of CalgaryCalgaryCanada
| | - Jangwoo Lee
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada
| | | | - Thierry Chekouo
- Department of Mathematics and StatisticsUniversity of CalgaryCalgaryCanada,Division of Biostatistics, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Xiaotian Dai
- Department of Mathematics and StatisticsUniversity of CalgaryCalgaryCanada
| | - Jason Cabaj
- Department of Community Health SciencesUniversity of CalgaryCalgaryCanada,Department of MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada,Provincial Population & Public HealthAlberta Health ServicesCalgaryCanada,O'Brien Institute for Public HealthUniversity of CalgaryCalgaryCanada
| | - Srijak Bhatnagar
- Faculty of Science and TechnologyAthabasca UniversityAthabascaAlbertaCanada
| | | | - Gopal Achari
- Department of Civil EngineeringUniversity of CalgaryCalgaryCanada
| | - Rhonda G. Clark
- Department of Biological SciencesUniversity of CalgaryCalgaryCanada
| | - Craig Pearce
- Infection Prevention and ControlAlberta Health ServicesCalgaryCanada
| | - Joe J. Harrison
- Department of Biological SciencesUniversity of CalgaryCalgaryCanada,Snyder Institute for Chronic DiseasesUniversity of Calgary and Alberta Health ServicesCalgaryCanada
| | - Jon Meddings
- Department of MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada
| | - Jenine Leal
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada,Department of Community Health SciencesUniversity of CalgaryCalgaryCanada,O'Brien Institute for Public HealthUniversity of CalgaryCalgaryCanada,Infection Prevention and ControlAlberta Health ServicesCalgaryCanada
| | - Jennifer Ellison
- Infection Prevention and ControlAlberta Health ServicesCalgaryCanada
| | - Bayan Missaghi
- Department of MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada,Infection Prevention and ControlAlberta Health ServicesCalgaryCanada
| | - Jamil N. Kanji
- Department of MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada,Department of Laboratory Medicine and PathologyUniversity of AlbertaEdmontonAlbertaCanada,Alberta Precision Laboratories, Public Health LaboratoryAlberta Health ServicesEdmontonAlbertaCanada,Department of Pathology and Laboratory MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada
| | - Oscar Larios
- Department of MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada,Infection Prevention and ControlAlberta Health ServicesCalgaryCanada,Alberta Precision Laboratories, Public Health LaboratoryAlberta Health ServicesEdmontonAlbertaCanada
| | - Elissa Rennert‐May
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada,Department of Community Health SciencesUniversity of CalgaryCalgaryCanada,Department of MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada,O'Brien Institute for Public HealthUniversity of CalgaryCalgaryCanada,Snyder Institute for Chronic DiseasesUniversity of Calgary and Alberta Health ServicesCalgaryCanada
| | - Joseph Kim
- Department of MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada,Infection Prevention and ControlAlberta Health ServicesCalgaryCanada
| | - Steve E. Hrudey
- Department of Laboratory Medicine and PathologyUniversity of AlbertaEdmontonAlbertaCanada,Department of Analytical and Environmental ToxicologyUniversity of AlbertaEdmontonAlbertaCanada
| | - Bonita E. Lee
- Department of PediatricsUniversity of AlbertaEdmontonAlbertaCanada,Women & Children's Health Research InstituteEdmontonAlbertaCanada,Li Ka Shing Institute of VirologyUniversity of AlbertaEdmontonAlbertaCanada
| | - Xiaoli Pang
- Department of Laboratory Medicine and PathologyUniversity of AlbertaEdmontonAlbertaCanada,Alberta Precision Laboratories, Public Health LaboratoryAlberta Health ServicesEdmontonAlbertaCanada,Li Ka Shing Institute of VirologyUniversity of AlbertaEdmontonAlbertaCanada
| | - Kevin Frankowski
- Advancing Canadian Water AssetsUniversity of CalgaryCalgaryCanada
| | - John Conly
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada,Department of MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada,O'Brien Institute for Public HealthUniversity of CalgaryCalgaryCanada,Infection Prevention and ControlAlberta Health ServicesCalgaryCanada,Snyder Institute for Chronic DiseasesUniversity of Calgary and Alberta Health ServicesCalgaryCanada,Department of Pathology and Laboratory MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada
| | | | - Michael D. Parkins
- Department of Microbiology, Immunology and Infectious DiseasesUniversity of CalgaryCalgaryCanada,Department of MedicineUniversity of Calgary and Alberta Health ServicesCalgaryCanada,Snyder Institute for Chronic DiseasesUniversity of Calgary and Alberta Health ServicesCalgaryCanada
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5
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Lee J, Acosta N, Doorn JV, Low K, Westlund P, Chavarriaga MB, M. Waddell BJ, Du K, McCalder J, Pradhan P, Sedaghat N, Papparis C, Chen J, Xiang K, Chan L, Vivas L, Ruecker NJ, Webster B, Meddings J, Achari G, Cathryn Ryan M, Clark R, Frankowski K, Hubert CRJ, Parkins M. 1874. Comprehensive, longitudinal wastewater surveillance for SARS-CoV-2 across a university campus, demonstrates low levels of SARS-CoV-2 activity relative to the surrounding community. Open Forum Infect Dis 2022. [PMCID: PMC9752603 DOI: 10.1093/ofid/ofac492.1501] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Universities are interactive communities where frequent contacts between individuals occur, increasing the risk of outbreaks of COVID-19. We embarked upon a real-time wastewater (WW) monitoring program across the University of Calgary (UofC) campus measuring WW SARS-CoV-2 burden relative to levels of disease in the broader surrounding community.
![]() The colour scheme shows 6 sewer sub-catchments at the University of Calgary. Autosamplers were deployed at 4 sampling nodes within sub-catchments CR and YA (both residence halls), and UCE and UCS (catchments that include several campus buildings).
![]() Log10-transformed abundance (i.e., copies per mL) of nucleocapsid gene (i.e., N1) for SARS-CoV-2 for each sampling location during October 2021 – April 2022. Locations denoted by the same letters (A, B, or C) show no statistical difference (p > 0.05) according to the Wilcoxon rank-sum test. The WWTP sample corresponds to a catchment area covering most of Calgary including the university campus, for which sampling locations CR, UCE, UCS, and UCW are defined in Fig. 1. Methods From October 2021 – April 2022, WW was collected thrice weekly across UofC campus through 4 individual sewer sampling nodes (Fig. 1) using autosamplers (C.E.C. Analytics, CA). Results from these 4 nodes were compared with community monitoring at Calgary’s largest WW treatment plant (WWTP), which received WW from surrounding neighborhoods, and also from UofC. Nucleic acid was extracted from WW for RTqPCR quantification of the N1 nucleocapside gene from SARS-CoV-2 genomic RNA. Qualitative (positive samples defined if cycle threshold < 40) and quantitative statistical analyses were performed using R. Results Levels of SARS-CoV-2 in WW were significantly lower at all campus monitoring sites relative to the WWTP (Wilcoxon rank-sum test p < 0.05; Fig. 2). The proportion of WW samples that were positive for SARS-CoV-2 was significantly higher for WWTP than at least two campus locations (p < 0.05 for Crowsnest Hall and UCE - University way and campus drive) according to Fischer’s exact 2-sided test. The proportion of WW samples with positive WW signals were still higher for WWTP than the other two locations, but statistically not significant (p = 0.216). Among campus locations, the buildings in UCE catchment showed much lower N1 signals than other catchments, likely owing to buildings in this catchment primarily being administration and classroom environments, with lower human-to-human contact and less defecation compared to the other 3 catchments, which include residence hall, a dining area, and/or laboratory spaces. Conclusion Our results show that SARS-CoV-2 RNA shedding in WW at the UofC is significantly lower than the city-wide signal associated with surrounding neighborhoods. Furthermore, we demonstrate that WW testing at well-defined nodes is a sampling strategy for potentially locating specific places where high transmission of infectious disease occurs. Disclosures All Authors: No reported disclosures.
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Affiliation(s)
- Jangwoo Lee
- University of Calgary, Calgary, Alberta, Canada
| | | | | | - Kashtin Low
- University of Calgary, Calgary, Alberta, Canada
| | | | | | | | - Kristine Du
- University of Calgary, Calgary, Alberta, Canada
| | | | | | | | | | | | - Kevin Xiang
- University of Calgary, Calgary, Alberta, Canada
| | - Leslie Chan
- University of Calgary, Calgary, Alberta, Canada
| | - Laura Vivas
- University of Calgary, Calgary, Alberta, Canada
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6
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Acosta N, Chavarriaga MB, Waddell BJM, McCalder J, Du K, Pradhan P, Sedaghat N, Papparis C, Chen J, Doorn JV, Xiang K, Chan L, Vivas L, Low K, Lu X, Chekouo T, Dai X, Cabaj J, Hrudey S, Bhatnagar S, Ruecker NJ, Achari G, Cathryn Ryan M, Clark R, Pearce C, Harrison J, Meddings J, Leal J, Missaghi B, Kanji J, Larios O, May ER, Kim J, Pang XL, Lee B, Frankowski K, Conly JM, Hubert CRJ, Parkins M. 1074. Surveillance of SARS-CoV-2 variants of concern (VOC) in hospital wastewater (WW) and its correlation with hospitalized cases of COVID-19 and the occurrence of outbreaks. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.915] [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: 12/23/2022] Open
Abstract
Abstract
Background
WW surveillance enables real time monitoring of SARS-CoV-2 burden in defined sewer catchment areas. Here, we assessed the occurrence of total, Delta and Omicron SARS-CoV-2 RNA in sewage from three tertiary-care hospitals in Calgary, Canada.
Methods
Nucleic acid was extracted from hospital (H) WW using the 4S-silica column method. H-1 and H-2 were assessed via a single autosampler whereas H-3 required three separate monitoring devices (a-c). SARS-CoV-2 RNA was quantified using two RT-qPCR approaches targeting the nucleocapsid gene; N1 and N200 assays, and the R203K/G204R and R203M mutations. Assays were positive if Cq< 40. Cross-correlation function analyses (CCF) was performed to determine the time-lagged relationships between WW signal and clinical cases. SARS-CoV-2 RNA abundance was compared to total hospitalized cases, nosocomial-acquired cases, and outbreaks. Statistical analyses were conducted using R.
Results
Ninety-six percent (188/196) of WW samples collected between Aug/21-Jan/22 were positive for SARS-CoV-2. Omicron rapidly supplanted Delta by mid-December and this correlated with lack of Delta-associated H-transmissions during a period of frequent outbreaks. The CCF analysis showed a positive autocorrelation between the RNA concentration and total cases, where the most dominant cross correlations occurred between -3 and 0 lags (weeks) (Cross-correlation values: 0.75, 0.579, 0.608, 0.528 and 0.746 for H-1, H-2, H-3a, H-3b and H-3c; respectively). VOC-specific assessments showed this positive association only to hold true for Omicron across all hospitals (cross-correlation occurred at lags -2 and 0, CFF value range between 0.648 -0.984). We observed a significant difference in median copies/ml SARS-CoV-2 N-1 between outbreak-free periods vs outbreaks for H-1 (46 [IQR: 11-150] vs 742 [IQR: 162-1176], P< 0.0001), H-2 (24 [IQR: 6-167] vs 214 [IQR: 57-560], P=0.009) and H-3c (2.32 [IQR: 0-19] vs 129 [IQR: 14-274], P=0.001).
Conclusion
WW surveillance is a powerful tool for early detection and monitoring of circulating SARS-CoV-2 VOCs. Total SARS-CoV-2 and VOC-specific WW signal correlated with hospitalized prevalent cases of COVID-19 and outbreak occurrence.
Disclosures
All Authors: No reported disclosures.
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Affiliation(s)
| | | | | | | | - Kristine Du
- University of Calgary , Calgary, Alberta , Canada
| | - Puja Pradhan
- University of Calgary , Calgary, Alberta , Canada
| | | | | | - Jianwei Chen
- University of Calgary , Calgary, Alberta , Canada
| | | | - Kevin Xiang
- University of Calgary , Calgary, Alberta , Canada
| | - Leslie Chan
- University of Calgary , Calgary, Alberta , Canada
| | - Laura Vivas
- University of Calgary , Calgary, Alberta , Canada
| | - Kashtin Low
- University of Calgary , Calgary, Alberta , Canada
| | - Xuewen Lu
- University of Calgary , Calgary, Alberta , Canada
| | | | - Xiaotian Dai
- University of Calgary , Calgary, Alberta , Canada
| | - Jason Cabaj
- University of Calgary , Calgary, Alberta , Canada
| | - Steve Hrudey
- University of Alberta , Edmonton, Alberta , Canada
| | | | | | - Gopal Achari
- University of Calgary , Calgary, Alberta , Canada
| | | | - Rhonda Clark
- University of Calgary , Calgary, Alberta , Canada
| | - Craig Pearce
- University of Calgary , Calgary, Alberta , Canada
| | - Joe Harrison
- University of Calgary , Calgary, Alberta , Canada
| | - Jon Meddings
- University of Calgary , Calgary, Alberta , Canada
| | - Jenine Leal
- University of Calgary , Calgary, Alberta , Canada
| | | | - Jamil Kanji
- University of Alberta , Edmonton, Alberta , Canada
| | - Oscar Larios
- University of Calgary , Calgary, Alberta , Canada
| | | | - Joseph Kim
- University of Calgary , Calgary, Alberta , Canada
| | - Xiao-Li Pang
- University of Alberta , Edmonton, Alberta , Canada
| | - Bonita Lee
- University of Alberta , Edmonton, Alberta , Canada
| | | | - John M Conly
- University of Calgary , Calgary, Alberta , Canada
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Dias R, Evans D, Chen SF, Chen KY, Loguercio S, Chan L, Torkamani A. Rapid, Reference-Free human genotype imputation with denoising autoencoders. eLife 2022; 11:e75600. [PMID: 36148981 PMCID: PMC9555874 DOI: 10.7554/elife.75600] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 09/19/2022] [Indexed: 11/13/2022] Open
Abstract
Genotype imputation is a foundational tool for population genetics. Standard statistical imputation approaches rely on the co-location of large whole-genome sequencing-based reference panels, powerful computing environments, and potentially sensitive genetic study data. This results in computational resource and privacy-risk barriers to access to cutting-edge imputation techniques. Moreover, the accuracy of current statistical approaches is known to degrade in regions of low and complex linkage disequilibrium. Artificial neural network-based imputation approaches may overcome these limitations by encoding complex genotype relationships in easily portable inference models. Here, we demonstrate an autoencoder-based approach for genotype imputation, using a large, commonly used reference panel, and spanning the entirety of human chromosome 22. Our autoencoder-based genotype imputation strategy achieved superior imputation accuracy across the allele-frequency spectrum and across genomes of diverse ancestry, while delivering at least fourfold faster inference run time relative to standard imputation tools.
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Affiliation(s)
- Raquel Dias
- Scripps Research Translational Institute, Scripps Research InstituteLa JollaUnited States
- Department of Integrative Structural and Computational Biology, Scripps ResearchLa JollaUnited States
- Department of Microbiology and Cell Science, University of FloridaGainesvilleUnited States
| | - Doug Evans
- Scripps Research Translational Institute, Scripps Research InstituteLa JollaUnited States
- Department of Integrative Structural and Computational Biology, Scripps ResearchLa JollaUnited States
| | - Shang-Fu Chen
- Scripps Research Translational Institute, Scripps Research InstituteLa JollaUnited States
- Department of Integrative Structural and Computational Biology, Scripps ResearchLa JollaUnited States
| | - Kai-Yu Chen
- Scripps Research Translational Institute, Scripps Research InstituteLa JollaUnited States
- Department of Integrative Structural and Computational Biology, Scripps ResearchLa JollaUnited States
| | - Salvatore Loguercio
- Scripps Research Translational Institute, Scripps Research InstituteLa JollaUnited States
- Department of Integrative Structural and Computational Biology, Scripps ResearchLa JollaUnited States
| | - Leslie Chan
- Scripps Research Translational Institute, Scripps Research InstituteLa JollaUnited States
- Department of Integrative Structural and Computational Biology, Scripps ResearchLa JollaUnited States
| | - Ali Torkamani
- Scripps Research Translational Institute, Scripps Research InstituteLa JollaUnited States
- Department of Integrative Structural and Computational Biology, Scripps ResearchLa JollaUnited States
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8
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Hubert CRJ, Acosta N, Waddell BJM, Hasing ME, Qiu Y, Fuzzen M, Harper NBJ, Bautista MA, Gao T, Papparis C, Van Doorn J, Du K, Xiang K, Chan L, Vivas L, Pradhan P, McCalder J, Low K, England WE, Kuzma D, Conly J, Ryan MC, Achari G, Hu J, Cabaj JL, Sikora C, Svenson L, Zelyas N, Servos M, Meddings J, Hrudey SE, Frankowski K, Parkins MD, Pang XL, Lee BE. Tracking Emergence and Spread of SARS-CoV-2 Omicron Variant in Large and Small Communities by Wastewater Monitoring in Alberta, Canada. Emerg Infect Dis 2022. [PMID: 35867051 DOI: 10.1101/2022.03.07.22272055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
Wastewater monitoring of SARS-CoV-2 enables early detection and monitoring of the COVID-19 disease burden in communities and can track specific variants of concern. We determined proportions of the Omicron and Delta variants across 30 municipalities covering >75% of the province of Alberta (population 4.5 million), Canada, during November 2021-January 2022. Larger cities Calgary and Edmonton exhibited more rapid emergence of Omicron than did smaller and more remote municipalities. Notable exceptions were Banff, a small international resort town, and Fort McMurray, a medium-sized northern community that has many workers who fly in and out regularly. The integrated wastewater signal revealed that the Omicron variant represented close to 100% of SARS-CoV-2 burden by late December, before the peak in newly diagnosed clinical cases throughout Alberta in mid-January. These findings demonstrate that wastewater monitoring offers early and reliable population-level results for establishing the extent and spread of SARS-CoV-2 variants.
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9
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Hubert CRJ, Acosta N, Waddell BJM, Hasing ME, Qiu Y, Fuzzen M, Harper NBJ, Bautista MA, Gao T, Papparis C, Van Doorn J, Du K, Xiang K, Chan L, Vivas L, Pradhan P, McCalder J, Low K, England WE, Kuzma D, Conly J, Ryan MC, Achari G, Hu J, Cabaj JL, Sikora C, Svenson L, Zelyas N, Servos M, Meddings J, Hrudey SE, Frankowski K, Parkins MD, Pang XL, Lee BE. Tracking Emergence and Spread of SARS-CoV-2 Omicron Variant in Large and Small Communities by Wastewater Monitoring in Alberta, Canada. Emerg Infect Dis 2022; 28:1770-1776. [PMID: 35867051 PMCID: PMC9423933 DOI: 10.3201/eid2809.220476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Wastewater monitoring of SARS-CoV-2 enables early detection and monitoring of the COVID-19 disease burden in communities and can track specific variants of concern. We determined proportions of the Omicron and Delta variants across 30 municipalities covering >75% of the province of Alberta (population 4.5 million), Canada, during November 2021-January 2022. Larger cities Calgary and Edmonton exhibited more rapid emergence of Omicron than did smaller and more remote municipalities. Notable exceptions were Banff, a small international resort town, and Fort McMurray, a medium-sized northern community that has many workers who fly in and out regularly. The integrated wastewater signal revealed that the Omicron variant represented close to 100% of SARS-CoV-2 burden by late December, before the peak in newly diagnosed clinical cases throughout Alberta in mid-January. These findings demonstrate that wastewater monitoring offers early and reliable population-level results for establishing the extent and spread of SARS-CoV-2 variants.
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10
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Makary J, Van Diepen D, Plagakis S, Tse V, Chan L. Continence outcomes in females post mid-urethral sling excision. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00655-8] [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: 11/27/2022]
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11
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Herrmann D, Vasquez E, Chan L. 240: Post–cystic fibrosis clinic follow-up calls performed by a cystic fibrosis pharmacy technician and the impact on adherence of medications. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01665-9] [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: 11/25/2022]
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12
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Krepostman N, Collins M, Merchant K, De Sirkar S, Chan L, Allen S, Newman J, Patel D, Fareed J, Berg S, Darki A. Discriminatory accuracy of the SOFA score for determining clinical decompensation in patients presenting with COVID-19. Eur Heart J 2021. [PMCID: PMC8767580 DOI: 10.1093/eurheartj/ehab724.2492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction While the global dissemination of vaccines targeting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a decline in the incidence of infections, the case fatality rates have remained relative stable. A major objective of managing hospitalized patients with documented or suspected COVID-19 infection is the rapid identification of features associated with severe illness using readily available laboratory tests and clinical tools. The sequential organ failure assessment (SOFA) score is a validated tool to facilitate the identification of patients at risk of dying from sepsis. Purpose The aim of this study was to assess the discriminatory accuracy of the SOFA score in predicting clinical decompensation in patients hospitalized with COVID-19 infection. Methods We conducted a retrospective analysis at a three-hospital health system, comprised of one tertiary and two community hospitals, located in the Chicago metropolitan area. All patients had positive SARS-CoV-2 testing and were hospitalized for COVID-19 infection. The primary outcome was clinical decompensation, defined as the composite endpoint of death, ICU admission, or need for intubation. We utilized the most abnormal laboratory values observed during the admission to calculate the SOFA score. Receiver Operating Curves (ROC) were then constructed to determine the sensitivity and specificity of SOFA scores. Results Between March 1st and May 31st 2020, 1029 patients were included in our analysis with 367 patients meeting the study endpoint. The median SOFA score was 2.0 IQR (Q1, Q3 1,4) for the entire cohort. Patients who had in-hospital mortality had a median SOFA score of 4.0 (Q1,Q3 3,7). In patients that met the primary composite endpoint, the median SOFA score was 3.0, IQR (Q1, Q3 2,6). The ROC was 0.776 (95% CI 0.746–0.806, p<0.01). Conclusion The SOFA score demonstrates strong discriminatory accuracy for prediction of clinical decompensation in patients presenting with COVID-19 at our urban hospital system. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Loyola University Medical Center
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Affiliation(s)
- N Krepostman
- Loyola University Medical Center, Maywood, United States of America
| | - M Collins
- Loyola University Medical Center, Maywood, United States of America
| | - K Merchant
- Loyola University Medical Center, Maywood, United States of America
| | - S De Sirkar
- Loyola University Medical Center, Maywood, United States of America
| | - L Chan
- Loyola University Medical Center, Maywood, United States of America
| | - S Allen
- Loyola University Medical Center, Maywood, United States of America
| | - J Newman
- Loyola University Medical Center, Maywood, United States of America
| | - D Patel
- Loyola University Medical Center, Maywood, United States of America
| | - J Fareed
- Loyola University Medical Center, Maywood, United States of America
| | - S Berg
- Loyola University Medical Center, Maywood, United States of America
| | - A Darki
- Loyola University Medical Center, Maywood, United States of America
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13
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Krepostman N, Collins M, Merchant K, De Sirkar S, Chan L, Allen S, Newman J, Patel D, Fareed J, Berg S, Darki A. Predictors of clinical decompensation in patients presenting with COVID-19 in an urban hospital health system. Eur Heart J 2021. [PMCID: PMC8767592 DOI: 10.1093/eurheartj/ehab724.2473] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a pandemic which has infected more than 128 million people and led to over 2.8 million deaths worldwide. Although the introduction of efficacious vaccines has led to overall declines in the incidence of SARS-CoV-2 infection, there has been a recent increase in infections once more due to the appearance of mutant strains with higher virulence. It therefore remains vital to identify predictors of poor outcomes in this patient population. Purpose The objective of our study was to identify predictors of prolonged hospitalization, intensive care unit (ICU) admission, intubation, and death in patients infected with SARS-CoV-2. Methods We conducted a retrospective analysis of all patients hospitalized with SARS-CoV-2 at our health system that includes one tertiary care center and two community hospitals located in the Chicago metropolitan area. The main outcome was a composite endpoint of hospitalization >28 days, ICU admission, intubation, and death. Explanatory variables associated with the primary outcome in the bivariate analysis (p<0.05) were included in the multivariable logistic regression model. Statistical analysis was performed using IBM SPSS 25.0. Results Between March 1, 2020 and May 31, 2020, 1029 patients hospitalized with SARS-CoV-2 were included in our analysis. Of these patients, 379 met the composite endpoint. Baseline demographics are described in Table 1. Of note, our cohort consisted of a predominantly minority patient population including 47% Hispanic, 17% African American, 16% Caucasian, and 16% other. In bivariate analysis, age, hypertension, tobacco and alcohol abuse, obesity, coronary artery disease, arrhythmias, valvular heart disease, dyslipidemia, hypertension, stroke, diabetes, documented thrombosis, troponin, CRP, ESR, ferritin, LDH, BNP, D-dimer >5x the upper limit of normal, lactate, and right ventricular outflow tract velocity time integral <9.5 were significant. After multivariable adjustment, explanatory variables associated with the composite endpoint included troponin (OR 2.36; 95% CI 1.08–5.17, p 0.03), D-dimer (OR 1.5; 95% CI 1.23–1.98, p<0.01, lactate (OR 1.58; 95% CI 1.28–1.95, p<0.01), and documented thrombosis (OR 3.56; 95% CI 1.30–8.70, p<.05). Race was not a predictor of poor outcomes in the bivariate or multivariate analysis (Table 2). Conclusions In a large urban cohort with a predominantly minority population, we identified several clinical predictors of poor outcomes. Of note, race was not a predictor of the primary endpoint in this study. While recent literature has demonstrated worse outcomes among racial minorities infected with SARS-CoV-2, our data suggests these variations are related to social determinants of health rather than biologic causes. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Loyola University Medical Center
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Affiliation(s)
- N Krepostman
- Loyola University Medical Center, Maywood, United States of America
| | - M Collins
- Loyola University Medical Center, Maywood, United States of America
| | - K Merchant
- Loyola University Medical Center, Maywood, United States of America
| | - S De Sirkar
- Loyola University Medical Center, Maywood, United States of America
| | - L Chan
- Loyola University Medical Center, Maywood, United States of America
| | - S Allen
- Loyola University Medical Center, Maywood, United States of America
| | - J Newman
- Loyola University Medical Center, Maywood, United States of America
| | - D Patel
- Loyola University Medical Center, Maywood, United States of America
| | - J Fareed
- Loyola University Medical Center, Maywood, United States of America
| | - S Berg
- Loyola University Medical Center, Maywood, United States of America
| | - A Darki
- Loyola University Medical Center, Maywood, United States of America
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14
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Chan L, Dobak S, Brody R, Peterson S. Digital Learning: A Survey of RDN Attitudes and Utilization of YouTube for Nutrition Education. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.146] [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: 11/30/2022]
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15
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Joseph ALC, Lippa SM, McNally SM, Garcia KM, Leary JB, Dsurney J, Chan L. Estimating premorbid intelligence in persons with traumatic brain injury: an examination of the Test of Premorbid Functioning. Appl Neuropsychol Adult 2021; 28:535-543. [PMID: 31519111 PMCID: PMC7067634 DOI: 10.1080/23279095.2019.1661247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Knowledge of intelligence is essential for interpreting cognitive performance following traumatic brain injury (TBI). The Test of Premorbid Functioning (ToPF), a word reading test co-normed with the Wechsler Adult Intelligence Scale 4th Edition (WAIS-IV), was examined as a tool for estimating premorbid intelligence in persons with a history of TBI. Fifty-two participants with mild, moderate, or severe TBI were administered the ToPF and WAIS-IV between two weeks and 19 months post-injury. The independent ability of the ToPF/demographic score and the Verbal Comprehension Index (VCI) to predict WAIS-IV Full Scale IQ (FSIQ) was examined, as were discrepancies between ToPF and WAIS-IV scores within and between participants. The ToPF/demographic predicted FSIQ accounted for a significant proportion of variability in actual FSIQ, above and beyond that accounted for by education or time since injury. ToPF and WAIS-IV scores did not differ by injury severity. In our sample, the ToPF/demographic predicted FSIQ underestimated intelligence in a substantial portion of our participants (31%), particularly in those with high average to superior intelligence. Finally, VCI scores were more predictive of actual FSIQ than the ToPF/demographic predicted FSIQ. The ToPF frequently underestimated post-injury intelligence and is therefore not accurately measuring premorbid intelligence in our sample, particularly in those with above average to superior intelligence. Clinicians are encouraged to administer the entire WAIS-IV, or at minimum the VCI subtests, for a more accurate measure of intelligence in those with above average intelligence and history of TBI.
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Affiliation(s)
- Annie-Lori C. Joseph
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - S. M. Lippa
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, USA
- Defense and Veterans Brain Injury Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - S. M. McNally
- Center for Neuroscience and Regenerative Medicine, National Institutes of Health Clinical Center, Bethesda, MD
| | - K. M. Garcia
- Center for Neuroscience and Regenerative Medicine, National Institutes of Health Clinical Center, Bethesda, MD
| | - J. B. Leary
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - J. Dsurney
- Tampa Psychological Associates, Tampa, FL, USA
| | - L. Chan
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, USA
- Center for Neuroscience and Regenerative Medicine, National Institutes of Health Clinical Center, Bethesda, MD
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16
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Sodhi J, Chan L, Chow R, Chen I. P-296 Examining the link between environmental toxin exposure and uterine leiomyoma: a systematic review. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.074] [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: 11/12/2022] Open
Abstract
Abstract
Study question
Is there an association between exposure to certain environmental toxins and the prevalence of uterine leiomyoma in women?
Summary answer
Some evidence was obtained to suggest an association between phthalate esters, bisphenol A, heavy metals, persistent organic pollutants and the prevalence of uterine fibroids.
What is known already
Environmental toxins are naturally occurring, or human made chemicals that can act as endocrine disrupting chemicals (EDCs) by binding and activating estrogen receptors in the body. Uterine fibroids, often called leiomyoma are non-cancerous growths occurring in the uterus. Though often asymptomatic, they can cause pain, infertility, pregnancy complications and are a leading cause for hysterectomy. The aetiology of leiomyoma is not fully understood but both estrogen and progesterone have been implicated in their growth. We aimed to investigate the epidemiological evidence for the association between EDCs and the prevalence of fibroids.
Study design, size, duration
We undertook a systematic review and in keeping with PRISMA guidelines, a structured search of Medline, Embase, Scopus, and Web of Science was conducted (to October 2020). Case-control, cross-sectional, cohort and experimental studies were included.
Participants/materials, setting, methods
The included studies analyzed the association between one or more toxins and the occurrence, or growth of leiomyoma in humans, including human cell lines. The types of toxins, patient characteristics, association and outcome, body concentration of toxin and confounding variables were extracted and analyzed. Quality assessment was performed using the Newcastle-Ottawa Scale.
Main results and the role of chance
In total, 34 studies were included. The majority (76%) of studies revealed a significant association between the exposure studied and the prevalence of uterine leiomyoma. In examining body burden in cases vs controls, phthalate esters showed an association with increased odds of uterine leiomyoma, except in one case where a negative association was observed. In vitro experimental studies examining the effect of alkyl-phenols such as bisphenol A (BPA), octylphenol (OP) and nonylphenol (NP) demonstrated that these environmental estrogens can act to promote the proliferation of leiomyoma cells through a number of mechanisms, typically including the estrogen receptor alpha (ERa) signalling pathway. There were conflicting results for the association between alkyl-phenols and fibroids in case-control studies. A positive association between cadmium was demonstrated in only two studies. There were conflicting results for the association between lead, mercury, arsenic and uterine fibroids. Several metabolites of organophosphate esters, alternative plasticizers, and persistent organic pollutants were associated with an increased risk of uterine fibroids.
Limitations, reasons for caution
Separating these exposures from the multiple other factors that could affect the outcome of leiomyoma is challenging, but an important issue for future research.
Wider implications of the findings
The link between some environmental toxins and uterine fibroids discussed is in agreement with previous literature. However, our review provides a more in depth analysis on specific dosage effects, odds ratios, and potential gene mechanisms of the exposures. This information could contribute to more accurate preventative measures.
Trial registration number
not applicable
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Affiliation(s)
- J Sodhi
- University of Ottawa, Biology, Ottawa, Canada
| | - L Chan
- University of Ottawa, Biology- Toxicology and Environmental Health, Ottawa, Canada
| | - R Chow
- University of Ottawa, Faculty of Medicine, Ottawa, Canada
| | - I Chen
- The Ottawa Hospital Research Institute- University of Ottawa, Clinical Epidemiology Program- Obstetrics and Gynecology, Ottawa, Canada
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17
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Sodhi J, Chan L, Chow R, Chen I. P–296 Examining the link between environmental toxin exposure and uterine leiomyoma: a systematic review. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.295] [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: 11/12/2022] Open
Abstract
Abstract
Study question
Is there an association between exposure to certain environmental toxins and the prevalence of uterine leiomyoma in women?
Summary answer
Some evidence was obtained to suggest an association between phthalate esters, bisphenol A, heavy metals, persistent organic pollutants and the prevalence of uterine fibroids.
What is known already
Environmental toxins are naturally occurring, or human made chemicals that can act as endocrine disrupting chemicals (EDCs) by binding and activating estrogen receptors in the body. Uterine fibroids, often called leiomyoma are non-cancerous growths occurring in the uterus. Though often asymptomatic, they can cause pain, infertility, pregnancy complications and are a leading cause for hysterectomy. The aetiology of leiomyoma is not fully understood but both estrogen and progesterone have been implicated in their growth. We aimed to investigate the epidemiological evidence for the association between EDCs and the prevalence of fibroids.
Study design, size, duration
We undertook a systematic review and in keeping with PRISMA guidelines, a structured search of Medline, Embase, Scopus, and Web of Science was conducted (to October 2020). Case-control, cross-sectional, cohort and experimental studies were included.
Participants/materials, setting, methods
The included studies analyzed the association between one or more toxins and the occurrence, or growth of leiomyoma in humans, including human cell lines. The types of toxins, patient characteristics, association and outcome, body concentration of toxin and confounding variables were extracted and analyzed. Quality assessment was performed using the Newcastle-Ottawa Scale.
Main results and the role of chance
In total, 34 studies were included. The majority (76%) of studies revealed a significant association between the exposure studied and the prevalence of uterine leiomyoma. In examining body burden in cases vs controls, phthalate esters showed an association with increased odds of uterine leiomyoma, except in one case where a negative association was observed. In vitro experimental studies examining the effect of alkyl-phenols such as bisphenol A (BPA), octylphenol (OP) and nonylphenol (NP) demonstrated that these environmental estrogens can act to promote the proliferation of leiomyoma cells through a number of mechanisms, typically including the estrogen receptor alpha (ERa) signalling pathway. There were conflicting results for the association between alkyl-phenols and fibroids in case-control studies. A positive association between cadmium was demonstrated in only two studies. There were conflicting results for the association between lead, mercury, arsenic and uterine fibroids. Several metabolites of organophosphate esters, alternative plasticizers, and persistent organic pollutants were associated with an increased risk of uterine fibroids.
Limitations, reasons for caution
Separating these exposures from the multiple other factors that could affect the outcome of leiomyoma is challenging, but an important issue for future research.
Wider implications of the findings: The link between some environmental toxins and uterine fibroids discussed is in agreement with previous literature. However, our review provides a more in depth analysis on specific dosage effects, odds ratios, and potential gene mechanisms of the exposures. This information could contribute to more accurate preventative measures.
Trial registration number
Not applicable
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Affiliation(s)
- J Sodhi
- University of Ottawa, Biology, Ottawa, Canada
| | - L Chan
- University of Ottawa, Biology- Toxicology and Environmental Health, Ottawa, Canada
| | - R Chow
- University of Ottawa, Faculty of Medicine, Ottawa, Canada
| | - I Chen
- The Ottawa Hospital Research Institute- University of Ottawa, Clinical Epidemiology Program- Obstetrics and Gynecology, Ottawa, Canada
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Michelet F, Szyniarowski P, Radhakrishnan S, Sin W, Ivon Leo V, Alagppan D, Lam P, Chan L. Advancing lentiviral vector manufacture for clinical cell and gene therapy. Cytotherapy 2021. [DOI: 10.1016/s1465324921005752] [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: 10/21/2022]
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Taparra K, Deek M, Dao D, Chan L, Phillips R, Isaacsson Velho P, Gao R, Deville C, Song D, Greco S, Carducci M, Eisenberger M, DeWeese T, Denmeade S, Pienta K, Paller C, Antonarakis E, Park S, Tran P, Stish B. Modes of Failure Following Metastasis Directed Therapy in Patients with Oligometastatic Hormone Sensitive Prostate Cancer: A Multi-institutional Analysis. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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McDougall CC, Chan L, Sachan S, Guo J, Sah RG, Menon BK, Demchuk AM, Hill MD, Forkert ND, d'Esterre CD, Barber PA. Dynamic CTA-Derived Perfusion Maps Predict Final Infarct Volume: The Simple Perfusion Reconstruction Algorithm. AJNR Am J Neuroradiol 2020; 41:2034-2040. [PMID: 33004342 DOI: 10.3174/ajnr.a6783] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/07/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Infarct core volume measurement using CTP (CT perfusion) is a mainstay paradigm for stroke treatment decision-making. Yet, there are several downfalls with cine CTP technology that can be overcome by adopting the simple perfusion reconstruction algorithm (SPIRAL) derived from multiphase CTA. We compare SPIRAL with CTP parameters for the prediction of 24-hour infarction. MATERIALS AND METHODS Seventy-two patients had admission NCCT, multiphase CTA, CTP, and 24-hour DWI. All patients had successful/quality reperfusion. Patient-level and cohort-level receiver operator characteristic curves were generated to determine accuracy. A 10-fold cross-validation was performed on the cohort-level data. Infarct core volume was compared for SPIRAL, CTP-time-to-maximum, and final DWI by Bland-Altman analysis. RESULTS When we compared the accuracy in patients with early and late reperfusion for cortical GM and WM, there was no significant difference at the patient level (0.83 versus 0.84, respectively), cohort level (0.82 versus 0.81, respectively), or the cross-validation (0.77 versus 0.74, respectively). In the patient-level receiver operating characteristic analysis, the SPIRAL map had a slightly higher, though nonsignificant (P < .05), average receiver operating characteristic area under the curve (cortical GM/WM, r = 0.82; basal ganglia = 0.79, respectively) than both the CTP-time-to-maximum (cortical GM/WM = 0.82; basal ganglia = 0.78, respectively) and CTP-CBF (cortical GM/WM = 0.74; basal ganglia = 0.78, respectively) parameter maps. The same relationship was observed at the cohort level. The Bland-Altman plot limits of agreement for SPIRAL and time-to-maximum infarct volume were similar compared with 24-hour DWI. CONCLUSIONS We have shown that perfusion maps generated from a temporally sampled helical CTA are an accurate surrogate for infarct core.
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Affiliation(s)
- C C McDougall
- From the Department of Clinical Neurosciences (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d., P.A.B.), Calgary Stroke Program.,Department of Radiology (C.C.M., B.K.M., N.D.F., C.D.d.E., P.A.B.).,Hotchkiss Brain Institute (C.C.M., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E., P.A.B.).,Department of Clinical Neurosciences (C.C.M., L.C., S.S., J.G., R.G.S., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E.).,Seaman Family Centre (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d.E., P.A.B.), Foothills Medical Centre, Calgary, Alberta, Canada
| | - L Chan
- Department of Clinical Neurosciences (C.C.M., L.C., S.S., J.G., R.G.S., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E.)
| | - S Sachan
- Department of Clinical Neurosciences (C.C.M., L.C., S.S., J.G., R.G.S., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E.)
| | - J Guo
- Department of Clinical Neurosciences (C.C.M., L.C., S.S., J.G., R.G.S., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E.)
| | - R G Sah
- From the Department of Clinical Neurosciences (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d., P.A.B.), Calgary Stroke Program.,Department of Clinical Neurosciences (C.C.M., L.C., S.S., J.G., R.G.S., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E.).,Seaman Family Centre (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d.E., P.A.B.), Foothills Medical Centre, Calgary, Alberta, Canada
| | - B K Menon
- From the Department of Clinical Neurosciences (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d., P.A.B.), Calgary Stroke Program.,Department of Radiology (C.C.M., B.K.M., N.D.F., C.D.d.E., P.A.B.).,Hotchkiss Brain Institute (C.C.M., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E., P.A.B.).,Department of Clinical Neurosciences (C.C.M., L.C., S.S., J.G., R.G.S., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E.).,Seaman Family Centre (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d.E., P.A.B.), Foothills Medical Centre, Calgary, Alberta, Canada
| | - A M Demchuk
- From the Department of Clinical Neurosciences (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d., P.A.B.), Calgary Stroke Program.,Hotchkiss Brain Institute (C.C.M., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E., P.A.B.).,Department of Clinical Neurosciences (C.C.M., L.C., S.S., J.G., R.G.S., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E.).,Seaman Family Centre (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d.E., P.A.B.), Foothills Medical Centre, Calgary, Alberta, Canada
| | - M D Hill
- From the Department of Clinical Neurosciences (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d., P.A.B.), Calgary Stroke Program.,Hotchkiss Brain Institute (C.C.M., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E., P.A.B.).,Department of Clinical Neurosciences (C.C.M., L.C., S.S., J.G., R.G.S., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E.).,Seaman Family Centre (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d.E., P.A.B.), Foothills Medical Centre, Calgary, Alberta, Canada
| | - N D Forkert
- Department of Radiology (C.C.M., B.K.M., N.D.F., C.D.d.E., P.A.B.).,Hotchkiss Brain Institute (C.C.M., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E., P.A.B.).,Department of Clinical Neurosciences (C.C.M., L.C., S.S., J.G., R.G.S., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E.).,Alberta Children's Hospital Research Institute (N.D.F.), University of Calgary, Calgary, Alberta, Canada
| | - C D d'Esterre
- From the Department of Clinical Neurosciences (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d., P.A.B.), Calgary Stroke Program.,Department of Radiology (C.C.M., B.K.M., N.D.F., C.D.d.E., P.A.B.).,Hotchkiss Brain Institute (C.C.M., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E., P.A.B.).,Department of Clinical Neurosciences (C.C.M., L.C., S.S., J.G., R.G.S., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E.).,Seaman Family Centre (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d.E., P.A.B.), Foothills Medical Centre, Calgary, Alberta, Canada
| | - P A Barber
- From the Department of Clinical Neurosciences (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d., P.A.B.), Calgary Stroke Program .,Department of Radiology (C.C.M., B.K.M., N.D.F., C.D.d.E., P.A.B.).,Hotchkiss Brain Institute (C.C.M., B.K.M., A.M.D., M.D.H., N.D.F., C.C.d.E., P.A.B.).,Seaman Family Centre (C.C.M., R.G.S., B.K.M., A.M.D., M.D.H., C.D.d.E., P.A.B.), Foothills Medical Centre, Calgary, Alberta, Canada
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Hariri F, Abdullah MF, Adam KBC, Bahuri NFA, Kulasegarah J, Nathan AM, Ismail F, Khaliddin N, May CM, Chan L, Keong TM, Ganesan D, Rahman ZAA. Analysis of complications following multidisciplinary functional intervention in paediatric craniomaxillofacial deformities. Int J Oral Maxillofac Surg 2020; 50:457-462. [PMID: 32891466 DOI: 10.1016/j.ijom.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 06/20/2020] [Accepted: 08/11/2020] [Indexed: 11/24/2022]
Abstract
Paediatric craniomaxillofacial (CMF) surgery requires a multidisciplinary team approach to ensure the optimal and holistic management of children with craniofacial deformities. The aim of this retrospective study was to analyse the complications following functional interventions among 34 CMF deformity patients in a single multidisciplinary craniofacial centre. Electronic data including patient demographic characteristics and clinical entry were analysed. Inclusion criteria were all paediatric patients with CMF deformities who underwent various functional interventions. A total of 64 interventions (48 intermediate and 16 definitive) were conducted. Based on the Sharma classification of complications, 20.3% were type I, 4.7% were type II, 1.6% were type III, and 4.7% were type IV . Most complications were type I, which included local infection (3.1%) and premature opening of tarsorrhaphy (3.1%). More serious complications (types III and IV) included temporary visual loss (1.6%) and intraoperative haemorrhage (1.6%). Although a low complication rate was observed in intermediate interventions, a higher complication rate was observed in more complex definitive interventions such as monobloc distraction osteogenesis. Although most complications were manageable, effective prevention remains mandatory, as serious complications may lead to permanent damage and mortality. This analysis highlights the importance of a multidisciplinary team approach to optimize the outcomes in CMF patient management.
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Affiliation(s)
- F Hariri
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
| | - M F Abdullah
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia; School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - K B C Adam
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia; Department of Oral Maxillofacial Surgery and Diagnosis, Kulliyyah of Dentistry, IIUM Kuantan Campus, Kuantan, Malaysia
| | - N F A Bahuri
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - J Kulasegarah
- Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - A M Nathan
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - F Ismail
- Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - N Khaliddin
- Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - C M May
- Department of Ophthalmology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - L Chan
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - T M Keong
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - D Ganesan
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Z A A Rahman
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng JCK, Atkin G, Azizi A, Cargill Z, China Z, Elliot J, Jebakumar R, Lam J, Mudalige G, Onyerindu C, Renju M, Babu VS, Hussain M, Joji N, Lovett B, Mownah H, Ali B, Cresswell B, Dhillon AK, Dupaguntla YS, Hungwe C, Lowe-Zinola JD, Tsang JCH, Bevan K, Cardus C, Duggal A, Hossain S, McHugh M, Scott M, Chan F, Evans R, Gurung E, Haughey B, Jacob-Ramsdale B, Kerr M, Lee J, McCann E, O'Boyle K, Reid N, Hayat F, Hodgson S, Johnston R, Jones W, Khan M, Linn T, Long S, Seetharam P, Shaman S, Smart B, Anilkumar A, Davies J, Griffith J, Hughes B, Islam Y, Kidanu D, Mushaini N, Qamar I, Robinson H, Schramm M, Tan CY, Apperley H, Billyard C, Blazeby JM, Cannon SP, Carse S, Göpfert A, Loizidou A, Parkin J, Sanders E, Sharma S, Slade G, Telfer R, Huppatz IW, Worley E, Chandramoorthy L, Friend C, Harris L, Jain P, Karim MJ, Killington K, McGillicuddy J, Rafferty C, Rahunathan N, Rayne T, Varathan Y, Verma N, Zanichelli D, Arneill M, Brown F, Campbell B, Crozier L, Henry J, McCusker C, Prabakaran P, Wilson R, Asif U, Connor M, Dindyal S, Math N, Pagarkar A, Saleem H, Seth I, Sharma S, Standfield N, Swartbol T, Adamson R, Choi JE, El Tokhy O, Ho W, Javaid NR, Kelly M, Mehdi AS, Menon D, Plumptre I, Sturrock S, Turner J, Warren O, Crane E, Ferris B, Gadsby C, Smallwood J, Vipond M, Wilson V, Amarnath T, Doshi A, Gregory C, Kandiah K, Powell B, Spoor H, Toh C, Vizor R, Common M, Dunleavy K, Harris S, Luo C, Mesbah Z, Kumar AP, Redmond A, Skulsky S, Walsh T, Daly D, Deery L, Epanomeritakis E, Harty M, Kane D, Khan K, Mackey R, McConville J, McGinnity K, Nixon G, Ang A, Kee JY, Leung E, Norman S, Palaniappan SV, Sarathy PP, Yeoh T, Frost J, Hazeldine P, Jones L, Karbowiak M, Macdonald C, Mutarambirwa A, Omotade A, Runkel M, Ryan G, Sawers N, Searle C, Suresh S, Vig S, Ahmad A, McGartland R, Sim R, Song A, Wayman J, Brown R, Chang LH, Concannon K, Crilly C, Arnold TJ, Burgin A, Cadden F, Choy CH, Coleman M, Lim D, Luk J, Mahankali-Rao P, Prudence-Taylor AJ, Ramakrishnan D, Russell J, Fawole A, Gohil J, Green B, Hussain A, McMenamin L, McMenamin L, Tang M, Azmi F, Benchetrit S, Cope T, Haque A, Harlinska A, Holdsworth R, Ivo T, Martin J, Nisar T, Patel A, Sasapu K, Trevett J, Vernet G, Aamir A, Bird C, Durham-Hall A, Gibson W, Hartley J, May N, Maynard V, Johnson S, Wood CM, O'Brien M, Orbell J, Stringfellow TD, Tenters F, Tresidder S, Cheung W, Grant A, Tod N, Bews-Hair M, Lim ZH, Lim SW, Vella-Baldacchino M, Auckburally S, Chopada A, Easdon S, Goodson R, McCurdie F, Narouz M, Radford A, Rea E, Taylor O, Yu T, Alfa-Wali M, Amani L, Auluck I, Bruce P, Emberton J, Kumar R, Lagzouli N, Mehta A, Murtaza A, Raja M, Dennahy IS, Frew K, Given A, He YY, Karim MA, MacDonald E, McDonald E, McVinnie D, Ng SK, Pettit A, Sim DPY, Berthaume-Hawkins SD, Charnley R, Fenton K, Jones D, Murphy C, Ng JQ, Reehal R, Robinson H, Seraj SS, Shang E, Tonks A, White P, Yeo A, Chong P, Gabriel R, Patel N, Richardson E, Symons L, Aubrey-Jones D, Dawood S, Dobrzynska M, Faulkner S, Griffiths H, Mahmood F, Patel P, Perry M, Power A, Simpson R, Ali A, Brobbey P, Burrows A, Elder P, Ganyani R, Horseman C, Hurst P, Mann H, Marimuthu K, McBride S, Pilsworth E, Powers N, Stanier P, Innes R, Kersey T, Kopczynska M, Langasco N, Patel N, Rajagopal R, Atkins B, Beasley W, Lim ZC, Gill A, Ang HL, Williams H, Yogeswara T, Carter R, Fam M, Fong J, Latter J, Long M, Mackinnon S, McKenzie C, Osmanska J, Raghuvir V, Shafi A, Tsang K, Walker L, Bountra K, Coldicutt O, Fletcher D, Hudson S, Iqbal S, Bernal TL, Martin JWB, Moss-Lawton F, Smallwood J, Vipond M, Cardwell A, Edgerton K, Laws J, Rai A, Robinson K, Waite K, Ward J, Youssef H, Knight C, Koo PY, Lazarou A, Stanger S, Thorn C, Triniman MC, Botha A, Boyles L, Cumming S, Deepak S, Ezzat A, Fowler AJ, Gwozdz AM, Hussain SF, Khan S, Li H, Morrell BL, Neville J, Nitiahpapand R, Pickering O, Sagoo H, Sharma E, Welsh K, Denley S, Khan S, Agarwal M, Al-Saadi N, Bhambra R, Gupta A, Jawad ZAR, Jiao LR, Khan K, Mahir G, Singagireson S, Thoms BL, Tseu B, Wei R, Yang N, Britton N, Leinhardt D, Mahfooz M, Palkhi A, Price M, Sheikh S, Barker M, Bowley D, Cant M, Datta U, Farooqi M, Lee A, Morley G, Amin MN, Parry A, Patel S, Strang S, Yoganayagam N, Adlan A, Chandramoorthy S, Choudhary Y, Das K, Feldman M, France B, Grace R, Puddy H, Soor P, Ali M, Dhillon P, Faraj A, Gerard L, Glover M, Imran H, Kim S, Patrick Y, Peto J, Prabhudesai A, Smith R, Tang A, Vadgama N, Dhaliwal R, Ecclestone T, Harris A, Ong D, Patel D, Philp C, Stewart E, Wang L, Wong E, Xu Y, Ashaye T, Fozard T, Galloway F, Kaptanis S, Mistry P, Nguyen T, Olagbaiye F, Osman M, Philip Z, Rembacken R, Tayeh S, Theodoropoulou K, Herman A, Lau J, Saha A, Trotter M, Adeleye O, Cave D, Gunwa T, Magalhães J, Makwana S, Mason R, Parish M, Regan H, Renwick P, Roberts G, Salekin D, Sivakumar C, Tariq A, Liew I, McDade A, Stewart D, Hague M, Hudson-Peacock N, Jackson CES, James F, Pitt J, Walker EY, Aftab R, Ang JJ, Anwar S, Battle J, Budd E, Chui J, Crook H, Davies P, Easby S, Hackney E, Ho B, Imam SZ, Rammell J, Andrews H, Perry C, Schinle P, Ahmed P, Aquilina T, Balai E, Church M, Cumber E, Curtis A, Davies G, Dennis Y, Dumann E, Greenhalgh S, Kim P, King S, Metcalfe KHM, Passby L, Redgrave N, Soonawalla Z, Waters S, Zornoza A, Gulzar I, Hole J, Hull K, Ishaq H, Karaj J, Kelkar A, Love E, Patel S, Thakrar D, Vine M, Waterman A, Dib NP, Francis N, Hanson M, Ingleton R, Sadanand KS, Sukirthan N, Arnell S, Ball M, Bassam N, Beghal G, Chang A, Dawe V, George A, Huq T, Hussain A, Ikram B, Kanapeckaite L, Khan M, Ramjas D, Rushd A, Sait S, Serry M, Yardimci E, Capella S, Chenciner L, Episkopos C, Karam E, McCarthy C, Moore-Kelly W, Watson N, Ahluwalia V, Barnfield J, Ben-Gal O, Bloom I, Gharatya A, Khodatars K, Merchant N, Moonan A, Moore M, Patel K, Spiers H, Sundaram K, Turner J, Bath MF, Black J, Chadwick H, Huisman L, Ingram H, Khan S, Martin L, Metcalfe M, Sangal P, Seehra J, Thatcher A, Venturini S, Whitcroft I, Afzal Z, Brown S, Gani A, Gomaa A, Hussein N, Oh SY, Pazhaniappan N, Sharkey E, Sivagnanasithiyar T, Williams C, Yeung J, Cruddas L, Gurjar S, Pau A, Prakash R, Randhawa R, Chen L, Eiben I, Naylor M, Osei-Bordom D, Trenear R, Bannard-Smith J, Griffiths N, Patel BY, Saeed F, Abdikadir H, Bennett M, Church R, Clements SE, Court J, Delvi A, Hubert J, Macdonald B, Mansour F, Patel RR, Perris R, Small S, Betts A, Brown N, Chong A, Croitoru C, Grey A, Hickland P, Ho C, Hollington D, McKie L, Nelson AR, Stewart H, Eiben P, Nedham M, Ali I, Brown T, Cumming S, Hunt C, Joyner C, McAlinden C, Roberts J, Rogers D, Thachettu A, Tyson N, Vaughan R, Verma N, Yasin T, Andrew K, Bhamra N, Leong S, Mistry R, Noble H, Rashed F, Walker NR, Watson L, Worsfold M, Yarham E, Abdikadir H, Arshad A, Barmayehvar B, Cato L, Chan-lam N, Do V, Leong A, Sheikh Z, Zheleniakova T, Coppel J, Hussain ST, Mahmood R, Nourzaie R, Prowle J, Sheik-Ali S, Thomas A, Alagappan A, Ashour R, Bains H, Diamond J, Gordon J, Ibrahim B, Khalil M, Mittapalli D, Neo YN, Patil P, Peck FS, Reza N, Swan I, Whyte M, Chaudhry S, Hernon J, Khawar H, O'Brien J, Pullinger M, Rothnie K, Ujjal S, Bhatte S, Curtis J, Green S, Mayer A, Watkinson G, Chapple K, Hawthorne T, Khaliq M, Majkowski L, Malik TAM, Mclauchlan K, En BNW, Parton S, Robinson SD, Saat MI, Shurovi BN, Varatharasasingam K, Ward AE, Behranwala K, Bertelli M, Cohen J, Duff F, Fafemi O, Gupta R, Manimaran M, Mayhew J, Peprah D, Wong MHY, Farmer N, Houghton C, Kandhari N, Khan K, Ladha D, Mayes J, McLennan F, Panahi P, Seehra H, Agrawal R, Ahmed I, Ali S, Birkinshaw F, Choudhry M, Gokani S, Harrogate S, Jamal S, Nawrozzadeh F, Swaray A, Szczap A, Warusavitarne J, Abdalla M, Asemota N, Cullum R, Hartley M, Maxwell-Armstrong C, Mulvenna C, Phillips J, Yule A, Ahmed L, Clement KD, Craig N, Elseedawy E, Gorman D, Kane L, Livie J, Livie V, Moss E, Naasan A, Ravi F, Shields P, Zhu Y, Archer M, Cobley H, Dennis R, Downes C, Guevel B, Lamptey E, Murray H, Radhakrishnan A, Saravanabavan S, Sardar M, Shaw C, Tilliridou V, Wright R, Ye W, Alturki N, Helliwell R, Jones E, Kelly D, Lambotharan S, Scott K, Sivakumar R, Victor L, Boraluwe-Rallage H, Froggatt P, Haynes S, Hung YMA, Keyte A, Matthews L, Evans E, Haray P, John I, Mathivanan A, Morgan L, Oji O, Okorocha C, Rutherford A, Spiers H, Stageman N, Tsui A, Whitham R, Amoah-Arko A, Cecil E, Dietrich A, Fitzpatrick H, Guy C, Hair J, Hilton J, Jawad L, McAleer E, Taylor Z, Yap J, Akhbari M, Debnath D, Dhir T, Elbuzidi M, Elsaddig M, Glace S, Khawaja H, Koshy R, Lal K, Lobo L, McDermott A, Meredith J, Qamar MA, Vaidya A, Acquaah F, Barfi L, Carter N, Gnanappiragasam D, Ji C, Kaminski F, Lawday S, Mackay K, Sulaiman SK, Webb R, Ananthavarathan P, Dalal F, Farrar E, Hashemi R, Hossain M, Jiang J, Kiandee M, Lex J, Mason L, Matthews JH, McGeorge E, Modhwadia S, Pinkney T, Radotra A, Rickard L, Rodman L, Sales A, Tan KL, Bachi A, Bajwa DS, Battle J, Brown LR, Butler A, Calciu A, Davies E, Gardner I, Girdlestone T, Ikogho O, Keelan G, O'Loughlin P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Leete JJ, Pattinson CL, Guedes VA, Lai C, Devoto C, van der Merwe A, Lippa S, Shahim P, Moore BE, Chan L, Gill J. 1118 Examining the Role of Serum and Exosomal Biomarkers in Symptoms of Fatigue and Daytime Sleepiness Following Traumatic Brain Injury. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Fatigue and daytime sleepiness are two of the most common chronic symptoms reported after traumatic brain injury (TBI). However, there is limited understanding of the pathophysiological mechanisms following TBI that result in these symptoms. Previous research has observed elevations in peripheral blood levels of proteins in TBI patients versus controls, including neurofilament light chain (NFL)—predominantly expressed in long myelinated subcortical axons—and glial fibrillary acidic protein (GFAP)—predominantly expressed in reactive astrocytes responding to central nervous system injuries. This study examines the relationship between serum and exosomal NFL and GFAP, and symptoms of fatigue and daytime sleepiness in TBI patients 1-year after injury.
Methods
Sixty-seven patients with TBIs ranging from mild to severe were included in this study. Blood samples were collected from all participants 1-year post TBI, with concentrations of GFAP and NFL measured in serum and exosomes using Single Molecule Array technology (Simoa), an ultrasensitive assay. Participants reported fatigue using the Fatigue Severity Scale (FSS), and daytime sleepiness using the Epworth Sleepiness Scale (ESS).
Results
A linear regression model of fatigue symptoms and exosomal NFL controlling for age revealed that fatigue was negatively associated with exosomal NFL concentrations (β = -.317, p = .041, ηp2 = -.343) and accounted for 20.2% of the change in NFL. Serum NFL concentrations were not associated with fatigue, nor were GFAP serum or exosomes. No significant associations were found between NFL, GFAP, and daytime sleepiness.
Conclusion
Our findings suggest that exosomal NFL may be related to mechanisms underlying TBI-related fatigue and the potential of NFL as a biomarker of fatigue. To our knowledge, this study is the first to examine the relationship between post-TBI NFL levels and fatigue symptoms. Further investigation into serum and exosome biomarkers of TBI-related fatigue and daytime sleepiness is warranted.
Support
National Institutes of Health and Center for Neuroscience and Regenerative Medicine
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Affiliation(s)
- J J Leete
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
| | - C L Pattinson
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
| | - V A Guedes
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
| | - C Lai
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
| | - C Devoto
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
| | - A van der Merwe
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, MD
- Henry M. Jackson Foundation, Bethesda, MD
- Center for Neuroscience and Regenerative Medicine, Bethesda, MD
| | - S Lippa
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
| | - P Shahim
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, MD
- Center for Neuroscience and Regenerative Medicine, Bethesda, MD
| | - B E Moore
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, MD
- Henry M. Jackson Foundation, Bethesda, MD
- Uniformed Services University for the Health Sciences, Bethesda, MD
- Center for Neuroscience and Regenerative Medicine, Bethesda, MD
| | - L Chan
- Department of Rehabilitation Medicine, National Institutes of Health, Bethesda, MD
- Center for Neuroscience and Regenerative Medicine, Bethesda, MD
| | - J Gill
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
- Center for Neuroscience and Regenerative Medicine, Bethesda, MD
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Morris ZV, Chin LMK, Chan L, Guccione AA, Ahmad A, Keyser RE. Cardiopulmonary exercise test indices of respiratory buffering before and after aerobic exercise training in women with pulmonary hypertension: Differentiation by magnitudes of change in six-minute walk test performance. Respir Med 2020; 164:105900. [PMID: 32217288 PMCID: PMC10367185 DOI: 10.1016/j.rmed.2020.105900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 02/01/2023]
Abstract
While aerobic exercise training (AET) has generally been shown to improve 6-min walk test (6MWT) distance (6MWD) in patients with pulmonary hypertension (PH), a substantial number of patients appear to adapt differently, with minimal or even negative changes in 6MWT distance being reported. PURPOSE To compare post-aerobic exercise training adaptations in cardiorespiratory functional capacity across three groups of patients with PH: those with high (HI), low (LI) and negative (NEG) post-training increases in 6MWD. METHODS Participants were 25 females (age 54 ± 11 years; BMI 31 ± 7 kg/m2) who completed a vigorous, 10-week, thrice weekly, supervised treadmill walking exercise program. Cardiopulmonary exercise tests (CPET) and 6MWT were completed before and after training. Ten of the 25 participants were classified as HI (range = 47-143 m), 11 were classified as LI (range = 4-37 m) and 4 were classified as NEG (range = -17 to -53 m). RESULTS Peak CPET duration, WR and time to anaerobic threshold (AT) were significantly higher (p < 0.05) after training in both the LI and HI groups but not in the NEG group. There was a significant improvement in VE/VCO2 (p = 0.042), PETCO2 (p = 0.011) and TV (p = 0.050) in the HI group after training, but not in the NEG or LI group. CONCLUSION These findings suggest that sustained ventilatory inefficiency and restricted respiratory buffering may mediate exercise intolerance and impede the ability to adapt to exercise training in some patients with PH.
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Affiliation(s)
- Z V Morris
- Department of Rehabilitation Science, George Mason University, Fairfax, VA, USA; Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - L M K Chin
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - L Chan
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - A A Guccione
- Department of Rehabilitation Science, George Mason University, Fairfax, VA, USA
| | - A Ahmad
- Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - R E Keyser
- Department of Rehabilitation Science, George Mason University, Fairfax, VA, USA; Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, USA.
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Menon S, Ellis C, Poudel S, Johnson J, Szabo A, George B, Kevin Kelly W, Grant S, McPherson J, Cristofanilli M, Hoimes C, Gutierrez M, Doudement J, Chan L, Singal G, Alexander B, Miller V, Sohal D. B08 Impact of Concurrent STK11 Loss and c-MYC Amplification in Metastatic Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
This randomized controlled trial compared Bispectral Index (BIS) values in 40 patients after a modified rapid sequence induction using thiopentone 4 mg/kg or propofol 2 mg/kg with rocuronium 0.6 mg/kg as muscle relaxant. Endotracheal intubation was performed at 60 seconds from induction of anaesthesia and BIS values were recorded for three minutes after induction. At the 120, 150 and 180 second measurements there was a significantly greater proportion of subjects with BIS values ≤ 60 (“anaesthetized”) in the propofol group compared with the thiopentone group (P values <0.02, <0.01 and <0.01 respectively). All intubations were completed within two minutes. No explicit recall of intubation was detected clinically with either induction agent. The BIS scores we have measured suggest that thiopentone 4 mg/kg is more likely to be associated with lighter planes of anaesthesia and consequent risk of awareness than propofol 2 mg/kg, if intubation is delayed or prolonged.
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Affiliation(s)
- M Y Sie
- Department of Anaesthesiology, University Malaya Medical Centre, Kuala Lumpur 50603, Malaysia
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Xu K, Lo A, Chin V, Gzell C, O’Connor C, Forstner D, Gallagher R, Bova R, Crawford J, Harvey R, Lochhead A, Earls P, Qiu M, Hsu E, Bigg-Wither G, Chan L, Bao H, Foltyn P, Sim HW, Prawira A. Development of overall survival (OS) and progression free survival (PFS) nomograms for Australian patients with locoregionally advanced oropharyngeal squamous cell carcinoma (LA OPSCC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.049] [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: 11/14/2022] Open
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Gerber L, Mansky P, Chesney M, Silverman M, Chan L, Yao K, Stoddard S, Baranova, Birerdinc A. Results of a randomized trial comparing aerobic exercise and tai chi on cardiovascular function, cytokines and metabolic markers in survivors of solid tumors. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.663] [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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Sullivan S, Tran A, Yin Y, Fang Z, Chan L, Zhou C, Dugar S, Bae-Jump V. SPR965, a PI3K/mTORC1/2 inhibitor, as a targeted therapy in endometrial cancer. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.389] [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: 11/26/2022]
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Zhu D, McCague K, Lin W, Rong R, Xu M, Chan L, Zhu T. Outcome of Kidney Transplantation From Donor After Cardiac Death: Reanalysis of the US Mycophenolic Renal Transplant Registry. Transplant Proc 2018; 50:1258-1263. [DOI: 10.1016/j.transproceed.2018.01.051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 12/17/2017] [Accepted: 01/23/2018] [Indexed: 12/19/2022]
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Tran A, Sullivan S, Chan L, Yin Y, Fang Z, Zhou C, Dugar S, Bae-Jump V. Preclinical assessment of SPR965, a dual PI3K/mTOR1/2 inhibitor, in ovarian cancer. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.149] [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]
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32
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Chan L, Kuo W. Abstract No. 649 Percutaneous removal of the 24-French stainless steel greenfield filter: retrieval techniques and prospective outcomes. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.694] [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: 10/17/2022] Open
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Hosseini-Beheshti E, Choi W, Weiswald LB, Kharmate G, Ghaffari M, Roshan-Moniri M, Hassona MD, Chan L, Chin MY, Tai IT, Rennie PS, Fazli L, Tomlinson Guns ES. Exosomes confer pro-survival signals to alter the phenotype of prostate cells in their surrounding environment. Oncotarget 2018; 7:14639-58. [PMID: 26840259 PMCID: PMC4924741 DOI: 10.18632/oncotarget.7052] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [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: 06/17/2015] [Accepted: 12/22/2015] [Indexed: 12/15/2022] Open
Abstract
Prostate cancer (PCa) is the most frequently diagnosed cancer in men. Current research on tumour-related extracellular vesicles (EVs) suggests that exosomes play a significant role in paracrine signaling pathways, thus potentially influencing cancer progression via multiple mechanisms. In fact, during the last decade numerous studies have revealed the role of EVs in the progression of various pathological conditions including cancer. Moreover, differences in the proteomic, lipidomic, and cholesterol content of exosomes derived from PCa cell lines versus benign prostate cell lines confirm that exosomes could be excellent biomarker candidates. As such, as part of an extensive proteomic analysis using LCMS we previously described a potential role of exosomes as biomarkers for PCa. Current evidence suggests that uptake of EV's into the local tumour microenvironment encouraging us to further examine the role of these vesicles in distinct mechanisms involved in the progression of PCa and castration resistant PCa. For the purpose of this study, we hypothesized that exosomes play a pivotal role in cell-cell communication in the local tumour microenvironment, conferring activation of numerous survival mechanisms during PCa progression and development of therapeutic resistance. Our in vitro results demonstrate that PCa derived exosomes significantly reduce apoptosis, increase cancer cell proliferation and induce cell migration in LNCaP and RWPE-1 cells. In conjunction with our in vitro findings, we have also demonstrated that exosomes increased tumor volume and serum PSA levels in vivo when xenograft bearing mice were administered DU145 cell derived exosomes intravenously. This research suggests that, regardless of androgen receptor phenotype, exosomes derived from PCa cells significantly enhance multiple mechanisms that contribute to PCa progression.
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Affiliation(s)
- Elham Hosseini-Beheshti
- Department of Experimental Medicine University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada.,The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Wendy Choi
- The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Louis-Bastien Weiswald
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Geetanjali Kharmate
- The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Mazyar Ghaffari
- Department of Experimental Medicine University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada.,The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Mani Roshan-Moniri
- Department of Experimental Medicine University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada.,The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Mohamed D Hassona
- The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Leslie Chan
- The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Mei Yieng Chin
- The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Isabella T Tai
- Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Paul S Rennie
- Department of Urologic Sciences University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada.,The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Ladan Fazli
- Department of Urologic Sciences University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada.,The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
| | - Emma S Tomlinson Guns
- Department of Urologic Sciences University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada.,The Vancouver Prostate Centre University of British Columbia, Vancouver, British Columbia, V6H 3Z6, Canada
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Hong C, Chan L, Bai C. Prevalence of cerebral and cardiovascular disease in Parkinson’s disease patients: A meta-analysis. Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.029] [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: 11/28/2022]
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Ng W, Ngan R, Lee A, Kwong D, Tung S, Yuen K, Kam K, Chan L, Li-Lung M. Phase 2 Multicenter Trial Evaluating the Role of Induction TPF Followed by Weekly Docetaxel and Cetuximab in Combination With IMRT for Locally Recurrent Nasopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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36
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Lee A, Tung S, Ng W, Ngan R, Lee V, Choi H, Chan L, Lu T, Siu L, Tan T, Ng A, Yiu H, Leung T, O'Sullivan B, Tan E, Chappell R. 10-Year Outcome on the Efficacy and Late Toxicities Attributed to the Addition of Concurrent-Adjuvant Chemotherapy for Stage III-IVB Nasopharyngeal Carcinoma (Combined Analyses of the NPC-9901 and NPC-9902 Trials). Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.118] [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]
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37
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Grimm J, Shen C, Redmond K, Sloan L, Hazell S, Chan L, Seo Y, Nikolaidis D, Moore J, Huang E, Quon H, Bettegowda C, Lim M, Kleinberg L. Low Risk of Symptomatic Radionecrosis Following Stereotactic Radiosurgery for Multiple Brain Metastases. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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38
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Wong V, Yung M, Chan L, Lee J, Lee K, Chiu P, Wong S, Ng E. OR38: Does Early Total Parenteral Nutrition Improve Post-Operative Outcome for Intestinal Obstruction? – A Randomized Controlled Trial. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30749-5] [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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39
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Qing L, Wei R, Chan L, Xiaoya Z, Xin X. Sensitivity of various body indices and visceral adiposity index in predicting metabolic syndrome among Chinese patients with adult growth hormone deficiency. J Endocrinol Invest 2017; 40:653-661. [PMID: 28233232 PMCID: PMC5443877 DOI: 10.1007/s40618-017-0621-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 01/18/2017] [Indexed: 12/28/2022]
Abstract
AIM Adult growth hormone deficiency (AGHD) refers to decreased secretion of growth hormones in the adults, which is associated with increased clustering of conventional cardiovascular risk factors such as central obesity, insulin resistance and dyslipidemia. Metabolic syndrome (MetS), a recognized risk factor of cardiovascluar diseases, shares some clinical features. Given that the prevalence of MetS is on the rise in patients with AGHD, and that cardiovascular disease (CVD) is an important cause of morbidity and mortality in that population, the alternative, simple, non-invasive methods of assessing MetS among this population are needed. This study aims to determine the sensitivity of five anthropometric indices [Body mass index (BMI), Waist circumference (WC), Waist-to-hip ratio (WHR), Waist-to-height ratio (WHtR) and Visceral adiposity index (VAI)] in predicting metabolic syndrome in Chinese population-based patients with adult growth hormone deficiency. MATERIALS AND METHODS A total of 96 Chinese patients with adult growth hormone deficiency were included in this study. They were compared with equal number of apparently healthy persons with similar characteristics (matched with age and gender) to the previous group. Anthropometric measurements including weight, height, serum lipids indices, blood pressure (BP), fasting plasma glucose (FPG), WC were measured. BMI, WHR, WHtR, and VAI were calculated. RESULTS AND DISCUSSION AGHD patients with MetS had higher WC (91.00 ± 8.28 vs 78.01 ± 7.12), BMI (24.95 ± 2.91 VS 23.30 ± 2.80), WHR (0.92 ± 0.06 VS 0.87 ± 0.07), WHtR (0.53 ± 0.06 VS 0.47 ± 0.05), VAI [(5.59 (4.02, 7.55) VS 1.69 (0.87, 3.05)] levels in comparison to those without MetS. Meantime WC, BMI, WHR, WHtR, VAI was positively correlated to MetS components. ROC curve for participants with AGHD showed that VAI had the highest SS of 92% (BMI 0.812; WHR 0.706; WHtR 0.902; VAI 0.920, respectively) for prediction of MetS in AGHD. The optimal cutoff values for different adiposity markers in predicting MetS were as follows: WC (79.65), BMI (23.46); WHR (0.89); WHtR (0.54); VAI (2.29). CONCLUSION In conclusion, our study showed all adiposity measures of interest present themselves as easy and practical tools for use in population studies and clinical practice for evaluating MetS in AGDH and VAI was identified as the best in Chinese AGHD patients among them.
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Affiliation(s)
- L Qing
- Department of Endocrinology, Chongqing Medical University First Affiliated Hospital, #1 You-Yi Rd., Yu-zhong District, Chongqing, 400016, China
| | - R Wei
- Department of Endocrinology, Chongqing Medical University First Affiliated Hospital, #1 You-Yi Rd., Yu-zhong District, Chongqing, 400016, China.
| | - L Chan
- Department of Endocrinology, Chongqing Medical University First Affiliated Hospital, #1 You-Yi Rd., Yu-zhong District, Chongqing, 400016, China
| | - Z Xiaoya
- Department of Endocrinology, Chongqing Medical University First Affiliated Hospital, #1 You-Yi Rd., Yu-zhong District, Chongqing, 400016, China
| | - X Xin
- Department of Endocrinology, Chongqing Medical University First Affiliated Hospital, #1 You-Yi Rd., Yu-zhong District, Chongqing, 400016, China
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40
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Chan L, MacDonald M, Chung D, Hutchins N, Ooi A. Analysis of the coherent and turbulent stresses of a numerically simulated rough wall pipe. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1742-6596/822/1/012011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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41
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Carpenter J, Chan L, Thevathasan N, De Sousa M, Stys D, McDiarmid L. Global Health Practice Competencies: Building Health Professionals'
Capacity to Work in Global Health Contexts. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.059] [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: 10/19/2022] Open
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42
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Carpenter J, Chan L, Thevathasan N, De Sousa M, Suart T, McDiarmid L. Teaching Advocacy to Health Professional Students: Advancing Global and
Population Health by Training the Next Generation of Health
Professionals. Ann Glob Health 2017. [DOI: 10.1016/j.aogh.2017.03.058] [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] Open
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43
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Saha A, Poojary P, Chan L, Chauhan K, Nadkarni G, Coca S, Uribarri J. Increased odds of metabolic syndrome with consumption of high dietary advanced glycation end products in adolescents. Diabetes Metab 2017; 43:469-471. [PMID: 28161371 DOI: 10.1016/j.diabet.2017.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 12/30/2016] [Accepted: 01/01/2017] [Indexed: 02/07/2023]
Affiliation(s)
- A Saha
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - P Poojary
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L Chan
- Division of Nephrology, Department of Medicine Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - K Chauhan
- Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Nephrology, Department of Medicine Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - G Nadkarni
- Division of Nephrology, Department of Medicine Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - S Coca
- Division of Nephrology, Department of Medicine Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Uribarri
- Division of Nephrology, Department of Medicine Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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44
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Chan L, Kishore S, Lungren M, Mohler D, Avedian R, Hovsepian D, Bazzocchi A, Napoli A, Ghanouni P. Treatment of vascular malformations using MR-guided high intensity focused ultrasound: preliminary results after five patients. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.709] [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] Open
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45
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Brandt D, McDonough C, Chan L. Assessing work disability in the US Social Security Administration (SSA) Disability Programs: Novel methods to assess function. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw168.081] [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: 11/12/2022] Open
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46
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Chan L, Jette A, Brandt D. Policy implications and use of the Work Disability Functional Assessment Batter (WD-FAB). Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw171.070] [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: 11/12/2022] Open
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47
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McDonough C, Brandt D, Chan L. Beyond classical test theory-assessing function using item response theory/computer adaptive testing. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw172.071] [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: 11/13/2022] Open
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48
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Tosun M, Chan L, Amani M, Roy T, Ahn GH, Taheri P, Carraro C, Ager JW, Maboudian R, Javey A. Air-Stable n-Doping of WSe2 by Anion Vacancy Formation with Mild Plasma Treatment. ACS Nano 2016; 10:6853-60. [PMID: 27294286 DOI: 10.1021/acsnano.6b02521] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Transition metal dichalcogenides (TMDCs) have been extensively explored for applications in electronic and optoelectronic devices due to their unique material properties. However, the presence of large contact resistances is still a fundamental challenge in the field. In this work, we study defect engineering by using a mild plasma treatment (He or H2) as an approach to reduce the contact resistance to WSe2. Material characterization by X-ray photoelectron spectroscopy, photoluminescence, and Kelvin probe force microscopy confirm defect-induced n-doping, up to degenerate level, which is attributed to the creation of anion (Se) vacancies. The plasma treatment is adopted in the fabrication process flow of WSe2 n-type metal-oxide-semiconductor field-effect transistors to selectively create anion vacancies at the metal contact regions. Due to lowering the metal contact resistance, improvements in the device performance metrics such as a 20× improvement in ON current and a nearly ideal subthreshold swing value of 66 mV/dec are observed. This work demonstrates that defect engineering at the contact regions can be utilized as a reliable scheme to realize high-performance electronic and optoelectronic TMDC devices.
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Affiliation(s)
- Mahmut Tosun
- Materials Sciences Division, Lawrence Berkeley National Laboratory , Berkeley, California 94720, United States
| | | | - Matin Amani
- Materials Sciences Division, Lawrence Berkeley National Laboratory , Berkeley, California 94720, United States
| | - Tania Roy
- Materials Sciences Division, Lawrence Berkeley National Laboratory , Berkeley, California 94720, United States
| | - Geun Ho Ahn
- Materials Sciences Division, Lawrence Berkeley National Laboratory , Berkeley, California 94720, United States
| | | | | | - Joel W Ager
- Materials Sciences Division, Lawrence Berkeley National Laboratory , Berkeley, California 94720, United States
| | | | - Ali Javey
- Materials Sciences Division, Lawrence Berkeley National Laboratory , Berkeley, California 94720, United States
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Modena BD, Kurian SM, Gaber LW, Waalen J, Su AI, Gelbart T, Mondala TS, Head SR, Papp S, Heilman R, Friedewald JJ, Flechner S, Marsh CL, Sung RS, Shidban H, Chan L, Abecassis MM, Salomon DR. Gene Expression in Biopsies of Acute Rejection and Interstitial Fibrosis/Tubular Atrophy Reveals Highly Shared Mechanisms That Correlate With Worse Long-Term Outcomes. Am J Transplant 2016; 16:1982-98. [PMID: 26990570 PMCID: PMC5501990 DOI: 10.1111/ajt.13728] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 01/08/2016] [Accepted: 01/13/2016] [Indexed: 01/25/2023]
Abstract
Interstitial fibrosis and tubular atrophy (IFTA) is found in approximately 25% of 1-year biopsies posttransplant. It is known that IFTA correlates with decreased graft survival when histological evidence of inflammation is present. Identifying the mechanistic etiology of IFTA is important to understanding why long-term graft survival has not changed as expected despite improved immunosuppression and dramatically reduced rates of clinical acute rejection (AR) (Services UDoHaH. http://www.ustransplant.org/annual_reports/current/509a_ki.htm). Gene expression profiles of 234 graft biopsy samples were obtained with matching clinical and outcome data. Eighty-one IFTA biopsies were divided into subphenotypes by degree of histological inflammation: IFTA with AR, IFTA with inflammation, and IFTA without inflammation. Samples with AR (n = 54) and normally functioning transplants (TX; n = 99) were used in comparisons. A novel analysis using gene coexpression networks revealed that all IFTA phenotypes were strongly enriched for dysregulated gene pathways and these were shared with the biopsy profiles of AR, including IFTA samples without histological evidence of inflammation. Thus, by molecular profiling we demonstrate that most IFTA samples have ongoing immune-mediated injury or chronic rejection that is more sensitively detected by gene expression profiling. These molecular biopsy profiles correlated with future graft loss in IFTA samples without inflammation.
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Affiliation(s)
- B. D. Modena
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
| | - S. M. Kurian
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA,DNA Microarray and Next Generation Sequencing Core, The Scripps Research Institute, La Jolla, CA
| | - L. W. Gaber
- Department of Pathology, The Methodist Hospital, Houston, TX
| | - J. Waalen
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
| | - A. I. Su
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA
| | - T. Gelbart
- DNA Microarray and Next Generation Sequencing Core, The Scripps Research Institute, La Jolla, CA
| | - T. S. Mondala
- DNA Microarray and Next Generation Sequencing Core, The Scripps Research Institute, La Jolla, CA
| | - S. R. Head
- DNA Microarray and Next Generation Sequencing Core, The Scripps Research Institute, La Jolla, CA
| | - S. Papp
- DNA Microarray and Next Generation Sequencing Core, The Scripps Research Institute, La Jolla, CA
| | - R. Heilman
- Transplant Genomics Collaborative Group (TGCG), La Jolla, CA,Department of Transplant Nephrology, Mayo Clinic, Phoenix, AZ
| | - J. J. Friedewald
- Northwestern Comprehensive Transplant Center, Northwestern University, Chicago, IL
| | - S.M. Flechner
- Transplant Genomics Collaborative Group (TGCG), La Jolla, CA,Glickman Urology and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - C. L. Marsh
- Transplant Genomics Collaborative Group (TGCG), La Jolla, CA,Scripps Center for Organ and Cell Transplantation, Scripps Health, La Jolla, CA
| | - R. S. Sung
- Transplant Genomics Collaborative Group (TGCG), La Jolla, CA,Section of Transplant Surgery, University of Michigan, Ann Arbor, MI
| | - H. Shidban
- Transplant Genomics Collaborative Group (TGCG), La Jolla, CA,Department of Surgery, St Vincent Medical Center, Los Angeles, CA
| | - L. Chan
- Transplant Genomics Collaborative Group (TGCG), La Jolla, CA,Department of Transplant/Nephrology, University of Colorado, Aurora, CO
| | - M. M. Abecassis
- Northwestern Comprehensive Transplant Center, Northwestern University, Chicago, IL
| | - D. R. Salomon
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA,DNA Microarray and Next Generation Sequencing Core, The Scripps Research Institute, La Jolla, CA,Transplant Genomics Collaborative Group (TGCG), La Jolla, CA,Corresponding author: Daniel R. Salomon,
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50
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Chan L, Xue H, Xiaoya Z, Jiajia X, Wei R, Linman L, Qing L, Lan L. Lipid Accumulation Product: a Simple and Accurate Index for Predicting Metabolic Syndrome in Patients with Adult Growth Hormone Deficiency. Exp Clin Endocrinol Diabetes 2016; 124:220-4. [PMID: 27123781 DOI: 10.1055/s-0035-1569402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 10/21/2022]
Abstract
PURPOSE It has been demonstrated that metabolic risk factors were increased in adult growth hormone deficiency (AGHD) patients. Lipid accumulation product (LAP) is a novel biomarker of central lipid accumulation related to risk of metabolic syndrome (MS), diabetes and cardiovascular disease. The aim of this study was to investigate the ability of LAP to identify MS in AGHD Patients. MATERIALS AND METHODS In this cross-sectional study, 75 AGHD patients and 75 controls matched with age and gender were enrolled. The general anthropometries and blood biochemical indexes were measured. Body mass index(BMI), waist-hip ratio (WHR), LAP, HOMA-IR were calculated. Receiver operating characteristic (ROC) analysis was used to find out the cut-off points of LAP to predict MS. RESULTS Compared with control group, waist circumference (WC), WHR, Systolic blood pressure (SBP), Diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG) and LAP were increased in AGHD group, while high density lipoprotein cholesterol (HDL-c) level was lower in AGHD group (P<0.05). The prevalence of MS was 41.3% in AGHD patients. AGHD patients with MS had significantly higher LAP levels compared to those without MS. LAP was highly correlated with components of MS. ROC analysis showed that LAP was a significant discriminator for MS in AGHD patients, and the optimal cutoff point of LAP to predict MS was 44.96 (96.8% sensitivity, 86.4% specificity). CONCLUSIONS LAP was associated with MS and had a strong and reliable diagnostic accuracy for MS in AGHD patients.
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Affiliation(s)
- L Chan
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - H Xue
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Z Xiaoya
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - X Jiajia
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - R Wei
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - L Linman
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - L Qing
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - L Lan
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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